4067 Background: The clinical therapeutic effect for patients with postoperative loco-regional recurrent esophageal squamous cell carcinoma (ESCC) is not satisfactory. Nimotuzumab, an EGFR-targeted humanized antibody, showed efficacy in the treatment of ESCC. We explored the efficacy of nimotuzumab combined with concurrent chemoradiotherapy (CCRT) for patients with postoperative loco-regional recurrent ESCC. Methods: Eligible patients (18-75 years) with postoperative loco-regional recurrent ESCC were enrolled in this single-arm phase II study, received nimotuzumab (400mg on D1, 200mg/w for 6 weeks) combined with CCRT (chemotherapy:TP regimen, radiotherapy: 45-50.4Gy/25-28f/5-6w), sequentially nimotuzumab 200mg every 3 weeks plus chemotherapy (patients with partial response or stable disease). The primary endpoint was objective response rate (ORR), the second endpoints were disease control rate (DCR), overall survival (OS), progression-free survival (PFS), and local-regional control (LRC) and adverse events. Results: From Sep 2021 to Apr 2024, 44 patients were screened, ultimately 42 patients were included in the Full Analysis set. The median age was 69 years (range: 48-75). 12 (28.57%) patients achieved complete response, 24 (57.14%) patients with partial response, 5 (11.90%) patients with stable disease, and 1 (2.38%) patient with progressive disease. ORR was 85.71%, and DCR was 97.62%. The failure patterns showed that 10 (23.81%) patients had loco-regional recurrence, and 9 (21.43%) had distant metastases after CCRT. The median follow-up was 29.3 months (95%CI: 25.7-38.0). 3-year OS was 51.8% (95%CI: 36.9-72.8%), with the median OS was not reached. 3-year PFS was 33.4% (95%CI: 20.4-54.7%), and the median PFS was 15.1 months (95%CI: 11.8-NE), 3-year LRC was 46.1% (95%CI: 29.9-71.0%), the median LRC was 30.8 (95%CI: 16.6-NE). The most common Graded 3-5 adverse events (AEs) included leukopenia, thrombocytopenia, hemoglobin decreased, radiation esophagitis, radiation-induced lung injury, fatigue, and radiodermatitis. 4 patients experienced Grade 3-5 radiation esophagitis, in which 2 patients developed esophageal fistulas (1 patient died). No nimotuzumab-related serious AEs occurred. Conclusions: Nimotuzumab combined with CCRT showed promising ORR and survival with tolerable toxicity in patients with postoperative loco-regional recurrent ESCC. Clinical trial information: ChiCTR2200063875.

Background: As a member of the T-box transcription factor family, TBX18 was found to be involved in ESCC progression, while its role in regulating radiotherapy resistance in ESCC remains unclear. This study was designed to investigate the molecular mechanisms underlying the regulation of radioresistance in ESCC by TBX18. Methods: Sphere formation assay, Transwell invasion assay, and wound healing assay were conducted to show the influence of TBX18 on tumor stemness and epithelial-mesenchymal transition (EMT). Western blot, immunofluorescence, chromatin immunoprecipitation-qPCR (ChIP-qPCR) and dual-luciferase reporter assay were preformed to identify regulatory networks. A nude mouse xenograft tumor model was established to assess the regulatory effect of TBX18 and SIX1 on radioresistance of ESCC in vivo. Results: TBX18 expression was positively associated with stemness markers, including CD44, CD271, and SOX2. TBX18 promoted stemness-associated phenotypes, EMT, migration, invasion, and radioresistance in ESCC cells. Mechanistically, TBX18 directly bound to the SIX1 promoter and transcriptionally activated SIX1 expression. In turn, SIX1 enhanced TBX18 protein stability by suppressing ubiquitin-proteasome-mediated degradation, thereby forming a positive feedback loop. Functional rescue experiments demonstrated that the TBX18/SIX1 axis coordinately maintained stemness and EMT phenotypes and attenuated radiotherapy-induced apoptosis. In vivo studies further confirmed that TBX18 knockdown enhanced radiosensitivity, whereas SIX1 overexpression partially reversed this effect. In addition, immunohistochemical analysis revealed that TBX18 and SIX1 were significantly upregulated in ESCC tissues and positively correlated with each other.

