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Comparison of Simplified Intensity-Modulated Radiotherapy versus 3-Dimensional Conformal Radiotherapy in Locally Advanced Cervical Cancer: A Dosimetric Study 认领 引用
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作者 Mamady Keita Chen Xi +4 位作者 Malick Bah Abou Camara Arbaba Balde Bangaly Traore Hong Liu 《Open Journal of Obstetrics and Gynecology》 2025年第2期240-249,共10页
Background: Early research describing the concept of intensity-modulated conformal radiotherapy (IMRT) was based on 7 to 9 beams to reach an adequate level of modulation. Nevertheless, its implementation demands signi... Background: Early research describing the concept of intensity-modulated conformal radiotherapy (IMRT) was based on 7 to 9 beams to reach an adequate level of modulation. Nevertheless, its implementation demands significant resources. Our objective was to compare the compliance and homogeneity of target dose distribution between simplified IMRT and 3D-CRT in patients with cervical cancer and to assess the clinical value of simplified IMRT. Materials and Methods: From 2016 to 2017, 17 patients with stage IIB - IIIC cervical cancer were treated with external beam radiotherapy using simplified IMRT (12 cases) or 3DCRT (05 cases) and brachytherapy. Prior to radiotherapy, CT scans were conducted to delineate the target volume. The clinical target volume (CTV) included the uterus, primary tumor, supravaginal portion of the cervix, paracervical tissue, common iliac, internal and external iliac lymph nodes, obturator, and pre sacral lymph nodes, and the surrounding tissues. If the lower vagina was involved, the target volume included the whole vagina. The planning target volume (PTV) included the CTV with 1 cm anteriorly and 0.5 cm in all other directions. The PTV received 95% of 45 Gy (1.8 Gy/25 fraction). Dose-volume histogram, conformity index, homogeneity index, and treatment time per fraction were compared. Results: The 3D-CRT plan was more homogeneous than the simplified IMRT plan, while the simplified IMRT plan was more conformal. The volume of small bowels that received high-dose radiation significantly increased with simplified IMRT compared to 3D-CRT. Treatment time per fraction was 6 and 13 minutes for 3D-CRT and simplified IMRT, respectively. Conclusion: The simplified IMRT treatment plan is technically and dosimetrically acceptable and an alternative to the classic 3D-CRT plan for cervical cancer. It provides better dose distribution than 3D-CRT. However, the 3D-CRT treatment plan significantly reduced the overall treatment time per fraction. 展开更多
关键词 Cervical Cancer Simplified Intensity-Modulated Radiotherapy 3D-CRT Dosimetry
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The Efficacy of Whole-Course Local Simultaneous Integrated Boost Intensity-Modulated Radiotherapy in the Treatment of Locally Advanced Esophageal Cancer and Its Impact on Immune Function 认领 引用
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作者 Lei Yuan Yujuan Gao 《Journal of Clinical and Nursing Research》 2025年第3期224-230,共7页
Objective:To analyze the efficacy of whole-course local simultaneous integrated boost intensity-modulated radiotherapy(SIB-IMRT)on patients with locally advanced esophageal squamous cell carcinoma(ESCC).Methods:88 pat... Objective:To analyze the efficacy of whole-course local simultaneous integrated boost intensity-modulated radiotherapy(SIB-IMRT)on patients with locally advanced esophageal squamous cell carcinoma(ESCC).Methods:88 patients with ESCC admitted to the hospital between October 2022 and October 2024 were selected and randomly divided into two groups using a random number table.The experimental group received SIB-IMRT treatment,while the control group received conventional intensity-modulated radiotherapy(C-IMRT).The objective remission rate,immune function,tumor markers,and adverse reaction rate were compared between the two groups.Results:The objective remission rate in the experimental group was higher than that in the control group(P0.05).After treatment,the immune function levels in the experimental group were better than those in the control group,and the tumor marker levels were lower than those in the control group(P<0.05).The adverse reaction rate in the experimental group was lower than that in the control group(P<0.05).Conclusion:SIB-IMRT can improve the objective remission rate of patients with ESCC,protect their immune function,down-regulate tumor marker levels,and prevent side effects after treatment. 展开更多
关键词 Whole-course local simultaneous integrated boost intensity-modulated radiotherapy Locally advanced esophageal squamous cell carcinoma Efficacy Immune function
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Intensity-modulated radiation therapy with concurrent chemotherapy for locally advanced cervical and upper thoracic esophageal cancer 认领 引用 被引量：27
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作者 Shu-Lian Wang Zhongxing Liao +4 位作者 Helen Liu( Jaffer Ajani Stephen Swisher James D Cox Ritsuko Komaki 《World Journal of Gastroenterology》 SCIE CAS 2006年第34期5501-5508,共8页
