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Unraveling the efficacy network: A network meta-analysis of adjuvant external beam radiation therapy methods after hepatectomy

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World Journal of Gastrointestinal Surgery 2024年第1期16卷 205-214页

作者： Gao-Yuan Yang Zhi-Wei He Yong-Chang Tang Feng Yuan Ming-Bo Cao Yu-Peng Ren Yu-Xuan Li Xiao-Rui Su Zhi-Cheng Yao Mei-Hai Deng Department of Hepatobiliary Surgery The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510630Guangdong ProvinceChina Department of General Surgery Qilu HospitalShandong UniversityJinan 250012Shandong ProvinceChina Department of General Surgery The First Affiliated HospitalGuangzhou Medical UniversityGuangzhou 511436Guangdong ProvinceChina Department of Hepatobiliary and Pancreatic Surgery The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510630Guangdong ProvinceChina

BACKGROUND Primary liver cancer is a malignant tumor with a high recurrence rate that significantly affects patient *** adjuvant external radiation therapy(RT)has been shown to effectively prevent recurrence after liver cancer ***,there are multiple RT techniques available,and the differ-ential effects of these techniques in preventing postoperative liver cancer re-currence require further *** To assess the advantages and disadvantages of various adjuvant external RT methods after liver resection based on overall survival(OS)and disease-free survival(DFS)and to determine the optimal *** This study involved network meta-analyses and followed the PRISMA *** data of qualified studies published before July 10,2023,were collected from PubMed,Embase,the Web of Science,and the Cochrane *** included relevant studies on postoperative external beam RT after liver resection that had OS and DFS as the primary *** magnitudes of the effects were determined using risk ratios with 95%confidential *** results were analyzed using R software and STATA *** A total of 12 studies,including 1265 patients with hepatocellular carcinoma(HCC)after liver resection,were included in this *** was no significant heterogeneity in the direct paired comparisons,and there were no significant differences in the inclusion or exclusion criteria,intervention measures,or outcome indicators,meeting the assumptions of heterogeneity and *** analysis revealed that patients who underwent stereotactic body radiotherapy(SBRT)after resection had longer OS than those who underwent intensity modulated radiotherapy(IMRT)or 3-dimensional conformal RT(3D-CRT).DFS analysis revealed that patients who underwent 3D-CRT after resection had the longest *** who underwent IMRT after resection had longer OS than those who underwent 3D-CRT and longer DFS than those who underwent ***

关键词： Primary liver cancer Hepatocellular carcinoma Network meta-analysis External beam radiation therapy Stereotactic body radiotherapy intensity modulated radiotherapy

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Dosimetric study comparing intensity modulated and conformal pelvic radiotherapy boost plans in locally advanced cancer cervix in NCI-Cairo

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The Chinese-German Journal of Clinical Oncology 2013年第6期12卷 293-296页

作者： Mohamed Mahmoud Hesham A. EL-Hossiny Nashaat A. Diab Mahmoud Shosha Department of Radiation Oncology National Cancer InstituteCairo University Department of Radiation Physics National Cancer InstituteCairo University

Objective:This study was to compare 5 field conformal technique to the intensity modulated radiotherapy (IMRT) 8 fields technique in boosting locally advanced cancer cervix cases after external beam radiotherapy with respect to target volume coverage and dose to normal tissues. Methods:We conducted a single institutional comparative dosimetric analysis of 10 patients with cancer cervix who was presented to radiotherapy department in National Cancer Institute, Cairo in period between June 2012 to September 2012 and received a CRT boost in the place of planned brachytherapy after large field pelvic radiotherapy (PRT) with concurrent chemotherapy were retrospectively identified. All tumors were situated in the low central pelvis. Two plans were done for every patient; one using the 8 fields IMRT and the second one using 5 fields' 3DCRT the two techniques were then compared using dose volume histogram (DVH) analysis for the PTV, bladder, rectum and both femoral heads. Results:Comparing different DVHs, it was found that the planning target volume (PTV) was adequately covered in both plans while it was demonstrates that the 8 fields IMRT technique carried less doses reaching OARs (rectum, bladder, both femoral heads). Conclusion:From the present study, it is concluded that IMRT technique spared more efficiently OARs than CRT technique but both techniques covered the PTV adequately so whenever possible IMRT technique should be used.

