Sequential transcatheter arterial chemoembolization,three-dimensional conformal radiotherapy,and high-intensity focused ultrasound treatment for unresectable hepatocellular carcinoma patients

The purpose of this study was to evaluate the outcome of patients with unresectable hepatocellular carcinoma（HCC） treated by sequential therapy of transcatheter arterial chemoembolization（TACE）,three-dimensional conformal radiotherapy（3-DCRT） and high-intensity focused ultrasound（HIFU）.From October,2005 to September,2010,120 patients with unresectable HCC received the sequential treatments of several courses of TACE followed in 2-4 weeks by 3-DCRT and then a single session of HIFU with a curative intent.The median tumor irradiation dose was 40 Gy.Tumor response,toxicity and overall survival rate were analyzed.Clinicopathologic factors affecting the primary technique effectiveness and overall survival rates were investigated by univariate analysis or multivariate analysis.All 120 HCC patients were followed up by the last follow-up time.Among these patients,hepatic toxicities due to treatment were notable in 9 cases.Gastrointestinal bleeding after the overall treatment occurred in 2 cases,leukopenia of grade III was detected in 1 case,radiation-induced liver disease（RILD） was observed in 2 patients,and first-and second-degree skin burn around the HIFU treatment zone were observed in 2 patients and 1 patient,respectively.Among 120 patients,23,83 and 14 cases achieved partial response,stable disease and progressive disease,respectively.The overall survival rates at 1 year,3 years and 5 years were 70%,35% and 15%,respectively,with a median survival time of 26 months.Both Child-Pugh liver function grading and radiation dose were determined to be independent predictors for overall survival revealed by the multivariate analysis.It is concluded that the sequential therapy of TACE,3-DCRT and HIFU is a promising therapeutic regimen for unresectable HCC.

Analysis of the efficacy and safety of conventional radiotherapy of chest wall and clavicular field and three-dimensional conformal radiotherapy in patients after modified radical mastectomy

Objective:To explore the efficacy and safety of conventional radiotherapy of chest wall and clavicular field and three-dimensional conformal radiotherapy in patients after modified radical mastectomy.Methods: A total of 84 patients who were admitted in our hospital after modified radical mastectomy were included in the study and divided into the conventional radiotherapy group (n=42) and the three-dimensional conformal radiotherapy group (n=42) according to different radiotherapy methods. The patients in the conventional radiotherapy group were given conventional radiotherapy of chest wall and clavicular field, while the patients in the three-dimensional conformal radiotherapy group were given three-dimensional conformal radiotherapy. The serum tumor markers and peripheral blood T lymphocyte subsets 6-8 weeks after treatment in the two groups were detected. The clinical efficacy, and toxic and side effects in the two groups were evaluated.Results: The serum CA15-3, CA125, CEA, and CK19 levels after treatment in the two groups were significantly reduced when compared with before treatment, CD3+,CD4+, and CD4+/CD8+ were significantly elevated, while CD8+ was significantly reduced when compared with before treatment, but the comparison of the above indicators between the two groups was not statistically significant. The occurrence rate of radioactive skin damage and pneumonia after treatment in the conventional radiotherapy group was significantly higher than that in the three-dimensional conformal radiotherapy group. Conclusions:The two kinds of radiotherapy schemes have an equal efficacy, but the toxic and side effects of three-dimensional conformal radiotherapy are significantly lower than those by the conventional radiotherapy, with a certain advantage.

