BackgroundSarcopenia (SP) is an important indicator for evaluating the nutritional status of cancer patients, but its impact on short-term efficacy, toxic and adverse reactions, and long-term survival in patients with non-small cell lung cancer (NSCLC) undergoing concurrent chemoradiotherapy (CRT) remains incompletely understood.MethodsClinical data of 86 newly diagnosed NSCLC patients who were admitted to Bengbu Medical University First Affiliated Hospital from January 2020 to June 2024 were collected. The skeletal muscle index (SMI) was calculated based on computed tomography (CT) images at the mid-vertebral body of L3. Patients were divided into the SP group (46 cases, 53.5%) and the non-sarcopenia group (40 cases, 46.5%). The incidence of adverse events, short-term efficacy (per RECIST 1.1 criteria), 1 and 3-year overall survival (OS), and progression-free survival (PFS) were compared between the two groups. Cox proportional hazards regression model was used to analyze prognostic factors.ResultsFollow-up was conducted until July 31, 2025. The objective response rate (ORR) in the sarcopenia group was significantly lower than that in the non-sarcopenia group (56.5 vs. 80.0%, χ2 = 5.371, P = 0.020), and the complete response rate (CR) showed a decreasing trend (4.3 vs. 20.0%, P = 0.055). There was no significant difference in the incidence of severe adverse events between the two groups (P > 0.05), but the incidence of radiation pneumonitis was higher in the sarcopenia group (43.5 vs. 25.0%). The median OS of the entire cohort was 24 months (95% confidence interval [CI] 18 ~30 months), and the median OS in the sarcopenia group (19 months) was significantly shorter than that in the non-sarcopenia group (36 months, P < 0.001). Multivariate Cox proportional hazards regression analysis revealed that sarcopenia (hazard ratio [HR] = 1.729, 95% CI 1.024–2.910, P = 0.040), Karnofsky Performance Status (KPS) score < 80, serum albumin < 40.0 g/L, and intermuscular adipose tissue (IMAT) ≥12.46 cm2 were independent prognostic factors for OS.ConclusionSP can reduce the short-term efficacy of CRT and shorten OS in NSCLC patients. It serves as an independent prognostic factor for these patients, providing guidance for formulating clinical treatment strategies.

The cGAS-STING pathway plays a central role in antitumor innate immunity, but the therapeutic efficacy of STING agonists is often limited by insufficient tumor delivery and inadequate amplification of endogenous danger signals. Here, we developed a lactate oxidase-engineered manganese layered double hydroxide nanoplatform loaded with the STING agonist MSA-2, termed Mn-LDH-M@LOX, to establish a tumor metabolism-driven STING amplification strategy. Under mildly acidic tumor-associated conditions, Mn-LDH-M@LOX underwent structural disassembly and synchronously released manganese ions and MSA-2. Meanwhile, surface-immobilized LOX converted tumor-derived lactate into hydrogen peroxide, thereby providing an endogenous fuel for manganese-mediated ROS amplification. This cascade induced oxidative DNA damage, mitochondrial dysfunction and cytosolic mtDNA accumulation, which further reinforced cGAS-STING-related immune activation together with MSA-2 and manganese ions. In 4T1 tumor cells, Mn-LDH-M@LOX efficiently enhanced ROS generation, mitochondrial depolarization, γ-H2AX-associated DNA damage, ICD-related signals and downstream immune responses, including increased p-IRF3, IFN-β and CXCL10. In vivo, Mn-LDH-M@LOX significantly suppressed tumor growth, reduced intratumoral lactate content and decreased Ki67 expression, while promoting CRT exposure, dendritic cell maturation, CD4+/CD8+ T-cell infiltration and intratumoral cytokine/chemokine production. Moreover, no obvious systemic toxicity was observed based on body weight, blood biochemical indices, routine blood parameters and major organ histology. Overall, this work presents a lactate-fueled manganese nanocatalytic platform that converts tumor metabolic reprogramming into ROS-amplified STING activation, offering a promising strategy for enhanced tumor immunotherapy.

