Survival prediction in patients with esophageal cancer is receiving a lot of attention from sarcopenia, myosteatosis, and systemic immune-inflammatory index (SII). The aim of this study was to investigate the survival prediction value of these parameters in esophageal cancer patients treated with immune checkpoint inhibitors (ICIs). Retrospective analysis of 178 patients with esophageal cancer who received immunotherapy and CT imaging. X-tile plots were utilized to determine optimal survival thresholds for skeletal muscle density (SMD), skeletal muscle index (SMI), and SII. The relationship between these parameters and patients’ overall survival (OS) and progression-free survival (PFS) was explored by Cox regression modeling and survival curve analysis. For OS, the Fine-Gray test was used to analyze competing risks. In addition, correlation and interaction analyses were performed on these indicators. Sarcopenia (mOS 10.3 months vs. 23.6 months; P < 0.001), and myosteatosis (mOS 13.0 months vs. 23.4 months; P = 0.008), high SII (14.4 months vs. 40.7 months; P = 0.002) were associated with poor OS. Multifactorial regression showed that sarcopenia (HR: 2.15; 95

Abstract Background: Patients with brain metastases (BM) often suffer from peritumoral edema. The purpose of study was to assess the effect of anlotinib in alleviating peritumoral edema and increasing tumour regression in symptomatic BM patients during radiotherapy. Methods: The volumes of the tumour (Vt), peritumoral edema (Ve) and whole brain (Vb) were delineated based on brain MRI acquired before and after radiotherapy. The regression rates of Vt, Ve and lesion volume (Vl =Vt + Ve) and the regression percentage of Vl in Vb were assessed 1 month after radiotherapy compared with pre-radiotherapy. A multivariate logistic regression analysis was used to analyse the factors related to the regression rates of Vt, Ve and Vl and the regression percentage of Vl in Vb after radiotherapy. Results: A total of 60 BM patients were included, with 14 in the radiotherapy plus anlotinib group and 46 in the radiotherapy alone group. Compared with the radiotherapy alone group, the combined therapy group had a larger regression rate of Vt (75.8% vs. 60.2%, P=0.043), Ve (88.0% vs. 48.0%, P=0.003) and Vl (79.8% vs. 50.5%, P=0.003) and a better regression percentage of Vl in Vb (9.18% vs. 1.57%, P<0.001). Multivariate analysis revealed that radiotherapy plus anlotinib could promote the reduction of Ve (OR=0.104, 95% CI: 0.020-0.544), Vl (OR=0.220, 95% CI: 0.002-0.238), and regression percentage of Vl in Vb (OR=0.030, 95% CI: 0.004-0.256). Conclusion: Concurrent treatment with anlotinib can further reduce peritumoral edema in the early postradiotherapy period for symptomatic BM patients undergoing radiotherapy.

Purpose: The aim of the present study was to assess the clinical outcomes and prognostic factors of lung adenocarcinoma patients with brain metastases (BMs) after intracranial local therapy. Patients and Methods: A total of 83 lung adenocarcinoma patients with BMs who underwent craniotomy combined with radiotherapy or intracranial radiotherapy alone were retrospectively analyzed. The intracranial tumor response was determined according to the Response Assessment in Neuro-Oncology of Brain Metastases (RANO-BM) criteria. The median overall survival (OS), intracranial progression-free survival (iPFS), and related prognostic factors were analyzed with the Kaplan-Meier estimator method and Cox Results: Among 83 patients, 20 patients received craniotomy combined with radiotherapy, and 63 patients received intracranial radiotherapy alone. Following intracranial local therapy, 11 patients (13.3%) achieved complete response (CR); among them, 8 patients underwent neurosurgical resection. In addition, 32 patients (38.55%) achieved partial response (PR), 32 patients (38.55%) experienced stable disease (SD), and 8 (9.6%) experienced progressive disease (PD). The median follow-up period was 25.4 months (range 0.8- 49.6 months). The median follow-up time for the iPFS was 16.2 months (range 0.6-41.2 months). The median OS, iPFS were 28.2 months and 24.7 months. Epidermal growth factor receptor (EGFR) / anaplastic lymphoma kinase (ALK) mutations (HR 3.216, 95% confidence interval (CI) 1.269-8.150, p = 0.014) and iPFS (HR 0.881, 95% CI 0.836-0.929, p < 0.001) were found to be beneficial factors for OS. An intracranial-tumor CR was associated with a longer iPFS (PR: HR 0.052, 95% CI 0.009-0.297, p = 0.001; SD: HR 0.081, 95% CI 0.025-0.259, p < 0.001; PD: HR 0.216, 95% CI 0.077-0.606, p = 0.004). Conclusion: Prolonged iPFS was associated with better OS in lung adenocarcinoma patients with BMs following intracranial local therapy, and mutations of EGFR / ALK or an intracranial-tumor CR are independent prognostic factors for prolonged survival.

