Objective:To carry out dosimetric comparison between volumetric modulated arc therapy(VMAT)and intensity-modulated radiation therapy(IMRT)in cervical cancer.Methods:50 postoperative cervical cancer patients were inclu...Objective:To carry out dosimetric comparison between volumetric modulated arc therapy(VMAT)and intensity-modulated radiation therapy(IMRT)in cervical cancer.Methods:50 postoperative cervical cancer patients were included in this study.The patients were admitted for treatment from January 2021 to January 2022.VMAT and IMRT plans were designed for each patient to analyze the dose distribution in the target area of the two treatment techniques.Results:Comparing the monitor unit for single treatment(638.21±116.21 MU)and time of single treatment(143.21±23.14 s)in the observation group and the monitor unit for single treatment(932.14±74.11 MU)and time of single treatment(223.14±17.26 s)in the control group,there was significant difference(P<0.05);there was also significant difference(P<0.05)between the normal tissue(bladder and rectum)of the observation group and that(bladder and rectum)of the control group.Conclusion:VMAT is more effective in cervical cancer,and it has a certain protective effect on normal tissues in patients and can reduce the radiation dose.展开更多
Intensity-modulated radiation therapy (IMRT) has become the mainstay of treatment for localized prostate cancer. In IMRT, minimizing differences between the conditions used during planning CT and daily treatment is im...Intensity-modulated radiation therapy (IMRT) has become the mainstay of treatment for localized prostate cancer. In IMRT, minimizing differences between the conditions used during planning CT and daily treatment is important to prevent adverse events in normal tissues. In the present study, we evaluated the impact of variation in bladder volume on the doses to various organs. A total of 35 patients underwent definitive radiotherapy at Saitama Medical Center. A Light Speed RT16 (GE Healthcare) was used for planning and to obtain examination CT images. Such images were acquired after 4 - 6 days of planning CT image acquisition. The IMRT plans were optimized using the planning CT data to satisfy the dose constraints set by our in-house protocols for the PTV and the OARs. The dose distributions were then re-calculated using the same IMRT beams, and checked on examination CT images. It was clear that bladder volume affected the doses to certain organs. We focused on the prostate, bladder, rectum, small bowel, and large bowel. Regression coefficients were calculated for variables that correlated strongly with bladder volume (p < 0.05). We found that variation in bladder volume [cm<sup>3</sup>] predicted deviations in the bladder V<sub>70Gy</sub>, V<sub>50Gy</sub>, and V<sub>30Gy</sub> [%];the maximum dose to the small bowel [cGy];and the maximum dose to the large bowel [cGy]. The regression coefficients were -0.065, -0.125, -0.180, -10.22, and -9.831, respectively. We evaluated the impacts of such variation on organ doses. These may be helpful when checking a patient’s bladder volume before daily IMRT for localized prostate cancer.展开更多
Background:Cancer of Head and Neck(HNC)is the 2 nd common cancer in India leading to around 8%of the global cancer mortality.Intensity-modulated radiation therapy(IMRT)is advanced method minimizing exposure of radiati...Background:Cancer of Head and Neck(HNC)is the 2 nd common cancer in India leading to around 8%of the global cancer mortality.Intensity-modulated radiation therapy(IMRT)is advanced method minimizing exposure of radiation to adjacent normal structures but is associated with higher fatigue indirectly elevating distress levels.Medical Qigong(MQ),a meditative mind therapy has numerous health benefits.The purpose of the current study was to investigate effect of MQ therapy on distress,fatigue,and quality of life in HNC patients undergoing IMRT.Materials and Methods:This experimental study was conducted on 16 Hospitalized HNC subjects undergoing IMRT aged 18–65 years.All the subjects performed Qigong Walk Cycle for 5 weekdays for 4 weeks from initiation of IMRT.Scores of Brief Fatigue Inventory(BFI),6 min walk distance(6 MWD),Functional Assessment of Cancer Therapy-Head and Neck(FACT-HN)were documented at the baseline and at end of 4 th week and compared.Results:IBM SPSS Statistics version 23.0;Indian version of Windows was used for statistical analysis.The 16 HNC subjects majorly rural residents(62.5%)of mean age group 47.68±10.25 years with tobacco chewing as prevalent habit(94%)with maximum cases recorded in stage III of the disease.The pre and post test score comparison of serum cortisol,BFI and 6 MWD found high statistical significance with P=0.001 while that of the total and all components of FACT HN was found to be significant with P≤0.05.Conclusion:MQ therapy was effective in managing the levels of distress and fatigue thereby improving quality of life of all HNC subjects.展开更多