Lung cancer has a poor prognosis with traditional treatments. Realgar (AS4S4), a traditional Chinese medicine, exhibits chemotherapeutic efficacy. However, its low solubility, complex dosage form, and limited therapeutic efficacy hinder its further application in lung cancer. In this study, AS4S4 was chemically synthesized using hydrochloric acid to disrupt the bonding between AS and NH2, producing realgar nanoclusters that improved solubility and reduced side effects. Simultaneously, Fe3O4 nanoparticles were introduced, and intelligent temperature-sensitive hydrogels were utilized to combine these two performance nanomaterials, developing a local injection nano-diagnosis and treatment unit (AS4S4/Fe3O4@Gel) that integrates chemotherapy with alternating current magnetic field (ACMF) induction hyperthermia. The morphological characteristics, thermal stability, and controlled release of AS4S4/Fe3O4@Gel were assessed. After processing the Lewis cells, the CCK-8 method, hemolysis test, EdU method, cell apoptosis test, reactive oxygen species detection, and cellular ultrastructure analysis were used to evaluate the biological effects. Western blot was employed to detect Bcl-2, BAX, GPX4, and HO-1 protein expression in cells. After injecting the gel system into the transplanted tumor, in vivo imaging, near-infrared thermography, and the antitumor effect were studied. AS4S4/Fe3O4@Gel, which exhibits fluorescence and magnetic inductive hyperthermia, was successfully developed. The gel system, which has good hemocompatibility, possesses ideal temperature sensitivity. It can transform from liquid to solid within a specific temperature range, and the drug release rate about 80

Background:Triple-negative breast cancer (TNBC) is a highly aggressive subtype of breast cancer lacking estrogen receptor (ER), progesterone receptor (PR), and HER2 expression, which limits targeted therapies. Cancer-associated fibroblasts (CAFs) in the tumor microenvironment are known to secrete factors that promote tumor progression. The role of neuregulin-1 (NRG1), a ligand of HER3 and HER4, in TNBC and its association with CAFs remains unclear. Methods:We analyzed NRG1 mRNA and protein levels in TNBC tumor and adjacent tissues using qRT-PCR and ELISA, and evaluated their relationship with clinicopathological parameters and prognosis in 174 patients. Serum NRG1 levels were assessed via ELISA in TNBC patients and healthy controls. The effects of CAF-secreted NRG1 on TNBC cells were studied using conditioned medium, siRNA knockdown, and xenograft mouse models. Statistical analyses, including ROC curves and survival analyses, were performed to determine diagnostic and prognostic value. Results:NRG1 expression was significantly upregulated in TNBC tissues and serum compared to controls, correlating with advanced TNM stages and poor prognosis. ROC analysis demonstrated diagnostic value of NRG1 in tissues and serum. CAFs secreted higher levels of NRG1 compared to normal fibroblasts. Conditioned medium from CAFs enhanced TNBC cell proliferation, migration, and MMP9 expression, effects reduced by NRG1 knockdown. In vivo, CAF-conditioned medium promoted tumor growth, while NRG1 knockdown reduced this effect. Conclusion:Our findings suggest that CAF-secreted NRG1 is closely associated with TNBC progression and may represent a potential biomarker and therapeutic target, although further validation is needed to establish causality.

BackgroundSarcopenia is a common indicator of systemic nutritional status in patients with cancer progression. This study investigated the impacts of sarcopenia on adverse effects and prognosis of sarcopenia on patients with esophageal cancer receiving chemoradiotherapy.MethodsThe clinical data of 158 patients with initially diagnosed esophageal cancer who received chemoradiotherapy were collected, and nutritional indexes and inflammatory markers were calculated. The cross-sectional areas of the skeletal muscle, subcutaneous fat and visceral fat were calculated using computed tomography (CT) images of the midpoint of the third lumbar (L3) vertebra. The incidence of adverse events, response evaluation, 1-year and 3-year overall survival (OS) and progression-free survival (PFS) were compared between sarcopenia group and non-sarcopenia groups.ResultsThis study included 158 patients, 103 (71.5%) in the sarcopenia group and 45 (28.5%) in the non-sarcopenia group. The last follow-up date was January 31, 2024. The median follow-up time was 36 months for all patients. The chi-square test revealed no significant difference in the incidence of serious adverse events between the two groups. The complete response rates (CR) of patients in the sarcopenia and non-sarcopenia groups 1 month after chemoradiotherapy were 2.7 and 13.3%, respectively, p = 0.017, and the difference was statistically significant. Moreover, the objective response rates (ORR) were 38.9 and 60.0%, respectively (χ2 = 5.770, p = 0.016). The median survival time for all patients was 36 months [95% Confidence Interval CI 24–48]. Univariate analysis (Cox proportional risk model) showed that sarcopenia, KPS score, albumin level, T stage, and N stage were correlated with patients’ OS. Multivariate analysis showed that sarcopenia (Hazard Ratio HR 2.84, 95%CI [1.45–5.57], p = 0.002), KPS score, albumin level and N stage were independent prognostic factors for OS.ConclusionSarcopenia reduced OS in patients with EC treated with chemoradiotherapy. It can be used as an independent indicator to predict the OS of such patients, which may help in developing optimal treatment strategies.

