论著

MR引导的海马保护用于小细胞肺癌全脑放疗

Hippocampal avoidant whole brain radiotherapy guided by MR of small cell lung cancer

:330-337
 
目的 研究核磁共振(MR)引导的海马保护技术应用于小细胞肺癌全脑放射治疗(放疗)的效果。方法 对确定行全脑放疗的30例小细胞肺癌脑转移患者,行常规放疗CT定位后以定位体位行全头颅MR平扫,将计算机断层扫描(CT)和MR的T1加权像在Monaco 5.1计划系统上进行精准融合,勾画全脑放疗及海马区域,在海马区域三维方向上分别外扩5、15 mm作为海马与计划靶区之间的剂量跌落,每一例患者在Monaco 5.1计划系统上按照不保护海马组织以及外扩5、15 mm进行保护设计3个容积旋转调强技术(VMAT)放疗计划,观察海马组织的平均及最大放疗剂量。结果 增加保护海马组织之后,3个放疗计划的D100均≥95%,每例的3个放疗计划间D100比较差异无统计学意义(P>0.05);设置外扩5、15 mm的剂量跌落区后,左、右海马的平均剂量、最大剂量均明显降低,而且3个放疗计划的海马平均剂量、最大剂量之间对比差异有统计学意义。结论 小细胞肺癌脑转移患者进行全脑放疗时,利用MR引导的海马保护技术并设置外扩15 mm的剂量跌落区,能够显著降低海马的剂量,达到保护目的。
Objective To explore the application of MR guided hippocampal avoidant whole brain radiotherapy(WBRT)for small cell lung cancer(SCLC).Methods Thirty SCLC patients with brain metastases who underwent WBRT were enrdled.After routine CT localization was performed,and a head MR was performed in a the same position.T1 weighted images of MR and CT images were accurately fused on the Monaco 5.1 planning system.The entire brain tissue and hippocampus region were delineated. The dose drop areas between the hippocampus and the planned target area were expanded 5mm and 15mm in the three-dimensional direction of the hippocampus,respectively.Three volumetric modulated arc therapy(VMAT)radiotherapy plans were designed for each patient on the Monaco 5.1 planning system based on whether the hippocampal tissue was avoid.The average and maximum doses of hippocampal tissue were observed.Results After the avoidance of hippocampal tissue,the D100 of the three radiotherapy plans reached ≥95%,and there was no significant difference in D100 between the three radiotherapy plans in each case.After setting dose drop areas of 5mm and 15mm for external expansion,the average and maximum doses of the left and right hippocampus were significantly reduced,and there was a significant difference in the comparison between the average and maximum doses in the hippocampus of the three radiotherapy plans.Conclusions MR guided hippocampal avoidant technology and the setting of a 15 mm dose drop area can significantly reduce the dose to the hippocampus in patients with SCLC undergo whole brain radiotherapy.
论著

容积调强在全脊柱骨多发转移瘤放疗中应用研究

Research on the application of volumetric modulated arc therapy in the radiotherapy for multiple bone metastases in the whole spine