Objective Patients with nasopharyngeal carcinoma(NPC)undergoing intensity-modulated radiation therapy(IMRT)may experience significant volumetric and dosimetric variations throughout the treatment course.However,neoadj...Objective Patients with nasopharyngeal carcinoma(NPC)undergoing intensity-modulated radiation therapy(IMRT)may experience significant volumetric and dosimetric variations throughout the treatment course.However,neoadjuvant chemotherapy may reduce the extent of these variations.This study was carried out to evaluate volumetric and dosimetric changes in target volumes and organs at risk(OARs)during IMRT in patients with locally advanced NPC who received concurrent chemoradiotherapy(CCRT)alone or in combination with neoadjuvant chemotherapy(NACT).Methods 35 NPC patients were recruited for this study and divided into the NACT(n=15)and CCRT(n=20)groups.Computed tomography(CT)scans were performed before neoadjuvant chemotherapy,before IMRT,before the 24 th fraction of IMRT,and after treatment.The original plan(plan 0)was based on CT images collected before IMRT.Hybrid plan 1(plan 1)and hybrid plan 2(plan 2)were generated by applying the beam configurations of plan0 to the CT scans collected before the 24 th fraction of IMRT and after treatment.Volumetric and dosimetric variations were assessed by comparing the results of plan 0 with those of plan 1 and plan 2.Results In the NACT group,compared with that in plan 0,the primary gross tumor volume(GTVnx)decreased by 33.2%±18.4%and 50.5%±12.6%in plan1 and plan 2,respectively.In the CCRT group,the corresponding reduction rates in plan 1 and plan 2 were 49.4%±8.0%and 77.8%±28.1%,respectively.The volume decrease rates in the NACT group were less than those in the CCRT group(P<0.001).In the NACT group,compared with that of plan0,the dose to 95%of the volume(D95)for the planning target volume of the primary tumor(PTVnx)decreased by 1.0%±0.7%and 0.6%±0.6%in plan 1 and plan 2,respectively.In the CCRT group,the corresponding decrease rates in plan 1 and plan 2 were 4.2%±3.8%and 6.1%±6.3%,respectively.The decrease rate of D95 for PTVnx in the NACT group was less than that in the CCRT group(P<0.001).Similar results among the plans were found in terms of D99,Dmean,V93 for PTVnxand PTVnd,and Dmeanfor the parotid glands.Conclusion Neoadjuvant chemotherapy reduces the extent of volumetric and dosimetric variations in target volumes and OARs during IMRT and,thus,helps achieve better target volume coverage,protects adjacent important structures,and minimizes unnecessary replanning during radiotherapy.展开更多
Objective To evaluate the long-term outcome and prognostic factors of patients with nasopharyngeal carcinoma(NPC)from low-endemic regions of China who received definitive intensity-modulated radiation therapy(IMRT).Me...Objective To evaluate the long-term outcome and prognostic factors of patients with nasopharyngeal carcinoma(NPC)from low-endemic regions of China who received definitive intensity-modulated radiation therapy(IMRT).Methods The clinical data from 608 patients with newly-diagnosed non-metastatic NPC who have received initial treatment at our cancer center from January,2008 to December,2013 were retrospectively reviewed.All patients received definitive IMRT,and 87.7%received platinum-based chemotherapy.Results The median follow-up duration was 51 months(follow-up rate,98.5%;range,10–106 months)for the entire cohort.The 5-year overall survival rate was 79.7%.The 5-year local relapse-free survival rate,regional relapse-free survival rate,distant metastasis-free survival rate and progression-free survival rate were 92.4%,93.3%,79.2%and 74.3%,respectively.A total of 153 patients had experienced treatment failure,with distant metastasis as the primary cause in 77.1%(118/153).Patients with T4 or N3 diseases had a significantly poorer prognosis than other subcategories.Stage T4 and N3 were closely associated with distant metastasis,with the metastatic rate of 29.3%and 45.5%,respectively.Conclusion IMRT provides patients with non-metastatic NPC with satisfactory long-term survival.Both T stage and N stage are important prognostic factors for NPC patients.Patients with T4 or N3 diseases have significantly increased distant metastatic rates and poor survival time.展开更多