Primary cardiac tumors are extremely rare, with an incidence rate ranging from only 0.17% to 0.33%. Clinically, their diagnosis is often delayed due to nonspecific clinical symptoms. This paper reports a case of primary cardiac angiosarcoma (PCAS) pathologically confirmed via surgery, presenting with recurrent palpitations during exertion as the initial symptom. The patient subsequently developed bilateral lung and liver metastases and received chemotherapy. Through a comprehensive review of the literature, this report explores the diagnostic and therapeutic strategies for PCAS, with a focus on analyzing the mechanisms underlying the atypical disease course, the rationale for treatment decisions, and the key clinical insights.

Advanced hypopharyngeal squamous cell carcinoma (HPSCC) often presents with late-stage diagnosis and high recurrence rates. This study aimed to evaluate the efficacy and prognostic factors of combined surgery and chemoradiotherapy versus chemoradiotherapy alone in treating stage III/IV HPSCC. A cohort of 85 patients with stage III/IV HPSCC were analyzed for survival outcomes and prognostic indicators. The combined treatment group had a lower mortality rate (53.33 %) compared to the chemoradiotherapy group (69.09 %). The combined treatment group demonstrated significantly higher 1-, 3-, and 5-year overall survival (OS) rates. Additionally, progression-free survival (PFS) rates showed significant differences between groups at 1-, 3-, and 5-year intervals. Prognostic assessments revealed tumor T stage, N stage, overall stage, and treatment modality as significant influencers of OS for locally advanced HPSCC patients (P < 0.05). Independent prognostic factors for OS, as determined by multivariate analysis, included age, tumor T stage, and treatment approach. Similarly, these three factors were also independent predictors for PFS. Notably, the incidence of radiation pharyngitis and dermatitis presented significant disparities between the two groups (P < 0.05). The study indicates that surgery combined with chemoradiotherapy improves survival outcomes over chemoradiotherapy alone in locally advanced HPSCC patients.

Introduction Metastasis remains a major cause of death among patients with malignant tumors. Radiotherapy is one of the main modalities of cancer treatment. The rapid development of radiotherapy technology has enabled the widespread application of hypofractionated radiotherapy (HFRT) in clinical practice. This study aimed to evaluate the effect of HFRT on the survival and safety of patients with oligometastatic tumors. Methods We conducted a retrospective study that involved 65 patients with well-controlled primary tumors and 1–5 metastatic foci treated at the study site between January 2020 and December 2022. Patients were aged >18 years and had a ≥ 6-month life expectancy. The patients received standard treatments plus HFRT for all metastatic foci. The dose fractionation regimen was adjusted according to the location and size of the patient’s metastatic foci. The planning gross tumor volume of HFRT was 82.93 cm 3 (range: 10.12-562.80 cm 3 ), and the radiation dose range was 20 Gy/5 F–60 Gy/15 F. Progression-free survival (PFS), overall survival (OS), local control rates, and incidence of adverse events of the patients were observed. Results Among the 65 patients, the median follow-up time, PFS, and OS were 26 months (95% CI: 0.80-37.50), 15 months (95% CI: 9.36-20.64), and 28 months (95% CI: 16.71-39.29), respectively. The 1- and 2-year PFS were 53.8% and 40.0%, respectively, while the 1- and 2-year OS rates were 73.8% and 56.9%, respectively. In total, 13.8%, 55.4%, 20.0%, and 13.8% of patients showed complete response, partial response, stable disease, and progressive disease, respectively. Four patients developed grade 3 or worse adverse events, and no treatment-related deaths occurred. Conclusions HFRT showed favorable clinical efficacy and safety in patients with oligometastatic tumors, generally achieving a good OS rate. Further randomized trials should be conducted.