:69-75
 
目的 探讨容积调强(VMAT)在全脊柱骨多发转移瘤放疗中的运用,观察疗效及安全性。方法 选取 2018年1月—2021年1月本科室收治的50例全脊柱骨多发转移瘤姑息止痛放疗的临床资料,分别对全脊柱靶区设计适形放疗(CRT)和VMAT多中心计划,运用剂量体积直方图及所对应的统计表评估靶区及危及器官剂量覆盖情况,放疗结束后通过1-8周视觉模拟评分法评价近期疗效,每3个月复查全脊柱MRI观察放疗不良反应。结果 采用VMAT技术放疗靶区剂量覆盖度、靶区适形指数和剂量均匀指数均优于CRT技术(P<0.01),照射野重叠区未见明显剂量热点和冷点。采用VMAT技术危及器官V5 Gy受照体积高于CRT(P<0.01),除了胃、胰腺和小肠,危及器官V10 Gy受照体积高于CRT(P<0.01或P<0.05),危及器官V20 Gy受照体积则低于CRT(P<0.01),除了肾,危及器官V30 Gy受照体积也低于CRT(P<0.01)。采用VMAT技术时危及器官的最大受照量低于CRT(P<0.01或P<0.05),但除了心脏、胰腺和小肠,VMAT技术的危及器官平均受照量高于CRT(P<0.01或P<0.05)。采用VMAT技术较CRT出束时间增加(P<0.01),采用CRT时技师摆位时间较VMAT增加(P<0.05),对于总治疗时间VMAT较CRT增加(P<0.01)。8周后评估疼痛完全缓解16例,部分缓解 22例,轻度缓解8例,无效4例,总有效率为76%。随访日期截至2021年 12月,所有配合随诊的患者3、6、9、12个月全脊柱MRI复查结果显示,VMAT技术照射野内重叠处均未见脊髓及其他组织急慢性损伤情况。结论 VMAT技术对长靶区多中心放疗剂量分布均匀,近期疗效显著,安全性良好。
Objective To investigate the application of volumetric modulated arc therapy(VMAT) in the radiotherapy for multiple bone metastases in the whole spine,and observe of efficacy and evaluation of safety.Methods The clinical data were selected from 50 patients who were treated in our department between January 2018 and January 2021 with palliative analgesic radiotherapy for multiple metastases of the whole spine.Conformal radiotherapy(CRT)and multicenter VMAT plans were respectively applied to target areas of whole spine,and dose volume histogram was used to evaluate the dose coverage of target area and organ at risk(OAR). After radiotherapy,the short-term efficacy was evaluated by visual analog scale in between 1-8 weeks,and the whole spine MRI was reviewed every 3 months to observe the adverse reactions of radiotherapy.Results The dose coverage,target conformality index and homogeneity index of VMAT treatment were significantly better than those of CRT treatment(P<0.01),and no obvious dose hotspots and cold spots were observed in the overlapping area of irradiation field. When VMAT treatment was applied,the exposure volume of V5 Gy in OAR was significantly higher when compared with CRT treatment(P<0.01).Except for stomach,pancreas and small intestine,the exposure volume of V10 Gy in OAR was significantly higher for VMAT treatment when compared with CRT treatment (P<0.01 or P<0.05).When VMAT treatment was applied,the exposure volume of V20 Gy in OAR was significantly lower when compared with CRT treatment(P<0.01),and except for kidney,the exposure volume of V30 Gy in OAR was significantly lower when compared with CRT treatment(P<0.01).When VMAT treatment was applied,the maximum exposure of OAR was significantly lower than that of CRT(P<0.01 or P<0.05),however,except for the heart,pancreas and small intestine,the average exposure of VMAT treatment to OAR was higher than that of CRT (P<0.01 or P<0.05).Compared with CRT,VMAT treatment had significantly increased beam-out time(P<0.01),the therapist setting time of CRT was increased when compared with that of VMAT(P<0.05),and the total treatment time of VMAT was increased when compared with that of CRT(P<0.01). In the assessment 8 weeks after the treatments,16 patients had complete pain relief,22 had partial relief,8 had mild relief,and 4 had no effect,which total effective rate was 76%.The follow-up was ended in December 2021.There was no acute or chronic injury to the spinal cord and other tissues in the overlapping areas of the irradiation fields observed for all follow-up patients in the 3rd,6th,9th and 12th month whole-spine MRI re-examination.Conclusions VMAT has uniform dose distribution in multi-center radiotherapy for long target areas,with significant short-term efficacy and safety.
论著

化疗联合调强放疗治疗老年(≥65岁)局部晚期鼻咽癌的临床疗效

Clinical efficacy of chemotherapy combined with intensity-modulated radiotherapy in the treatment of elderly(≥65 years old)locally advanced nasopharyngeal carcinoma

