Comparison of efficacy and safety between late-course and simultaneous integrated dose-increasing intensity-modulated radiation therapy for cervical cancer complicated with pelvic lymph node metastasis

Objective This study aimed to compare and analyze the clinical efficacy and safety of late-course and simultaneous integrated dose-increasing intensity-modulated radiation therapy(IMRT) for cervical cancer complicated with pelvic lymph node metastasis. Methods Sixty patients with cervical cancer complicated with pelvic lymph node metastasis who were admitted to our hospital from January 2013 to January 2015 were enrolled. The patients were randomly divided into the late-course dose-increasing IMRT group and the simultaneous integrated dose-increasing IMRT group, with 30 cases included in each group, respectively. All patients were concurrently treated with cisplatin. After treatment, the clinical outcomes of the two groups were compared. Results The remission rate of symptoms in the simultaneous integrated dose-increasing IMRT group was significantly higher than that in the late-course dose-increasing IMRT group(P < 0.05). The follow-up results showed that the overall survival time, progression-free survival time, and distant metastasis time of patients in the simultaneous integrated dose-increasing IMRT group were significantly longer than those in the late-course dose-increasing IMRT group(P < 0.05). The recurrent rate of lymph nodes in the radiation field in the simultaneous integrated dose-increasing IMRT group was significantly lower(P < 0.05) than in the late-course dose-increasing IMRT group. There was no significant difference in the incidence of cervical and vaginal recurrence and distant metastasis between the two groups(P > 0.05). The radiation doses of Dmax in the small intestine, D1 cc(the minimum dose to the 1 cc receiving the highest dose) in the bladder, and Dmax in the rectum in the simultaneous integrated dose-increasing IMRT group were significantly lower(P < 0.05) than in the late-course dose-increasing IMRT group. There was no significant difference in intestinal D2 cc(the minimum dose to the 2 cc receiving the highest dose) between the two groups(P > 0.05). The incidence of bone marrow suppression in the simultaneous integrated dose-increasing IMRT group was significantly lower(P < 0.05) than in the late-course dose-increasing IMRT group.Conclusion The application of simultaneous integrated dose-increasing IMRT in the treatment of cervical cancer patients complicated with pelvic lymph node metastasis can significantly control tumor progression, improve the long-term survival time, and postpone distant metastasis time with high safety.

Favorable response after radiation therapy for intraductal papillary mucinous neoplasms manifesting as acute recurrent pancreatitis:A case report

BACKGROUND There has been an increasing number of elderly patients with intraductal papillary mucinous neoplasm(IPMN),who are surgically intolerant and require less invasive treatment options,which are limited.In the present study,we report a case of IPMN presenting with acute recurrent pancreatitis(ARP),in which radiation therapy effectively prevented further attacks of ARP and reduced tumor volume.CASE SUMMARY An 83-year-old man was referred to our hospital with an asymptomatic incidental pancreatic cyst.Endoscopic ultrasound imaging and magnetic resonance cholangiopancreatography revealed a multiloculated tumor in the head of the pancreas,with dilated pancreatic ducts and mural nodules.The patient was diagnosed with mixed-type IPMN,and five years later,he developed ARP.Several endoscopic pancreatic ductal balloon dilatations failed to prevent further ARP attacks.Surgery was considered clinically inappropriate because of his old age and comorbidities.He was referred to our department for radiation therapy targeted at those lesions causing intraductal hypertension and radiation was administered at a dose of 50 Gy.An magnetic resonance imaging scan taken ten weeks after treatment revealed a decrease in tumor size and improvement of pancreatic duct dilatation.Fourteen months later,he remains symptom-free from ARP.CONCLUSION This case highlights the important role of radiation therapy in mitigating the signs and symptoms of ARP in patients with inoperable IPMN.