AIM： To evaluate the dosimetry, efficacy and toxicity of intensity-modulated radiation therapy （IMRT） and concurrent chemotherapy for patients with locally advanced cervical and upper thoracic esophageal cancer. ME... AIM： To evaluate the dosimetry, efficacy and toxicity of intensity-modulated radiation therapy （IMRT） and concurrent chemotherapy for patients with locally advanced cervical and upper thoracic esophageal cancer. METHODS： A retrospective study was performed on 7 patients who were definitively treated with IMRT and concurrent chemotherapy. Patients who did not receive IMRT radiation and concurrent chemotherapy were not included in this analysis. IMRT plans were evaluated to assess the tumor coverage and normal tissue avoidance. Treatment response was evaluated and toxicities were assessed. RESULTS： Five- to nine-beam IMRT were used to deliver a total dose of 59.4-66 Gy （median： 64.8 Gy） to the primary tumor with 6-MV photons. The minimum dose received by the planning tumor volume （PTV） of the gross tumor volume boost was 91.2%-98.2% of the prescription dose （standard deviation [SD]： 3.7%-5.7%）. The minimum dose received by the PTV Of the clinical tumor volume was 93.8%-104.8% （SD： 4.3%-11.1%） of the prescribed dose. With a median follow-up of 15 rno （range： 3-21 too）, all 6 evaluable patients achieved complete response. Of them, 2 developed local recurrences and 2 had distant metastases, 3 survived with no evidence of disease. After treatment, 2 patients developed esophageal stricture requiring frequent dilation and 1 patient developed tracheal-esophageal fistula. CONCLUSION： Concurrent IMRT and chemotherapy resulted in an excellent early response in patients with locally advanced cervical and upper thoracic esophageal cancer. However, local and distant recurrence and toxicity remain to be a problem. Innovative approaches are needed to improve the outcome. 展开更多
关键词 Esophageal cancer Intensity-modulated radiation therapy Chemotherapy
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Prognostic factors and failure patterns in non-metastatic nasopharyngeal carcinoma after intensity-modulated radiotherapy 认领 引用 被引量：53
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作者 Yan-Ping Mao Ling-Long Tang +7 位作者 Lei Chen Ying Sun Zhen-Yu Qi Guan-Qun Zhou Li-Zhi Liu Li Li Ai-Hua Lin Jun Ma 《Chinese Journal of Cancer》 2016年第12期673-682,共10页
Background: The prognostic values of staging parameters require continual re?assessment amid changes in diag?nostic and therapeutic methods. This study aimed to identify the prognostic factors and failure patterns of ... Background: The prognostic values of staging parameters require continual re?assessment amid changes in diag?nostic and therapeutic methods. This study aimed to identify the prognostic factors and failure patterns of non?meta?static nasopharyngeal carcinoma(NPC) in the intensity?modulated radiotherapy(IMRT) era.Methods: We reviewed the data from 749 patients with newly diagnosed, biopsy?proven, non?metastatic NPC in our cancer center(South China, an NPC endemic area) between January 2003 and December 2007. All patients under?went magnetic resonance imaging(MRI) before receiving IMRT. The actuarial survival rates were estimated using the Kaplan–Meier method, and survival curves were compared using the log?rank test. Multivariate analyses with the Cox proportional hazards model were used to test for the independent prognostic factors by backward eliminating insigniicant explanatory variables.Results: The 5?year occurrence rates of local failure, regional failure, locoregional failure, and distant failure were 5.4, 3.0, 7.4, and 17.4%, respectively. The 5?year survival rates were as follows: local relapse?free survival, 94.6%; nodal relapse?free survival, 97.0%; distant metastasis?free survival, 82.6%; disease?free survival, 75.1%; and overall survival, 82.0%. Multivariate Cox regression analysis revealed that orbit involvement was the only signiicant prognostic fac?tor for local failure(P = 0.011). Parapharyngeal tumor extension, retropharyngeal lymph node involvement, and the laterality, longest diameter, and Ho's location of the cervical lymph nodes were signiicant prognostic factors for both distant failure and disease failure(all P < 0.05). Intracranial extension had signiicant prognostic value for distant failure(P = 0.040).Conclusions: The key failure pattern for NPC was distant metastasis in the IMRT era. With changes in diagnostic and therapeutic technologies as well as treatment modalities, the signiicant prognostic parameters for local control have also been altered substantially. 展开更多
关键词 Nasopharyngeal carcinoma Intensity-modulated radiotherapy Prognosis Failure pattern Tumor staging
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Long-term outcomes of a phase Ⅱ randomized controlled trial comparing intensity-modulated radiotherapy with or without weekly cisplatin for the treatment of locally recurrent nasopharyngeal carcinoma 认领 引用 被引量：20
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作者 Ying Guan Shuai Liu +6 位作者 Han-Yu Wang Ying Guo Wei-Wei Xiao Chun-Yan Chen Chong Zhao Tai-Xiang Lu Fei Han 《Chinese Journal of Cancer》 2016年第4期181-189,共9页