:40-44
 
目的 探析化疗联合调强放疗(IMRT)治疗老年(≥65岁)局部晚期鼻咽癌的临床效果。方法 选取2018年1月—2019年1月我院诊治的90例老年局部晚期鼻咽癌患者为研究对象,使用随机数表法将此90例患者分为观察组及对照组,各45例。观察组行IMRT,对照组行化疗联合IMRT,对比2组的效果。结果 2组的治疗总有效率均为100%,组间差异不显著(P<0.05)。观察组的生活质量改善率(93.33%)高于对照组(77.78%)(P<0.05)。对照组出现3~4级白细胞减少、呕吐、黏膜炎人数明显高于观察组(P<0.05),两者其他毒副反应比较无显著差异(P>0.05)。观察组的1年总体生存率(91.11%)及3年总体生存率(75.56%)均高于对照组(86.67%、68.89%)(P<0.05)。结论 对于老年局部晚期鼻咽癌,化疗联合IMRT相比单纯IMRT降低了远期生存率,增加了毒副反应并影响疗后生活质量的改善,不宜常规应用,单纯IMRT可能是更合适的治疗选择。
Objective To explore the clinical effect of chemotherapy combined with intensity modulated radiation therapy(IMRT)in the treatment of elderly(≥65 years old)locally advanced nasopharyngeal carcinoma.Methods The study was carried out from January 2018 to January 2019.During this period,90 elderly patients with locally advanced nasopharyngeal carcinoma who were diagnosed and treated in our hospital were selected as the research objects.The random number table method was used to divide the 90 patients into observation groups,and the control group,each with 45 cases.The observation group was treated with IMRT,and the control group was treated with chemotherapy combined with IMRT.The effects of the two groups were compared.Results The total effective rate of the two groups was 100%,and there was no significant difference between the two groups(P<0.05).The improvement rate of quality of life in the observation group(93.33%)was higher than that in the control group(77.78%,P<0.05).The number of grade 3-4 leukopenia,vomiting and mucositis in the control group was significantly higher than that in the observation group(P<0.05),and there was no significant difference in other side effects between the two groups(P>0.05).The 1-year overall survival rate(91.11%)and 3-year overall survival rate(75.56%)of the observation group were higher than those of the control group(86.67%,68.89%,P<0.05).Conclusions For locally advanced nasopharyngeal carcinoma in the elderly,chemotherapy combined with IMRT reduces the long-term survival rate,increases the toxic and side effects and affects the improvement of the quality of life after treatment.It is not suitable for routine application,and IMRT alone may be a more appropriate treatment choice.
论著

老年食管鳞癌患者单纯放疗和同步放化疗的临床观察

Clinical observation of radiotherapy only and concurrent chemoradiotherapy in elderly patients with esophageal squamous cell carcinoma

:35-38
 
目的 探究老年食管鳞癌患者单纯放疗、同步放化疗临床治疗效果。方法 选我院2018年1月—2020年12月期间90例老年食管鳞癌患者为研究对象,依据不同治疗方式将其分为对照组、观察组,各45例,分别接受单纯放疗、同步放化疗治疗,比较2组治疗效果及治疗安全性。结果 观察组治疗总有效率为75.56%,与对照组60.00%相近(P>0.05);观察组疾病控制率为97.78%,较对照组84.44%高(P<0.05);观察组放射性肺炎、骨髓抑制发生率为24.44%、77.78%,较对照组6.67%、48.89%高;且观察组放射性肺炎、骨髓抑制、放射性食管炎2级占比分别为17.78%、35.56%、57.78%,均较对照组2.22%、8.89%、24.44%高(P<0.05)。结论 在老年食管鳞癌患者治疗中,与单纯放疗相比,同步放化疗可提升疾病控制能力,但会增加治疗不良反应,增加不良反应严重程度,因此在临床治疗中,需慎重选择。
Objective To explore the clinical effect of radiotherapy only and concurrent chemoradiotherapy in elderly patients with esophageal squamous cell carcinoma. Methods Ninety cases of elderly patients with esophageal squamous cell carcinoma in our hospital from January 2018 to December 2020 were selected as research objects.According to different treatment methods, they were divided into control group and observation group, 45 cases in each group.They were treated with radiotherapy and concurrent chemoradiotherapy respectively.The treatment effect and safety of the two groups were compared. Results The total effective rate of the observation group was 75.56%, which was close to the control group (60.00%, P>0.05). The disease control rate of the observation group was 97.78%, which was higher than control group (84.44%, P<0.05). The incidence of radiation pneumonia and bone marrow suppression of the observation group were 24.44% and 77.78%, which were higher than that of the control group (6.67%, 48.89%). The proportion of radiation pneumonia, bone marrow suppression, radiation esophagitis grade 2 of the observation group were 17.78%, 35.78% and 57.78% respectively, higher than that of the control group (2.22%, 8.89%, 24.44% respectively, P<0.05). Conclusion Compared with radiotherapy only, concurrent chemoradiotherapy improved the ability of disease control in elderly patients with esophageal squamous cell carcinoma, but it increased the adverse reactions and aggravated the severity of adverse reactions.Therefore, it is necessary to make a careful choice in clinical treatment.
论著