PURPOSE:Radiation-induced pulmonary fibrosis (RIPF) is a common side effect of radiation therapy for thoracic tumors without effective prevention and treatment methods at present. The aim of this study was to explore whether glycyrrhetinic acid (GA) has a protective effect on RIPF and the underlying mechanism. METHODS AND MATERIALS:A RIPF mouse model administered GA was used to determine the effect of GA on RIPF. The cocultivation of regulatory T (Treg) cells with mouse lung epithelial-12 cells or mouse embryonic fibroblasts and intervention with GA or transforming growth factor-β1 (TGF-β1) inhibitor to block TGF-β1 was conducted to study the mechanism by which GA alleviates RIPF. Furthermore, injection of Treg cells into GA-treated RIPF mice to upregulate TGF-β1 levels was performed to verify the roles of TGF-β1 and Treg cells. RESULTS:GA intervention improved the damage to lung tissue structure and collagen deposition and inhibited Treg cell infiltration, TGF-β1 levels, epithelial mesenchymal transition (EMT), and myofibroblast (MFB) transformation in mice after irradiation. Treg cell-induced EMT and MFB transformation in vitro were prevented by GA, as well as a TGF-β1 inhibitor, by decreasing TGF-β1. Furthermore, reinfusion of Treg cells upregulated TGF-β1 levels and exacerbated RIPF in GA-treated RIPF mice. CONCLUSIONS:GA can improve RIPF in mice, and the corresponding mechanisms may be related to the inhibition of TGF-β1 secreted by Treg cells to induce EMT and MFB transformation. Therefore, GA may be a promising therapeutic candidate for the clinical treatment of RIPF.

Purpose: Radiation-induced pulmonary fibrosis (RIPF) is a serious side effect of radiation therapy, but the underlying mecha-nisms are unknown. B10 cells, as negative B regulatory cells, play important roles in regulating inflammation and autoimmu-nity. However, the role of B10 cells in RIPF progression is unclear. The aim of this study was to determine the role of B10 cells in aggravating RIPF and the underlying mechanism.Methods and Materials: The role of B10 cells in RIPF was studied by constructing mouse models of RIPF and depleting B10 cells with an anti-CD22 antibody. The mechanism of B10 cells in RIPF was further explored through cocultivation of B10 cells and MLE-12 or NIH3T3 cells and administration of an interleukin (IL)-10 antibody to block IL-10.Results: B10 cell numbers increased significantly during the early stage in the RIPF mouse models compared with the controls. In addition, depleting B10 cells with the anti-CD22 antibody attenuated the development of lung fibrosis in mice. Subse-quently, we confirmed that B10 cells induced epithelial-mesenchymal transition and the transformation of myofibroblasts via activation of STAT3 signaling in vitro. After blockade of IL-10, it was verified that IL-10 secreted by B10 cells mediates the epi-thelial-mesenchymal transition of myofibroblasts, thereby promoting RIPF.Conclusions: Our study uncovers a novel role for IL-10-secreting B10 cells that could be a new target of research for relieving RIPF.& COPY; 2023 Elsevier Inc. All rights reserved.