This work was focused on developing a stable, selective, and sensitive electrochemical aptasensor based on 3,4,9,10-perylene tetracarboxylic acid-functionalized chemically converted graphene (PTCA/CCG)-modified electrode for monitoring neuron-specific enolase (NSE), lung-specific biomarkers. The electrochemical aptasensor relied on the purified NSE aptamer immobilized on PTCA/CCG-modified electrode. The PTCA/CCG promoted both the immobilization of the aptamer and the electrochemical signal. The aptasensor exhibited a low limit of detection (0.008 ng/mL), a broad linear range (10–3 to 103 ng/mL), remarkable specificity, excellent repeatability and long-term stability, maintaining initial resistance at 96.57

This study focused on synthesizing AgPb bimetallic core-shell nanoparticles (AgPb NPs) using a simple polyol reduction method and applying them for amplifying the signal in glucose oxidase (GOx)-assisted SERS immunoassays for sensitive and selective detection of carcinoembryonic antigen (CEA) as a main biomarker for lung cancer. Results of SERS monitoring demonstrated the redox activity of GOx in the presence of varying concentrations of hydrogen peroxide (H2O2) using SERS. In the SERS immunoassay, glucose was oxidized by GOx to produce H2O2 which triggered the oxidation of Ag in AgPd nanoparticles, which enhanced the SERS signal and promoted sensitivity for detecting low concentrations of CEA. The SERS spectra showed significant enhancement in the presence of AgPd NPs, indicating their effectiveness in signal amplification. Study the analytical performance indicated to obtain a limit of detection of 0.41 pg/mL for CEA and detection range from 1 pg/mL to 1000 ng/mL, demonstrating superior sensitivity compared to other reported methods. These factors collectively contributed to the exceptional performance of AgPd bimetallic nanoparticles in enhancing SERS signals and sensitivity, making them promising candidates for advanced detection applications. The study demonstrated the potential of this SERS immunoassay for clinical use, providing accurate CEA detection in lung cancer patient serum.

This work was focused on development a stable, selective and sensitive electrochemical aptasensor based on 3,4,9,10-perylene tetracarboxylic acid -functionalized chemical converted graphene (PTCA/CCG) modified electrode for monitoring neuron specific enolase (NSE), lung-specific biomarkers. The electrochemical aptasensor was relied on the purified NSE aptamer immobilized on PTCA/CCG modified electrode. The PTCA/CCG promoted both the immobilization of the aptamer and the electrochemical signal. The aptasensor exhibited a low limit of detection (0.008 ng/mL), broad linear range (10− 3 to 103 ng/mL), remarkable specificity, and excellent repeatability and long-term stability, maintaining initial resistance at 96.57% after 30 days. Results exhibited that the recoveries ranging from 98.00–99.00% and relative standard deviation less than 4.08%, demonstrating the acceptable precision and reliability of the fabricated aptadensor and confirming the aptasensor's performance and efficiency in complex biological fluids and clinical applications.