Background:Salvage treatment for locally recurrent nasopharyngeal carcinoma(NPC) is complicated and relatively limited.Radiotherapy,combined with effective concomitant chemotherapy,may improve clinical treatment outco... Background:Salvage treatment for locally recurrent nasopharyngeal carcinoma(NPC) is complicated and relatively limited.Radiotherapy,combined with effective concomitant chemotherapy,may improve clinical treatment outcomes.We conducted a phase Ⅱ randomized controlled trial to evaluate the efficacy of intensity-modulated radiotherapy with concomitant weekly cisplatin on locally recurrent NPC.Methods:Between April 2002 and January 2008,69 patients diagnosed with non-metastatic locally recurrent NPC were randomly assigned to either concomitant chemoradiotherapy group(n = 34) or radiotherapy alone group(n = 35).All patients received intensity-modulated radiotherapy.The radiotherapy dose for both groups was 60 Gy in 27 fractions for 37 days(range 23-53 days).The concomitant chemotherapy schedule was cisplatin 30 mg/m^2 by intravenous infusion weekly during radiotherapy.Results:The median follow-up period of all patients was 35 months(range 2-112 months).Between concomitant chemoradiotherapy and radiotherapy groups,there was only significant difference in the 3-year and 5-year overall survival(OS) rates(68.7%vs.42.2%,P = 0.016 and 41.8%vs.27.5%,P = 0.049,respectively).Subgroup analysis showed that concomitant chemoradiotherapy significantly improved the 5-year OS rate especially for patients in stage rT3-4(33.0%vs.13.2%,P = 0.009),stages Ⅲ-Ⅳ(34.3%vs.13.2%,P = 0.006),recurrence interval >30 months(49.0%vs.20.6%,P = 0.017),and tumor volume >26 cm^3(37.6%vs.0%,P = 0.006).Conclusion:Compared with radiotherapy alone,concomitant chemoradiotherapy can improve OS of the patients with locally recurrent NPC,especially those with advanced T category(rT3-4) and stage(lll-IV) diseases,recurrence intervals >30 months,and tumor volume >26 cm^3. 展开更多
关键词 Recurrence Nasopharyngeal carcinoma Intensity-modulated radiation therapy Concomitant chemoradiotherapy Cisplatin
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Significant value of 18F-FDG-PET/CT in diagnosing small cervical lymph node metastases in patients with nasopharyngeal carcinoma treated with intensity-modulated radiotherapy 认领 引用 被引量：19
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作者 Hao Peng Lei Chen +11 位作者 Ling-Long Tang Wen-Fei Li Yan-Ping Mao Rui Guo Yuan Zhang Li-Zhi Liu Li Tian Xu Zhang Xiao-Ping Lin Ying Guo Ying Sun Jun Ma 《Chinese Journal of Cancer》 2017年第12期757-766,共10页
Background: Little is known about the nature of metaistasis to small cervical lymph nodes(SCLNS) in the patients with nasopharyngeal carcinoma(NPC)examined by using 18-fluoro-2-deoxy-glucose(18F-FDG) positron emiss... Background: Little is known about the nature of metaistasis to small cervical lymph nodes(SCLNS) in the patients with nasopharyngeal carcinoma(NPC)examined by using 18-fluoro-2-deoxy-glucose(18F-FDG) positron emission tomography/computed tomography(PET/CT).The present study aimed to evaluate the diagnostic values of PET/CT in identifying metastasis in SCLNs in NPC patients.Methods: Magnetic resonance images(MRI) and PET/CT scans for 470 patients with newly diagnosed, non-distant metastatic NPC were analyzed. Metastatic rates of SCLNs were defined by the positive number of SCLNs on PET/CT scans and total number of SCLNs on MRI scans. Receiver operating characteristic curve was applied to compare PET/CT-determined stage with MRI-determined stage.Results: In total, 2082 SCLNs were identified, with 808(38.8%) ≥ 5 and < 6 mm in diameter(group A), 526(25.3%)≥ 6 and < 7 mm in diameter(group B),374(18.0%)≥ 7 and < 8 mm in diameter(group C), 237(11.4%) ≥8 and<9 mm in diameter(group D),and 137(6.5%) ≥ 9 and <10 mm in diameter(group E).The overall metastatic rates examined by using PET/CT for groups A, B,C,D, and E were 3.5%, 8.0%, 31.3%, 60.0%, and 83.9%, respectively(P< 0.001). In level IV/Vb, the metastatic rate for nodes ≥ 8 mm was 84.6%. PET/CT examination resulted in modification of N category and overall stage for 135(28.7%) and 46(9.8%) patients, respectively. The areas under curve of MRIdetermined and PET/CT-determined overall stage were 0.659 and 0.704 for predicting overall survival, 0.661 and 0.711 for predicting distant metastasis-free survival, and 0.636 and 0.663 for predicting disease-free survival.Conclusions: PET/CT was more effective than MRI in identifying metastatic SCLNs, and the radiologic diagnostic criteria for metastatic lymph nodes in level IV/Vb should be re-defined. 展开更多
关键词 Nasopharyngeal carcinoma 18-fluoro-2-deoxy-glucose positron emission tomography with computed tomography (18F-PET/CT) Magnetic resonance image Intensity-modulated radiotherapy Small cervical lymph nodes
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A prospective trial of volumetric intensity-modulated arc therapy vs conventional intensity modulated radiation therapy in advanced head and neck cancer 认领 引用 被引量：3
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作者 Simon D Fung-Kee-Fung Rachel Hackett +2 位作者 Lee Hales Graham Warren Anurag K Singh 《World Journal of Clinical Oncology》 2012年第4期57-62,共6页