OBJECTIVES: To explore the effect of tumor and normal lung volumes on lung volume-dose parameters in patients with non-small-cell lung cancer (NSCLC) who had undergone intensity-modulated radiation therapy (IMRT). METHODS: The clinical data of 208 patients with NSCLC who underwent radical IMRT between June 2014 and June 2018 were retrospectively analyzed. A regression model curve was used to evaluate the effect of tumor and normal lung volumes on normal lung relative volumes receiving greater than 5 and 20 Gy (V5, V20), on mean lung dose (MLD), and on absolute volumes spared from greater than 5 and 20 Gy (AVS5, AVS20). RESULTS: The V5, V20, and MLD of the bilateral lung were fitted to a quadratic equation curve with the change in tumor volume, which increased initially and then decreased when the tumor volume increased. The V5, V20, and MLD of the lung reached their apex when the tumor volumes were 288.07, 341.69, and 326.83 cm(3), respectively. AVS5 and AVS20 decreased in a logarithmic curve with an increase in tumor volume. The V5, V20, and MLD of the small normal lung volume group were all significantly higher than those of the large normal lung volume group (p<0.001, p=0.004, p=0.002). However, the AVS5 and AVS20 of the small normal lung volume group were all significantly lower than those of the large normal lung volume group (p<0.001). CONCLUSION: The effects of tumor volume and normal lung volume on dose-volume parameters should be considered. AVS5 is an important supplementary dose limitation parameter for patients whose tumor volume exceeds a certain boundary value (approximately 300 cm(3)).

目的:探究B10细胞放射性肺纤维化进程中的动态变化.方法:将30只6～8周C57BL/6小鼠随机分为未照射对照组、照射后2 d组(IR2d组)、照射后14 d组(IR14d组)、照射后3个月组(IR3m组)、照射后5个月组(IR5m组),应用电离辐射建立放射性肺纤维化的动物模型,通过HE染色法、Masson染色观察肺组织的病理变化,免疫荧光染色法观察α-平滑肌肌动蛋白(α-smooth muscle actin,α-SMA)表达,流式细胞术检测B10细胞在肺、脾脏中的数目变化.结果:胸部照射后早期小鼠肺组织呈现炎性反应;照射后3个月出现肺泡结构破坏,间质填充,照射后5个月大量胶原填充,α-SMA表达较对照组明显增加.IR2d组、IR14d组肺组织中的B10细胞比例较对照组明显增加,而IR3m组B10细胞较IR2d组明显下降;照射后2d脾脏中B10细胞开始增加,照射后14d达到峰值,照射后3个月较照射后2 d、14d明显下降.结论:放射性肺纤维化进程中存在B10细胞浸润,呈现早期升高晚期降低的趋势.

目的 研究肝动脉化疗栓塞(TACE)联合放疗(RT)对照单纯TACE 治疗中晚期原发性肝细胞癌(肝癌)的疗效和毒性反应.方法 回顾性分析无法手术的肝癌患者的临床资料,通过倾向评分进行1:2 匹配分为TACE+RT 组(75 例)和单纯TACE 组(150例).根据实体瘤疗效评价标准(RECIST V1.1)评价近期疗效,根据美国国立癌症研究所常规毒性判定标准(NCI-CTC V4.0)评估毒性反应.结果 TACE+RT 组和单纯TACE组的客观有效率分别为81.3％和50.7％(x2 = 19.745,P＜0.001).TACE+RT组的肝功能异常和白细胞计数下降发生率均略高于单纯TACE 组,但差别无统计学意义(P＞0.05).结论 TACE 联合RT 较单纯TACE可提高中晚期肝癌的治疗有效率,且毒性反应未明显增加.