The Physical and Clinical Aspects of Radiation Therapy in Skin Cancer and Subcutaneous Tissue Neoplasm

Cancers, malignant melanoma and sarcomas of the skin represent the most common group of malignancies in humans. The main treatment method of almost all skin cancers and subcutaneous tissue tumours is surgery, which consists of complete removal of a neoplastic lesion, with an adequate margin of healthy tissue. Radiotherapy plays an adjuvant role in this process, meaning complementing of the surgical procedure. This study compared four methods of irradiation treatment of cancer located in the skin or in subcutaneous tissues: contact brachytherapy, conventional orthovoltage therapy, electron beam conformal teleradiotherapy and IMRT dynamically shaped photonic beams conformal teleradiotherapy. In order to compare the methods and techniques of surface radiotherapy, following specific objectives were formulated. At the beginning in order to compare the scopes of the absorbed doses at different tissue depths, an analysis of parameters describing particular beams or radiation source has been performed—the curves for the absorbed-dose depth drop-offs. Doses distribution in tissue-like phantoms stimulating homogeneous cuboidal tissue block has been determined. A quality comparison of dose distribution in 2D and 3D treatment planning system for contact brachytherapy application has been made. The dose distribution for electron beam in the system has been determined. Conformal plannings for electron beam treatment, contact brachytherapy applicator treatment and 4 photon beams treatment optimized in IMRT technology have been performed. Dose distribution has been performed for the irradiated female patient within the well chest—the target included the recurrence area in the post-operative scar. The radiation therapy with X-rays has actually been completely eliminated from skin cancer and subcutaneous tissue radiotherapy by the electrons generated in linear accelerators, contact brachytherapy HDR and by high-energy photons used in conformal techniques, ex. IMRT. It is because the residual dose beyond the target is the highest for single X-ray beam. Although in brachytherapy HDR a rapid dose drop-off is observed, 5 cm from its normalization level for the target the residual radiation remains at the level of several percent. So, both X-rays beam radiation and brachytherapy in skin cancer treatment is connected with the administration of the dose with a high gradient in the health tissues. The dose distribution for photon conformal techniques IMRT or for electron radiation looks different. There with the dose normalization at the level of 90% or 85% we deal with the dose layer, the division does not exceed 15% of heterogeneity.

Role of stereotactic body radiation therapy for hepatocellular carcinoma

The integration of new technologies has raised an interest in liver tumor radiotherapy,with literature evolving to support its efficacy.These advances,particularly stereotactic body radiation therapy(SBRT),have been critical in improving local control or potential cure in liver lesions not amenable to first-line surgical resection or radiofrequency ablation.Active investigation of SBRT,particularly for hepatocellular carcinoma(HCC),has recently started,yielding promising local control rates.In addition,data suggest a possibility that SBRT can be an alternative option for HCC unfit for other local therapies.However,information on optimal treatment indications,doses,and methods remains limited.In HCC,significant differences in patient characteristics and treatment availability exist by country.In addition,the prognosis of HCC is greatly influenced by underlying liver dysfunction and treatment itself in addition to tumor stage.Since they are closely linked to treatment approach,it is important to understand these differences in interpreting outcomes from various reports.Further studies are required to validate and maximize the efficacy of SBRT by a large,multi-institutional setting.

Complete response to radiation therapy of orbital metastasis from hepatocellular carcinoma

The incidence of hepatocellular carcinoma(HCC)is increasing in the United States,and 50%-75%o patients with HCC will develop metastatic disease Orbital metastases from HCC are extremely rare.We report the case of a 52-year-old male with known metastatic HCC,who presented with severe proptosis and diplopia.An orbital mass was identified on magnetic resonance imaging(MRI)and confirmed to have hypermetabolic activity on positron emission tomography/computed tomography.He received a palliative course of external beam radiation therapy to the right orbit.Intensity modulated radiation therapy (IMRT)was used to allow sparing of critical norma tissues in close proximity to the tumor.One month after completion of IMRT to 58 Gray in 30 fractions delivered over 6 wk,the patient had a complete clinical,radiologic(MRI)and symptomatic response The patient continues to have local control in the orbi 1.7 years after therapy completion.All critical norma structures were kept below the tolerance dose using IMRT,and no toxicities were observed.