Late course three-dimensional conformal radiotherapy for esophageal carcinoma

我们的学习的目的是近来评估临床的结果和尖锐副作用的目的路线为食道的癌的三维的保角的放射疗法(3DCRT ) 。从 2004 年 1 月的方法到 2006 年 10 月，有食道的癌的 70 个病人收到了迟了的功课 3DCRT。他们的临床的数据回顾地被分析。短期的临床的结果，尖锐副作用，本地控制率和幸存率被评估。结果完全的反应率是 62.9% ，部分反应率是 35.7% ，并且全面反应率是 98.6% 。1- ， 2 年、 3 年的本地控制率分别地是 77.1% ， 51.4% 和 45.7% 。1- ， 2 年、 3 年的全面幸存率分别地是 75.7% ， 54.3% 和 38.6% 。中部的幸存时间是 26 个月。结论这种技术近来功课 3DCRT 是为食道的癌的有效治疗并且趋于改进全面幸存率。

Three-Dimensional Conformal Radiotherapy for Rectal Cancer and the Changes in Cancer Multi-biomarkers

OBJECTIVE To investigate the clinical efficacy of three-dimensional conformal radiotherapy(3D-CRT)for local y advanced or postoperatively relapsed rectal cancer,and to examine the changes in cancer multi-biomarkers. METHODS Sixty patients with locally advanced or postoperatively relapsed rectal cancer were randomly divided into two groups after 40 Gy external radiation,namely a late-course 3D-CRT group and a conventional radiotherapy group that served as the control.There were 30 patients in each group.For patients in the 3D-CRT group,multi-biomarkers were measured before and after radiotherapy and after relapse. RESULTS Response rates in the 3D-CRT and the control groups were 86.7%(26/30)and 70%(21/30)respectively,without a significant difference (P>0.05).The 1-,2-and 3-year survival rates were 80%,53.3%and 36.7% in the 3D-CRT group;in the control group the rates were 56.7%,40%and 13.3%respectively,with a significant difference(P=0.0213).CEA,CA19-9, CA242 and FER decreased after radiotherapy in the 3D-CRT group,P<0.01, indicating a significant difference.The values after relapse were higher than those without relapse,P<0.01,indicating a significant difference. CONCLUSION Conventional radiotherapy with a 3D-CRT boost gives better therapeutic effect to patients with locally advanced or postoperatively local y relapsed rectal cancer.A multi-biomarker protein chip diagnosis system can be utilized as an effective tool to determine the therapeutic effect and prognosis.

Evaluation of whole-course three-dimensional conformal radiotherapy combined with late-course accelerated hyperfractionated radiotherapy for esophageal carcinoma patients

学习的目的是评估整个功课的三维的保角的放射疗法(3DCRT ) 的治疗学的效果和安全的目的与食道的癌在病人上与迟了功课的加速的 hyperfractionated 放射疗法(LCAFR ) 结合了。有食道的癌的 101 个病人被划分成二个组的方法。观察组(49 个盒子) 被整个功课的 3DCRT 对待。在控制组(52 个盒子) 的病人被常规放射疗法对待。临床的效率和放射毒性在二个组之间被比较。结果包括放射食道炎(63.2%) 和气管炎(49.0%) 的副作用在观察组减少了，但是二个组之间没有重要差别(69.2% 和 55.7% 在控制) 。在观察的组的1-，2年、3年的肿瘤本地人控制率和全面幸存率显著地与控制组相比被改进，分别地87.8%，75.5%，63.3%对71.2%，55.8%，42.3%和85.7%，71.4%，46.7%对69.2%，51.9%，26.9%(所有 P < 0.05 )。整个功课的 3DCRT 的治疗学的效果为食道的癌与 LCAFR 相结合的结论比常规放射疗法优异。

Clinical Research on Three-Dimensional Conformal Radiotherapy of Non-Small Cell Lung Cancer