目的:研究调节性T细胞(Treg细胞)在放射性肺纤维化进程中的动态变化.方法:80只8周龄雌性C57BL/6小鼠随机分成对照组和照射组,每组40只.用15 Gy 6 MV X线单次照射小鼠胸部构建放射性肺纤维化模型.分别于照射后2天、17天、3个月和5个月取小鼠外周血、肺组织、脾脏.用HE染色和Masson染色评估小鼠肺组织的病理情况;用流式细胞仪检测各时间点外周血、肺和脾脏中Treg/CD4+T细胞的比例;采用2×4析因设计方差分析比较是否照射及各组照射后不同时间点Treg/CD4+T细胞比例的差异.结果:照射后2天、17天,照射组小鼠肺组织出现炎性病理特征;照射后5个月,小鼠的肺泡间隔可见大量胶原沉积,照射组肺组织的胶原容积分数明显高于对照组(P<0.01).照射后2天、17天,照射组小鼠外周血、肺组织和脾脏中Treg细胞比例均明显高于对照组(P<0.01);照射后3个月,小鼠外周血、肺组织和脾脏中Treg细胞比例较照射后17天明显下降(P<0.01);照射后5个月外周血和肺组织中的Treg细胞比例下降至对照组水平,脾脏中的Treg细胞比例则明显低于照射后3个月和对照组(P均<0.01).对照组各时间点间无显著差异(P>0.05).结论:Treg细胞在小鼠放射性肺纤维化进程中发生着动态的变化,总体表现出先升高后下降的趋势.

研究淫羊藿素对人角质形成细胞HaCat的放射防护作用.将HaCat细胞分成正常对照组、单纯淫羊藿素组、单纯照射组以及照射+淫羊藿素高/中/低剂量组.以6 MV X射线(剂量率为0.5 Gy/min),给予照射组和各个加药照射组细胞20 Gy的单次照射.所有药物处理组均于照射前6小时给予不同浓度的淫羊藿素处理,细胞照射后1小时,采用DCFH-DA探针检测细胞内活性氧水平、6小时使用实时荧光定量PCR法测定炎症因子mRNA表达水平、24小时采用硫代巴比妥酸法检测胞内丙二醛水平、48小时CCK-8法检测细胞的增殖能力、Annexin Ⅴ-PI双染检测细胞凋亡、酶联免疫吸附法测定炎症因子分泌水平.结果 表明,HaCat细胞经20 Gy的X射线照射后,细胞生存率下降,细胞凋亡率升高.给予淫羊藿素处理,可以刺激其增殖,提高细胞生存率,降低细胞凋亡比例.照射后细胞内活性氧(ROS)和丙二醛(MDA)的含量显著升高,淫羊藿素处理可以降低两者的含量,保护细胞.同时受到照射的HaCat细胞炎症因子IL-1β、IL-6以及TNF-α表达和分泌的量显著升高,淫羊藿素可以抑制这些因子的表达,减少其分泌.实验结果证明,淫羊藿素对HaCat细胞存在明显的放射保护作用,具有促进增殖、抑制凋亡、抗氧化和抗炎的能力,有望成为防护放射性皮肤损伤的中药防护剂.

Objective To evaluate the effect of tumor shape and location on pulmonary dose-volume parameters by intensity-modulated radiation therapy (IMRT) in patients with non-small cell lung cancer (NSCLC), aiming to provide a reference basis for establishing limits of the pulmonary dose-volume parameters during IMRT. Methods Clinical data of 208 NSCLC patients undergoing radical IMRT from June 2009 to June 2016 were retrospectively analyzed. According to the tumor shape and location, 208 cases were divided into the vertical bar group (n=127) and the horizontal bar group (n=81), the superior lung group (n=103) and the inferior lung group (n=105). Regression model curve was used to evaluate the effect of tumor shape and location upon the common pulmonary dose-volume parameters(V5, V20, MLD, AVS5 and AVS20). Results In all groups, the fitting curves of V5, V20 and MLD were manifested in the quadratic equation pattern, and AVS5 and AVS20 in the logarithmic equation manner. In the vertical bar group, the V5(P=0.015), V20(P=0.047) and MLD (P=0.012) were significantly higher, whereas the AVS5(P=0.044) was significantly lower compared with those in the horizontal bar group. No statistical significance was observed in AVS20 between two groups (P=0.490). The tumor location exerted significant effect upon V5 alone (P=0.009). Conclusions When the tumors presents in the vertical bar shape, the limits of the common lung dose-volume parameters are likely to exceed those of tumors in the vertical bar shape. Lung tumors located in the inferior lobe exerts a more significant effect upon the low-dose region volume compared with the tumors in the superior lobe. Key words: Dose-volume parameter; Tumor shape; Tumor location

