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Clinicopathological and Prognostic Significance of Circulating Tumor Cells in Patients with Head and Neck Cancer: A Meta-Analysis

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2016年第2期5卷 138-149页

作者： Ruiwan Chen Yu Zhou bixiu wen Department of Radiotherapy The First Affiliated Hospital Sun Yat-sen University Guangzhou China Department of General Surgery Guangdong General Hospital Guangzhou China

Purpose: The aim of the study was to evaluate the association between clinicopathological and prognostic significance and circulating tumor cells (CTCs) in patients with head and neck cancer. Methods: We searched PubMed, MEDLINE, BioMed, and EMbase databases for studies that assessed the association between clinicopathological and prognostic significance and CTCs in patients with head and neck cancer. Studies obtained from search strategy were screened using pre-specified criteria, and necessary data were retrieved for meta-analysis. Results: Seventeen studies with 816 patients were eligible for combined analysis. Presence of CTCs in peripheral blood was significantly associated with N stage (OR 0.50, 95%CI [0.30, 0.81], n = 10, P = 0.005). Patients in the high-CTC group were significantly associated with poorer disease-free survival (DFS;HR = 1.73, 95%CI [1.01 - 2.96], P = 0.050) and poorer overall survival (OS;HR = 2.53, 95%CI [1.37 - 4.69] P = 0.003). Further analyses indicated strong prognostic powers of CTCs in non-RT-PCR group and pre-treatment group. Conclusion: Our meta-analysis indicates that presence of CTCs is associated with higher N stage and poorer prognosis in patients with head and neck cancer. The potential for further clinical application may be needed for further investigation.Purpose: The aim of the study was to evaluate the association between clinicopathological and prognostic significance and circulating tumor cells (CTCs) in patients with head and neck cancer. Methods: We searched PubMed, MEDLINE, BioMed, and EMbase databases for studies that assessed the association between clinicopathological and prognostic significance and CTCs in patients with head and neck cancer. Studies obtained from search strategy were screened using pre-specified criteria, and necessary data were retrieved for meta-analysis. Results: Seventeen studies with 816 patients were eligible for combined analysis. Presence of CTCs in peripheral blood was significantly associated with N stage (OR 0.50, 95%CI [0.30, 0.81],

关键词： Circulating Tumor Cells Head and Neck Cancer Clinicopathological Characteristic Prognosis Meta-Analysis

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Impact of Olaparib for Maintenance Monotherapy on Survival in Breast and Ovarian Cancer: A Systematic Review and Pooled Analysis of Published Trials

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2015年第4期4卷 338-347页

作者： Jun Dong Tian Zhang bixiu wen Department of Radiation Oncology The First Affiliated Hospital of Sun Yat-sen University Guangzhou China

Purpose: To assess the efficacy and safety of Olaparib, a PARP inhibitor on progression-free survival (PFS), objective response rate (ORR) and overall survival (OS) in patients with breast and ovarian cancer. Methods: Research data from clinical trials through PubMed, Science Citation Index, Elsevier Science Direct and Cochrane Library of all published studies exploring the PFS, ORR or OS of Olaparib for maintenance monotherapy on survival in breast and ovarian cancer were analysed. Pooled estimates of the ORR, weighted medians of PFS and OS from all Olaparib were calculated. Assessment of quality and level of evidence was assigned by Cochrane guidelines and guidelines of Oxford Centre for Evidence-Based Medicine. Results: Data of 893 patients (731 olaparib;162 control) from 6 trials, 2 randomised controlled trials and 4 non-randomised trials, were included. The overall median weighted PFS and OS in patients treated with Olaparib were 5.9 and 19.1 months, respectively. The pooled ORR was 25%. Olaparib showed a greater effect on PFS in patients with both wild-type BRCA and BRCA mutant gene. The most common toxicity were nausea and vomiting. Conclusions: Olaparib as maintenance monotherapy for breast and ovarian cancer is associated with promising outcomes including increased response rate and improved PFS. Its potential in clinical application is needed for further investigation in phase III trials.