Radiotherapy is a cornerstone treatment for lung cancer; however, enhancing its efficacy and overcoming immune escape mechanisms - particularly those mediated by tumor-associated macrophages (TAMs) expressing programmed death-ligand 1 (PD-L1) - remain significant challenges. The E3 ubiquitin ligase RNF200 has been implicated in the regulation of PD-L1 expression, yet its role in the context of radiotherapy is not well understood. To address this, non-small cell lung cancer (NSCLC) tissue samples from patients with and without prior radiotherapy were analyzed for RNF200 and PD-L1 expression using quantitative RT-PCR and Western blotting. Additionally, RAW264.7 macrophages were subjected to ionizing radiation and genetically manipulated to assess the impact of RNF200 on PD-L1 expression and stability through co-immunoprecipitation and ubiquitination assays. Co-culture experiments with macrophages and lung cancer cells were performed to evaluate the influence of RNF200 on radiotherapy sensitivity. In NSCLC tissues and macrophages, radiotherapy was found to downregulate RNF200 expression while upregulating PD-L1 expression. Overexpression of RNF200 led to marked suppression of PD-L1 expression, whereas RNF200 knockdown produced the opposite effect. Co-immunoprecipitation and ubiquitination assays revealed that RNF200 physically interacted with PD-L1 and promoted its polyubiquitination and proteasomal degradation. Furthermore, co-culture studies demonstrated that macrophages overexpressing RNF200 enhanced the sensitivity of lung cancer cells to radiotherapy, as evidenced by reduced proliferation, increased necrosis, and decreased secretion of transforming growth factor beta TGF-β. Collectively, these findings indicate that RNF200 enhances radiotherapy sensitivity in lung cancer by regulating PD-L1 expression through ubiquitination. Targeting RNF200 may represent a promising strategy to improve the efficacy of radiotherapy in lung cancer treatment.

BACKGROUND:Ubiquitin-conjugating enzyme 2T (UBE2T) has been reported to be associated with uncontrolled cell growth and tumorigenesis in multiple cancer types. However, the understanding of its regulatory role in the carcinogenesis of Head And Neck Squamous Cell Carcinoma (HNSC) is limited. METHODS:UBE2T expression in HNSC patient samples and the correlation between its expression and patients' survival rates were evaluated using The Cancer Genome Atlas (TCGA) database. Cell survival and proliferation were investigated in UM-SCC1 and UM-SCC15 cells infected with control and shUBE2T lentivirus. The xenograft mouse model was established using UM-SCC15 cells to examine HNSC tumorigenesis with or without UBE2T. Western blot, qRT-PCR, and ferroptosis assays were carried out to disclose the interaction between UBE2T and NF-κB signaling and ferroptosis. RESULTS:The increased expression of UBE2T was noted in tumor tissues of patients with HNSC, correlating with a significantly reduced overall survival time in this patient cohort. Knockdown of UBE2T inhibited HNSC tumorigenesis and tumor growth. Mechanistically, inhibition of UBE2T suppressed NF-κB signaling and induced ferroptosis in HNSC. CONCLUSION:Our study underscores the multifaceted role of UBE2T in HNSC, illuminating its potential as a biomarker and therapeutic target.

We aimed to investigate galectin-1 overexpression induces normal fibroblasts (NFs) translates into cancer-associated fibroblasts (CAFs). Galectin-1 overexpression was conducted in Human embryonic lung fibroblasts (HFL1) cell. The motilities of H1299 and A549 cells were measured. Human umbilical vein endothelial cell (HUVEC) proliferation and tube formation ability were assessed. Tumor volume and tumor weight was recorded. Cells motilities were increased, while apoptosis rates were decreased after CMs co-cultured. B-cell lymphoma-2 (Bcl-2) expression level was increased, while Bcl2-associatedX (Bax) and cleaved-caspase3 decreased. CMs treatment enhanced HUVEC proliferation and tube formation. Tumor volume and weight in CMs treated mice were increased, and the sensitivity of anlotinib in co-cultured cells was decreased. Our results revealed that galectin-1 overexpression induced NFs translated into CAFs.