AIM:To prospectively compare volumetric intensitymodulated arc therapy(VMAT)and conventional intensity-modulated radiation therapy(IMRT)in coverage of planning target volumes and avoidance of multiple organs at risk(O... AIM:To prospectively compare volumetric intensitymodulated arc therapy(VMAT)and conventional intensity-modulated radiation therapy(IMRT)in coverage of planning target volumes and avoidance of multiple organs at risk(OARs)in patients undergoing definitive chemoradiotherapy for advanced(stageⅢorⅣ)squamous cell cancer of the head and neck.METHODS:Computed tomography scans of 20 patients with advanced tumors of the larynx,naso-,oroand hypopharynx were prospectively planned using IMRT(7 field)and VMAT using two arcs.Calculated doses to planning target volume(PTV)and OAR were compared between IMRT and VMAT plans.Dose-volume histograms(DVH)were utilized to obtain calculated doses to PTV and OAR,including parotids,cochlea,spinal cord,brainstem,anterior tongue,pituitary and brachial plexus.DVH's for all structures were compared between IMRT and VMAT plans.In addition the planswere compared for dose conformity and homogeneity.The final treatment plan was chosen by the treating radiation oncologist.RESULTS:VMAT was chosen as the ultimate plan in 18 of 20 patients(90%)because the plans were thought to be otherwise clinically equivalent.The IMRT plan was chosen in 2 of 20 patients because the VMAT plan produced concentric irradiation of the cord which was not overcome even with an avoidance structure.For all patients,VMAT plans had a lower number of average monitor units on average(MU=542.85)than IMRT plans(MU=1612.58)(P<0.001).Using the conformity index(CI),defined as the 95%isodose volume divided by the PTV,the IMRT plan was more conformal with a lower conformity index(CI=1.61)than the VMAT plan(CI=2.00)(P=0.003).Dose homogeneity,as measured by average standard deviation of dose distribution over the PTV,was not different with VMAT(1.45 Gy)or IMRT(1.73 Gy)(P=0.069).There were no differences in sparing organs at risk.CONCLUSION:In this prospective study,VMAT plans were chosen over IMRT 90%of the time.Compared to IMRT,VMAT plans used only one third of the MUs,had shorter treatment times,and similar sparing of OAR.Overall,VMAT provided similar dose homogeneity but less conformity in PTV irradiation compared to IMRT.This difference in conformity was not clinically significant. 展开更多
关键词 Volumetric intensity-modulated arc therapy Intensity-modulated radiation therapy Target coverage Organs at risk
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Intensified intensity-modulated radiotherapy in anal cancer with prevalent HPV p16 positivity 认领 引用 被引量：2
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作者 Liliana Belgioia Stefano Vagge +7 位作者 Dario Agnese Stefania Garelli Roberto Murialdo Giuseppe Fornarini Silvana Chiara Fabio Gallo Almalina Bacigalupo Renzo Corvò 《World Journal of Gastroenterology》 SCIE CAS 2015年第37期10688-10696,共9页
AIM: To investigate the toxicity and response of intensity-modulated radiotherapy schedule intensified with a simultaneous integrated boost in anal canal cancer.METHODS: From March 2009 to March 2014, we retrospective... AIM: To investigate the toxicity and response of intensity-modulated radiotherapy schedule intensified with a simultaneous integrated boost in anal canal cancer.METHODS: From March 2009 to March 2014, we retrospectively analyzed 41 consecutive patients treated with intensity-modulated radiotherapy(IMRT) and concurrent chemotherapy for anal canal squamous cell carcinoma at our center. Radiotherapy was delivered via simultaneous integrated boost(SIB) technique by helical tomotherapy, and doses were adapted to two clinical target volumes according to the tumor-nodemetastasis(TNM) stage: 50.6 Gy and 41.4 Gy in 23 fractions in T1N0, 52.8 Gy and 43.2 Gy in 24 fractionsin T2N0, and 55 Gy and 45 Gy in 25 fractions in all patients with N positive and/or ≥ T3, respectively, to planning target volumes 1 and 2. The most common chemotherapy regimen was 5-fluorouracil and mitomycin-based. Human papilloma virus(HPV) p16 expression was performed by immunohistochemistry and evaluated in the majority of patients. Acute and late toxicity was scored according to CTCAe v 3.0 and RTOG scales.RESULTS: The median follow-up was 30 mo(range:12-71). Median age was 63 years(range 32-84). The stage of disease was: stage Ⅰ in 2 patients, stage Ⅱin 13 patients, stage ⅢA in 12 patients, and stage ⅢB in 14 patients, respectively. Two patients were known to be HIV positive(4.9%). HPV p16 expression status was positive in 29/34(85.3%) patients. The 4-year progression-free survival and overall survival in HPVpositive patients were 78% and 92%, respectively.Acute grade 3 skin and gastrointestinal toxicities were reported in 5% and 7.3% of patients, respectively;patients' compliance to the treatment was good due to a low occurrence of severe acute toxicity, although treatment interruptions due to toxicity were required in 7.3% of patients. At 6 mo from end of treatment,36/40(90%) patients obtained complete response;during follow-up, 5(13.8%) patients presented with disease progression(local or systemic).CONCLUSION: In our experience, intensified SIBIMRT with chemotherapy is very feasible in clinical practice, with excellent results in terms of overall survival and local control. 展开更多
关键词 Anal canal cancer Intensity-modulated radiotherapy
