Background:In the era of intensity?modulated radiotherapy(IMRT),the role of neoadjuvant chemotherapy(NACT)in treating ascending?type nasopharyngeal carcinoma(NPC)is under?evaluated.This study was to compare the effica...Background:In the era of intensity?modulated radiotherapy(IMRT),the role of neoadjuvant chemotherapy(NACT)in treating ascending?type nasopharyngeal carcinoma(NPC)is under?evaluated.This study was to compare the efficacy of NACT followed by IMRT(NACT+RT)with the efficacy of concurrent chemoradiotherapy(CCRT)on ascending?type NPC.Methods:Clinical data of 214 patients with ascending?type NPC treated with NACT+RT or CCRT between Decem?ber 2009 and July 2011 were analyzed.Of the 214 patients,98 were treated with NACT followed by IMRT,and 116 were treated with CCRT.The survival rates were assessed using Kaplan–Meier analysis,and the survival curves were compared using a log?rank test.Results:The 4?year overall survival,locoregional failure?free survival,distant failure?free survival,and failure?free sur?vival rates were not significantly different between the two groups(all P>0.05).However,patients in the CCRT group exhibited more severe acute adverse events than did patients in the NACT+RT group during radiotherapy,includ?ing leukopenia(30.2%vs.15.3%,P=0.016),neutropenia(25.9%vs.11.2%,P=0.011),and mucositis(57.8%vs.40.8%,P=0.028).After radiotherapy,patients in the CCRT group exhibited significantly higher rates of xerostomia(21.6%vs.Conclusions:The treatment outcomes of the NACT+RT and CCRT groups were similar;however,CCRT led to higher rates of acute and late toxicities.NACT+RT may therefore be a better treatment strategy for ascending?type NPC.展开更多
The application of simultaneous integrated boost-intensity modulated radiotherapy(SIB-IMRT)in pediatric and adolescent nasopharyngeal carcinoma(NPC)is underevaluated.This study aimed to evaluate long-term outcome and ...The application of simultaneous integrated boost-intensity modulated radiotherapy(SIB-IMRT)in pediatric and adolescent nasopharyngeal carcinoma(NPC)is underevaluated.This study aimed to evaluate long-term outcome and late toxicities in pediatric and adolescent NPC after SIB-IMRT combined with chemotherapy.Thirty-four patients(aged 8–20 years)with histologically proven,non-disseminated NPC treated with SIB-IMRT were enrolled in this retrospective study.The disease stage distribution was as follows:stage I,1(2.9%);stage III,14(41.2%);and stage IV,19(55.9%).All patients underwent SIBIMRT and 30 patients also underwent cisplatin-based chemotherapy.The prescribed dose of IMRT was64–68 Gy in 29–31 fractions to the nasopharyngeal gross target volume.Within the median follow-up of 52months(range,9–111 months),1 patient(2.9%)experienced local recurrence and 4(11.8%)developed distant metastasis(to the lung in 3 cases and to multiple organs in 1 case).Four patients(11.8%)died due to recurrence or metastasis.The 5-year locoregional relapse–free survival,distant metastasis–free survival,disease-free survival,and overall survival rates were 97.1%,88.2%,85.3%,and 88.2%,respectively.The most common acute toxicities were grades 3–4 hematologic toxicities and stomatitis.Of the 24 patients who survived for more than 2 years,16(66.7%)and 15(62.5%)developed grades 1–2 xerostomia and ototoxicity,respectively.Two patients(8.3%)developed grade 3 ototoxicity;no grade 4 toxicities were observed.SIB-IMRT combined with chemotherapy achieves excellent long-term locoregional control in pediatric and adolescent NPC,with mild incidence of late toxicities.Distant metastasis is the predominant mode of failure.展开更多