OBJECTIVE To investigate the clinical efficacy and toxic effect of the 3-dimensional conformal radiation therapy(3DCRT)for non- small cell lung cancer(NSCLC). METHODS Fifty-two patients with the Stage-I and IV NSCLC were treated with 3DCRT.Cross analysis of the clinical data was conducted in the comparison between the 52 cases with 3DCRT and the other 50 cases with the conventional radiation therapy (CRT).In the 3DCRT group,only the primary tumor and positive lymph-node draining area were included in the clinical target area,setting 4 to 6 coplanar or non-coplanar irradiation fields,with 2 Gy or 3 Gy/fraction,1 fraction a day and 5 fractions per week. The total dose ranged from a test dose(DT)of 66 Gy to 72 Gy.In the CRT group,the field area contained the primary tumor plus the homolateral hilum of the lung,the mediastinum superior or hol-mediastinum,and opposed anteroposterior irradiation.When the dosage reached DT 36～40 Gy,an oblique portal administered radiation was conducted in order to avoid injuring the spinal cord. The DT was 1.8～2.0 Gy/fraction,1 fraction a day,5 fractions per week,with a total dose of 60 Gy to 70 Gy. RESULTS The therapeutic effect(CR+PR)was 90.4% in the 3DCRT group,and was 72% in the CRT group.There was statistically significant difference between the two groups,P<0.01. There was a clinical symptom improvement attained by 96.5% and 86.4% respectively in the two groups,and there was a statistically significant difference between the groups,P<0.01.The 6-month, 1 and 2-year overall survival rates were 92.3%,75.0% and 42.3% in the 3DCRT group,and 76%,60% and 30% in the CRT group, respectively.There was a significant difference in the 6-month overall survival rate between the groups,P<0.05.There was no obvious significant difference in the 1 and 2-year overall survival rates between the two groups,P>0.05.The toxic reaction was 12.5% and 23.7% respectively in the 3DCRT and CRT groups. Acute radioactive esophagitis and leucopenia were markedly lower in the 3DCRT group than in the CRT group.There was a statistically significant difference between the groups,P<0.05.No toxic reaction of Stage-Ⅲand over was found in the 3DCRT group during radiation therapy. CONCLUSION The 3DCRT method has a satisfactory short- term efficacy and improvement of clinical symptoms in treating NSCLC,with a mild toxic reaction and good tolerance in patients. It can be used for enhancing the tumor-control rate and bettering the quality of life.

Management of Hepatocellular Carcinoma Patients with Portal Vein Thrombosis Using Three-Dimensional Conformal Radiotherapy

Objective: To determine the possible therapeutic gain of using three-dimensional conformal radiotherapy (3D-CRT) as a treatment option for portal vein tumor thrombus (PVTT) in patients with hepatocellular carcinoma (HCC) and to evaluate the tolerance and toxicity of using such treatment. Materials and methods: Sixty two patients were enrolled in this prospective study between June 2013 and August 2015. The clinical target volume (CTV) was the PVTT and the prescribed dose was 50 Gy/25 fractions. The median follow-up time was 7.4 months. Results: The thrombus crude response rate was 40.4% and the only significant prognostic factor for response was the thrombus size. Responders had significant better survival compared to non-responders with a median survival of 12.5 and 8 months respectively (P Conclusions: The results of this study suggest that radiotherapy should be considered as a safe treatment option for HCC patients with PVTT. It is effective not only for PVTT local control but also for survival, although prospective randomized trials are needed to confirm these results.

Three-Tesla Magnetic Resonance and Computed Tomography Imaging in Three-Dimensional Conformal Radiotherapy for Localized Prostate Cancer

Aims and background: we evaluate CT-3Tesla MRI fusion in conformal radiotherapy for localized prostate cancer.Methods: 18 consecutive patients underwent a 3T MRI scan under radiotherapy planning conditions, after the CT scan. Bowel and bladder preparation were prescribed. CT and MR images were automatically fused;prostate and seminal vesicles were contoured on CT and on MRI, organs at risk were defined on CT-MRI fusion. Late rectal and sexual toxicity, differences in target volume between MRI and CT and differences in rectal and penile bulb dose distribution based on CT only or on CT-MRI fusion were evaluated.Results: one patient experienced a late rectal toxicity;no patient had sexual toxicity. The difference between the mean MRI and CT target volumes was statistically significant (p = 0.0001 paired Student's t-test). The dose-volume histogram (DVH) analysis shows a significant reduction of the dose received by the rectum and the penile bulb in MRI-plans compared to CT-plans.Conclusions: 3 Tesla MRI scan under radiotherapy planning conditions along with bowel preparation significantly improves the definition of the target volume sparing normal tissue irradiation.