关键词： Olaparib PARP Inhibitor Breast Cancer Ovarian Cancer Pooled Analysis

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The Dosimetric Characteristics and Potential Limitation in Clinical Application of a Low Energy Photon Intra-Operative Radiotherapy System

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2015年第2期4卷 184-195页

作者： Zhenhua Xiao Ouyang Bin Zhenyu Wang Botian Huang bixiu wen Department of Radiation Oncology The First Affiliated Hospital of Sun Yat-sen University Guangzhou China

Purpose: To investigate the dosimetric characteristics of a low energy photon intra-operative radiotherapy (IORT) system and explore its potential limitation in clinical application. Methods: A special water phantom, a parallel-plate ionization chamber and an electrometer were used to measure the depth dose rate, isotropy of dose distribution in X/Y plane, dosimetry reproducibility of bare probe and spherical applicators of different size which were used in comparison with the system data. Results: The difference in depth dose rate between the measurement and system data for bare probe is -2.16% ± 1.36%, the range of the relative deviation for isotropy in the X/Y plane is between -1.9% and 2.1%. The difference in depth dose rate, transfer coefficient, isotropy in X/Y plane between the measurement and system data for the whole set of spherical applicators is -10.0% - 2.3%, -8.9% - 4.2% and -1.6% - 2.6%, respectively. Higher surface dose rate and steeper gradient depth dose are observed in smaller spherical applicators. The depth dose rate and isotropy for bare probe and spherical applicators have been shown good reproducibility. The uncertainty of measurement is associated with the positioning accuracy, energy response, noise current and correction function f’(R). Conclusions: Thorough commissioning of the low energy photon IORT system helps us better understand the dosimetry characteristics, verify the system data, obtain adequate data for clinical application and routine quality assurance. The steep gradient depth dose and limited treatment range may restrain its potential in clinical application.

关键词： Intra-Operative Radiotherapy Low Energy Photon Dosimetry Isotropy Limitation

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The Application of Image Guided Radiotherapy on the Precision of Intensity Modulated Radiotherapy in Patients with Locally Advanced Rectal Cancer

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2018年第4期7卷 479-490页

作者： Chengtao Wang Zhenyu Wang Mengzhen Min Xiaobi Yu Jun Dong bixiu wen Department of Radiation Oncology The First Affiliated Hospital of Sun Yat-sen University Guangzhou China

Objective: To investigate the effect of onboard image (OBI) system-based image guided radiotherapy (IGRT) on the precision of fractionated intensity modulated radiotherapy (IMRT) for patients with locally advanced rectal cancer. Methods: The IGRT validation images of the 12 patients with rectal cancer were obtained after initial setup by the OBI system of Varian Novalis TX linear accelerator, and registered to the planning CT image system. Subsequently, the setup deviations on three translational directions [ventral-dorsal direction (VD), cranial-caudal direction (CD) and lateral direction (LD)] for the three-validation phase including Pre-treatment (Pre-RT1), repositioning (Pre-RT2) and Post-treatment (Post-RT) were obtained and comparatively analyzed. Results: The frequency of setup deviation of ≤2.0 mm in the lateral, cephalocaudal and ventral direction was 83.01%, 65.71%, and 68.91%, respectively for Pre-RT1;100%, 98.72% and 100%, respectively for Pre-RT2;100%, 97.76%, and 99.68%, respectively for Post-RT. Compared with the Pre-RT1 phase, the ranges of setup deviation on Pre-RT2 and Post-RT phases possessed a significant contraction trend. The absolute values of setup deviations on the three translation directions between the Pre-RT1 and Pre-RT2 or Post-RT were statistically significant (p < 0.05). Through positioning adjustment based on IGRT based on the OBI system, the setup deviations on the three translational directions decreased significantly. Conclusion: Application of OBI-based daily IGRT may help improve the precise delivery of fractionated IMRT by decreasing the inter- and intra-fractionated setup deviation in the ventral-dorsal direction, cranial-caudal direction and lateral direction for patients with locally advanced rectal cancer.

关键词： Rectal Cancer IMRT IGRT OBI Setup Deviation

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

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2015年第1期4卷 54-63页

作者： Ge wen Jinshan Zhang Feng Chi Li Chen Sijuan Huang Shaoqing Niu Yuanhong Gao bixiu wen Yujing Zhang Department of Radiation Oncology Sun Yat-sen University Cancer Center State Key Laboratory of Oncology in Southern China Collaborative Innovation Center of Cancer Medicine Guangzhou China Department of Radiation Oncology The Third Affiliated Hospital of Guangzhou Medical University Guangzhou China Department of Radiation Oncology The First Affiliated Hospital Sun Yat-sen University Guangzhou China

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

关键词： Rectal Cancer Preoperative Radiotherapy Dosimetry Conformity Index Homogeneity Index