自适应调强放疗同步铂类化疗治疗局部晚期宫颈癌患者的可行性分析

Feasibility analysis of adaptive intensity modulated radiotherapy combined with platinum-based chemotherapy in the treatment of local advanced cervical cancer

:93-96
 
目的 研究自适应调强放疗(ART)同步铂类化疗治疗局部晚期宫颈癌患者的可行性。方法 选取我院诊治的92例局部晚期宫颈癌患者,随机分为研究组与对照组各46例,其中对照组行调强放疗(IMRT)同步铂类化疗,研究组行ART同步铂类化疗。治疗8周后,比较2组患者临床疗效;于治疗前后比较2组患者肿瘤标志物[癌胚抗原(CEA)、鳞状细胞癌抗原(SCC-Ag)]水平;以急性放射损伤分级标准(RTOG)和常见不良反应事件评价标准(CTCAE)比较2组患者不良反应发生情况。结果 治疗8周后,研究组客观缓解率高于对照组(P<0.05);2组患者CEA、SCC-Ag水平均较治疗前降低,且研究组低于对照组 (P<0.05);研究组基于RTOG的消化道反应等级与泌尿系统反应等级均低于对照组(P<0.05);2组患者基于CTCAE的肝功能损害与皮疹评级相比,差异无统计学意义(P>0.05)。结论 ART同步铂类化疗治疗局部晚期宫颈癌患者疗效较好,使患者病情好转,同时安全性突出,切实可行。
Objective To study the feasibility of adaptive radiotherapy (ART) combined with platinum chemotherapy in the treatment of locally advanced cervical cancer. Methods A total of 92 patients with locally advanced cervical cancer treated in our hospital were randomly divided into study group and control group, with 46 cases in each group. The control group received intensity-modulated radiation therapy (IMRT) combined with platinum chemotherapy and the study group received ART combined with platinum chemotherapy. After 8 weeks of treatment, the clinical effects of the two groups were compared. The levels of tumor markers [carcinoembryonic antigen (CEA) and squamous cell carcinoma associated antigen (SCC-Ag)] were compared between the two groups before and after treatment. The incidence of adverse reactions in the two groups was compared with the grading standard of Acute Radiation Injury Group (RTOG) and Common Terminology Criteria for Adverse Events (CTCAE). Results After 8 weeks of treatment, the Objective remission rate in the study group was higher than that in the control group (P<0.05). The levels of CEA and SCC-Ag in the study group were significantly lower than those in the control group (P<0.05). The reaction grades of digestive tract and urinary system based on RTOG in the study group were significantly lower than those in the control group (P<0.05). There was no significant difference in CTCAE based liver function impairment and rash rating between the two groups (P> 0.05). Conclusions ART combined with platinum chemotherapy is effective and safe in the treatment of locally advanced cervical cancer.
临床诊疗

鼻咽癌调强放疗后颞颌关节损伤患者的生存分析

Survival analysis of patients with temporomandibular joint injury after nasopharyngeal carcinoma treated with intensity-modulated radiotherapy