The prognostic value of T category for locoregional control in patients with nasopharyngeal carcinoma(NPC)has decreased with the extensive use of intensity-modulated radiotherapy(IMRT).We aimed to develop a prognostic...The prognostic value of T category for locoregional control in patients with nasopharyngeal carcinoma(NPC)has decreased with the extensive use of intensity-modulated radiotherapy(IMRT).We aimed to develop a prognostic scoring system(PSS)that incorporated tumor extension and clinical characteristics for locoregional control in NPC patients treated with IMRT.The magnetic resonance imaging scans and medical records of 717 patients with nonmetastatic NPC treated with IMRT at Sun Yat-sen University Cancer Center between January 2003 and January 2008 were reviewed.Age,pathologic classification,primary tumor extension,primary gross tumor volume(GTV-p),T and N categories,and baseline lactate dehydrogenase(LDH)level were analyzed.Hierarchical cluster analysis as well as univariate and multivariate analyses were used to develop the PSS.Independent prognostic factors for locoregional relapse included N2–3 stage,GTV-p≥26.8 mL,and involvement of one or more structures within cluster3.We calculated a risk score derived from the regression coefficient of each factor and classified patients into four groups:low risk(score 0),intermediate risk(score>0 and≤1),high risk(score>1 and≤2),and extremely high risk(score>2).The 5-year locoregional control rates for these groups were 97.4%,93.6%,85.2%,and 78.6%,respectively(P<0.001).We have developed a PSS that can help identify NPC patients who are at high risk for locoregional relapse and can guide individualized treatments for NPC patients.展开更多
The EGR (exhaust gas recirculation) technique can greatly reduce the NOx emission of diesel engines, especially when an EGR cooler is employed. Numerical simulations are applied to study the flow field and temperature...The EGR (exhaust gas recirculation) technique can greatly reduce the NOx emission of diesel engines, especially when an EGR cooler is employed. Numerical simulations are applied to study the flow field and temperature distributions inside the EGR cooler. Three different models of EGR cooler are investigated, among which model A is a traditional one, and models B and C are improved by adding a helical baffle in the cooling area. In models B and C the entry directions of cooling water are different, which mostly influences the flow resistance. The results show that the improved structures not only lengthen the flow path of the cooling water, but also enhance the heat exchange rate between the cool and hot media. In conclusion we suggest that the improved structures are more powerful than the traditional one.展开更多
To evaluate the performance of newly designed electro-pneumatic valves (EPVs) for the air-powered engine (APE) and study laws of parameters affecting them, a simulation model was established based on the thermodynamic...To evaluate the performance of newly designed electro-pneumatic valves (EPVs) for the air-powered engine (APE) and study laws of parameters affecting them, a simulation model was established based on the thermodynamics and mechanics theories. Experiments were set up to determine the instantaneous effective orifice area of solenoid valve by the constant volume discharge method. The simulation model was also validated by comparing the measured displacement curve with the simulated displacement curve of the valve in the pressure of 0.16 and 0.49 MPa. Simulation and experimental results showed that maximum working frequency of the designed EPV could reach 30 Hz corresponding to 2000 r/min of engine rotating speed. Based on simulation results, impacts of temperature and pressure of control air on delay time, full opening/closing time and seating velocity of EPV were analyzed. The simulation model could also act as EPV simulation prototype in designing the air exchange control system of APE.展开更多
A cooling system consisting of several heat exchange modules is a necessary part of an automobile, and its performance has a direct effect on a vehicle's energy consumption. Heat exchangers, such as a charged air ...A cooling system consisting of several heat exchange modules is a necessary part of an automobile, and its performance has a direct effect on a vehicle's energy consumption. Heat exchangers, such as a charged air cooler (CAC), radiator, oil cooler, or condenser have different structures and can be arranged in various orders, and each combination may produce different effects because of interactions among them. In this study, we aimed to explore the principles governing interactions among adjacent heat exchangers in a cooling system, using numerical simulation and experimental technology. 