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基于高程感知多尺度图卷积网络的地物分类

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北京航空航天大学学报 2023年第6期49卷 1471-1478页

作者：文沛程英蕾王鹏赵明钧张碧秀空军工程大学信息与导航学院西安710077 中国人民解放军93575部队承德067000 中国人民解放军93897部队西安710077

机载激光雷达获取的点云具有类别分布不均匀、样本高程差异大的复杂特点,现有方法难以充分识别其细粒度的局部结构。针对该问题,堆叠使用多层边缘卷积算子同时提取局部信息和全局信息,并引入高程注意力权重作为特征提取的补充,设计了一... 详细信息

机载激光雷达获取的点云具有类别分布不均匀、样本高程差异大的复杂特点,现有方法难以充分识别其细粒度的局部结构。针对该问题,堆叠使用多层边缘卷积算子同时提取局部信息和全局信息,并引入高程注意力权重作为特征提取的补充,设计了一种用于机载激光雷达点云地物分类的端到端网络,提出基于高程感知多尺度图卷积网络的地物分类方法。对原始点云划分子块并采样到固定点数;采用多尺度边缘卷积算子提取多尺度局部-全局特征并进行融合,同时采用高程感知模块生成注意力权重并应用于特征提取网络;利用改进的焦点损失函数进一步解决类别分布不均问题,完成分类。采用国际摄影测量与遥感学会(ISPRS)提供的标准测试数据集对所提方法进行验证,所提方法的总体分类精度达到0.859,单类别分类精度特别是对建筑物的提取精度较ISPRS竞赛中公开的最好结果提高了4.6%。研究结果对实际应用和网络设计优化具有借鉴意义。

关键词：图像处理图卷积深度学习高程感知点云分类

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基于模型微调与AM-Softmax的极化SAR图像分类

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空军工程大学学报 2022年第5期23卷 36-43页

作者：赵明钧程英蕾秦先祥王鹏文沛张碧秀空军工程大学信息与导航学院西安710077 93575部队河北承德067000 93897部队西安710077

针对极化SAR图像分类中卷积神经网络(CNN)方法训练时间长、收敛速度慢,原始Softmax函数无法对极化SAR图像的类内差异有效应对的问题,提出一种基于模型微调与加性边际Softmax(AM-Softmax)的极化SAR图像分类方法。该方法通过预训练网络的... 详细信息

针对极化SAR图像分类中卷积神经网络(CNN)方法训练时间长、收敛速度慢,原始Softmax函数无法对极化SAR图像的类内差异有效应对的问题,提出一种基于模型微调与加性边际Softmax(AM-Softmax)的极化SAR图像分类方法。该方法通过预训练网络的整体微调,来改进CNN模型的效率和分类准确率,然后以AM-Softmax替代Softmax,以解决SAR图像中类内变化较大的问题,进一步提升分类精度。实验表明该方法具有快收敛的优势并且能够较好解决极化SAR图像类内差异较大的问题,模型的分类总体精度达到96%以上。

关键词：极化SAR图像分类模型迁移加性边际Softmax

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乏氧诱导因子的转化医学研究进展

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现代肿瘤医学 2015年第17期23卷 2546-2549页

作者：张天董隽文碧秀中山大学附属第一医院放疗科广东广州510080

乏氧诱导因子(HIFs)是机体器官组织中氧分压改变后发生一系列自适应反应的重要调节因子,在血管异常增生以及肿瘤发生发展的各种病理生理变化过程中起重要作用。乏氧可显著增加肿瘤侵袭性和对放化疗的抗拒性,是肿瘤治疗的一大难题。深入... 详细信息

乏氧诱导因子(HIFs)是机体器官组织中氧分压改变后发生一系列自适应反应的重要调节因子,在血管异常增生以及肿瘤发生发展的各种病理生理变化过程中起重要作用。乏氧可显著增加肿瘤侵袭性和对放化疗的抗拒性,是肿瘤治疗的一大难题。深入开展肿瘤乏氧分子影像、乏氧相关基因表达谱的转化医学研究,指导肿瘤个体化治疗的计划制定和预后评价是肿瘤治疗发展的方向。本文拟对上述研究进展做一综述,并探讨其进一步成为转化医学研究和潜在临床应用的可能性。

关键词：乏氧诱导因子微环境乏氧相关基因表达乏氧分子影像转化医学研究

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经IAEA-483报告修正前后高能光子束小野输出因子与蒙特卡罗模拟对比分析研究

