Objective:The aim of this study was to assess the long-term effect of breast conservation with breast intensitymodulated radiotherapy (IMRT) for early-stage breast cancers.Methods:Pub Med,EMBASE,Cochrane Library,Chine...Objective:The aim of this study was to assess the long-term effect of breast conservation with breast intensitymodulated radiotherapy (IMRT) for early-stage breast cancers.Methods:Pub Med,EMBASE,Cochrane Library,Chinese Biomedical Literature Database were searched to identify relevant original published trails,and the references of eligible studies were manually screened.Randomized controlled trails reported in any language,comparing breast IMRT with conventional radiotherapy (RT) in patients with early-stage breast cancer were eligible for inclusion.Two investigators independently assessed the quality of included trials and extracted data.The RevMan 5.0 software was used for statistical analysis.Results:Four trials involving 1440 patients were included.The results showed that in the IMRT group,the occurrence of acute moist dermatitis,the edema of the mammary gland and the occurrence of hyperpigmentation were lower than those of RT group,the pooled risk ratio value and 95% confidence interval were 0.28 (0.17-0.48),0.03 (0.00-0.21) and 0.06 (0.02-0.15) respectively.The use of IMRT did not correlate with pain and quality of life,but the presence of moist desquamation did significantly correlate with pain and reduced quality of life.Conclusion:The currently available evidence showed that IMRT significantly reduces the occurrence of moist acute dermatitis anywhere in the breast and alleviates the suffering of patients and improves the quality of life of patients.Future large-scale,high-quality,double-blind trials are needed.展开更多
Objective： The aim of the study was to compare the difference of dose distribution in clinical target volume and organ at risk （OAR） between five-field intensity-modulated radiotherapy （IMRT） and conventional thr...Objective： The aim of the study was to compare the difference of dose distribution in clinical target volume and organ at risk （OAR） between five-field intensity-modulated radiotherapy （IMRT） and conventional three-dimensional conformal radiotherapy （3DCRT） in the radiotherapy of rectal cancer. Methods： Fifteen patients with rectal cancer treated with radio- therapy （RT） were retrospectively analyzed. Among the patients, seven received RT preoperatively and 8 postoperatively. The target volume and the OARs such as the small bowel, bladder and femoral heads were contoured for each patient. 3DCRT-plan and IMRT-plan were performed for each patient respectively, with the prescribed dose covering at least 95% of the planning target volume （PTV）. The conformity index （CI） and homogeneity index （HI） were used for evaluation of the dose distribution in the target volume, and the Dx% （the lowest dose to the x% volume of the OARs that received the highest dose of irradiation） and the mean dose were used for evaluation of the dose to OARs. Paired-T test was used for companson of the difference between the two plans. Results： In the IMRT-plan and 3DCRT-plan, the CI were 0.94 and 0.87 （P = 0.000） and the HI were 1.13 and 1.17, respectively （P = 0.001）. For small bowel, the D30%, D50% and the mean dose were 19.67 Gy, 15.13 Gy and 18.81 Gy in the IMRT-plan and 25.20 Gy, 22.20 Gy and 22.89 Gy in the 3DCRT-plan, respectively （P 〈 0.001 for all pairs of parameters）. For bladder, the D30%, D50%, and the mean dose were 24.80 Gy, 34.20 Gy and 28.70 Gy in the IMRT- plan, and 35.07 Gy, 44.67 Gy and 35.68 Gy in the 3DCRT-plan, respectively （P 〈 0.001 for all pairs of parameters）. For femoral heads, the D5% in the IMRT-plan and 3DCRT-plan were 40.6 Gy and 40.47 Gy, respectively （P = 0.936）, and the mean dose were 30.14 Gy and 25.57 Gy, respectively （P = 0.001）. Conclusion： Five-field IMRT-plan is better than 3DCRT-plan in the conformity and the dose homogeneity within target volume and also better in sparing the small bowel and bladder.展开更多