3D models with different combinations were developed, compared, and analyzed comprehensively. A wind tunnel test platform was constructed to validate the computational results. We found that the heat dissipation of the modules was affected slightly by their relative position (the rules basically comply with the field synergy principle), but was independent of the modules' spacing within a certain distance range. The heat dissipation of one module could be effectively improved by restructuring, but with a penalty of higher resistance. However, the negative effect on the downstream module was much less than expected. The results indicated that the intensity of heat transfer depends not only on the average temperature difference between cold and hot mediums, but also on the temperature distribution.展开更多
基金supported by grants from the Science and Technology Project of Guangzhou City,China(No.14570006)the National Natural Science Foundation of China(Nos.81372409,81402532)the Sun Yat-sen University Clinical Research 5010 Program(No.2012011)
文摘Background:In the era of intensity?modulated radiotherapy(IMRT),the role of neoadjuvant chemotherapy(NACT)in treating ascending?type nasopharyngeal carcinoma(NPC)is under?evaluated.This study was to compare the efficacy of NACT followed by IMRT(NACT+RT)with the efficacy of concurrent chemoradiotherapy(CCRT)on ascending?type NPC.Methods:Clinical data of 214 patients with ascending?type NPC treated with NACT+RT or CCRT between Decem?ber 2009 and July 2011 were analyzed.Of the 214 patients,98 were treated with NACT followed by IMRT,and 116 were treated with CCRT.The survival rates were assessed using Kaplan–Meier analysis,and the survival curves were compared using a log?rank test.Results:The 4?year overall survival,locoregional failure?free survival,distant failure?free survival,and failure?free sur?vival rates were not significantly different between the two groups(all P>0.05).However,patients in the CCRT group exhibited more severe acute adverse events than did patients in the NACT+RT group during radiotherapy,includ?ing leukopenia(30.2%vs.15.3%,P=0.016),neutropenia(25.9%vs.11.2%,P=0.011),and mucositis(57.8%vs.40.8%,P=0.028).After radiotherapy,patients in the CCRT group exhibited significantly higher rates of xerostomia(21.6%vs.Conclusions:The treatment outcomes of the NACT+RT and CCRT groups were similar;however,CCRT led to higher rates of acute and late toxicities.NACT+RT may therefore be a better treatment strategy for ascending?type NPC.
基金Natural ScienceFoundation of China(No.81071836)Sun Yat-sen University5010 Projects(No.050243)
文摘The application of simultaneous integrated boost-intensity modulated radiotherapy(SIB-IMRT)in pediatric and adolescent nasopharyngeal carcinoma(NPC)is underevaluated.This study aimed to evaluate long-term outcome and late toxicities in pediatric and adolescent NPC after SIB-IMRT combined with chemotherapy.Thirty-four patients(aged 8–20 years)with histologically proven,non-disseminated NPC treated with SIB-IMRT were enrolled in this retrospective study.The disease stage distribution was as follows:stage I,1(2.9%);stage III,14(41.2%);and stage IV,19(55.9%).All patients underwent SIBIMRT and 30 patients also underwent cisplatin-based chemotherapy.The prescribed dose of IMRT was64–68 Gy in 29–31 fractions to the nasopharyngeal gross target volume.Within the median follow-up of 52months(range,9–111 months),1 patient(2.9%)experienced local recurrence and 4(11.8%)developed distant metastasis(to the lung in 3 cases and to multiple organs in 1 case).Four patients(11.8%)died due to recurrence or metastasis.The 5-year locoregional relapse–free survival,distant metastasis–free survival,disease-free survival,and overall survival rates were 97.1%,88.2%,85.3%,and 88.2%,respectively.The most common acute toxicities were grades 3–4 hematologic toxicities and stomatitis.Of the 24 patients who survived for more than 2 years,16(66.7%)and 15(62.5%)developed grades 1–2 xerostomia and ototoxicity,respectively.Two patients(8.3%)developed grade 3 ototoxicity;no grade 4 toxicities were observed.SIB-IMRT combined with chemotherapy achieves excellent long-term locoregional control in pediatric and adolescent NPC,with mild incidence of late toxicities.Distant metastasis is the predominant mode of failure.
