AIM:To evaluate impact of radiation therapy dose escalation through intensity modulated radiation therapy with simultaneous integrated boost(IMRT-SIB).METHODS:We retrospectively reviewed the patients who underwent fou...AIM:To evaluate impact of radiation therapy dose escalation through intensity modulated radiation therapy with simultaneous integrated boost(IMRT-SIB).METHODS:We retrospectively reviewed the patients who underwent four-dimensional-based IMRT-SIBbased neoadjuvant chemoradiation protocol.During the concurrent chemoradiation therapy,radiation therapy was through IMRT-SIB delivered in 28 consecutive daily fractions with total radiation doses of 56 Gy to tumor and 5040 Gy dose-painted to clinical tumor volume,with a regimen at the discretion of the treating medical oncologist.This was followed by surgical tumor resection.We analyzed pathological completion response(p CR) rates its relationship with overall survival and event-freesurvival.RESULTS:Seventeen patients underwent dose escalation with the IMRT-SIB protocol between 2007 and 2014 and their records were available for analysis.Among the IMRT-SIB-treated patients,the toxicity appeared mild,the most common side effects were grade 1-3 esophagitis(46%) and pneumonitis(11.7%).There were no cardiac events.The Ro resection rate was 94%(n = 16),the p CR rate was 47%(n = 8),and the postoperative morbidity was zero.There was one mediastinal failure found,one patient had local failure at the anastomosis site,and the majority of failures were distant in the lung or bone.The 3-year diseasefree survival and overall survival rates were 41%(n = 7) and 53%(n = 9),respectively.CONCLUSION:The dose escalation through IMRT-SIB in the chemoradiation regimen seems responsible for down-staging the distal esophageal with well-tolerated complications.展开更多
AIM:To determine the feasibility and safety of high dose rate intraluminal brachytherapy(HDR-ILBT) boost during preoperative chemoradiation for rectal cancer.METHODS:Between 2008 and 2009,thirty-six patients with loca...AIM:To determine the feasibility and safety of high dose rate intraluminal brachytherapy(HDR-ILBT) boost during preoperative chemoradiation for rectal cancer.METHODS:Between 2008 and 2009,thirty-six patients with locally advanced rectal cancer(≥ T3 or N+),were treated initially with concurrent capecitabine(825 mg/m2 oral twice daily) and pelvic external beam radiotherapy(EBRT)(45 Gy in 25 fractions),then were randomized to group A;HDR-ILBT group(n = 17) to receive 5.5-7 Gy×2 to gross tumor volume(GTV) and group B;EBRT group(n = 19) to receive 5.4 Gy×3 fractions to GTV with EBRT.All patients underwent total mesorectal excision.RESULTS:Grade 3 acute toxicities were registered in 12 patients(70.6%) in group A and in 8(42.1%) in group B.Complete pathologic response of T stage(ypT0) in group A was registered in 10 patients(58.8%) and in group B,3 patients(15.8%) had ypT0(P < 0.0001).Sphincter preservation was reported in 6/9 patients(66.7%) in group A and in 5/10 patients(50%) in group B(P < 0.01).Overall radiological response was 68.15% and 66.04% in Group A and B,respectively.During a median follow up of 18 mo,late grade 1 and 2 sequelae were registered in 3 patients(17.6%) and 4 patients(21.1%) in the groups A and B,respectively.CONCLUSION:HDR-ILBT was found to be effective dose escalation technique in preoperative chemoradiation for rectal cancers,with higher response rates,downstaging and with manageable acute toxicities.展开更多