Objective The aiom of this study was to study the efficacy and safety of berberine as a prophylactic treatment of acute radiation proctitis in postoperative patients with cervical cancer.Methods A total of 120 postope...Objective The aiom of this study was to study the efficacy and safety of berberine as a prophylactic treatment of acute radiation proctitis in postoperative patients with cervical cancer.Methods A total of 120 postoperative patients with cervical cancer were enrolled between July 2016 and October 2019,and randomly divided into a treatment group(berberine 300 mg three times a day,n=60)and a control group(receiving vitamin C tablets,100 mg three times a day;n=60)using the random number table method.All patients received pelvic intensity-modulated radiation therapy(IMRT)and concurrent sensitizing chemotherapy weekly.The difference in the percentage of irradiation volume to the rectum and small intestine as well as the incidence,onset time,severity,and duration of acute radiation proctitis and cystitis during radiotherapy were compared between the two groups.The completion rate,completion time,number of chemotherapy sessions,and quality of life during radiotherapy were also compared.Results There were no statistical differences in age,FIGO stage,pathological type,complications,highrisk factors,and rectum and small intestine irradiation dose distribution(V20,V30,V40,and V50)between the two groups(P>0.05).No acute radiation proctitis of grade 3 or above occurred in the two groups.There was no significant difference in the incidence of acute radiation cystitis,grade 2 acute radiation proctitis,completion rate of IMRT,and frequency of sensitization chemotherapy between the two groups.After prophylactic treatment with berberine,the incidence of grade 1 acute radiation proctitis,occurrence of grade 1 radiation proctitis,and completion time of radiotherapy in the treatment group were significantly lower than those in the control group(P<0.05).The SF-36 score of the treatment group after radiotherapy was 67.53±4.21,which was significantly better than that of the control group(64.90±6.32;P<0.05).The incidence of grade 3-4 neutropenia in the treatment group was 10%and lower than that in the control group(31.7%,P=0.003).No adverse reactions related to berberine were observed.Conclusion Prophylactic prescription with oral berberine can reduce the incidence,onset time,and duration of grade 1 acute radiation proctitis,and improve the quality of life of postoperative patients with cervical cancer receiving concurrent chemoradiotherapy.展开更多
文摘Objective:To carry out dosimetric comparison between volumetric modulated arc therapy(VMAT)and intensity-modulated radiation therapy(IMRT)in cervical cancer.Methods:50 postoperative cervical cancer patients were included in this study.The patients were admitted for treatment from January 2021 to January 2022.VMAT and IMRT plans were designed for each patient to analyze the dose distribution in the target area of the two treatment techniques.Results:Comparing the monitor unit for single treatment(638.21±116.21 MU)and time of single treatment(143.21±23.14 s)in the observation group and the monitor unit for single treatment(932.14±74.11 MU)and time of single treatment(223.14±17.26 s)in the control group,there was significant difference(P<0.05);there was also significant difference(P<0.05)between the normal tissue(bladder and rectum)of the observation group and that(bladder and rectum)of the control group.Conclusion:VMAT is more effective in cervical cancer,and it has a certain protective effect on normal tissues in patients and can reduce the radiation dose.
文摘Intensity-modulated radiation therapy (IMRT) has become the mainstay of treatment for localized prostate cancer. In IMRT, minimizing differences between the conditions used during planning CT and daily treatment is important to prevent adverse events in normal tissues. In the present study, we evaluated the impact of variation in bladder volume on the doses to various organs. A total of 35 patients underwent definitive radiotherapy at Saitama Medical Center. A Light Speed RT16 (GE Healthcare) was used for planning and to obtain examination CT images. Such images were acquired after 4 - 6 days of planning CT image acquisition. The IMRT plans were optimized using the planning CT data to satisfy the dose constraints set by our in-house protocols for the PTV and the OARs. The dose distributions were then re-calculated using the same IMRT beams, and checked on examination CT images. It was clear that bladder volume affected the doses to certain organs. We focused on the prostate, bladder, rectum, small bowel, and large bowel. Regression coefficients were calculated for variables that correlated strongly with bladder volume (p < 0.05). We found that variation in bladder volume [cm<sup>3</sup>] predicted deviations in the bladder V<sub>70Gy</sub>, V<sub>50Gy</sub>, and V<sub>30Gy</sub> [%];the maximum dose to the small bowel [cGy];and the maximum dose to the large bowel [cGy]. The regression coefficients were -0.065, -0.125, -0.180, -10.22, and -9.831, respectively. We evaluated the impacts of such variation on organ doses. These may be helpful when checking a patient’s bladder volume before daily IMRT for localized prostate cancer.