基金supported by grants from the Natural Science Foundation of China(No.81071836)Sun Yat-sen University 5010 projects(No.050243)
文摘The prognostic value of T category for locoregional control in patients with nasopharyngeal carcinoma(NPC)has decreased with the extensive use of intensity-modulated radiotherapy(IMRT).We aimed to develop a prognostic scoring system(PSS)that incorporated tumor extension and clinical characteristics for locoregional control in NPC patients treated with IMRT.The magnetic resonance imaging scans and medical records of 717 patients with nonmetastatic NPC treated with IMRT at Sun Yat-sen University Cancer Center between January 2003 and January 2008 were reviewed.Age,pathologic classification,primary tumor extension,primary gross tumor volume(GTV-p),T and N categories,and baseline lactate dehydrogenase(LDH)level were analyzed.Hierarchical cluster analysis as well as univariate and multivariate analyses were used to develop the PSS.Independent prognostic factors for locoregional relapse included N2–3 stage,GTV-p≥26.8 mL,and involvement of one or more structures within cluster3.We calculated a risk score derived from the regression coefficient of each factor and classified patients into four groups:low risk(score 0),intermediate risk(score>0 and≤1),high risk(score>1 and≤2),and extremely high risk(score>2).The 5-year locoregional control rates for these groups were 97.4%,93.6%,85.2%,and 78.6%,respectively(P<0.001).We have developed a PSS that can help identify NPC patients who are at high risk for locoregional relapse and can guide individualized treatments for NPC patients.
文摘The EGR (exhaust gas recirculation) technique can greatly reduce the NOx emission of diesel engines, especially when an EGR cooler is employed. Numerical simulations are applied to study the flow field and temperature distributions inside the EGR cooler. Three different models of EGR cooler are investigated, among which model A is a traditional one, and models B and C are improved by adding a helical baffle in the cooling area. In models B and C the entry directions of cooling water are different, which mostly influences the flow resistance. The results show that the improved structures not only lengthen the flow path of the cooling water, but also enhance the heat exchange rate between the cool and hot media. In conclusion we suggest that the improved structures are more powerful than the traditional one.
文摘To evaluate the performance of newly designed electro-pneumatic valves (EPVs) for the air-powered engine (APE) and study laws of parameters affecting them, a simulation model was established based on the thermodynamics and mechanics theories. Experiments were set up to determine the instantaneous effective orifice area of solenoid valve by the constant volume discharge method. The simulation model was also validated by comparing the measured displacement curve with the simulated displacement curve of the valve in the pressure of 0.16 and 0.49 MPa. Simulation and experimental results showed that maximum working frequency of the designed EPV could reach 30 Hz corresponding to 2000 r/min of engine rotating speed. Based on simulation results, impacts of temperature and pressure of control air on delay time, full opening/closing time and seating velocity of EPV were analyzed. The simulation model could also act as EPV simulation prototype in designing the air exchange control system of APE.
基金Project (No. 51206141) supported by the National Natural Science Foundation of China
文摘A cooling system consisting of several heat exchange modules is a necessary part of an automobile, and its performance has a direct effect on a vehicle's energy consumption. Heat exchangers, such as a charged air cooler (CAC), radiator, oil cooler, or condenser have different structures and can be arranged in various orders, and each combination may produce different effects because of interactions among them. In this study, we aimed to explore the principles governing interactions among adjacent heat exchangers in a cooling system, using numerical simulation and experimental technology. 3D models with different combinations were developed, compared, and analyzed comprehensively. A wind tunnel test platform was constructed to validate the computational results. We found that the heat dissipation of the modules was affected slightly by their relative position (the rules basically comply with the field synergy principle), but was independent of the modules' spacing within a certain distance range. The heat dissipation of one module could be effectively improved by restructuring, but with a penalty of higher resistance. However, the negative effect on the downstream module was much less than expected. The results indicated that the intensity of heat transfer depends not only on the average temperature difference between cold and hot mediums, but also on the temperature distribution.