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Long-term Therapeutic Outcome and Prognostic Factors of Patients with Nasopharyngeal Carcinoma Receiving Intensity-modulated Radiotherapy: An Analysis of 608 Patients from Low-endemic Regions of China 认领 引用 被引量：2
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作者 Jing HUANG Zhi-yong YANG +12 位作者 Bian WU Qian DING You QIN Zhan-jie ZHANG Zhong-yuan YIN Zhi-wen LIANG Jun HAN Ye WANG Zhen-jun PENG Gang PENG Qin LI Gang WU Kun-yu YANG 《Current Medical Science》 SCIE CAS 2021年第4期737-745,共9页
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
关键词 nasopharyngeal carcinoma long-term therapeutic outcome low-endemic regions of China intensity-modulated radiation therapy
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Prognostic value and predictive threshold of tumor volume for patients with locally advanced nasopharyngeal carcinoma receiving intensity-modulated radiotherapy 认领 引用 被引量：16
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作者 Yu-Xiang He Ying Wang +9 位作者 Peng-Fei Cao Lin Shen Ya-Jie Zhao Zi-Jian Zhang Deng-Ming Chen Tu-Bao Yang Xin-Qiong Huang Zhou Qin You-Yi Dai Liang-Fang Shen 《Chinese Journal of Cancer》 2016年第12期725-734,共10页
Background: Gross target volume of primary tumor(GTV?P) is very important for the prognosis prediction of patients with nasopharyngeal carcinoma(NPC), but it is unknown whether the same is true for locally advanced NP... Background: Gross target volume of primary tumor(GTV?P) is very important for the prognosis prediction of patients with nasopharyngeal carcinoma(NPC), but it is unknown whether the same is true for locally advanced NPC patients treated with intensity?modulated radiotherapy(IMRT). This study aimed to clarify the prognostic value of tumor volume for patient with locally advanced NPC receiving IMRT and to ind a suitable cut?of value of GTV?P for prognosis prediction.Methods: Clinical data of 358 patients with locally advanced NPC who received IMRT were reviewed. Receiver oper?ating characteristic(ROC) curves were used to identify the cut?of values of GTV?P for the prediction of diferent end?points [overall survival(OS), local relapse?free survival(LRFS), distant metastasis?free survival(DMFS), and disease?free survival(DFS)] and to test the prognostic value of GTV?P when compared with that of the American Joint Committee on Cancer T staging system.Results: The 358 patients with locally advanced NPC were divided into two groups by the cut?of value of GTV?P as determined using ROC curves: 219(61.2%) patients with GTV?P ≤46.4 mL and 139(38.8%) with GTV?P >46.4 mL. The 3?year OS, LRFS, DMFS, and DFS rates were all higher in patients with GTV?P ≤46.4 mL than in those with GTV?P > 46.4 mL(all P 46.4 mL was an independent unfavorable prognostic factor for patient survival. The ROC curve veriied that the predictive ability of GTV?P was superior to that of T category(P 46.4 mL is an independent unfavorable prognostic indi?cator for survival after IMRT, with a prognostic value superior to that of T category. 展开更多
关键词 Nasopharyngeal carcinoma Intensity-modulated radiotherapy Gross target volume of primary tumor Prognosis
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Clinical treatment considerationsin the intensity-modulated radiotherapy era for patients with NO-category nasopharyngeal carcinoma and enlarged neck lymph nodes 认领 引用 被引量：6
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作者 Hao Peng Lei Chen +8 位作者 Rui Guo Yuan Zhang Wen.Fei Li Yan.Ping Mao Ying Sun Fan Zhang Li.Zhi Liu Li Tian Jun Ma 《Chinese Journal of Cancer》 2017年第7期306-314,共9页
Background:Nasopharyngeal carcinoma(NPC) shows a high proportion of lymph node metastasis,and treatment guidelines have been developed for positive nodes.However,no irradiation guidelines have been proposed for patien... Background:Nasopharyngeal carcinoma(NPC) shows a high proportion of lymph node metastasis,and treatment guidelines have been developed for positive nodes.However,no irradiation guidelines have been proposed for patients with enlarged neck lymph nodes(ENLNs) that do not meet the radiological criteria of 10 mm in diameter for positive lymph nodes.This study aimed to determine the prognostic value and radiation dose for ENLNs in NO-category NPC patients treated with intensity-modulated radiotherapy(IMRT).Methods:We reviewed the medical data of 251 patients with non-metastatic,NO-category NPC treated with IMRT.Receiver operating characteristic curves were used to calculate the cut-off value of the ENLN diameter for the prediction of disease failure.The biological equivalent dose(BED) for ENLNs was calculated.Patient survival was compared between the small and large ENLN groups.Independent prognostic factors were identified using the Cox proportional hazards model.Results:The estimated 4-year regional relapse-free survival rate was higher in patients with ENLNs ≥5.5 mm than in those with ENLNs 0.05 for all survival rates).In the subgroup analysis,patients receiving BED ≥72 Gy had a similar prognosis as patients receiving BED <72 Gy in both the small and large ENLN groups.The multivariate analysis also confirmed that BED≥72 Gy was not associated with significantly improved prognosis in patients with NO-category NPC.Conclusions:A BED of 72 Gy to ENLNs is considerably sufficient to provide a clinical benefit to patients with NO-category NPC.Prospective studies are warranted to validate the findings in the present study. 展开更多