Treatment of Chronic Pelvic Inflammation with Acupuncture and TDP Irradiation—A Report of 23 Cases

With electro-acupuncture, red-hot needling and TDP irradiation, we have successfully treated 23 cases of chronic pelvic inflammation. A report follows.

Practical approaches to effective management of intestinal radiation injury:Benefit of resectional surgery

AIM:To study the outcome of patients undergoing surgical resection of the bowel for sustained radiation-induced damage intractable to conservative management.METHODS:During a 7-year period we operated on 17 cases (5 male,12 female) admitted to our surgical department with intestinal radiation injury (IRI).They were originally treated for a pelvic malignancy by surgical resection followed by postoperative radiotherapy.During follow-up,they developed radiation enteritis requiring surgical treatment due to failure of conservative management.RESULTS:IRI was located in the terminal ileum in 12 patients,in the rectum in 2 patients,in the descending colon in 2 patients,and in the cecum in one patient.All patients had resection of the affected region(s).There were no postoperative deaths,while 3 cases presented with postoperative complications (17.7%).All patients remained free of symptoms without evidence of recurrence of IRI for a median follow-up period of 42 mo (range,6-96 mo).CONCLUSION:We report a favorable outcome without IRI recurrence of 17 patients treated by resection of the diseased bowel segment.

膀胱容量测定仪在盆腔肿瘤放疗中的应用分析

目的:分析重庆康超Z5型B超膀胱容量测定仪(B-ultrasound bladder volume measurement scanner,BS)用于盆腔肿瘤放疗中膀胱体积测量的准确度,并探讨全流程膀胱充盈管理联合应用BS监测膀胱体积的方法在盆腔放疗中维持分次治疗间膀胱充盈一致性、减少靶区位移方面的临床价值。方法:选取30例盆腔肿瘤放疗患者入组,为每位患者进行个体化膀胱充盈评估,实施全流程管理下的膀胱充盈、制模、CT定位,于CT扫描完成后立即测量膀胱体积(记作BSV 2),将CT扫描图像导入计划系统,勾画得到CT扫描膀胱体积(记作CTSV)。对30例患者的BSV 2与CTSV进行相关性及偏差分析。对入组的30例盆腔肿瘤患者实施个体化全流程膀胱充盈管理,于每次放疗完成后立即应用BS测量膀胱体积(记作BSV 4)。取每位患者所有分次放疗后BSV 4的平均值(记作BSV mean)与CTSV进行相关性分析,并对患者每次放疗后的BSV 4与CTSV进行偏差分析。结果:入组的30例患者的BSV 2(Y)与CTSV(X)之间存在强相关,函数式为Y=24.838+0.959X,相关系数R=0.946;BSV 2与CTSV的平均偏差(均值±标准差)为(4.16%±2.43%)。入组的30例患者疗程内的BSV mean(Y)与CTSV(X)之间亦存在强相关,函数式为Y=27.115+0.936X,相关系数R=0.986;BSV 4与CTSV的平均偏差(均值±标准差)为(4.05%±2.88%)。结论:重庆康超Z5型B超膀胱容量测定仪测量精度高、重复性好,可应用于盆腔放疗中监测膀胱体积,配合全流程膀胱充盈管理,可有效保证盆腔肿瘤精确放疗中维持分次治疗间膀胱充盈一致性及靶区位置稳定性。