The effects of three-dimensional conformal radiotherapy combined with whole brain irradiation on brain metastases

观察三维的保角的放射疗法的最近治疗学的效果和毒性的目的与大脑转移为病人与整个大脑照耀结合了。33 个盒子其剂量是 36 40 Gy (18 20 f ) 起初被整个大脑照耀对待的方法。然后三维的保角的放射疗法与 20 25 Gy 的全部的剂量被加到焦点，其 fractionated 剂量是 2 5 Gy/time， 5 时间 / 星期或 3 时间 / 星期。在在放射疗法以后的 1 个月以内的结果根据大脑的成像，所有病人的 CR 是 45.5% ， PR 36.4% ， NC 15.1% ，和 PD 3% 。为有在放射前的神经症状的 32 个盒子，症状的 CR 是 40.6% 并且 PR 59.4% 。所有病人在 KPS 等级获得了不同增加。在后续时期底，有有直到 9.3 个月的吝啬的幸存时间的 22 死亡。与整个大脑照耀相结合的结论三维的保角的放射疗法不能仅仅有效地控制大脑转移并且改进生活质量，而且趋于延长幸存时间。

Three-dimensional conformal intensity-modulated radiation therapy of left femur foci does not damage the sciatic nerve

During radiotherapy to kill femoral hydatid tapeworms, the sciatic nerve surrounding the focus can be easily damaged by the treatment. Thus, it is very important to evaluate the effects of ra- diotherapy on the surrounding nervous tissue. In the present study, we used three-dimensional, conformal, intensity-modulated radiation therapy to treat bilateral femoral hydatid disease in Meriones meridiani. The focus of the hydatid disease on the left femur was subiected to radio- therapy （40 Gy） for 14 days, and the right femur received sham irradiation. Hematoxylin-eosin staining, electron microscopy, and terminal deoxynucleotidyl transferase-dUTP nick end labeling assays on the left femurs showed that the left sciatic nerve cell structure was normal, with no ob- vious apoptosis after radiation. Trypan blue staining demonstrated that the overall protoscolex structure in bone parasitized with Echinococcus granulosus disappeared in the left femur of the animals after treatment. The mortality of the protoscolex was higher in the left side than in the right side. The succinate dehydrogenase activity in the protoscolex in bone parasitized with Echi- nococcus granulosus was lower in the left femur than in the right femur. These results suggest that three-dimensional conformal intensity-modulated radiation therapy achieves good therapeutic effects on the secondary bone in hydatid disease in Meriones meridiani without damaging the morphology or function of the sciatic nerve.

Effect of intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy on clinical outcomes in patients with glioblastoma multiforme

Background Few studies were reported on the comparison of clinical outcomes between intensity-modulated radiotherapy （IMRT） and three-dimensional conformal radiotherapy （3D-CRT） in the treatment of glioblastoma multiforme （GBM）.This study aimed to determine whether IMRT improves clinical outcomes compared with 3D-CRT in patients with GBM.Methods The records of 54 patients with newly-diagnosed GBM from July 2009 to December 2010 were reviewed.The patients underwent postoperative IMRT or 3D-CRT with concurrent and adjuvant temozolomide.Kaplan-Meier method and log rank test were used to estimate differences of patients＇ survival.Results The median follow-up was 13 months.Of the 54 patients,fifty （92.6%） completed the combined modality treatment.The 1-year overall survival rate （OS） was 79.6%.The pattern of failure was predominantly local.A comparative analysis revealed that no statistical difference was observed between the IMRT group （n=21） and the 3D-CRT group （n=33） for 1-year OS （89.6% vs.75.8%,P=0.795）,or 1-year progression-free survival （PFS） （61.0% vs.45.5%,P=0.867）.In dosimetric comparison,IMRT seemed to allow better sparing of organs at risk than 3D-CRT did （P=0.050,P=0.055）.However,there was no significant difference for toxicities of irradiation between the IMRT group and the 3D-CRT group.Conclusions Our preliminary results suggested that delivering standard radiation doses by IMRT is unlikely to improve local control or overall survival for GBM compared with 3D-CRT.Given this lack of survival benefit and increased costs of IMRT,the utilization of IMRT treatment for GBM needs to be carefully rationalized.