目的 观察阿帕替尼治疗肺多发转移癌的疗效,并探讨其疗效评价标准.方法 3例肺多发转移癌患者给予阿帕替尼方案治疗,并在治疗前后均行肺部CT平扫,观察其中12个肺部转移病灶,利用Raystation放疗计划系统测量转移灶体积及CT值进行疗效评价.结果 12个肺转移病灶中,9个体积呈逐渐减小趋势,3个病灶维持稳定,体积退缩率最高达76.19％,平均退缩率为38.05％;12个肺转移病灶的CT值均呈下降趋势,最多下降164 Hu,平均下降49 Hu.结论 阿帕替尼治疗肺多发转移癌具有良好的疗效,利用肿瘤体积及CT值可有效评价抗血管生成靶向药物的疗效,值得临床应用及推广.

目的:探讨常规放疗、加速超分割放疗治疗老年中晚期非小细胞肺癌临床应用效果.方法:选取我院2015年4月-2016年10月收治的92例老年中晚期非小细胞肺癌患者,将其按单双数字法分为两组,均接受GP化疗,研究组在常规化疗基础上加用加速超分割放疗,对照组在常规化疗基础上加用常规放疗.结果:两组患者经相应放疗后,研究组OR率(80.43％)显著高于对照组(63.04％),差异具有统计学意义(P＜0.05);放疗过程中各类放疗相关毒性反应发生情况对比,差异无统计学意义(P＞0.05).结论:应用加速超分割放疗治疗老年中晚期非小细胞肺癌具有更为理想的临床疗效.

OBJECTIVE:To explore the effectof tumor volume on pulmonary dose-volume parameters by intensity-modulated radiation therapy (IMRT) in non-small cell lung cancer (NSCLC), and to provide a basis for pulmonary dose parameters in IMRT treatment.
 Methods: A total of 204 patients with NSCLC received IMRT were retrospectively analyzed from June, 2009 to October, 2013. The prescribed dose of planning target volume (PTV) for primary tumor was 60-66Gy (2.00-2.25 Gy, 27-33 times in all). The fractional volume percent of the lung received a dose >5 or 20 Gy (V5, V20), and absolute volume of lung received a dose <5 Gy (AVS5).The mean lung dose (MLD) in normal tissues were analyzed. Regression model curve was used to analyze them along with the change of primary tumor volume.
 Results: With the increase in lung tumor volume, the V5, V20 and MLD presented quadratic equation curve, and AVS5 presented logarithmic equation. When the tumor volume, less than a certain value (294.6, 283.2, 304.9 cm3, respectively), the V5, V20 and MLD increased with tumor size and presented an increased quadratic curve; when the tumor volume was higher than a certain value (294.6, 283.2, 304.9 cm3 respectively), the V5, V20 and MLD was declined. The AVS5 was declined in a logarithmic curve along with the increase of tumor volume.
 Conclusion: With the increase in lung tumor volume, the change in rule of V5, V20, MLD and AVS5 is not completely equivalent. When the tumor volume exceeds a certain boundary value (about 300 cubic centimeter), the corresponding tumor diameter is about 7-8 cm. In addition to the focus on pulmonary V5, V20 and MLD, we should also pay more attention to AVS5 restrictions in establishment of IMRT in NSCLC.