目的 分析根治性放化疗前淋巴细胞-单核细胞比值(lymphocyte-to-monocyte ratio,LMR)对老年食管癌(esophagus cancer,EC)患者预后的评估价值.方法 收集2014年1月—2017年12月在蚌埠医学院第一附属医院放射肿瘤科接受EC根治性放化疗的老年(≥65岁)患者220例,回顾性分析所纳入患者的临床数据及实验室检验指标.通过建立受试者工作特征曲线,约登指数最大值时的LMR为4.9,将LMR=4.9作为临界值,分为高LMR组(＞4.9,69例)和低LMR组(≤4.9,151例),通过Kaplan-Meier方法绘制2组患者的生存曲线,采用Log Rank法比较2组患者的生存状况,通过Cox回归模型进行多因素分析.结果 全组共有82例患者生存,总体中位随访时间为45个月,总体中位生存时间为28个月.高LMR组和低LMR组患者的5年无进展生存率分别为38.6％和29.8％(P=0.005),5年总生存率分别为47.0％和26.5％(P=0.003).Cox回归模型多因素分析结果显示,根治性放化疗前LMR值是老年EC患者预后的独立影响因素(HR=0.634,95％CI:0.422～0.954,P=0.029).结论 对于接受根治性放化疗的老年EC患者来说,根治性放化疗前LMR降低是独立不良预后因素.

目的 螺旋断层放疗在保护多病灶、大肿瘤周围的正常组织和器官,降低放疗的毒性反应方面有较大优势.本研究主要分析肺寡转移瘤患者应用螺旋断层调强大分割放射治疗的近期疗效和影响预后的危险因素.方法 回顾性分析2018年1月1日-2021年6月30日就诊于蚌埠医学院第一附属医院肿瘤放疗科的45例完成螺旋断层大分割放疗的肺寡转移瘤患者资料.采用Kaplan-Meier方法计算总生存(OS)、局部控制(LC)和无进展生存(PFS),运用Cox比例风险模型明确患者预后的独立影响因素.治疗相关毒性采用美国国家癌症研究所常见不良事件评价标准(CTCAE)5.0版本评价.结果 截至2021年9月30日,全组患者均完成放疗计划,随访时间为16.0(12.3,24.2)个月,生物等效剂量为76.8(72.8,90.0)Gy.1年与2年OS率分别为94.8％、58.1％;1年与2年LC率分别为83.8％、74.1％;1年与2年PFS率分别为57.8％、43.3％.单因素分析显示Karnofsky功能状态评分(KPS)＞80分与高LC率有关(P=0.043).多因素分析显示确诊肺转移前有无远处淋巴结转移患者OS比较差异有统计学意义(P=0.041,HR=3.014,95％CI:1.043～8.706);是否使用四维计算机断层扫描术定位患者PFS比较差异有统计学意义(P=0.035,HR=2.693,95％CI=1.072～6.761).无治疗相关性死亡及≥3级的放射性肺炎发生.结论 螺旋断层调强大分割放射治疗技术在肺寡转移瘤的治疗上是安全有效的,并且KPS＞80分、确诊肺转移前无远处淋巴结转移的患者有较长的生存时间.

ObjectiveTo define the properties of lung cancer cells that resisted conventionally fractionated radiation exposure.MethodsAcquired radioresistant lung cancer cell line A549 was constructed by X-ray irradiation with a clinical conventional fraction dose of 2 ​Gy daily during 30 fractions. Cell morphology, molecular markers, migration capacity and invasion potential were evaluated by the microscope, Western blot, immunofluorescence, wound healing test and transwell chamber assay, respectively.ResultsRadioresistant A549 ​cells shifted from an epithelial to a mesenchymal morphology, termed as epithelial-mesenchymal transition (EMT), and was accompanied by decreased expressions of epithelial markers (F ​= ​4.568, P ​< ​0.05) and increased expression of mesenchymal markers (F ​= ​4.270, P ​< ​0.05), greater migratory and invasive capabilities (t ​= ​6.386, 5.644, P ​< ​0.05). The expression of TGF-β, and phosphorylated levels of Akt and Smad3 were also enhanced (F ​= ​6.496, 4.685, 3.370, P ​< ​0.05). Furthermore, the EMT phenotype induced by radiation could be reversed through inhibition of TGF-β, Akt or Smad3, indicating a functional relationship between them.ConclusionsEMT mediates acquired radioresistance of lung cancer cells induced by IR with clinical parameters, and the crosstalk mode of TGF-β/Akt/Smad signaling plays a critical regulatory role in this process.