关键词： cancer cervix intensity modulated radiotherapy conformal radiotherapy

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Volumetric-modulated arc therapy vs c-IMRT in esophageal cancer:A treatment planning comparison

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World Journal of Gastroenterology 2012年第37期18卷 5266-5275页

作者： Li Yin Hao Wu Jian Gong Jian-Hao Geng Fan Jiang An-Hui Shi Rong Yu Yong-Heng Li Shu-Kui Han Bo Xu Guang-Ying Zhu Department of radiotherapy Peking University School of OncologyBeijing Cancer Hospital and InstituteBeijing 100142China

AIM： To compare the volumetric-modulated arc ther- apy （VMAT） plans with conventional sliding window intensity-modulated radiotherapy （c-IMRT） plans in esophageal cancer （EC）. METHODS： Twenty patients with EC were selected, including 5 cases located in the cervical, the upper, the middle and the lower thorax, respectively. Five plans were generated with the eclipse planning sys- tem： three using c-IMRT with 5 fields （5F）, 7 fields （7F） and 9 fields （gF）, and two using VMAT with a single arc （1A） and double arcs （2A）. The treatment plans were designed to deliver a dose of 60 Gy to the plan-ning target volume （PTV） with the same constrains in a 2.0 Gy daily fraction, 5 d a week. Plans were normal- ized to 95% of the PTV that received 100% of the pre- scribed dose. We examined the dose-volume histogram parameters of PTV and the organs at risk （OAR） such as lungs, spinal cord and heart. Monitor units （MU） and normal tissue complication probability （NTCP） of OAR were also reported. RESULTS： Both c-IMRT and VMAT plans resulted in abundant dose coverage of PTV for EC of different Io- cations. The dose conformity to PTV was improved as the number of field in c-IMRT or rotating arc in VMAT was increased. The doses to PTV and OAR in VMAT plans were not statistically different in comparison with c-IMRT plans, with the following exceptions： in cervical and upper thoracic EC, the conformity index （CI） was higher in VMAT （1A 0.78 and 2A 0.8） than in c-IMRT （5F 0.62, 7F 0.66 and 9F 0.73） and homogeneity was slightly better in c-IMRT （7F 1.09 and 9F 1.07） than in VMAT （1A 1,1 and 2A 1.09）, Lung V30 was lower in VMAT （1A 12.52 and 2A 12.29） than in c-IMRT （7F 14.35 and 9F 14.81）. The humeral head doses were significantly increased in VMAT as against c-IMRT. In the middle and lower thoracic EC, CI in VMAT （1A 0.76 and 2A 0.74） was higher than in c-IMRT （5F 0.63 Gy and 7F 0.67 Gy）, and homogeneity was almost similar between VMAT and c-IMRT. V20 （2A 21.49 Gy vs 7F 24.59 Gy and 9F 24.16

关键词： Esophageal cancer Treatment planning intensity modulated radiotherapy Volumetric modulat-ed arc radiotherapy Normal tissue complication prob-ability

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The role of radiotherapy in localised and locally advanced prostate cancer

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Asian Journal of Urology 2019年第2期6卷 153-161页

作者： Michel Bolla Ann Henry Malcom Mason Thomas Wiegel Department of Radiation Oncology Grenoble Alpes UniversityGrenobleFrance Department of Clinical Oncology St.James’s University HospitalLeedsUK Cardiff University Velindre HospitalWhitchurchUK Department of Radiation Oncology University Hospital UlmGermany