Radiotherapy of 180 cases of operable esophageal carcinoma

AIM To compare the validity of radiotherapy and surgery for operable esophageal carcinoma in 180 patients with pathologically proved esophageal carcinoma who had been accepted for surgery, but for various reasons, were given radical radiation therapy. METHODS The reasons of abandoning surgery in the patients were: poor cardiac function (21), poor pulmonary function (36), poor general condition (9), senility (aged 69～81 years), 32 and refusal by the patient (82). They were treated either by the isocenter technic alone or anteroposterior plus isocenter irradiation to a total dose of 50～70 Gy/5～7wk. RESULTS The 1 , 3 and 5 year survival rates were 64%, 34% and 23%. The 3 and 5 year survival rates showed that lesions in the upper third did better than those in the middle and lower thirds ( P <0 05). The 5 year survival rate by radiation alone (44 5%) of the upper third lesions was slightly better than by surgery. The effect for lesions in the middle third was slightly inferior, and that for the lower third was even poorer than that of surgery. CONCLUSION The result of radiation alone for the operable esophageal carcinoma was similar to that of surgery.

Indications of external radiotherapy for hepatocellular carcinoma from updated clinical guidelines: Diverse global viewpoints

The etiology and disease patterns of hepatocellular carcinoma(HCC)significantly vary among regions. Modern standard treatments commonly require multidisciplinary approaches, including applications of up-to date medicine and advanced procedures, and necessitate the support of socioeconomic systems. For these reasons, a number of clinical guidelines for HCC from different associations and regions have been presented. External beam radiation therapy was contraindicated for HCC until a few decades ago, but with the development of new technologies, its application has rapidly increased as selective irradiation for tumorous lesions became possible. Most of the guidelines had been opposed or indifferent to radiotherapy in the past, but several guidelines have introduced indications and recommendations for radiotherapy in their updated versions. This review will discuss the characteristics of important guidelines and their contents regarding radiotherapy and will also provide guidance to physicians who are considering applications of locoregional modalities that include radiotherapy.

A Survey of Researches on Synergy and Toxicity Abatement of Traditional Chinese Medicine in Radiotherapy of Nasopharyngeal Carcinoma

Even though radiotherapy is a therapy of first choice in the treatment of nasopharyngeal carcinoma, its radiotoxicity is often difficult to bear for patients in addition to the unsatisfactory effect in some patients. Therefore, an important problem in the treatment of nasopharyngeal carcinoma is to abate radiotherapeutic toxicity and improve its effect. Some progresses in promoting the effect of radiotherapy and abating its toxicity have been made through application of traditional Chinese medicine (TCM) which is briefly reviewed as follows.

Analysis of the Prognosis for Patients with Stage T3N0-1M0 Nasopharyngeal Carcinoma Treated by Chemotherapy Combined with Radiotherapy

OBJECTIVE To investigate the relationship between the therapeutic modality and prognostic factors for the patients with T3N0-1M0 nasopharyngeal carcinoma. METHODS The clinical data from 127 cases of T3N0-1M0 nasopharyngeal carcinoma patients with initial treatment, during the period from January 4th, 2000 to November 12th, 2001, were retrospectively analyzed. The cases were divided into Group A with simple radiotherapy (90) and Group B with the radiation therapy combined with chemotherapy (37), based on various patients' conditions. In group B, inductive chemotherapy was conducted for 18 cases, inductive chemotherapy plus homochronous chemotherapy for 5 and homochronous chemotherapy for 14. RESULTS The 5-year overall survival (OS) in the groups A and B was 73.4% and 72.3% respectively (P>0.05); the cancer-correlated survival (CCS) in the 2 groups was 76.4% and 72.3% respectively (P>0.05); the disease-free survival (DFS) in group A and B was 65.5% and 71.7% respectively (P<0.05). A multiple analysis showed that the mode of radiation therapy plus chemotherapy was a favorable independent impact factor for DFS. CONCLUSION Chemotherapy plus radiotherapy can improve the DFS of patients with T3N0-1M0 nasopharyngeal carcinoma, but fails to prolong the survival time of the patients. The modality of chemotherapy plus radiotherapy is not the necessary choice in treatment of patients with T3N0-1M0 nasopharyngeal carcinoma.

