目的:探究容积旋转调强放射治疗(VMAT)与7野调强放射治疗(7f-IMRT)对宫颈癌的效果及不良反应分析.方法:选取2021 年 5 月至 2022 年 8 月我院诊治的宫颈癌患者 92 例为研究对象,按随机数表法分为研究组和对照组,均 46 例.对照组采用7f-IMRT,研究组采用VMAT.观察两组患者临床疗效、放疗计划目标靶区剂量、治疗跳数、计划执行时间及不良反应情况.结果:治疗后,研究组临床好转率 93.48%(43/46)高于对照组73.91%(34/46),差异有统计学意义(P<0.05).放疗计划目标靶区剂量比较,两组在D2、D98、HI值比较差异无统计学意义(P>0.05),研究组Dmean、CI值均高于对照组,差异有统计学意义(P<0.05).研究组治疗跳数、计划执行时间低于对照组,差异有统计学意义(P<0.05).治疗后,研究组消化道反应、白细胞反应低于对照组,但差异无统计学意义(P>0.05),研究组泌尿系统反应低于对照组,差异有统计学意义(P<0.05).结论:VMAT治疗宫颈癌具有优异的临床疗效,可以提高患者的临床好转率,并且能够实现更好的放疗计划目标靶区剂量分布,减少治疗跳数,缩短计划执行时间,减少不良反应.

目的 比较局部晚期宫颈癌三维近距离治疗3D打印阴道多通道个体化施源管与常规施源器剂量学差异,观察疗效及毒副反应.方法 50例初治局部晚期宫颈癌行近距离根治性放射治疗,其中25例患者行3D打印多通道施源器(3DP-ISBT组),25例患者采用传统施源管(ICBT组).比较2组患者的HR-CTV剂量分布,评价危及器官的剂量分布、近期疗效与毒副反应.结果 3DP-ISBT、ICBT组近距离HR-CTV D90分别为(87±7)、(76±16)Gy.组间比较,3D打印多通道个体化施源管较常规施源器剂量分布更合理,且差异有统计学意义(P＜0.05).膀胱D2cc3DP-ISBT组为(81±8)Gy,ICBT组为(86±17)Gy;直肠D2cc3DP-ISBT组为(72±10)Gy,ICBT组为(79±14)Gy.组间比较,3D打印多通道个体化施源管患者放射性膀胱炎及放射性直肠炎发生率均低于常规施源器,且差异均有统计学意义(P＜0.05).结论 3D打印个体化施源管与传统常规施源器行腔内放射治疗相比剂量分布更加合理,降低正常组织受量有明显优势,具有疗效好、毒副反应轻的特点.

目的:探讨微小RNA-126(miR-126)增强胃癌细胞放射敏感性的分子生物学机制.方法:体外培养胃癌SGC-7901细胞,通过转染miR-126模拟序列上调细胞内的miR-126水平,使用RT-qPCR及Western blot检测miR-126上调后zeste基因增强子同源物2(EZH2)的mRNA及蛋白水平的变化.双萤光素酶报告基因实验确认miR-126与EZH2的靶向结合关系.在上调miR-126水平的同时,通过共转染pcDNA3.1-EZH2真核表达质粒提高细胞内的EZH2表达,CCK-8法及流式细胞术分析照射后胃癌细胞的活力及凋亡率的变化,从而评估EZH2过表达对miR-126放射增敏作用的影响.结果:上调胃癌SGC-7901细胞中的miR-126水平可以显著抑制EZH2的mRNA及蛋白水平(P<0.05).双萤光素酶报告基因实验提示miR-126与EZH2的mRNA间存在直接靶向关系.与仅上调miR-126的细胞相比,上调miR-126水平的同时过表达EZH2水平,将导致照射后SGC-7901细胞的活力增加,凋亡率减少(P<0.05).结论:对EZH2靶向抑制是miR-126增强胃癌SGC-7901细胞放射敏感性的机制之一.

AIM: To investigate the influences of microRNA-126 on the curative effect of chemoradiotherapy and radiosensitivity of SGC-7901 cells.METHODS: The patients of gastric cancer (n=60) were selected in this study including 32 males and 28 females with the average age of (51±7) years.All patients received similar chemoradiotherapy strategy.The tissue and blood samples were collected during treatment.The short-term curative effect was evaluated by the Response Evaluation Criteria in Solid Tumors (RECIST), and the patients were divided into sensitive group and insensitive group.The microRNA-126 levels were detected by RT-qPCR.The SGC-7901 cells were maintained in vitro and transfected with microRNA-126 mimic.The plate colony formation assay was used to determine the enhancement effect of microRNA-126 on radiosensitivity of the SGC-7901 cells.The apoptotic rate of the SGC-7901 cells induced by microRNA-126 was analyzed by flow cytometry.RESULTS: According to the RECIST, 28 cases were defined as sensitive patients and 32 cases were the insensitive patients.Compared with the sensitive patients, the microRNA-126 levels both in blood and tissue samples were lowered in the insensitive patients, and the relative fold changes were 0.72±0.04 and 0.48±0.03, respectively (P<0.05).After transfection with microRNA-126 minic, the SF2 and D0 in the SGC-7901 cells were decreased with the SER of 1.74.Furthermore, microRNA-126 induced apoptosis of SGC-7901 cells and enhanced their radiosensitivity.CONCLUSION: The patients with low microRNA-126 level may suffer a poor curative effect of chemoradiotherapy on the gastric cancer.MicroRNA-126 has an enhancement effect on the radiosensitivity to the SGC-7901 cells.