:55-58
 
目的 评价调强放疗后颞颌关节损伤的鼻咽癌患者的生存情况。方法 2010年2月—2013年11月期间90例经调强放疗后出现颞颌关节损伤的鼻咽癌患者,鼻咽病灶放疗剂量70~74Gy/32~33f,转移淋巴结放疗剂量64~70Gy/32~33f,高危区预防性放疗剂量58~66Gy/32~33f,低危区预防性放疗剂量54~58Gy/32~33f,采用顺铂、奈达铂或多西他赛行同步化疗。回顾性分析患者的张口困难程度、近期疗效、无局部复发生存、无远处转移生存及总生存情况,同时评价放疗毒副反应。结果 ①颞颌关节损伤:97.8%的患者为Ⅰ级损伤,2.2%的患者为Ⅱ级损伤,无Ⅲ~Ⅳ级重度放射性损伤;②近期疗效:完全缓解67例(74.5%),部分缓解21例(23.3%),稳定1例(1.1%),进展1例(1.1%),总有效率(ORR)为97.8%(88/90),疾病控制率(DCR)为98.9%。③生存情况:中位随访时间57个月(5~84个月),5年无局部复发生存率、无远处转移生存率和总生存率分别为85.6%、71.1%和73.3%。④不良反应:3~4度不良反应有白细胞减少(发生率为24.4%)、中性粒细胞减少(发生率为21.1%)和血小板减少(发生率为1.1%)等血液学毒性以及口腔黏膜炎(发生率为43.3%)、呕吐(发生率为1.1%)和放射性皮炎(发生率为3.3%)等非血液学毒性。结论 鼻咽癌调强放疗后颞颌关节损伤以I度为主;调强放疗后出现颞颌关节损伤的鼻咽癌患者以T3~T4为主,但仍可获得较满意的局控率、较低的远处转移率和较高的总生存率,且安全性较高。
临床诊疗

6野切线射野方式用于左侧乳腺癌根治术后放疗的临床研究

6F-IMRT applying in postoperation radiotherapy of left side radical mastectomy

:91-93
 
目的 探讨6野切线射野方式调强放疗(6F-IMRT)用于左侧乳腺癌根治术后放疗的临床价值。方法 纳入我院70例左侧乳腺癌根治术患者为研究对象,进行模拟CT增强扫描,三维重建后勾画大体靶区,分别对每个患者靶区设计4F-IMRT、5F-IMRT、6F-IMRT三种治疗计划,规定计划靶区(PTV)达到95%的处方剂量前提下,分析三种治疗计划PTV所受照射的平均剂量、最大剂量、最小剂量,95%、100%等剂量线包绕的靶区体积(V95、V100),适形度指数(CI)及剂量不均匀指数(HI),并比较三种计划下心脏、双肺、右乳受照射剂量。结果 各治疗计划靶区最大剂量、最小剂量、平均剂量比较无统计学意义(P>0.05)。6F-IMRT的V95、V100均高于4F-IMRT、5F-IMRT,差异有统计意义(P<0.05)。4F-IMRT、5F-IMRT、6F-IMRT的CI呈递增趋势,HI呈递减趋势,各组间比较差异有统计学意义(P<0.05)。三种放疗计划中心脏的平均剂量、V30,双肺的平均剂量、V20、右乳平均剂量比较无显著差异(P>0.05)。三种放疗计划中,4F-IMRT右乳V10显著低于5F-IMRT、6F-IMRT,差异有统计学意义(P<0.05),但均在最大耐受剂量范围内。结论 与4F-IMRT、5F-IMRT相比,6F-IMRT用于左侧乳腺癌根治术后放疗有明显剂量学优势,可提高靶区照射剂量,靶区适形程度及剂量均匀性均较好,而且并不会增加周围正常器官照射剂量。
论著

鼻咽癌放疗后鼻窦炎临床特征及其影响因素的Logistic分析

Logistic analysis of clinical characteristics and influencing factors of sinusitis after radiotherapy for nasopharyngeal carcinoma