XRCC1、XRCC3、ERCC2多态性与头颈部肿瘤患者放射性甲状腺功能异常风险的相关性

目的:探讨XRCC1、XRCC3、ERCC2多态性与头颈部肿瘤患者放射性甲状腺功能异常风险的相关性。方法:选择2019年5月~2020年12月于新疆维吾尔自治区人民医院行强调放射治疗的头颈部肿瘤患者120例作为研究对象。所有患者于放射治疗开始前收集临床资料,并抽取空腹静脉血对XRCC1、XRCC3、ERCC2多态性情况进行分析。强调放射治疗结束后进行为期1年的随访并统计随访期间出现甲状腺功能异常的情况。最后根据甲状腺功能异常情况对患者进行分组,分析XRCC1、XRCC3、ERCC2多态性与患者甲状腺功能异常的相关性。结果:异常组患者女性占比高于正常组(P<0.05)。异常组患者XRCC1单核甘酸多态性位点rs25487、rs1799782、XRCC3单核甘酸多态性位点rs861539及ERCC2单核甘酸多态性位点rs1799793基因型分布差异具有统计学意义(P<0.05)。异常组患者XRCC1单核甘酸多态性位点rs25487的G基因型频率、rs1799782的T基因型频率、XRCC3单核甘酸多态性位点rs861539的T基因型频率及ERCC2单核甘酸多态性位点rs1799793的T基因型频率高于正常组(P<0.05)。女性、XRCC1(rs25487、rs1799782)基因分型、XRCC3(rs861539)基因分型、ERCC2(rs1799793)基因分型均为放疗后甲状腺功能异常的独立影响因素(P<0.05)。结论:XRCC1、XRCC3、ERCC2基因多态性与头颈部肿瘤患者放射治疗后甲状腺功能损伤存在相关性,可以进一步探讨其作为放射后甲状腺功能异常预测因子的可能性。

妇产科实施慢性盆腔炎临床治疗的方法及效果分析

目的:探析慢性盆腔炎(CPID)临床治疗的方法及效果。方法:纳入本院2020年1月至2022年12月收治共计200例CPID患者,采用简单随机化方法将纳入患者均分且设定为对照组、观察组(均n=100),前一组给予常规西医治疗,后一组加施中成药口服+红外线腹部照射+低频脉冲电治疗,比较两组临床效果、症状缓解时间、中医症候积分、血液流变学指标以及炎症因子水平和不良反应发生情况。结果:观察组临床总有效率93.00%较对照组的82.00%居于更高水平(P<0.05)。观察组下腹坠胀、下腹疼痛以及腰骶部酸痛等症状缓解时间均较对照组更短(P<0.05)。治疗前,两组下腹胀痛或刺痛、带下色黄质稠量多、胸闷纳呆、经期长量大色黯红等症候评分均无差异(P>0.05);治疗2周,观察组各项症候评分均较对照组更低(P<0.05)。治疗前,两组ESP、CP、PV、FIB水平均无统计学差异(P>0.05);治疗2周,观察组ESP、CP、PV、FIB水平均较对照组更低(P<0.05)。治疗前,两组IL-8、IL-10、TGF-β1、MCP-1水平均无统计学差异(P>0.05);治疗2周,观察组IL-8、TGF-β1、MCP-1水平均较对照组更低,IL-10水平较对照组更高(P<0.05)。观察组头晕、恶心、皮疹等常见不良反应总发生率4.00%与对照组的6.00%比较无统计学差异(P>0.05)。结论:于CPID患者而言,在常规西医治疗基础上加施中成药口服+红外线腹部照射+低频脉冲电治疗,能够取得理想效果,且安全性较高,值得应用。