For a patient suffering from non-metastatic prostate cancer,the individualized recommendation of radiotherapy has to be the fruit of a multidisciplinary approach in the context of a Tumor Board,to be explained carefully to the patient to obtain his informed *** beam radiotherapy is now delivered by intensity modulated radiotherapy,considered as the gold *** a radiotherapy perspective,low-risk localized prostate cancer is treated by image guided intensity modulated radiotherapy,or brachytherapy if patients meet the required eligibility ***-risk patients may benefit from intensity modulated radiotherapy combined with 4e6 months of androgen deprivation therapy;intensity modulated radiotherapy alone or combined with brachytherapy can be offered to patients unsuitable for androgen deprivation therapy due to co-morbidities or unwilling to accept it to preserve their sexual ***-risk prostate cancer,***-risk localized and locally advanced prostate cancer,requires intensity modulated radiotherapy with long-term(≥2 years)androgen deprivation therapy with luteinizing hormone releasing hormone ***-operative irradiation,either immediate or early deferred,is proposed to patients classified as pT3pN0,based on surgical margins,prostate-specific antigen values and quality of *** the techniques and their degree of sophistication,quality assurance plays a major role in the management of radiotherapy,requiring the involvement of physicians,physicists,dosimetrists,radiation technologists and computer *** patients must be informed about the potential morbidity of radiotherapy and androgen deprivation therapy and followed regularly during and after treatment for tertiary prevention and evaluation.A close cooperation is needed with general practitioners and specialists to prevent and mitigate side effects and maintain quality of life.

关键词： Localized prostate cancer Locally advanced prostate cancer Brachytherapy intensity modulated radiotherapy Short-term and longterm androgen deprivation therapy

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Dosimetric comparison between helical tomotherapy and intensity-modulated radiation therapy plans for non-small cell lung cancer

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Chinese Medical Journal 2011年第11期124卷 1667-1671页

作者： MENG Ling-ling FENG Lin-chun WANG Yun-lai DAI Xiang-kun XIE Chuan-bin Department of Radiation Oncology People's Liberation ArmyGeneral Hospital Beijing 100853 China

Background Helical tomotherapy （HT） is a new image-guided intensity-modulated radiation therapy （IMRT） technique. It is reported that HT plan for non-small-cell lung cancer （NSCLC） can give better dose uniformity, dose gradients, and protection for the lung than IMRT plan. We compared the dosimetric characteristics of HT for NSCLC with those of conventional IMRT to observe the superiority of HT. Methods There was a comparative case series comprising 10 patients with NSCLC. Computed tomographic （CT） images of delineated targets were transferred to the PrecisePlan planning system （IMRT） and Tomo planning system （HT）. The prescription doses were 70 Gy/33F for the gross tumor volume （GTV） and the visible lymph nodes （GTVnd）,

关键词： helical tomotherapy intensity modulated radiotherapy non-small-cell lung cancer dosimetry

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Modified partially wide tangents technique in post-mastectomy radiotherapy for patients with left-sided breast cancer

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Chinese Medical Journal 2010年第20期123卷 2825-2831页

作者： ZHANG Qian CHEN Jia-yi HU Wei-gang GUO Xiao-mao Department of Radiation Oncology Fudan University Shanghai Cancer Center Department of Oncology Shanghai Medical CollegeFudan UniversityShanghai 200032China

Background The role of internal mammary nodes （IMN） irradiation for breast cancer patients after mastectomy remains controversial. This study aimed to compare different techniques for radiation of the chest wall （CW） and IMN post-mastectomy for left-breast cancer patients in terms of dose homogeneity within planning target volume （PTV） and dose to critical *** Thirty patients underwent CT simulation, while CW, IMN, left lung, heart and contralateral breast were contoured. Three three-dimensional conformal radiotherapy （3D-CRT） techniques, namely, standard tangents, partially wide tangents （PWT）, and modified PWT techniques plus intensity modulated radiotherapy （IMRT） technique have been used to radiate CW and IMN. In addition to the target coverage and dose homogeneity, we also evaluated the dose to the critical structures including heart, left lung and contralateral *** All three 3D-CRT techniques provided satisfactory coverage regarding total PTV. The PWT and the modified PWT gave better coverage of IMN PTV with V47.5 of （96.83±4.56）% and （95.19±3.90）% compared to standard tangents （（88.16±7.77）%）, P 〈0.05. The standard tangents also contributed the biggest IMN VD105%, VD110%, VD115% and VD120%. The lowest mean dose of the heart was achieved by the modified PWT （（8.47±2.30） Gy）, compared with PWT （（11.97±3.54）Gy） and standard tangents （（11.18±2.53） Gy）. The mean dose of lung and contralateral breast with the modified PWT was significantly lower than those with PWT. Comparing IMRT with the modified PWT, both techniques provided satisfactory coverage. The conformity indexes （CI） with IMRT （CI1： 0.71±0.02; CI2： 0.64±0.02） were better than those with the modified PWT （CI1： 0.50±0.02; CI2： 0.45±0.02）. The mean dose, V5, V10 and V5-10 of heart and left lung with the modified PWT were significantly lower than those with the IMRT. The mean dose and VD2% of contralateral breast with the modified PWT were not significantly different from the IMRT （