关键词 Nasopharyngeal carcinoma N0-category Enlarged neck lymph node Biological equivalent dose Intensity-modulated radiotherapy Prognosis
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Prognostic scoring system for locoregional control among the patients with nasopharyngeal carcinoma treated by intensity-modulated radiotherapy 认领 引用 被引量：10
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作者 Chang-Juan Tao Xu Liu +9 位作者 Ling-Long Tang Yan-Ping Mao Lei Chen Wen-Fei Li Xiao-Li Yu Li-Zhi Liu Rong Zhang Ai-Hua Lin Jun Ma Ying Sun 《Chinese Journal of Cancer》 2013年第9期494-501,共8页
The prognostic value of T category for locoregional control in patients with nasopharyngeal carcinoma(NPC)has decreased with the extensive use of intensity-modulated radiotherapy(IMRT).We aimed to develop a prognostic... The prognostic value of T category for locoregional control in patients with nasopharyngeal carcinoma(NPC)has decreased with the extensive use of intensity-modulated radiotherapy(IMRT).We aimed to develop a prognostic scoring system(PSS)that incorporated tumor extension and clinical characteristics for locoregional control in NPC patients treated with IMRT.The magnetic resonance imaging scans and medical records of 717 patients with nonmetastatic NPC treated with IMRT at Sun Yat-sen University Cancer Center between January 2003 and January 2008 were reviewed.Age,pathologic classification,primary tumor extension,primary gross tumor volume(GTV-p),T and N categories,and baseline lactate dehydrogenase(LDH)level were analyzed.Hierarchical cluster analysis as well as univariate and multivariate analyses were used to develop the PSS.Independent prognostic factors for locoregional relapse included N2–3 stage,GTV-p≥26.8 mL,and involvement of one or more structures within cluster3.We calculated a risk score derived from the regression coefficient of each factor and classified patients into four groups:low risk(score 0),intermediate risk(score>0 and≤1),high risk(score>1 and≤2),and extremely high risk(score>2).The 5-year locoregional control rates for these groups were 97.4%,93.6%,85.2%,and 78.6%,respectively(P<0.001).We have developed a PSS that can help identify NPC patients who are at high risk for locoregional relapse and can guide individualized treatments for NPC patients. 展开更多
关键词 Nasopharyngeal carcinoma prognostic scoring system Iocoregional control intensity-modulated radiotherapy
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A model to predict the risk of lethal nasopharyngeal necrosis after re-irradiation with intensity-modulated radiotherapy in nasopharyngeal carcinoma patients 认领 引用 被引量：6
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作者 Ya-Hui Yu Wei-Xiong Xia +9 位作者 Jun-Li Shi Wen-Juan Ma Yong Li Yan-Fang Ye Hu Liang Liang-Ru Ke Xing Lv Jing Yang Yan-Qun Xiang Xiang Guo 《Chinese Journal of Cancer》 2016年第11期617-624,共8页
Background:For patients with nasopharyngeal carcinoma(NPC) who undergo re-irradiation with intensity-modulated radiotherapy(IMRT),lethal nasopharyngeal necrosis(LNN) is a severe late adverse event.The purpose of this ... Background:For patients with nasopharyngeal carcinoma(NPC) who undergo re-irradiation with intensity-modulated radiotherapy(IMRT),lethal nasopharyngeal necrosis(LNN) is a severe late adverse event.The purpose of this study was to identify risk factors for LNN and develop a model to predict LNN after radical re-irradiation with IMRT in patients with recurrent NPC.Methods:Patients who underwent radical re-irradiation with IMRT for locally recurrent NPC between March 2001 and December 2011 and who had no evidence of distant metastasis were included in this study.Clinical characteristics,including recurrent carcinoma conditions and dosimetric features,were evaluated as candidate risk factors for LNN.Logistic regression analysis was used to identify independent risk factors and construct the predictive scoring model.Results:Among 228 patients enrolled in this study,204 were at risk of developing LNN based on risk analysis.Of the 204 patients treated,31(15.2%) developed LNN.Logistic regression analysis showed that female sex(P = 0.008),necrosis before re-irradiation(P = 0.008),accumulated total prescription dose to the gross tumor volume(GTV) ≥ 145.5 Gy(P = 0.043),and recurrent tumor volume >25.38 cm3(P = 0.009) were independent risk factors for LNN.A model to predict LNN was then constructed that included these four independent risk factors.Conclusions:A model that includes sex,necrosis before re-irradiation,accumulated total prescription dose to GTV,and recurrent tumor volume can effectively predict the risk of developing LNN in NPC patients who undergo radical re-irradiation with IMRT. 展开更多
关键词 Nasopharyngeal carcinoma Re-irradiation Intensity-modulated radiotherapy Necrosis
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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 认领 引用 被引量：1
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作者 Yi Cheng Nan Huang +3 位作者 Jing Zhao Jianhua Wang Chen Gong Kai Qin 《Oncology and Translational Medicine》 CAS 2019年第1期25-29,共5页