Objective:To explore the regular variation pattern of tumor volumes of the patients with non-small cell lung cancer (NSCLC) before and after targeting treatment of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI),and to clarify its clinical value.Methods:The materials of 39 NSCLC patients with EGFR-TKI targeting treatment were retrospectively analyzed. The tumor volumes were detected by volume measurement software of TPS and Image J image processing software,then the absolute and relative tumor volume changes of the NSCLC patients before and after targeting treatment were analyzed by paired sample comparison symbol Wilcoxon rank test. Results:The absolute tumor volumes (mm3 )of the patients with NSCLC before and 1 month after targeting treatment were 14 822.11 (7 524.73,54 999.41)and 7 954.42 (3 499.73,29 396.83),respectively, and there was statistically significant difference (Z=-3.257,P=0.001);the absolute tumor volumes of the patients with NSCLC 1 and 2 months after targeting treatment were 8 358.47 (4 394.36,24 430.05)and 7 028.76 (3 634.98,21 056.71),respectively,and there also was statisticaliy significant difference (Z=-2.213,P=0.027).When the original tumor volume before targeting treatment was regarded as 1,the relative tumor volume of 1 month after targeting theatment was 0.612 6 (0.313 8,0.853 7),and there was significant difference (Z=-3.855,P<0.001);the relative tumor volumes of 1 month and 2 months after targeting treatment were 0.608 4 (0.364 3,1.044 3)and 0.423 0 (0.248 8,0.877 7),respectively,and there also was statistically significant differernce (Z=-2.173,P=0.030);but the differences between other consecutive months (from 3 months to 6 months)had no statistically significant differences (P>0.05);the changes of tumor relative volume presented platform stage after 3 months.The tumor relative volumes of 7-9 months after EGFR-TKI treatment reached the bottom.Conclusion:The average primary tumor volume of the NSCLC patients is obviously reduced 1 and 2 months after TKI targeting treatment. It may be optimal to carry out radiotherapy in 3-9 months after EGFR-TKI targeting treatment.

Radiation-induced lung injury (RILI) is a common complication of thoracic radiotherapy, but efficacious therapy for RILI is lacking. This study ascertained whether glycyrrhetinic acid (GA; a functional hydrolyzed product of glycyrrhizic acid, which is extracted from herb licorice) can protect against RILI and investigated its relationship to the transforming growth factor (TGF)-β1/Smads signaling pathway. C57BL/6 mice were divided into four groups: a control group, a GA group and two irradiation (IR) groups. IR groups were exposed to a single fraction of X-rays (12 Gy) to the thorax and administered normal saline (IR + NS group) or GA (IR + GA group). Two days and 17 days after irradiation, histologic analyses were performed to assess the degree of lung injury, and the expression of TGF-β1, Smad2, Smad3 and Smad7 was recorded. GA administration mitigated the histologic changes of lung injury 2 days and 17 days after irradiation. Protein and mRNA expression of TGF-β1, Smad2 and Smad3, and the mRNA level of Smad7, in lung tissue were significantly elevated after irradiation. GA decreased expression of TGF-β1, Smad2 and Smad3 in lung tissue, but did not increase Smad7 expression. GA can protect against early-stage RILI. This protective effect may be associated with inhibition of the TGF-β1/Smads signaling pathway.

The aim of this study was to investigate the association between absolute volumes of lung spared from low-dose irradiation and radiation-induced lung injury (RILI) after intensity-modulated radiotherapy (IMRT) for lung cancer. The normal lung relative volumes receiving greater than 5, 10, 20 and 30 Gy (V5–30) mean lung dose (MLD), and absolute volumes spared from greater than 5, 10, 20 and 30 Gy (AVS5–30) for the bilateral and ipsilateral lungs of 83 patients were recorded. Any association of clinical factors and dose–volume parameters with Grade ≥2 RILI was analyzed. The median follow-up was 12.3 months; 18 (21.7%) cases of Grade 2 RILI, seven (8.4%) of Grade 3 and two (2.4%) of Grade 4 were observed. Univariate analysis revealed the located lobe of the primary tumor. V5, V10, V20, MLD of the ipsilateral lung, V5, V10, V20, V30 and MLD of the bilateral lung, and AVS5 and AVS10 of the ipsilateral lung were associated with Grade ≥2 RILI (P < 0.05). Multivariate analysis indicated AVS5 of the ipsilateral lung was prognostic for Grade ≥2 RILI (P = 0.010, OR = 0.272, 95% CI: 0.102–0.729). Receiver operating characteristic curves indicated Grade ≥2 RILI could be predicted using AVS5 of the ipsilateral lung (area under curve, 0.668; cutoff value, 564.9 cm3; sensitivity, 60.7%; specificity, 70.4%). The incidence of Grade ≥2 RILI was significantly lower with AVS5 of the ipsilateral lung ≥564.9 cm3 than with AVS5 < 564.9 cm3 (P = 0.008). Low-dose irradiation relative volumes and MLD of the bilateral or ipsilateral lung were associated with Grade ≥2 RILI, and AVS5 of the ipsilateral lung was prognostic for Grade ≥2 RILI for lung cancer after IMRT.