THREE-DIMENSIONAL CONFORMAL RADIATION THERAPY FOR LOCALLY RECURRENT NASOPHARYNGEAL CARCINOMA

Objective: To investigate the safety and effectiveness of three-dimensional conformal radiation therapy (3-D CRT) for locally recurrent nasopharyngeal carcinoma (NPC). Methods: From April 1998 to March 2000, 34 patients who had undergone previous external beam radiation therapy were retreated with 3-D CRT for locally recurrent NPC (33 poorly differentiated squamous cell carcinomas, 1 adenoma). The patients were re-staged according to Huaqing staging system with the following distribution: T1N0M0 in 5 cases, T2N0M0 in 11 cases, T3N0M0 in 12 cases, T4N0M0 in 6 cases. The maximal dimension of the gross tumor volume (GTV) ranged from 1.0 cm to 5.0 cm (median: 2.9 cm). CT simulation and 3-D planning were used to ensure full and conformal coverage of the planning target volume (PTV) by treated volume, while minimizing the absorbed dose of the adjacent normal tissue. 5–7 static conformal coplanar or noncoplanar portals were delivered for each fraction irradiation. The total dose delivered ranged from 65–70 Gy, with 2.5 Gy per fractionation, one fractionation per day, 5 days a week. Median follow-up time from 3-D CRT was 25 months (range: 12–36 months). Results: Over the follow-up period, local recurrence was observed in 3 patients, regional failure in 3, distant metastasis in 3, and six patients died; 88.2% (30/34) of the patient maintained local control, 82.4% (28/34) survived, and 76.5% (26/34) survived with no evidence of tumor. Acute complications were minor and few. The overall incidence of late complication was 20.6% (7/34), and severe complication was 14.7% (5/34), after re-irradiation with 3-D CRT. Conclusion: 3-D CRT is safety and effectiveness for most of the patients with locally recurrent NPC. Our preliminary results indicate a high local control rate and a low complication rate. The long-term curative effect and sequelae await further study.

Curative 3D Conformal Radiotherapy of Non-Operated Prostate Adenocarcinoma at Pointe-a-Pitre University Hospital (Guadeloupe): About 29 Cases

Context: Technological advances have improved the toxicities of radiotherapy. We are evaluating the 3D technique in prostate cancer. Materials and Methods: Retrospective study from January 2015 to December 2015 with 29 files. Survival was calculated by Kaplan-Meier method. Results: We collected 29 patient records over the study period. The median age was 75 years with the following extremes: 54 years and 83 years. The median PSA level was 12 ng/ml with a range of 3.05 to 79 ng/ml. Gleason score analysis showed 6 patients (20.69%) with a score of 6 (3 + 3), 23 patients (79.31%) with a score of 7 including 12 patients (41.38%) with grade 3 and 11 patients (37.93%) with grade 4. The median dose delivered was 74 Gy, with a mean dose of 73.79 Gy and extremes of 70 Gy for the minimum and 76 Gy for the maximum. Hormone therapy was combined with radiotherapy in 17 patients (58.62%). Seven patients (24.14%) had grade 1 acute bladder toxicity and one patient (3.45%) had grade 2 acute toxicity. Late bladder toxicity was grade 1 in 5 patients (17.24%), grade 2 in 3 patients (10.34%) and grade 3 in 1 patient (3.45%). Late rectal toxicity, grade 2 in 3 patients (10.34%), grade 3 in 1 patient, was noted. Overall survival at 2 years was 100% and 89.65% at 5 years. Relapse-free survival at 2 years was 82.76% and 62.07% at 5 years. There were 3 deaths (10.34%) of which only one was related to prostate cancer. Conclusion: Radiotherapy, like surgery, is a fundamental option for the treatment of prostate cancers, particularly those that are locally advanced. It is gaining in importance with the improvement of techniques (IMRT, VMAT…) and new fractionations which contribute to the reduction of toxicities and the comfort of patients (shorter spread).