Objective:To analyze the correlation of epidermal growth factor receptor (EGFR) expression in esophageal cancer tissues with sensitivity of radical radiotherapy and prognosis of patients.Methods:A total of 98 esophageal cancer patients admitted to the Affiliated Hospital of Jiangnan University from January 2017 to July 2019 were selected, and all patients received radical radiotherapy. The efficacy was assessed after 4 weeks of radiotherapy, partial remission (PR) + complete remission (CR) was treated as the sensitive group and disease progression (PD) + stable disease (SD) was treated as the tolerated group. The expression of EGFR in cancer tissues and paraneoplastic tissues (more than 5cm from the margin of cancer tissues) was measured by using immunohistochemistry. The expression of EGFR in cancer tissues and paraneoplastic tissues and the clinicopathological characteristics of the sensitive and tolerant groups were compared. Cox proportional risk model was used to analyze the factors influencing the prognosis of esophageal cancer patients; the Kaplan-Meier method was used to analyze the relationship between EGFR expression in cancer tissues and prognosis of patients.Results:The positive expression rate of EGFR in esophageal cancer tissues (66.3%, 65/98) was higher than that in paraneoplastic tissues (29.6%, 29/98), and the difference between the two groups was statistically significant (χ 2=26.49, P < 0.001). All 98 patients successfully completed radical radiotherapy, including 4 cases of CR, 60 cases of PR, 26 cases of SD and 8 cases of PD. The proportion of patients with highly differentiated and tumor length ≤1.5 cm in the sensitive group was higher than that in the tolerant group, and the differences were statistically significant (all P < 0.05). The positive expression rate of EGFR in cancer tissues in the sensitive group (56.3%, 36/64) was lower than that in the tolerant group (85.3%, 29/34), and the difference between the two groups was statistically significant ( χ2=8.39, P < 0.001). Multifactorial Cox regression analysis showed that poor differentiation, tumor long diameter >1.5 cm, and positive EGFR expression were independent risk factors for overall survival in patients with esophageal cancer (all P < 0.05). The difference in overall survival between patients with positive and negative EGFR expression was statistically significant ( χ2=9.70, P = 0.002). Conclusions:Highly-expressed EGFR in esophageal cancer tissues may suggest low sensitivity of radical radiotherapy and poor prognosis of patients.

Objective: Radioresistance is a challenge in the effective treatment of esophageal squamous cell carcinoma (ESCC). Herein, this research ascertained whether TBX18 reduced the radiosensitivity of ESCC. Methods: Bioinformatics analysis was utilized to retrieve differentially expressed genes. Then, the expression of corresponding candidate genes was tested using qRT-PCR in ESCC clinical specimens, and TBX18 was selected for subsequent experiments. The binding between TBX18 and CHN1 was evaluated by dual-luciferase reporter and ChIP assays, and the relationship between CHN1 and RhoA was identified by GST pull-down. Ectopic expression or knockdown experiments and radiation treatment were performed in cells and the nude mouse xenograft model to clarify the impacts of TBX18, CHN1, and RhoA on radiosensitivity in ESCC. Results: Bioinformatics analysis and qRT-PCR retrieved upregulated TBX18 in ESCC for the follow-up study. Additionally, TBX18 was positively correlated with CHN1 in ESCC clinical specimens. Mechanistically, TBX18 bound to the CHN1 promoter region to transcriptionally activate CHN1, thus elevating RhoA activity. Moreover, TBX18 knockdown reduced ESCC cell proliferation and migration while augmenting their apoptosis after radiation, which was negated by further overexpressing CHN1 or RhoA. CHN1 or RhoA knockdown diminished ESCC cell proliferation and migration, as well as enhanced cell apoptosis, subsequent to radiation. Likewise, TBX18 overexpression increased ESCC cell autophagy after radiation, which was partially reversed by knockdown of RhoA. The results of in vivo xenograft experiments in nude mice were concurrent with the in vitro results. Conclusion: TBX18 knockdown lowered CHN1 transcription and thus reduced RhoA activity, which sensitized ESCC cells to radiotherapy. & COPY; 2023 Elsevier B.V. All rights reserved. Radiotherapy and Oncology 186 (2023) 1-13