目的:观察甘草次酸对C57BL/6小鼠急性放射性肺损伤的保护效应.方法:成年C57BL/6雌性小鼠90只,随机数字表法分为3组,每组30只:空白对照组:未照射+生理盐水10 mL/kg灌胃;单纯照射组:照射+生理盐水10 mL/kg灌胃;甘草次酸组:照射+甘草次酸40 mg/kg灌胃.单纯照射组和甘草次酸组小鼠予6MV-X线12Gy全肺单次照射.照射前30 min给药一次,以后1次/d连续7d后改为隔日给药,直至照射后一个月.照射后第2、17、30天随机从各组分别选取10只小鼠处死.取双侧肺组织行HE染色、Mas-son染色观察肺组织形态变化.结果:空白对照组小鼠肺组织结构正常.单纯照射组小鼠肺组织在照射后第2天、17天以渗出为主,肺泡腔及间隔可见渗出、充血,伴有炎症细胞的浸润.照射后第30天,肺泡壁间隔增宽、肺泡结构变形、炎性细胞浸润,并可见胶原纤维沉积.甘草次酸组在不同时间点,肺泡炎及胶原沉积的情况均较单纯照射组改善,任一时间点两组之间差异有统计学意义(P＜0.05).结论:甘草次酸能够改善急性放射性肺损伤小鼠的一般情况,减轻肺组织炎症反应及改善胶原沉积.

目的：通过分析小细胞肺癌（SCLC）化疗后肿瘤体积的变化规律及可能影响其变化的相关因素，为诱导化疗的最佳周期数选择及放射治疗的最佳介入时机提供理论依据。方法回顾性分析行多周期诱导化疗的首诊 SCLC 患者的疗效。使用治疗计划系统自带体积测量软件及 Image J 图像处理软件测量肿瘤体积，分析诱导化疗不同周期后的体积变化情况，并分析可能的影响因素（性别、年龄、大体类型、患者 ECOG 评分、化疗前肿瘤体积、T 分期）对其的影响。结果（1）共有34例 SCLC 患者入组，化疗前和化疗1、2、3、4、5、6个周期后的肿瘤绝对体积分别为63002．89（18488．99，130598．54）、40523．12（12083．03，77139．65）、12145．31（2758．06，67560．39）、18141．67（4498．78，70062．25）、13864．67（2940．28，71071．43）、20964．56（1854．63，85806．55）和19600．00（5698．36，151165．90）mm 3。（2）化疗前和化疗1个周期后绝对体积之间差异有统计学意义（t ＝3．157，P ＝0．004），两组的相对体积（假定化疗前肿瘤体积为1）差异也有统计学意义（t ＝3．312，P ＝0．003），第3周期较第2周期化疗无效例数明显升高（P ＝0．025），其他各相邻周期间差异无统计学意义。（3）logistic 回归分析发现，T 分期（χ2＝5．512，P ＝0．019，OR ＝0．099）是 SCLC 化疗1个周期后肿瘤消退率的独立影响因素。结论SCLC 患者多周期化疗后体积变化呈现一定的规律。化疗1个周期后 SCLC 平均原发灶肿瘤体积明显下降，化疗3个周期后可能出现反弹。若采用诱导化疗，1个周期即可。 T3～4期较 T1～2期的第1周期肿瘤退缩效果相对较好。