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... 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 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). 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. 展开更多
关键词 simultaneous integrated dose-increasing intensity-modulated radiation therapy late-course dose-increasing intensity-modulated radiation therapy cervical cancer complicated with pelvic lymph node metastasis clinical efficacy safety
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Treatment outcomes for different subgroups of nasopharyngeal carcinoma patients treated with intensity-modulated radiation therapy 认领 引用 被引量：42
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作者 Sheng-Fa Su Fei Han +5 位作者 Chong Zhao Ying Huang Chun-Yan Chen Wei-Wei Xiao Jia-Xin Li Tai-Xiang Lu 《Chinese Journal of Cancer》 2011年第8期565-573,共9页
Although many studies have investigated intensity-modulated radiation therapy(IMRT)for nasopharyngeal carcinoma(NPC),sample sizes in the reported studies are usually small and different in outcomes in different T and ... Although many studies have investigated intensity-modulated radiation therapy(IMRT)for nasopharyngeal carcinoma(NPC),sample sizes in the reported studies are usually small and different in outcomes in different T and N subgroups are seldom analyzed.Herein,we evaluated the outcomes of NPC patients treated with IMRT and further explored treatment strategy to improve such outcome.We collected clinical data of 865 NPC patients treated with IMRT alone or in combination with chemotherapy,and classified all cases into the following prognostic categories according to different TNM stages:early stage group(T1-2N0-1M0),advanced local disease group(T3-4N0-1M0),advanced nodal disease group(T1-2N2-3M0),and advanced locoregional disease group(T3-4N2-3M0).The 5-year overall survival(OS),local relapse-free survival(LRFS),and distant metastases-free survival(DMFS)were 83.0%,90.4%,and 84.0%,respectively.The early disease group had the lowest treatment failure rate,with a 5-year OS of 95.6%.The advanced local disease group and advanced nodal disease group had similar failure pattern and treatment outcomes as well as similar hazard ratios for death(4.230 and 4.625,respectively).The advanced locoregional disease group had the highest incidence of relapse and death,with a 5-year DMFS and OS of 62.3%and 62.2%,respectively,and a hazard ratio for death of 10.402.Comparing with IMRT alone,IMRT in combination with chemotherapy provided no significant benefit to locoregionally advanced NPC.Our results suggest that the decision of treatment strategy for NPC patients should consider combinations of T and N stages,and that IMRT alone for early stage NPC patients can produce satisfactory results.However,for advanced local,nodal,and locoregional disease groups,a combination of chemotherapy and radiotherapy is recommended. 展开更多
关键词 Nasopharyngeal carcinoma intensity-modulated radiation therapy stratification treatment
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Intensity-modulated Radiotherapy for Sinonasal Teratocarcinosarcoma 认领 引用 被引量：1
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作者 彭纲 柯杨 +3 位作者 王涛 冯一鸣 李跃华 伍钢 《Journal of Huazhong University of Science and Technology(Medical Sciences)》 2011年第6期857-860,共4页
Surgical excision and postoperative radiotherapy are widely accepted therapeutic modalities for sinonasal teratocarcinosarcoma （SNTCS）. Previous studies have shown that intensity-modulated radiation therapy （IMRT）... Surgical excision and postoperative radiotherapy are widely accepted therapeutic modalities for sinonasal teratocarcinosarcoma （SNTCS）. Previous studies have shown that intensity-modulated radiation therapy （IMRT） is safe and effective for the treatment of some sinonasal malignancies. We hypothesize that use of IMRT for SNTCS may result in clinical benefits. We report here two cases of SNTCS that were treated by IMRT. One patient was given extensive IMRT involving elective neck irradiation. Follow-up examinations revealed no recurrence and metastasis 3.5 years after IMRT. Another patient simultaneously suffered from multiple systematical diseases and was administered involved-field radiotherapy. He was found to have a marginal recurrence during the follow up and eventually died 8 months after disease diagnosis. It was suggested in this study that appropriate use of IMRT for the treatment of SNTCS may achieve excellent local control. 展开更多
关键词 sinonasal teratocarcinosarcoma radiotherapy head and neck cancer intensity-modulated radiation therapy paranasal sinus
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COMBINATION OF PRONE POSITION AND INTENSITY-MODULATED RADIATION THERAPY (IMRT) REDUCES SMALL BOWEL DOSES IN RADIATION THERAPY FOR GYNECOLOGIC MALIGNANCIES 认领 引用
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作者 李文彬 李明华 +1 位作者 乐维婕 Nina A. Mayr 《Chinese Journal of Cancer Research》 CAS 2006年第1期51-56,共6页