:24-28
 
目的 探讨鼻咽癌(NPC)放疗致鼻窦炎发生的临床特征、影响因素。方法 回顾性分析2014年1月—2017年6月期间,我院收治的228例NPC患者临床资料,根据患者是否进行放疗,将患者分为非放疗组(106例)和放疗组(122例)。对比分析两组鼻咽癌致鼻窦炎的临床特点,以单因素和多因素Logistic分析鼻咽癌患者放疗后发生鼻窦炎的影响因素。结果 放疗组患者鼻窦炎发生率为81.97%,高于非放疗组患者鼻窦炎发生率54.72%,差异有统计学意义(P<0.05)。放疗组鼻窦炎累及部位发生率从高到低,依次为后组筛窦、蝶窦、前组筛窦、窦口鼻道复合体、额窦以及上颌窦。放疗组患者鼻窦炎后组筛窦、蝶窦累及率高于非放疗组患者,差异具有统计学意义(P<0.05)。单因素分析结果显示,放疗后鼻窦炎的发生,与患者年龄是否>50岁,病程是否>2年,是否存在鼻腔侵犯,肿瘤分期,是否使用滴鼻剂及是否进行鼻咽冲洗有关,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,患者病程>2年,存在鼻腔侵犯以及T3+T4期肿瘤是NPC放疗后鼻窦炎发生的独立危险因素;使用滴鼻剂和鼻咽冲洗是NPC放疗后鼻窦炎发生的保护因素。结论 NPC放疗后具有较高的鼻窦炎发生率,并且主要累及后组筛窦和蝶窦,对于病程>2年、存在鼻腔侵犯以及T3+T4期肿瘤的患者,应积极采取措施预防鼻窦炎的发生,使用滴鼻剂和鼻咽冲洗是预防NPC放疗后鼻窦炎发生的有效措施。
Objective To investigate the clinical features and influencing factors of nasosinusitis caused by nasopharyngeal carcinoma (NPC) radiotherapy. Methods The clinical data of 228 NPC patients admitted to our hospital from January 2014 to June 2017 were retrospectively analyzed. According to whether the patients were treated with radiotherapy, the patients were divided into non-radiotherapy group (106 cases) and radiotherapy group (122 cases). The clinical characteristics of nasosinusitis were analyzed and compared. Univariate and multivariate logistic analysis was used to analyze the influencing factors of nasosinusitis after radiotherapy in patients with nasopharyngeal carcinoma. Results The incidence of sinusitis was 81.97% in the radiotherapy group, which was higher than that in the non-radiotherapy group (54.72%). The difference was statistical significance (P<0.05). The incidence of sinusitis involvement in the radiotherapy group was in the order of ethmoid sinus, sphenoid sinus, anterior ethmoid sinus, sinus ostium and nasal tract sinus complex, frontal sinus, and maxillary sinus. The incidences of ethmoid sinus and sphenoid sinus in the post-nasal sinusitis group were higher than that in the non-radiotherapy group (P<0.05). Univariate analysis showed that the occurrence of sinusitis after radiotherapy was related to whether the patient's age was > 50 years, whether the disease duration was >2 years, whether there was nasal invasion, tumor staging, whether nasal drops were used, and whether nasopharyngeal irrigation was performed. Multivariate logistic regression analysis showed that patients with a disease course of >2 years had nasal invasion and T3+T4 tumors were independent risk factors for sinusitis after NPC radiotherapy; use of nasal drops and nasopharyngeal washing were protective factors. Conclusion There is a higher incidence of sinusitis after radiotherapy of NPC, and mainly affects the ethmoid sinus and sphenoid sinus in the posterior group. Patients with a disease course of >2 years, with nasal invasion, and T3+T4 tumors should actively take measures to prevent the occurrence of sinusitis. The use of nose drops and nasopharyngeal washing is an effective measure to prevent the occurrence of sinusitis after NPC radiotherapy.
论著

PF诱导化疗联合调强放疗及二维放疗对鼻咽癌近远期疗效影响的回顾性分析

Retrospective analysis of the effects of PF induced chemotherapy combined with intensity modulated radiation therapy and two-dimensional radiotherapy on the short and long term curative effects in nasopharyngeal carcinoma