Objective: The study aimed to investigate the role of general transcription factor 2B (GTF2B) in proliferation and apoptosis of human lung adenocarcinoma A549 cells.Methods: The expression of GTF2B in human lung cancer cell lines (H460, A549, H1299 and PC9) was detected by the qRT-PCR. A549 cells were infected by lentivirus carrying shRNA targeting GTF2B (shGTF2B) and control shRNA (shCtrl) for GTF2B knockdown, and the knockdown efficiency was verified by qPCR and Western blot. Cell proliferation was determined by CCK-8 assay and colony formation assay. The induction of apoptosis was detected by flow cytometry, and the related proteins were examined by Western blot.Results: GTF2B showed the highest expression in A549 cell among human lung cancer cell lines. shGTF2B efficiently reduced the mRNA and protein levels of GTF2B. Upon GTF2b silencing, cell proliferation was significantly impaired and the colony formation ability was decreased. GTF2B silencing caused a G1/S arrest in A549 cells, and led to an increased of apoptotic events, as well as the increased levels of pro-apoptotic proteins. Western blot results showed that C-JUN and mTOR protein levels in shGTF2B group were decreased, and P53, TNF-alpha and PTEN protein levels were increased upon GTF2B silencing.Conclusions: Taken together, our data suggest that GTF2B is required for the proliferation and survival of non-small cell lung cancer A549 cells, which may serve as a candidate for therapeutic intervention.

Objective:To evaluate the efficacy and safety of apatinib in combination with chemoradiotherapy for head and neck squamous cell carcinoma (HNSCC).Methods:37 patients orally received apatinib at 250 mg/d during concurrent chemoradiotherapy until completion of radiotherapy, complete remission assessed by imaging examination, the onset of unacceptable toxicity or death. Baseline characteristics, objective response rates (ORR) and adverse events were assessed in all enrolled patients with complete baseline and safety data. Progression-free survival (PFS) and overall survival (OS) were calculated by Kaplan-Meier method. Prognostic factors were statistically identified using Cox regression models.Results:The ORR was 85%(95% CI: 72%-98%). The median PFS was 17.9 months and the 2-year OS rate was 62%(95% CI: 48%-80%). Ineffective short-term efficacy ( HR=0.035, 995% CI: 0.02-0.652, P=0.025) was an independent risk factor for poor OS. In addition, ineffective short-term efficacy ( HR=0.104, 95% CI: 0.017-0.633, P=0.014) and lymphocytopenia ( HR=17.539, 95% CI: 2.040-150.779, P=0.009) were independent risk factors for poor PFS. Common adverse events (>60%) included lymphocytopenia (76%), leukopenia (68%) and irradiation-induced mucosal injury (65%). The most common treatment-associated grade 3 adverse event was lymphopenia (49%). Conclusions:Apatinib combined with chemoradiotherapy yield significant anti-tumor activity for HNSCC with controllable toxicity. For patients with advanced HNSCC, short-term efficacy and lymphocytopenia may be potential predictors for clinical efficacy of apatinib combined with chemoradiotherapy.

目的:探究以问题为基础的教学模式（PBL）和翻转课堂模式在肿瘤放射治疗学教学中的应用价值。方法:2020年9月至2021年1月选择五年制临床医学学生96人参与教学实践，采用随机数字表法分为三组各32例。对照组采用传统教学，A组采取PBL教学模式，B组采取翻转课堂模式，比较三组学生理论知识考核成绩、实际操作技能考核以及对教学的满意度评价。结果:三组学生理论知识考核得分比较，差异有统计学意义（ P < 0.001）；A、B组理论知识考核总分［（87.88±7.37）分、（94.24±6.33）分］均显著高于对照组的（75.74±10.31）分，差异有统计学意义（ F=42.26， P < 0.05）；B组学生选择题、填空题得分和总分均显著高于A组，差异均有统计学意义（均 P < 0.05）。A、B组实际操作技能考核总分［（89.86±6.37）分、（92.10±5.64）分］均显著高于对照组的（79.08±10.02）分，差异有统计学意义（ F=26.92， P < 0.05），B组学生放射治疗技术部分的实操得分显著高于A组，差异有统计学意义（ P < 0.05）。A、B组学生对4个方面的教学满意程率均显著高于对照组，差异均有统计学意义（χ 2=6.16、13.65、13.97、14.05，均 P < 0.05），B组学生对勾画靶区水平的满意率（100.00%）显著高于A组（84.38%），差异有统计学意义（χ 2=5.42， P=0.020）。 结论:PBL模式和翻转课堂模式均有助于提升医学学生肿瘤放射治疗学理论和实际操作考核得分，其中经翻转课堂进行教学的学生理论考核得分、放射治疗技术实操得分更佳，教学满意率更高。

临床教学是现代医学培训的重要环节,对于提升学生对理论知识的理解和实践能力具有重要意义.放射肿瘤学理论知识复杂,临床表现特点丰富,必须引起医学培训教师的重视.要想合理化进行放射肿瘤学的临床教学,教师必须正确认识现阶段临床教学中亟须解决的问题并进行合理化改善,才能推进医学教育的不断进步,推进放射肿瘤学的不断发展,最终帮助患者减轻痛苦,延续生命.