PEG-rhG-CSF皮下注射与替吉奥联合调强放疗对晚期食管癌的疗效及生存质量的影响

目的探讨皮下注射聚乙二醇化重组人粒细胞集落刺激因子(PEG-rhG-CSF)联合替吉奥在晚期食管癌调强放疗治疗中的价值。方法前瞻性选取2018年1月至2019年9月淮北矿工总医院收治的60例晚期食管癌患者作为研究对象,采用随机数字表法将患者分为观察组和对照组,各30例。对照组患者采用替吉奥+调强放疗措施治疗,观察组患者在对照组基础上同时给予PEG-rhG-CSF注射治疗。比较两组患者放疗近期效果、外周血T淋巴细胞亚群及NK细胞、生存质量评分、毒副反应发生率、生存率及生存时间差异。结果两组的治疗效果分布比较,差异无统计学意义(P>0.05)。治疗后,观察组患者的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、CD16^(+)CD56^(+)NK细胞占比分别为(62.50±4.80)%、(38.51±3.00)%、1.49±0.15、(22.63±2.24)%,均高于对照组[(58.83±5.28)%、(36.67±2.89)%、1.39±0.13、(21.55±1.87)%],差异均有统计学意义(P<0.05)。治疗后,观察组患者的乏力、恶心、食欲不振、失眠评分为(36.29±4.16)、(44.10±5.06)、(33.52±4.27)、(34.20±4.86)分,均低于对照组[(38.85±3.78)、(47.03±4.81)、(37.30±4.52)、(37.56±5.20)分],差异均有统计学意义(P<0.05)。治疗过程中,观察组患者的恶心、呕吐、放射性食管炎、放射性肺炎发生程度均低于对照组,差异有统计学意义(P<0.05)。随访2年,观察组生存率43.33%,对照组生存率33.33%,观察组的中位生存时间21个月,对照组20个月,两组差异无统计学意义(P>0.05)。结论PEG-rhG-CSF联合替吉奥在晚期食管癌调强放疗治疗中应用能缓解放化疗引起的细胞免疫功能受损、改善生存质量、降低毒副反应发生率。

多原发肺癌诊疗策略的最新进展

随着后疫情时代的到来,计算机断层扫描在肺癌筛查中运用愈加广泛,多原发性肺癌(multiple primary lung cancer, MPLC)的检出率在不同国家和地区也随之飙升。尽管先进的组织学和测序技术不断应用于该领域,但MPLC和肺内转移(intrapulmonary metastasis, IM)的鉴别仍具有挑战性。近年来,遗传和环境因素在MPLC中的特殊机制逐渐被人们发掘。在MPLC的治疗中,肺叶切除术仍然居于主要地位,但特定肿瘤亚肺叶切除并未对生存产生负面影响,这似乎是一种合理的选择。随着理念的革新,以手术为主的综合治疗是一种新趋势。其中,立体定向消融放疗(stereotactic ablative radiotherapy, SABR)和肺消融技术成为早期不可切除肿瘤和控制残留病灶的有效治疗手段。此外,驱动基因阳性的靶向治疗和免疫治疗在术后辅助阶段也显示出良好的结果。本文拟基于最新的研究成果对MPLC的管理进行综述。

早期非小细胞肺癌患者立体定向放射治疗的预后分析

背景与目的随着人口老龄化和肺癌筛查受重视程度的提高,近年来早期肺癌就诊量呈上升趋势。其病理类型以非小细胞肺癌(non-small cell lung cancer,NSCLC)为主,可被划分为可手术早期肺癌和不可手术早期肺癌。立体定向放射治疗(stereotactic body radiation therapy,SBRT)是不可手术早期NSCLC的首选治疗方法。本研究旨在探讨我院早期NSCLC患者行SBRT后的预后及其影响因素,以期提高早期NSCLC患者接受SBRT后的生存期。方法收集2010年8月-2020年8月在我院接受SBRT的早期NSCLC患者的临床资料及随访情况,采用Kaplan-Meier法评估预后,采用Cox比例风险模型进行多因素分析寻找影响预后的因素。结果共纳入165例患者,中位随访时间为43.2(范围:4.8-132.1)个月。1年、2年、5年局部控制(local control,LC)率分别为98.1%、94.8%和86.5%,卡氏功能状态评分(Karnofsky performance status,KPS)>80分是LC的独立预后因素(P=0.02);1年、2年、5年总生存(overall survival,OS)率分别为97.6%、93.0%和68.9%,生物等效剂量(biological equivalent dose whenα/β=10,BED_(10))>132 Gy是OS的独立预后因素(P=0.04);1年、2年、5年无进展生存(progression-free survival,PFS)率分别为93.3%、79.5%和55.3%;1年、2年、5年无远处转移生存(distance metastasis free survival,DMFS)率分别为94.5%、83.2%和58.4%,BED_(10)>150 Gy是DMFS的独立预后因素(P=0.02);1年、2年、5年区域控制(region control,RC)率分别为98.8%、95.4%和87.9%。结论SBRT治疗早期NSCLC疗效好,KPS>80分是影响LC的独立预后因素;BED_(10)>132Gy是OS的独立预后因素;BED_(10)>150 Gy是DMFS的独立预后因素。