关键词： breast cancer internal mammary nodes postmastectomy radiotherapy intensity modulated radiotherapy

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Radiation Oncology and Medical Devices(Part 2)

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中国医疗设备 2014年第1期29卷 1-10页

作者： Ning J.Yue Ting Chen Wei Zou Department of Radiation Oncology Rutgers Cancer Institute of New JerseyRutgers University-Robert Wood Johnson Medical School

Radiation oncology is one of the three major treatment modalities to manage cancer patient cares,and is a discipline mainly driven by technology and medical *** radiation treatments have become fairly complex and involve in utilizing a variety of medical devices to achieve the goal of providing conformal radiation dose coverage to the tumor target(s)while maximizing the sparing of normal organ ***,different forms of linear accelerators/radioactive source based machines have been invented and developed with the aim of providing improved treatments and more treatment *** linear accelerators(Linac)that have been undergoing constant improvement and advancement and can deliver fairly complicated dose distribution patterns,imaging systems,computer information and calculation systems have been more and more integrated into radiotherapy *** bring radiotherapy to a potentially higher level,many institutions have either acquired or started to consider particle therapy,especially proton *** complexity of modern radiotherapy demands in-depth understanding of radiation physics and machine engineering as well as computer information *** paper is intended to provide an introductory description of radiation oncology and related procedures,and to provide an overview of the current status of medical devices in radiotherapy in the United States of *** paper covers the radiation delivery systems,imaging systems,treatment planning systems,record and verify systems,and QA systems.

关键词： radiation oncology radiotherapy external beam radiotherapy Brachytherapy intensity modulated radiotherapy SRS SBRT Linac treatment planning system record and verify system 3DCRT Simulator

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Comparative Study between Patients Treated with Conventional radiotherapy and IMRT with Chemotherapy for Stage III - IVA Nasopharyngeal Carcinoma: A Single Institution Retrospective Report

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Journal of Cancer Therapy 2023年第12期14卷 451-464页

作者： Mamady Keita Juan Li Malick Bah Mamadou Aliou Diallo Alhassane Ismaël Touré Abou Camara Bangaly Traoré Abdoulaye Keita Wenbing Shen Department of radiotherapy The Fourth Affiliated Hospital of Hebei Medical University Shijiazhuang China Cancer Department of Donka National Hospital Conakry Guinea Faculty of Health Sciences and Techniques of Gamal Abdel Nasser University of Conakry Conakry Guinea Department of ENT-CFS Donka National Hospital Conakry Guinea