Objective The aim of the study was to compare tomotherapy-based bone marrow-sparing intensity-mod- ulated radiotherapy （BMS-IMRT） with intensity-modulated radiotherapy （IMRT） without entering the pelvic bone marro...Objective The aim of the study was to compare tomotherapy-based bone marrow-sparing intensity-mod- ulated radiotherapy （BMS-IMRT） with intensity-modulated radiotherapy （IMRT） without entering the pelvic bone marrow as a planning constraint in the treatment of cervical cancer after hysterectomy. Methods BMS-IMRT and IMRT plans were designed for a cohort of nine patients. The prescribed dose was 45 Gy in 1.8 Gy daily fractions, and 95% of the planned target volume received this dose. The doses were computed using a commercially available treatment planning system with the convolution/superposition algorithm. Plans were compared according to dose-volume histogram analysis in terms of planning target volume homogeneity and conformity indices （HI and CI） as well as organ at risk dose and volume parameters. Results BMS-IMRT had advantages over IMRT in terms of CI, but was equivalent to the latter in H1. V5, V10, V20, V30, and V40 of pelvic bone marrow in BMS-IMRT decreased by 0.06%, 17.33%, 22.19%, 13.85%, and 16.46%, respectively, compared with IMRT. Except for V30 of the small bowel and V30 and V40 of the bladder, no statistically significant differences were found between BMS-IMRT and IMRT in the small bowel, bladder, and rectum. Conclusion For cervical cancer patients receiving tomotherapy-based radiotherapy after hysterectomy, BMS-IMRT reduced pelvic bone marrow volume receiving low-dose radiation, and it may be conducive to preventing acute hematologic toxicity.展开更多
Objective:The aim of our study was to comprehensively access current status of radiotherapy physicians' opinions in post-mastectomy radiotherapy(PMRT) for breast cancer in Guangdong province.Methods:From June 2007...Objective:The aim of our study was to comprehensively access current status of radiotherapy physicians' opinions in post-mastectomy radiotherapy(PMRT) for breast cancer in Guangdong province.Methods:From June 2007 to June 2008,questionnaires on the clinical value,sequencing with chemotherapy and endocrine therapy,indications and irradiated targets for PMRT were sent to physicians of all radiotherapy departments registering at Radiotherapy Professional Committee of Guangdong Anti-cancer Association.Results:There were 126 physicians joining this investigation.Proportions of physicians who accepted the views that PMRT could merely improve local control or can improve both local control and overall survival were 100% and 25.2%.The most common sequences of PMRT and chemotherapy or endocrine therapy were "sandwich" and sequential modes,performed 46.9% and 59.5% respectively.The median interval of surgery and PMRT was 8 weeks.Proportions of physicians who accepted T3-4 diseases,or four or more axillary lymph nodes metastasis,or T1-2 with 1-3 positive lymph nodes,or T1-2N0 with primary tumor located in the center or inner quadrant as the indications of PMRT were 97.6%,100%,46.8%,13.5%,respectively.Proportions of physicians who accepted chest wall,supraclavicular region,internal mammary chain or axilla as irradiated targets were 86.5%,100%,49.2% and 38.9% respectively.Conclusion:For Radiotherapy physicians of Guangdong Province,there is still lacking of consensus in the opinions of whether PMRT can improve survival,and optimal sequencing with chemotherapy or endocrine therapy,and how to make decision for patients with T1-2 with 1-3 positive lymph nodes,and rational irradiated targets,which requires advanced professional training for physicians and further prospective clinical trial evidences to guide clinical practice.展开更多
基金Supported by a grant from the National Nature Science Foundation of China(No. 096RJZA036)
文摘Objective:The aim of this study was to assess the long-term effect of breast conservation with breast intensitymodulated radiotherapy (IMRT) for early-stage breast cancers.Methods:Pub Med,EMBASE,Cochrane Library,Chinese Biomedical Literature Database were searched to identify relevant original published trails,and the references of eligible studies were manually screened.Randomized controlled trails reported in any language,comparing breast IMRT with conventional radiotherapy (RT) in patients with early-stage breast cancer were eligible for inclusion.Two investigators independently assessed the quality of included trials and extracted data.The RevMan 5.0 software was used for statistical analysis.Results:Four trials involving 1440 patients were included.The results showed that in the IMRT group,the occurrence of acute moist dermatitis,the edema of the mammary gland and the occurrence of hyperpigmentation were lower than those of RT group,the pooled risk ratio value and 95% confidence interval were 0.28 (0.17-0.48),0.03 (0.00-0.21) and 0.06 (0.02-0.15) respectively.The use of IMRT did not correlate with pain and quality of life,but the presence of moist desquamation did significantly correlate with pain and reduced quality of life.Conclusion:The currently available evidence showed that IMRT significantly reduces the occurrence of moist acute dermatitis anywhere in the breast and alleviates the suffering of patients and improves the quality of life of patients.Future large-scale,high-quality,double-blind trials are needed.