Objective:To explore the efficacy of elective nodal irradiation (ENI) and involved field irradiation (IFI) combined with chemotherapy in treatment of esophageal cancer.Methods:A total of 104 patients with esophageal cancer in Affiliated Hospital of Jiangnan University from May 2018 to May 2020 were selected as subjects for prospective study. All patients were randomly divided into observation group and control group by lottery method with 52 cases in each group. The target volume of observation group was delineated with IFI, and the control group was delineated with ENI. The curative effects, the levels of serum tumor markers [carbohydrate antigen 50 (CA50), squamous cell carcinoma (SCC) and carcinoembryonic antigen (CEA)] before and after treatment, the 1-year overall survival (OS) rate, the incidence of adverse reactions and the scores of various dimensions of health survey summary (SF-36) after treatment were compared between the two groups.Results:The total effective rate in the observation group was 90.38% (47/52), the total effective rate in the control group was 84.62% (44/52), and the difference was not statistically significant ( χ2 = 0.79, P =0.374). There was no statistical difference in CA50, CEA, SCC levels between the two groups before and after treatment (all P > 0.05). After treatment, the CA50, CEA and SCC levels in the two groups were lower than those before treatment, and the differences were statistically significant (all P < 0.05). The 1-year OS rate of the observation group was 94.23%, the control group was 90.38%, and the difference in OS between the two groups was not statistically significant ( χ2 = 0.54, P = 0.462). The incidence of acute radiation esophagitis in the observation group was lower than that in the control group, and the difference was statistically significant ( P < 0.001). There was no statistical difference between the two groups in SF-36 scale scores of physical functioning, role-physical, bodily pain, mental health, vitality, social functioning, role-emotional, and general health after treatment (all P > 0.05). Conclusions:Both ENI and IFI are effective treatments for patients with esophageal cancer. There is no significant difference in the quality of life of patients between the two delineation methods, but the incidence of acute radiation esophagitis is lower in patients with IFI regimen.

目的 探讨重组人白细胞介素2(rhIL-2)联合重组人粒细胞-巨噬细胞刺激因子(rhGM-CSF)治疗食管癌放疗后放射性食管炎的临床效果.方法 选择食管癌放疗后放射性食管炎患者106例,随机分为观察组、对照组各53例.对照组予rhIL-2100万U静脉滴注,每天1次;观察组在对照组基础上予rhGM-CSF 100μg皮下注射,每周3次.两组均连续治疗14 d.比较两组治疗前后放射性食管炎分级、外周血T淋巴细胞亚群(CD3+、CD4+、CD8+T细胞及CD4+/CD8+)和自然杀伤细胞(CD16+CD56+NK细胞)以及生活质量核心问卷-30(QLQ-C30)评分(包括躯体功能、角色功能、情绪功能、认知功能和社会功能五个维度).结果 观察组治疗后放射性食管炎分级0、Ⅰ级占比显著高于本组治疗前和对照组治疗后,而放射性食管炎分级Ⅱ～Ⅳ级占比显著低于本组治疗前和对照组治疗后(P均<0.05).两组治疗后CD3+、CD4+T细胞及CD4+/CD8+和CD16+CD56+NK细胞均高于治疗前,而CD8+T细胞均低于治疗前,以观察组治疗后上述指标变化更明显(P均<0.05).两组治疗后躯体功能、角色功能、情绪功能、认知功能和社会功能评分均高于治疗前,以观察组治疗后上述评分变化更明显(P均<0.05).结论 rhIL-2联合rhGM-CSF能够降低食管癌放疗后放射性食管炎严重程度,提高机体免疫功能,改善患者生活质量.

Purpose: To analyze the prognostic value of total, bioavailable and free 25-hydroxyvitamin D (25(OH)D) as well as vitamin D-binding protein (VDBP) in NSCLC patients. Methods: We prospectively collected and analyzed data for 395 patients diagnosed with NSCLC between January 2016 and December 2018 in two university-affiliated hospitals. Total and free 25(OH)D and VDBP were measured directly, and bioavailable 25(OH)D was calculated using a validated formula. Their prognostic values were evaluated by Cox proportional hazards model, and hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. Results: Patients with NSCLC had significantly lower levels of total, bioavailable, and free 25(OH)D and higher VDBP levels in comparison to healthy controls (all P <0.001). In multivariate analyses, higher levels of total, bioavailable, and free 25(OH)D were independently associated better overall survival (OS) and progression-free survival (PFS). For OS, the adjusted HRs were 0.58 (95%CI, 0.40-0.87; P for trend=0.008), 0.45 (95%CI, 0.30-0.67; P for trend<0.001) and 0.49 (95%CI, 0.33-0.73; P for trend<0.001) for the highest versus lowest tertile of total, bioavailable and free 25(OH)D, respectively. The corresponding adjusted HRs for PFS were 0.61 (95%CI, 0.43-0.86; P for trend=0.006), 0.56 (95%CI, 0.40-0.80; P for trend=0.001) and 0.60 (95%CI, 0.42-0.85; P for trend=0.004), respectively. However, VDBP was not associated with either OS or PFS. Conclusion: The current study suggested that total, bioavailable and free 25(OH)D may be reliable prognosis indicators in NSCLC patients, though the optimal 25(OH)D form for NSCLC prognosis remains to be assessed in future studies.