文摘Background:Cancer of Head and Neck(HNC)is the 2 nd common cancer in India leading to around 8%of the global cancer mortality.Intensity-modulated radiation therapy(IMRT)is advanced method minimizing exposure of radiation to adjacent normal structures but is associated with higher fatigue indirectly elevating distress levels.Medical Qigong(MQ),a meditative mind therapy has numerous health benefits.The purpose of the current study was to investigate effect of MQ therapy on distress,fatigue,and quality of life in HNC patients undergoing IMRT.Materials and Methods:This experimental study was conducted on 16 Hospitalized HNC subjects undergoing IMRT aged 18–65 years.All the subjects performed Qigong Walk Cycle for 5 weekdays for 4 weeks from initiation of IMRT.Scores of Brief Fatigue Inventory(BFI),6 min walk distance(6 MWD),Functional Assessment of Cancer Therapy-Head and Neck(FACT-HN)were documented at the baseline and at end of 4 th week and compared.Results:IBM SPSS Statistics version 23.0;Indian version of Windows was used for statistical analysis.The 16 HNC subjects majorly rural residents(62.5%)of mean age group 47.68±10.25 years with tobacco chewing as prevalent habit(94%)with maximum cases recorded in stage III of the disease.The pre and post test score comparison of serum cortisol,BFI and 6 MWD found high statistical significance with P=0.001 while that of the total and all components of FACT HN was found to be significant with P≤0.05.Conclusion:MQ therapy was effective in managing the levels of distress and fatigue thereby improving quality of life of all HNC subjects.
基金The Startup Fund for Scientific ResearchFujian Medical University(2017XQ1210)+4 种基金Youths from Fujian Provincial Health and Family Planning Research Talent Training Program(2013-2-10)Innovative Medical Subject of Fujian Province(2014-CX-7)Key Joint Project for Health Education of Fujian Province(WKJ2016-2-33)Fujian Province Health and Family Planning Research Talent Training Programthe National Clinical Key Specialty Construction Program of China
文摘Objective Patients with nasopharyngeal carcinoma(NPC)undergoing intensity-modulated radiation therapy(IMRT)may experience significant volumetric and dosimetric variations throughout the treatment course.However,neoadjuvant chemotherapy may reduce the extent of these variations.This study was carried out to evaluate volumetric and dosimetric changes in target volumes and organs at risk(OARs)during IMRT in patients with locally advanced NPC who received concurrent chemoradiotherapy(CCRT)alone or in combination with neoadjuvant chemotherapy(NACT).Methods 35 NPC patients were recruited for this study and divided into the NACT(n=15)and CCRT(n=20)groups.Computed tomography(CT)scans were performed before neoadjuvant chemotherapy,before IMRT,before the 24 th fraction of IMRT,and after treatment.The original plan(plan 0)was based on CT images collected before IMRT.Hybrid plan 1(plan 1)and hybrid plan 2(plan 2)were generated by applying the beam configurations of plan0 to the CT scans collected before the 24 th fraction of IMRT and after treatment.Volumetric and dosimetric variations were assessed by comparing the results of plan 0 with those of plan 1 and plan 2.Results In the NACT group,compared with that in plan 0,the primary gross tumor volume(GTVnx)decreased by 33.2%±18.4%and 50.5%±12.6%in plan1 and plan 2,respectively.In the CCRT group,the corresponding reduction rates in plan 1 and plan 2 were 49.4%±8.0%and 77.8%±28.1%,respectively.The volume decrease rates in the NACT group were less than those in the CCRT group(P<0.001).In the NACT group,compared with that of plan0,the dose to 95%of the volume(D95)for the planning target volume of the primary tumor(PTVnx)decreased by 1.0%±0.7%and 0.6%±0.6%in plan 1 and plan 2,respectively.In the CCRT group,the corresponding decrease rates in plan 1 and plan 2 were 4.2%±3.8%and 6.1%±6.3%,respectively.The decrease rate of D95 for PTVnx in the NACT group was less than that in the CCRT group(P<0.001).Similar results among the plans were found in terms of D99,Dmean,V93 for PTVnxand PTVnd,and Dmeanfor the parotid glands.Conclusion Neoadjuvant chemotherapy reduces the extent of volumetric and dosimetric variations in target volumes and OARs during IMRT and,thus,helps achieve better target volume coverage,protects adjacent important structures,and minimizes unnecessary replanning during radiotherapy.