女性盆腔肿瘤放疗的热塑体膜形变及其对定位点影响的临床研究

目的分析女性盆腔肿瘤放疗热塑体膜固定时的收缩性与冷却时间的关系,观察体膜形变对放疗定位标记点位移的变化规律,明确不同时间热塑体膜定位点的稳定性差异。方法选取2021年12月至2022年3月于我院放疗中心拟行调强放疗的中晚期宫颈癌患者30例,采用真空垫和热塑体膜固定。将Y轴的定位中心点分别置于脐上3 cm(A点)、脐水平(B点)、脐下3 cm(C点);X轴均置于体中线,Z轴均置于腋中线。采用三维激光灯系统在体膜上的十字激光处做标记。以体膜冷却20 min后画的“十”字线为基准,分别观察和记录热塑膜体的3个定位点在第4小时和第24小时“十”字线的三维空间位移情况。结果3个观察定位点中,在X轴上第4小时有23.3%、20.0%、23.3%的病例移位>5 mm,Y轴、Z轴0例。此外,3个观察点有13.3%在第24小时的X轴移位>5 mm,在Y轴上各1例,在Z轴上0例。热塑体膜收缩在X轴的不同观察时间点的3个观察点(A点、B点、C点)之间均具有统计学差异(P<0.05)。结论女性盆腔肿瘤热塑体膜固定时体膜制作后应至少间隔4 h后再进行模拟定位,如能间隔24 h后再定位更佳。

红外线照射理疗在慢性盆腔炎患者中的疗效观察

目的观察红外线照射理疗在慢性盆腔炎患者中的疗效。方法抽取2018年2月—2020年2月峡江县中医院收治的215例慢性盆腔炎患者,依据治疗方式的不同分为对照组(108例)、观察组(107例),对照组应用常规抗生素静脉滴注方式进行治疗,观察组以对照组为基础联合红外线照射理疗法治疗。对比2组临床应用效果及对炎症因子的影响。结果和对照组相比,治疗后观察组治疗总有效率较高(98.13%)(P<0.05),症状缓解时间较短(P<0.05),血清炎症因子水平较低(P<0.05),不良反应发生率较低3.74%(P<0.05)。结论红外线照射理疗在慢性盆腔炎患者中的应用效果显著,有利于改善机体炎症因子水平,可降低不良反应发生率,加快患者症状恢复进程,值得推广。

立体定向放疗后原发病灶旁新发快速进展磨玻璃型肺腺癌1例

磨玻璃型肺癌临床常表现为惰性,其接受立体定向放疗(stereotactic body radiation therapy,SBRT)治疗后长期随访的临床研究较少。本文提供1例接受SBRT治疗的磨玻璃型肺癌的成功案例,但随访中发现临近SBRT治疗靶区的肺组织内,新发1例磨玻璃结节。该结节进展迅速,经手术切除证实为肺腺癌,但分子病理结果及基因检测未见明显高危因素和相关驱动基因。新发磨玻璃结节是否与既往SBRT治疗有关,值得进一步研究。本案例提示,SBRT治疗后的随访复查,应警惕靶区及临近肺组织内新发快速进展型肺癌的发生。