3D conformal radiotherapy combined with transcatheter arterial chemoembolization for hepatocellular carcinoma

AIM:To compare transcatheter arterial chemoembolization(TACE)and 3D conformal radiotherapy(3D-CRT)with TACE monotherapy in hepatocellular carcinoma(HCC).METHODS:We searched all the eligible studies from the Cochrane Library,Pub Med,Medline,Embase,and CNKI.The meta-analysis was performed to assess the survival benefit,tumor response,and the decline inα-fetoprotein(AFP)level.According to the heterogeneity of the studies,pooled OR with 95%CI were calculated using the fixed-effects or random-effects model.An observed OR>1 indicated that the addition of 3D-CRT to TACE offered survival benefits to patients that could be considered statistically significant.Statistical analyses were performed using Review Manager Software.RESULTS:Ten studies met the criteria to perform a meta-analysis including 908 HCC participants,with 400patients in the TACE/3D-CRT combination group and508 in the TACE alone group.TACE combined with 3DCRT significantly improved 1-,2-and 3-year overall survival compared with TACE monotherapy(OR=1.87,95%CI:1.37-2.55,P<0.0001),(OR=2.38,95%CI:1.78-3.17,P<0.00001)and(OR=2.97,95%CI:2.10-4.21,P<0.00001).In addition,TACE plus 3DCRT was associated with a higher tumor response(complete remission and partial remission)(OR=3.81;95%CI:2.70-5.37;P<0.00001),and decline rates of AFP level(OR=3.24,95%CI:2.09-5.02,P<0.00001).CONCLUSION:This meta-analysis demonstrated that TACE combined with 3D-CRT was better than TACE monotherapy for patients with HCC,which needs to be confirmed by large multicenter trials.

Dosimetric Comparison of Volumetric Modulated Arc Therapy (VMAT), 5F Intensity Modulated Radiotherapy (IMRT) and 3D Conformal Radiotherapy (3DCRT) in Rectal Carcinoma Receiving Neoadjuvant Chemoradiotherapy

Objective: To investigate better dosimetric distribution of volumetric modulated arc therapy (VMAT) vs. 5F intensity modulated radiotherapy (IMRT) and 3D conformal radiotherapy (3DCRT) in patients with locally advanced rectal cancer (LARC) when treated with neoadjuvant chemoradiotherapy. Methods: 3D-CRT, 5F-IMRT and VMAT plans for preoperative radiotherapy were 66011designed in 12 patients with locally advanced rectal cancer. The conformity index (CI) and homogeneity index (HI) in target volume, and the dose and volume of the organs at risk (OAR) irradiated including small bowel, bladder and bilatera1 femoral heads were compared among the three plans. Results: The CI for planning target volume (PTV) 2 and HI for PTV1 of VMRT and 5F-IMRT were superior to 3D-CRT. The CI of VMAT, 5F-IMRT and 3D-CRT plans were 0.71, 0.69 and 0.62 (p = 0.011 and p = 0.019, respectively). The HI of the VMAT and 5F-IMRT plans were both 1.04 and 3D-CRT planning was 1.06 (p = 0.022 and p = 0.006, respectively). The V35 - V45 of small bowel in VMAT were significantly less than in 5F-IMRT and 3D-CRT. V35 was 47.0, 56.4, and 72.8 cm3 for VMAT, 5F-IMRT, and 3D-CRT (p = 0.021 and p = 0.034, respectively), while V40 was 30.5, 35.5, 45.1 cm3 (p = 0.024 and p = 0.032, respectively) and V45 was 15.1, 18.1, 30.0 cm3 (p = 0.033 and p = 0.032, respectively). The D5, V30 and V50 of bladder in 3D-CRT were less than in VMAT and 5F-IMRT planning (p = 0.034, 0.004, 0.002 and p = 0.027, 0.003, 0.002, respectively). The Dmean of left femoral head in VMAT and 5F-IMRT were less than in 3D-CRT planning (p = 0.028 and p = 0.022, respectively) and the Dmean, V30 of right femoral head in VMAT and 5F-IMRT were better than in 3D-CRT planning (p = 0.044, 0.036 and p = 0.023, 0.028, respectively). Conclusions: Dosimetric analyses demonstrated that IMRT is superior to 3D-CRT in the conformity and homogeneity of dose distribution to the target volume, and provide a better protection to OARs sparing in patients with locally advanced rectal cancer for preoperative radiotherapy. With similar target coverage, VMRT is superior to 5F-IMRT in normal tissue sparing.