文摘Objective To evaluate the long-term outcome and prognostic factors of patients with nasopharyngeal carcinoma(NPC)from low-endemic regions of China who received definitive intensity-modulated radiation therapy(IMRT).Methods The clinical data from 608 patients with newly-diagnosed non-metastatic NPC who have received initial treatment at our cancer center from January,2008 to December,2013 were retrospectively reviewed.All patients received definitive IMRT,and 87.7%received platinum-based chemotherapy.Results The median follow-up duration was 51 months(follow-up rate,98.5%;range,10–106 months)for the entire cohort.The 5-year overall survival rate was 79.7%.The 5-year local relapse-free survival rate,regional relapse-free survival rate,distant metastasis-free survival rate and progression-free survival rate were 92.4%,93.3%,79.2%and 74.3%,respectively.A total of 153 patients had experienced treatment failure,with distant metastasis as the primary cause in 77.1%(118/153).Patients with T4 or N3 diseases had a significantly poorer prognosis than other subcategories.Stage T4 and N3 were closely associated with distant metastasis,with the metastatic rate of 29.3%and 45.5%,respectively.Conclusion IMRT provides patients with non-metastatic NPC with satisfactory long-term survival.Both T stage and N stage are important prognostic factors for NPC patients.Patients with T4 or N3 diseases have significantly increased distant metastatic rates and poor survival time.
基金Supported by a grant from The Health Commission of Hubei Province Scientific Research Project(No.WJ2019M118).
文摘Objective The aiom of this study was to study the efficacy and safety of berberine as a prophylactic treatment of acute radiation proctitis in postoperative patients with cervical cancer.Methods A total of 120 postoperative patients with cervical cancer were enrolled between July 2016 and October 2019,and randomly divided into a treatment group(berberine 300 mg three times a day,n=60)and a control group(receiving vitamin C tablets,100 mg three times a day;n=60)using the random number table method.All patients received pelvic intensity-modulated radiation therapy(IMRT)and concurrent sensitizing chemotherapy weekly.The difference in the percentage of irradiation volume to the rectum and small intestine as well as the incidence,onset time,severity,and duration of acute radiation proctitis and cystitis during radiotherapy were compared between the two groups.The completion rate,completion time,number of chemotherapy sessions,and quality of life during radiotherapy were also compared.Results There were no statistical differences in age,FIGO stage,pathological type,complications,highrisk factors,and rectum and small intestine irradiation dose distribution(V20,V30,V40,and V50)between the two groups(P>0.05).No acute radiation proctitis of grade 3 or above occurred in the two groups.There was no significant difference in the incidence of acute radiation cystitis,grade 2 acute radiation proctitis,completion rate of IMRT,and frequency of sensitization chemotherapy between the two groups.After prophylactic treatment with berberine,the incidence of grade 1 acute radiation proctitis,occurrence of grade 1 radiation proctitis,and completion time of radiotherapy in the treatment group were significantly lower than those in the control group(P<0.05).The SF-36 score of the treatment group after radiotherapy was 67.53±4.21,which was significantly better than that of the control group(64.90±6.32;P<0.05).The incidence of grade 3-4 neutropenia in the treatment group was 10%and lower than that in the control group(31.7%,P=0.003).No adverse reactions related to berberine were observed.Conclusion Prophylactic prescription with oral berberine can reduce the incidence,onset time,and duration of grade 1 acute radiation proctitis,and improve the quality of life of postoperative patients with cervical cancer receiving concurrent chemoradiotherapy.