局地微地形产生的微气象环境是造成气象预报误差的重要因素之一,也是导致覆冰预报准确性不高的主要原因。该研究利用高精度MODIS系统15 s(约500 m)地形数据驱动中尺度天气研究和预报(weather research and forecasting,WRF)模式,并使用...局地微地形产生的微气象环境是造成气象预报误差的重要因素之一,也是导致覆冰预报准确性不高的主要原因。该研究利用高精度MODIS系统15 s(约500 m)地形数据驱动中尺度天气研究和预报(weather research and forecasting,WRF)模式,并使用基于决策树的梯度提升框架(light gradient boosting machine,LightGBM)对WRF预报进行订正,通过局地个例评估订正后的覆冰预测效果。结果表明:在假设条件下,过冷液滴覆冰速率随温度降低先快速增加,后增长速率保持不变,且液滴粒径越大,完全冻结所需温度越低;WRF-LightGBM订正算法在山区微地形下有效提升了温度预报准确度,典型冬季寒潮条件下预测温度与实际温度的误差在2℃以内,预报准确率为76%;以典型区域杆塔覆冰为例,输入订正后的温度和相对湿度数据后,覆冰融化时段被消除,覆冰厚度曲线与实际基本一致,增长速率接近一致。展开更多
文摘AIM:To evaluate impact of radiation therapy dose escalation through intensity modulated radiation therapy with simultaneous integrated boost(IMRT-SIB).METHODS:We retrospectively reviewed the patients who underwent four-dimensional-based IMRT-SIBbased neoadjuvant chemoradiation protocol.During the concurrent chemoradiation therapy,radiation therapy was through IMRT-SIB delivered in 28 consecutive daily fractions with total radiation doses of 56 Gy to tumor and 5040 Gy dose-painted to clinical tumor volume,with a regimen at the discretion of the treating medical oncologist.This was followed by surgical tumor resection.We analyzed pathological completion response(p CR) rates its relationship with overall survival and event-freesurvival.RESULTS:Seventeen patients underwent dose escalation with the IMRT-SIB protocol between 2007 and 2014 and their records were available for analysis.Among the IMRT-SIB-treated patients,the toxicity appeared mild,the most common side effects were grade 1-3 esophagitis(46%) and pneumonitis(11.7%).There were no cardiac events.The Ro resection rate was 94%(n = 16),the p CR rate was 47%(n = 8),and the postoperative morbidity was zero.There was one mediastinal failure found,one patient had local failure at the anastomosis site,and the majority of failures were distant in the lung or bone.The 3-year diseasefree survival and overall survival rates were 41%(n = 7) and 53%(n = 9),respectively.CONCLUSION:The dose escalation through IMRT-SIB in the chemoradiation regimen seems responsible for down-staging the distal esophageal with well-tolerated complications.
文摘AIM:To determine the feasibility and safety of high dose rate intraluminal brachytherapy(HDR-ILBT) boost during preoperative chemoradiation for rectal cancer.METHODS:Between 2008 and 2009,thirty-six patients with locally advanced rectal cancer(≥ T3 or N+),were treated initially with concurrent capecitabine(825 mg/m2 oral twice daily) and pelvic external beam radiotherapy(EBRT)(45 Gy in 25 fractions),then were randomized to group A;HDR-ILBT group(n = 17) to receive 5.5-7 Gy×2 to gross tumor volume(GTV) and group B;EBRT group(n = 19) to receive 5.4 Gy×3 fractions to GTV with EBRT.All patients underwent total mesorectal excision.RESULTS:Grade 3 acute toxicities were registered in 12 patients(70.6%) in group A and in 8(42.1%) in group B.Complete pathologic response of T stage(ypT0) in group A was registered in 10 patients(58.8%) and in group B,3 patients(15.8%) had ypT0(P < 0.0001).Sphincter preservation was reported in 6/9 patients(66.7%) in group A and in 5/10 patients(50%) in group B(P < 0.01).Overall radiological response was 68.15% and 66.04% in Group A and B,respectively.During a median follow up of 18 mo,late grade 1 and 2 sequelae were registered in 3 patients(17.6%) and 4 patients(21.1%) in the groups A and B,respectively.CONCLUSION:HDR-ILBT was found to be effective dose escalation technique in preoperative chemoradiation for rectal cancers,with higher response rates,downstaging and with manageable acute toxicities.
文摘局地微地形产生的微气象环境是造成气象预报误差的重要因素之一,也是导致覆冰预报准确性不高的主要原因。该研究利用高精度MODIS系统15 s(约500 m)地形数据驱动中尺度天气研究和预报(weather research and forecasting,WRF)模式,并使用基于决策树的梯度提升框架(light gradient boosting machine,LightGBM)对WRF预报进行订正,通过局地个例评估订正后的覆冰预测效果。结果表明:在假设条件下,过冷液滴覆冰速率随温度降低先快速增加,后增长速率保持不变,且液滴粒径越大,完全冻结所需温度越低;WRF-LightGBM订正算法在山区微地形下有效提升了温度预报准确度,典型冬季寒潮条件下预测温度与实际温度的误差在2℃以内,预报准确率为76%;以典型区域杆塔覆冰为例,输入订正后的温度和相对湿度数据后,覆冰融化时段被消除,覆冰厚度曲线与实际基本一致,增长速率接近一致。