:31-32
 
目的 研究PF诱导化疗联合调强放疗及二维放疗对鼻咽癌近远期疗效影响的回顾性分析。方法 回顾性分析2008年1月—2008年12月中山大学附属肿瘤医院收治的101例鼻咽癌患者治疗情况,按照治疗方案技术分为调强组(n=42)和二维组(n=59)。比较两组患者临床疗效,近期毒副反应及生存情况。结果 放疗结束时调强组患者总缓解率92.86%与二维组77.97%比较差异有统计学意义(P<0.05)。调强组Ⅲ-Ⅳ级胃肠道反应26.19%及黏膜炎14.29%发生率与二维组比较显著较少,差异有统计学意义(P<0.05)。两组患者远期毒副反应及生存率比较无显著差异(P>0.05)。结论 PF诱导化疗联合调强放疗治疗鼻咽癌患者,近远期临床疗效好,毒副反应少。
Objective To study the effects of PF induced chemotherapy combined with intensity modulated radiation therapy and two-dimensional radiotherapy on the short and long term curative effects in nasopharyngeal carcinoma. Methods The treatment condition of 101 cases of patients with nasopharyngeal carcinoma who were treated in the Tumor Hospital Affiliated to San Yat-sen University between January and December 2008 were retrospectively analyzed. According to different treatments, the cases were divided into the intensity modulated group and the two-dimensional group. The clinical curative effects, short-term toxic and side effects and survival status were compared between the two groups. Results At the end of radiotherapy, the total remission rate in the intensity modulated group was 92.86% while in the two-dimensional group was 77.97% (P<0.05). In the intensity modulated group, the incidence rates of grade Ⅲ-Ⅳgastrointestinal tract reactions (26.19%) and mucositis (14.29%) were significantly lower than those in the two-dimensional group (P<0.05). There was no significant difference in long-term side effects and survival rate between the two groups (P>0.05). Conclusion PF induced chemotherapy combined with intensity modulated radiation therapy in the treatment of patients with nasopharyngeal carcinoma has good short and long-term curative effects and few toxic and side effects.
论著

自噬对鼻咽癌细胞CNE2放疗敏感性的调节作用

The regulatory effects of autophagy to the CNE2 cells radio-sensitization

:4-7
 
目的 探讨自噬激活剂和自噬抑制剂分别对鼻咽癌细胞CNE2放疗敏感性的影响。方法 利用RNA干扰技术使atg5基因沉默,构建自噬抑制细胞模型后,与雷帕霉素、氯喹分别处理的两组细胞一起,每天以X射线5Gy照射细胞,连续8天观察各组细胞的生长状况,并设置对照组。以MTT法及克隆集落形成法检测其细胞活力,用流式细胞仪分析其细胞周期。结果 与对照组相比,其他三组细胞存活率、克隆形成率、照射后存活率均显著降低(P<0.05);细胞周期检测除对照组外其他三组细胞集中在G0/G1期,其他两个时期比G0/G1期相对较少。结论 自噬抑制剂与激活剂和atg5沉默均能为CNE2放疗增敏,然而自噬激活剂的增敏效果好于其他,为增敏放疗提供实验依据,开辟新的放疗增敏途径。
Objective This study aimed to investigate the autophagy activators and inhibitors effects in nasopharyngeal CNE2 cells radiotherapy sensitization. Methods Atg5 gene silencing by RNA interference technology, two groups of cell autophagy inhibition were built by rapamycin and chloroquine respectively. Then 5Gy x-ray irradiation of cells was taken every day, after 8 days in a row in each group of cell growth and setting a control group. The cell viability was clonaled colony formation by MTT method assay and cell cycle by flow cytometry analysis. Results The three cell group survival rate, colony-forming rate and survival after irradiation were significantly lower (P<0.05) than the control group. Detection of cell cycle in addition to control three other groups concentrated in the G0/G1 period.That of two other periods was relatively fewer than that of the G0/G1 period. Conclusion Autophagy inhibitors, activators and atg5 silence improved the radio-sensitization to CNE2. The autophagy activator group improving the sensitivity was better than the others.This study provided evidence to sensitive radiotherapy, explored a new promising radiosensitization ways.
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