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中华放射肿瘤学杂志 2021年第12期30卷 1280-1285页

作者：肖振华王振宇欧阳斌文碧秀中山大学附属第一医院放射治疗科广州510080

目的根据IAEA-483号报告对临床使用的各类半导体或电离室探头进行高能光子束小野输出因子(Scp)测量并修正,探讨其修正数据在小野Scp测量的准确性。方法使用EGSnrc蒙特卡罗(MC)模拟软件模拟Varian Novalis Tx直线加速器参考测量剂量曲线(... 详细信息

目的根据IAEA-483号报告对临床使用的各类半导体或电离室探头进行高能光子束小野输出因子(Scp)测量并修正,探讨其修正数据在小野Scp测量的准确性。方法使用EGSnrc蒙特卡罗(MC)模拟软件模拟Varian Novalis Tx直线加速器参考测量剂量曲线(Profile)和百分深度剂量曲线,调整模拟参数。使用电离室A16、A14 sL、CC01、CC13和半导体探头PFD、EFD、Razor在不同射野下(0.5~10.0 cm方野)的剂量曲线测量值、半峰全宽等效方野Scp测量值分别与MC模拟结果对比分析。使用IAEA-483报告修正因子对测量Scp修正,比对和分析修正前后测量数据和MC模拟数据。结果MC模拟对比PFD测量曲线偏差<2.0%。在<3.0 cm方野时MC模拟Profile曲线与半导体探头测量吻合。野外低剂量区Razor相对于MC和PFD偏高(2.3%),随射野增加而增加,10.0 cm方野达3.0%。CC13在10.0 cm方野Profile曲线的20.0%~80.0%半影宽度最大偏差3.0 mm。随射野减小,7种探头修正前Scp测量均值相对MC模拟偏差增大,标准差在接近1.0 cm方野时迅速变大,由5.0~1.5 cm方野的0.009~0.014变化到1.0~0.5 cm方野的0.030~0.089,修正前全体均值0.030。修正后的6种探头测量的Scp标准差均值0.008,0.8 cm方野为0.013,0.6 cm方野为0.021。等效方野≥1.0 cm时修正后Scp与MC模拟偏差-3.6%~-0.5%,<1.0 cm偏差-6.9%~-1.3%。结论经IAEA-483报告修正后各探头测量Scp标准差较小,与MC模拟结果吻合较好,可用于高能光子束小野的临床剂量学研究。

关键词：输出因子小野剂量学蒙特卡罗模拟 IAEA-483报告

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低能X射线术中放疗系统剂量学特点和潜在临床应用局限性

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中华放射肿瘤学杂志 2016年第8期25卷 867-871页

作者：欧阳斌肖振华王振宇黄伯天文碧秀中山大学附属第一医院放疗科广州510080

目的：测试移动式光子线术中放疗德国INTRABEAM系统，分析X射线源及球形施源器下低能光子线剂量学特点和潜在临床应用局限性。方法采用专用水箱、平行板电离室和静电计等测量仪器，对INTRABEAM系统X射线源和不同球形施源器深度剂量率，x... 详细信息

目的：测试移动式光子线术中放疗德国INTRABEAM系统，分析X射线源及球形施源器下低能光子线剂量学特点和潜在临床应用局限性。方法采用专用水箱、平行板电离室和静电计等测量仪器，对INTRABEAM系统X射线源和不同球形施源器深度剂量率，x、y平面剂量分布各向同性等进行测量，并与系统数据进行比对。结果 X射线源深度剂量率测量值与系统数据偏差为（－2．16±1.36）％，x、y平面各向同性的相对偏差为－1．9％～2.1％。不同直径施源器的深度剂量率测量值、转换系数和 x、y平面各向同性与系统数据偏差范围分别为－10．0％～2.3％、－8．9％～4.2％和－1．6％～2.6％。球形施源器直径越小表面剂量率越高，剂量梯度越大。 X射线源、球形施源器的深度剂量率、各向同性的测量重复性较好。影响测量准确度的因素包括电离室的位置偏差、能量响应、噪声电流和修正因子f′（ R）等。结论通过测试可充分了解INTRABEAM剂量特性、验证系统数据准确性，获得临床应用和日常质量保证所需数据，但剂量梯度大、治疗范围局限等限制其临床广泛应用。

关键词：术中放射疗法低能光子线剂量学各向同性局限性

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