Introduction: Nasopharyngeal carcinomas are the most radiation-sensitive tumours, and radiotherapy alone provides better local control. Objectives: To evaluate the clinical efficacy and acute and late toxicities of two different treatment regimens for locally advanced nasopharyngeal carcinoma. Methods: From 2014 to 2017, 150 cases of stage III and 68 cases of stage IVA nasopharyngeal carcinoma were treated. Of these, 137 received conventional radiotherapy plus chemotherapy, and 81 received intensity-modulated radiotherapy plus chemotherapy. Chemotherapy was given either as induction, concurrent or adjuvant therapy. Survival rates were calculated according to Kaplan Meier and compared with the Log-rank test. The RTOG or EORTC criteria were used to assess acute and late toxicities. Results: The median follow-up time was 21.5 months, and the 2-year locoregional relapse-free survival, distant metastases-free survival, and overall survival rates in the conventional radiotherapy plus chemotherapy group were 76%, 71% and 77%, respectively;in the intensity-modulated radiotherapy plus chemotherapy group, they were 97%, 84%, and 100%, respectively. The difference in survival between the two groups was significant (χ2 = 5.06, P = 0.028). The incidence of grade 2 and 3 xerostomia one year after radiotherapy was 45.1% and 30.9% versus 33.3% and 0%. Conclusion: Compared with conventional radiotherapy plus chemotherapy, intensity-modulated radiotherapy plus chemotherapy offers better locoregional relapse-free survival and overall survival in patients with stage III and IVA nasopharyngeal carcinoma, and may significantly reduce the occurrence of radiation-induced xerostomia.

关键词： Nasopharyngeal Carcinoma Conventional radiotherapy intensity modulated radiotherapy Chemotherapy Prognosis

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The association of the uterine motion with bladder volume during radiotherapy in gynecological malignancies

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Journal of Cancer Metastasis and Treatment 2016年第1期2卷 139-143页

作者： Bhandari Virendra Mutneja Abhinav Gurjar Omprakash Saadvik Raghuram Bagdare Priyusha Gupta Krishnlal Singh Kanchan Department of Radiation Oncology Sri Aurobindo Medical College and PG InstituteIndore 452001India

Aim:This study was performed to assess the extent of interfraction uterine motion during radiotherapy for cervical cancer and uterine body carcinoma while maintaining a strict bladder filling ***:Twenty-four patients with cervical cancer or uterine body carcinoma who were treated on a linear accelerator,were *** the course of external beam radiotherapy,cone beam computed tomographic scans were taken,once at the start of treatment and then weekly until the completion of the radiotherapy *** were instructed to maintain a strict bladder filling *** negating the effect of patient’s setup error by offline cone beam computed tomographic imaging,the position of the uterus was defined in the clinical target *** the position of the uterus was compared in the following weekly *** position of the uterus was also correlated with the position and the filling of the *** change in uterus position was measured separately in the anterioposterior(AP),superioinferior(SI),and lateral ***:According to calculations based on weekly imaging,The mean values of shift in AP,SI,and lateral directions were respectively 0.67,0.29,and 0.23 The mean extent of motion in the uterine position on a daily basis for individual patients ranged from-2.28 to+1.3 in AP,-0.56 to+0.71 in SI,and from-0.6 to+0.45 in lateral ***:At least once a week cone beam computed tomography might be necessary to minimize the geometrical miss and deliver the planned doses to the target tissue and normal structure provide best results with minimum toxicity by maintaining a bladder volume of about 100 mL and an empty rectum during the whole course of *** daily anatomical shift and contour of the patients maintaining a bladder volume of approximately 100 mL with an empty rectum may result in asymmetrical conforming to the planning target volume and hence appropriate and adequate planning target volume margins are r

关键词： Uterine motion weekly computed tomographic evaluation intensity modulated radiotherapy inter-fraction variation bladder volume

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Nasopharyngeal carcinoma-Improving cure with technology and clinical trials

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2020年第1期6卷 1-3页

作者： Raymond K.Tsang Division of Otolaryngology Department of SurgeryUniversity of Hong KonsHong KongChina Dept.of Surgery University of Hong Kong Queen Mary Hospital102 Pokfulam RoadHong KongChina

Nasopharyngeal carcinoma is a unique cancer in the head and neck *** has a very distinct geographic variation of incidence with more than ten times difference in incidence in high risk population compared with low-risk *** other head and neck cancer has this large worldwide variation of *** remained commonest cancer in young male adults below the age of 50 in southern China.

关键词： Nasopharyngeal carcinoma intensity modulated radiotherapy Concurrent chemoradiotherapy Neoadjuvant chemotherapy Nasopharyngectomy

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