A study of transarterial infusion chemotherapy of gemcitabine plus three dimensional conformal radiotherapy for local advanced pancreatic cancer

Objective: To evaluate the clinical effect of transarterial infusion chemotherapy of gemcitabine plus three dimen- sional conformal radiotherapy on patients with local advanced pancreatic cancer. Methods: Fifty-one patients with local ad- vanced pancreatic cancer from June 2002 to February 2004 were enrolled, twenty-four patients of combined group were treat- ed with transarterial infusion chemotherapy of gemcitabine plus three dimensional conformal radiotherapy, while twenty-seven patients of control group were treated only with transarterial infusion chemotherapy of gemcitabine. Results: There were significant statistical differences between two groups in clinical benefit response (91.7% versus 74.1%, P < 0.01) and overall remission rate (70.8% versus 33.3%, P < 0.01). The 6-month survival rate, 12-month survival rate and 24-month survival rate of combined group were 83.3%, 62.5% and 37.5% respectively, while that of control group were 55.6%, 33.3% and 11.1% respectively. This showed significant difference between the two groups. Conclusion: Transarterial infusion chemotherapy of gemcitabine plus three dimensional conformal radiotherapy may be better than single transarterial infusion chemotherapy of gemcitabine in improving survival rates and elongating survival time of patients with local advanced pancreatic cancer.

Concurrent gemcitabine and cisplatin combined with 3D conformal radiotherapy for stage III non-small cell lung cancer

对加 cisplatin 的并发的 gemcitabine 的毒性和功效为阶段 III 非小的房间肺癌症(NSCLC ) 与三维的保角的放射疗法相结合的学习客观。有病理地诊断的 NSCLC 的 36 个病人收到了放射疗法和并发的化疗的方法。与 IIIb 有有阶段 IIIa 和 14 个病人的 22 个病人。放射疗法在常规分别被给 60 70 Gy 的一个总数。化疗包括了 gemcitabine (600 mg/m 2) 和 cisplatin (20 mg/m 2), 一次每星期。结果 32 个病人收到了 60 72 Gy 的全部的剂量。二个病人收到了二个病人收到了的 56 Gy 和另外一个 58 Gy。34 个病人 6 星期化疗收到了 4，当二个病人收到了仅仅化疗的 2 个星期时。全面反应率(CR + PR ) ，完全的反应率(CR ) ，部分反应率(PR ) 是 83.3%(30/36 ) ， 11.1%(4/36 ) 并且 72.2%(26/36 ) 分别地。中部的后续持续时间是 18.4 个月。1 年、 2 年的全面幸存率是 77.8%(28/36 ) 并且 55.6%(20/36 ) 分别地。为阶段 III 非小的房间肺癌症与三维的保角的放射疗法相结合的结论并发的 gemcitabine 和 cisplatin 有效、很好容忍。孤独术语的结果需要推进学习。

Technical and Dosimetric Study of Four Facio-cervical Fields Conformal Radiotherapy for Nasopharyngeal Carcinoma