文摘Objective： The aim of the study was to compare the difference of dose distribution in clinical target volume and organ at risk （OAR） between five-field intensity-modulated radiotherapy （IMRT） and conventional three-dimensional conformal radiotherapy （3DCRT） in the radiotherapy of rectal cancer. Methods： Fifteen patients with rectal cancer treated with radio- therapy （RT） were retrospectively analyzed. Among the patients, seven received RT preoperatively and 8 postoperatively. The target volume and the OARs such as the small bowel, bladder and femoral heads were contoured for each patient. 3DCRT-plan and IMRT-plan were performed for each patient respectively, with the prescribed dose covering at least 95% of the planning target volume （PTV）. The conformity index （CI） and homogeneity index （HI） were used for evaluation of the dose distribution in the target volume, and the Dx% （the lowest dose to the x% volume of the OARs that received the highest dose of irradiation） and the mean dose were used for evaluation of the dose to OARs. Paired-T test was used for companson of the difference between the two plans. Results： In the IMRT-plan and 3DCRT-plan, the CI were 0.94 and 0.87 （P = 0.000） and the HI were 1.13 and 1.17, respectively （P = 0.001）. For small bowel, the D30%, D50% and the mean dose were 19.67 Gy, 15.13 Gy and 18.81 Gy in the IMRT-plan and 25.20 Gy, 22.20 Gy and 22.89 Gy in the 3DCRT-plan, respectively （P 〈 0.001 for all pairs of parameters）. For bladder, the D30%, D50%, and the mean dose were 24.80 Gy, 34.20 Gy and 28.70 Gy in the IMRT- plan, and 35.07 Gy, 44.67 Gy and 35.68 Gy in the 3DCRT-plan, respectively （P 〈 0.001 for all pairs of parameters）. For femoral heads, the D5% in the IMRT-plan and 3DCRT-plan were 40.6 Gy and 40.47 Gy, respectively （P = 0.936）, and the mean dose were 30.14 Gy and 25.57 Gy, respectively （P = 0.001）. Conclusion： Five-field IMRT-plan is better than 3DCRT-plan in the conformity and the dose homogeneity within target volume and also better in sparing the small bowel and bladder.
基金Supported by a grant of the Military Medical Metrology Project(No.2011-JL2-005)
文摘Objective The aim of the study was to compare tomotherapy-based bone marrow-sparing intensity-mod- ulated radiotherapy （BMS-IMRT） with intensity-modulated radiotherapy （IMRT） without entering the pelvic bone marrow as a planning constraint in the treatment of cervical cancer after hysterectomy. Methods BMS-IMRT and IMRT plans were designed for a cohort of nine patients. The prescribed dose was 45 Gy in 1.8 Gy daily fractions, and 95% of the planned target volume received this dose. The doses were computed using a commercially available treatment planning system with the convolution/superposition algorithm. Plans were compared according to dose-volume histogram analysis in terms of planning target volume homogeneity and conformity indices （HI and CI） as well as organ at risk dose and volume parameters. Results BMS-IMRT had advantages over IMRT in terms of CI, but was equivalent to the latter in H1. V5, V10, V20, V30, and V40 of pelvic bone marrow in BMS-IMRT decreased by 0.06%, 17.33%, 22.19%, 13.85%, and 16.46%, respectively, compared with IMRT. Except for V30 of the small bowel and V30 and V40 of the bladder, no statistically significant differences were found between BMS-IMRT and IMRT in the small bowel, bladder, and rectum. Conclusion For cervical cancer patients receiving tomotherapy-based radiotherapy after hysterectomy, BMS-IMRT reduced pelvic bone marrow volume receiving low-dose radiation, and it may be conducive to preventing acute hematologic toxicity.
文摘Objective:The aim of our study was to comprehensively access current status of radiotherapy physicians' opinions in post-mastectomy radiotherapy(PMRT) for breast cancer in Guangdong province.Methods:From June 2007 to June 2008,questionnaires on the clinical value,sequencing with chemotherapy and endocrine therapy,indications and irradiated targets for PMRT were sent to physicians of all radiotherapy departments registering at Radiotherapy Professional Committee of Guangdong Anti-cancer Association.Results:There were 126 physicians joining this investigation.Proportions of physicians who accepted the views that PMRT could merely improve local control or can improve both local control and overall survival were 100% and 25.2%.The most common sequences of PMRT and chemotherapy or endocrine therapy were "sandwich" and sequential modes,performed 46.9% and 59.5% respectively.The median interval of surgery and PMRT was 8 weeks.Proportions of physicians who accepted T3-4 diseases,or four or more axillary lymph nodes metastasis,or T1-2 with 1-3 positive lymph nodes,or T1-2N0 with primary tumor located in the center or inner quadrant as the indications of PMRT were 97.6%,100%,46.8%,13.5%,respectively.Proportions of physicians who accepted chest wall,supraclavicular region,internal mammary chain or axilla as irradiated targets were 86.5%,100%,49.2% and 38.9% respectively.Conclusion:For Radiotherapy physicians of Guangdong Province,there is still lacking of consensus in the opinions of whether PMRT can improve survival,and optimal sequencing with chemotherapy or endocrine therapy,and how to make decision for patients with T1-2 with 1-3 positive lymph nodes,and rational irradiated targets,which requires advanced professional training for physicians and further prospective clinical trial evidences to guide clinical practice.