Objective： To evaluate if the combination of both prone position on a belly board and intensity-modulated radiotherapy （IMRT） further reduces the radiation dose to small bowel in pelvic RT for gynecologic malignanc... Objective： To evaluate if the combination of both prone position on a belly board and intensity-modulated radiotherapy （IMRT） further reduces the radiation dose to small bowel in pelvic RT for gynecologic malignancies. Methods： Conformal pelvic RT plans were computed in 13 patients with gynecologic malignancies who had pre-existing planning computed tomography （CT） scans in both the supine position and prone position on a belly board. There were 10 cervical cancer and 3 endometrial cancer patients. A limited arc technique （180° arc length） and an extended arc technique （340° arc length） were used in IMRT plans. Normal tissue regions of interest （ROI） included small bowel, large bowel and bladder. Dose and volume for normal tissue structures were traced and compared between supine and prone plans using the paired t-test. Results： For the limited arc technique, prone position using a belly board device improved small bowel sparing. Analysis of the results showed a 12~26 Gy reduction of volume of small bowel irradiation compared to the supine position. With the extended arc technique, there was no obvious radiation reduction in the prone position. Large bowel and bladder dose showed no significant differences between prone and supine position with either technique. Conclusion： Prone positioning on a belly board decreases the small bowel dose in gynecologic pelvic IMRT, and the magnitude of improvement depended on the limited arc IMRT technique used. 展开更多
关键词 Intensity-modulated radiotherapy Bowel complications Patient positioning Gynecologic malignancies Radiotherapy
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Dosimetric analysis of tomotherapy-based intensity-modulated radiotherapy with and without bone marrow sparing for the treatment of cervical cancer 认领 引用
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作者 Fuli Zhang Weidong Xu +8 位作者 Huayong Jiang Yadi Wang Junmao Gao Qingzhi Liu Na Lu Diandian Chen Bo Yao Jianping Chen Heliang He 《Oncology and Translational Medicine》 CAS 2015年第3期135-139,共5页
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
关键词 cervical neoplasm helical tomotherapy intensity-modulated radiotherapy （IMRT） dosimetry
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Pre-treatment verification of intensity-modulated radiation therapy in paediatric patients: adequate estimation for tolerance limits 认领 引用
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作者 Ehab M. Attalla Hassan Shafik +3 位作者 Hany Ammar Ismail Eldesoky Mohamed Farouk Shimaa Shoier 《The Chinese-German Journal of Clinical Oncology》 2012年第11期621-625,共5页
Objective: The objective of this work was to establish adequate tolerance limits based on a certain defined institutional indices and generate published data presenting our results to the radiotherapy community. Metho... Objective: The objective of this work was to establish adequate tolerance limits based on a certain defined institutional indices and generate published data presenting our results to the radiotherapy community. Methods: One hundred paediatric patients were treated using 6-MV X-ray beams produced by Siemens ONCOR Expression linear accelerator. The clinical step-and-shoot intensity-modulated radiation therapy (IMRT) treatment plans were designed using KonRad release 2.2.23. For two treatment sites (abdomen, head and neck), the fluence maps generated by the treatment planning system were all delivered for the quality assurance (QA) which included absolute dose verification for all treatment fields, relative dose verification for each treatment field. Results: The 724 fluence maps were analyzed at three different criteria using the gamma index tool. The 3% dose difference of local prescribed dose /3 mm was considered adequate. The passing rate for all fields of all plans always exceeded 70%. The dose differences between the measured and calculated doses ranged from -2.2% to +4% [mean and standard deviation (s): 1.4 ± 1.5] for the abdominal case, and from -3.3% to +5.6% (1.3 ± 1.6) for head and neck case with total confidence limit 0.046 (4.6%). The 14/100 (14%) of the absolute point dose measurements were out of ±3% from the dose predicted by the treatment planning system. Only two cases were below -3%, while 12 cases over +3%. Conclusion: At 3% dose difference of local prescribed dose /3 mm criteria, a 75% passing a gamma criterion and 3% for absolute point dose can be achieved for abdomen and head and neck treatments site. We considered the tolerance limits based on these indices for IMRT QA adequate. 展开更多
关键词 intensity-modulated radiation therapy （IMRT） quality assurance （QA） tolerance paediatric patient
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Three-dimensional conformal intensity-modulated radiation therapy of left femur foci does not damage the sciatic nerve 认领 引用 被引量：6
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作者 Wanlong Xu Xibin Zhao +6 位作者 Qing Wang Jungang Sun Jiangbo Xu Wenzheng Zhou Hao Wang Shigui Yan Hong Yuan 《Neural Regeneration Research》 SCIE CAS CSCD 2014年第20期1824-1829,共6页
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 surrou... 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. 展开更多
关键词 nerve regeneration three-dimensional conformal intensity-modulated radiation thera-py hydatid disease sciatic nerve neurons radiation damage succinate dehydrogenase NSFC grants neural regeneration
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