Background : With continued improvement in radiotherapy technology, hypofractionated radiotherapy has helped achieve good results in the local control and toxicity of pulmonary oligometastases. This study aimed to investigate the efficacy of radiotherapy and the prognostic factors that affect survival in patients with pulmonary oligometastases who undergo helical tomotherapy (TOMO) hypofractionated radiotherapy. Methods : Ninety pulmonary oligometastases in 40 patients (26 males, 14 females; median age 57 years) were retrospectively investigated and treated with hypofractionated radiotherapy in the Department of Oncology and Radiotherapy of the First Affiliated Hospital of Bengbu Medical College during 2018-2020. Their Karnofsky performance status (KPS) was ≥70 points. The primary endpoints were overall survival (OS), local control (LC), and progression-free survival (PFS), and we determine the related influencing factors. Results : The median gross tumor volume (GTV) and planning target volume (PTV) were 9.7 cm³ (range 1.1–287.0 cm³) and 56.9 cm³ (range 16.3–494.2 cm³), respectively, the median biological effective dose, α/β=10 (BED10), was 76.8 Gy (range 56-96 Gy), and four-dimensional computed tomography positioning was applied to 52.5% of the patients. All patients completed the treatment plan during a median follow-up of 16.1 months (range 4.9–33.3 months). The 1- and 2-year OS rates were 90.3% and 55.2%, respectively. The 1- and 2-year LC rates were 80.8% and 64.7%, respectively. The 1- and 2-year PFS rates were 47.3% and 28.4%, respectively. Univariate analysis revealed that colorectal primary (p=0.004), age >57 years (p=0.037), and number of organ metastases ≥2 (p=0.046) were associated with OS, whereas disease-free interval (DFI) ≤17.4 months (p=0.032), number of lung metastases≥2 (p=0.049), and PTV >56.9 cm³ (p=0.041) were associated with LC; and number of metastatic organs ≥2 (p=0.015) was independently associated with PFS. In multivariate analysis, colorectal cancer (p=0.010) and age >57 years (p=0.009) were significantly associated with OS. No > grade 3 toxic reaction. Conclusions : The median OS, LC, and PFS rates of TOMO hypofractionated radiotherapy for pulmonary oligometastases were 24.9, 25.9, and 11.8 months, respectively, showing that good survival rates and low toxicity could still be achieved using the medium dose.

目的 分析放疗前外周血中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞计数比(PLR)对局部晚期下咽鳞状细胞癌患者的预后评估价值.方法 回顾性分析2017年2月-2018年12月蚌埠医学院第一附属医院放疗科收治的27例接受单纯放疗、序贯放化疗或同步放化疗下咽癌患者的临床以及随访资料.通过建立受试者工作特征曲线,获得最佳界值,根据界值将患者分为高NLR组、低NLR组以及高PLR组、低PLR组,分析患者放疗前外周血NLR和PLR与临床病理特征及预后的相关性,通过Kaplan-Meier法绘制患者的生存曲线,log rank法比较患者的预后,通过Cox比例风险回归模型进行多因素分析.结果 27例患者中,有10例患者生存,中位随访时间为34个月,中位生存时间为21个月.放疗前NLR的最佳界值为2.30,PLR的最佳界值为131.46.放疗前高NLR组和低NLR组患者的2年总生存率分别为18.8％和45.5％(P =0.006).放疗前高PLR组和低PLR组患者的2年总生存率分别为18.8％和45.5％ (P =0.040).Log rank单因素分析显示肿瘤临床分期、治疗方式、放疗前NLR和放疗前PLR与患者的总生存有关(均P＜0.05).多因素分析结果显示,肿瘤临床分期和治疗方式为影响患者总生存的独立因素.结论 放疗前NLR、PLR升高对于接受放疗的下咽癌患者可能是预后不良的影响因素,但仍需进一步深入研究.