Objective: The aim of this study is to establish the methods of four facio-cervical fields′conformal radiotherapy(4F-CRT) for nasopharyngeal carcinoma (NPC), and to optimize the methods for clinical practice. Methods and Materials: 40 patients with untreated NPC of T1-T4 (1997AJCC Staging System) were rolled into this study. Conventional and four facio-cervical fields conform plans were designed for each patient using Pinnacle 8.0 three-dimension treatment planning system(3D-TPS): 1) Improved plan, four facio-cervical fields′conform plans, anterior, posterior facio-cervical and 2 lateral opposing facio-cervical fields; 2) Conventional plan, two lateral opposing facio-cervical fields only with the same dose delivered to the target in each plan, dose volume histograms(DVHs) of the targets and normal organs, brain stem, spinal cord, parotid glands, and temporal mandibular joints(TMJs) were compared and the dose distribution were evaluated. Results: 1) The dose distribution of the improved plan could meet the requirements for the target volume. 2) There was not any significant difference in the dose of spinal cord between the two plans. The mean doses of Dmax for brain stem in conventional plan were much lower than those in the improved plan, though both were within safety limits. 3) Compared with the conventional plans, the improved plan significantly decreased the hotspot areas in the target volume and had better parotid glands and temporal mandibular joints sparing effect. Conclusion: Compared with the conventional plan, the improved plan provides satisfactory dose coverage to the tumor volume and better sparing of the parotid gland, TMJs and other normal tissues in external beam radiotherapy of NPC.

Protein conformation in solution by three-dimensional fluorescence spectrometry

The conformations of bovine serum albumin (USA) and egg albumin (EA) in solution and their conformation changes under different conditions were studied by using three-dimensional fluorescence spectrometry (TDFS) such as three-dimensional fluorescence (TDF) spectra and three-dimensional fluorescence polarization (TDFP) spectra with tryptophan residues in protein molecules as an intrinsic fluorescent probe. The results show that the microenvironment of tryptophan residues of protein molecules in various solutions can be directly indicated and TDFS is an effective tool for studying protein conformation in solution. Meantime, some valuable results were obtained.

Comparison of Dosiology between Three Dimensional Conformal and Intensity-modulated Radiotherapies (5 and 7 fields) in Gastric Cancer Post-surgery

The purpose of this study was to compare the dose distribution of intensity-modulated ra- diotherapy （IMRT） in 7 and 5 fields as well as 3-D conformal radiotherapy （3D-CRT） plans for gastric cancer using dosimetric analysis. In 15 patients with gastric cancer after D1 resection, dosimetric pa- rameters for IMRT （7 and 5 fields） and 3D-CRT were calculated with a total dose of 45 Gy （1.8 Gy/day） These parameters included the conformal index （CI）, homogeneity index （HI）, maximum dose spot for the planned target volume （PTV）, dose-volume histogram （DVH） and dose distribution in the organs at risk （OAR）, mean dose （Dmean）, maximal dose （Dmax） in the spinal cord, percentage of the normal liver volume receiving more than 30 Gy （V30） and percentage of the normal kidney volume receiving more than 20 Gy （V20）. IMRT （7 and 5 fields） and 3D-CRT achieved the PTV coverage. However, IMRT presented significantly higher CI and HI values and lower maximum dose spot distribution than 3D-CRT （P=0.001）. For dose distribution of OAR, IMRT had a significantly lower Dmean and Dmax in spinal cord than 3D-CRT （P=-0.009）. There was no obvious difference in V30 of liver and V20 of kidney between IMRT and 3D-CRT, but 5-field IMRT showed lower Dmean in the normal liver than other two plans （P=0.001）. IMRT revealed favorable tumor coverage as compared to 3D-CRT and IMRT plans. Specifically, 5-field IMRT plan was superior to 3D-CRT in protecting the spinal cord and liver, but this superiority was not observed in the kidney. Further studies are needed to compare differences among the three approaches.