目的 基于炎症和营养指标探讨非小细胞肺癌(non-small-cell lung cancer,NSCLC)患者预后的影响因素建立预测总生存期(overall survival,OS)的列线图.方法 选取苏州肺癌生存队列2016年1月-2020年1月NSCLC患者371例,随机分为训练队列(n=278)和验证队列(n=93).在训练队列中,通过Cox比例风险模型确定独立危险因素,构建列线图.通过Bootstrap法和十折交叉验证对模型的性能进行评价.结果 训练队列和验证队列的1年生存率分别为83.8％和83.9％,2年生存率分别为65.1％和66.7％.最后纳入模型的变量为吸烟状况、分期、治疗方式、BMI、红细胞分布宽度(red cell distribution width,RDW)、中性粒细胞与淋巴细胞比值(neu-trophil-to-lymphocyte ratio,NLR)和白蛋白与球蛋白比值(albumin-to-globulin ratio,AGR)(均有P＜0.05).训练队列和验证队列的预测OS的C-index分别为0.824和0.762,模型十折交叉验证的平均准确率为77.3％,ROC曲线下面积(area under the curve,AUG)为0.885(95％ CI:0.751～1.000).结论 基于炎症和营养指标构建的列线图可以有效地预测NSCLC患者的总生存期.

Radioresistance is a major challenge in lung cancer radiotherapy, and new radiosensitizers are urgently needed. Estrogen receptor β (ERβ) is involved in the progression of non-small cell lung cancer (NSCLC), however, the role of ERβ in the response to radiotherapy in lung cancer remains elusive. In the present study, we investigated the mechanism underlying ERβ-mediated transcriptional activation and radioresistance of NSCLC cells. Quantitative real-time PCR, western blot and immunohistochemistry were used to detect the expression of CLPTM1L, ERβ and other target genes. The mechanism of CLPTM1L in modulation of radiosensitivity was investigated by chromatin immunoprecipitation assay, luciferase reporter gene assay, immunofluorescence staining, confocal microscopy, coimmunoprecipitation and GST pull-down assays. The functional role of CLPTM1L was detected by function assays in vitro and in vivo. CLPTM1L expression was negatively correlated with the radiosensitivity of NSCLC cell lines, and irradiation upregulated CLPTM1L in radioresistant (A549) but not in radiosensitive (H460) NSCLC cells. Meanwhile, IR induced the translocation of CLPTM1L from the cytoplasm into the nucleus in NSCLC cells. Moreover, CLPTM1L induced radioresistance in NSCLC cells. iTRAQ-based analysis and cDNA microarray identified irradiation-related genes commonly targeted by CLPTM1L and ERβ, and CLPTM1L upregulated ERβ-induced genes CDC25A, c-Jun, and BCL2. Mechanistically, CLPTM1L coactivated ERβ by directly interacting with ERβ through the LXXLL NR (nuclear receptor)-binding motif. Functionally, ERβ silencing was sufficient to block CLPTM1L-enhanced radioresistance of NSCLC cells in vitro. CLPTM1L shRNA treatment in combination with irradiation significantly inhibited cancer cell growth in NSCLC xenograft tumors in vivo. The present results indicate that CLPTM1L acts as a critical coactivator of ERβ to promote the transcription of its target genes and induce radioresistance of NSCLC cells, suggesting a new target for radiosensitization in NSCLC therapy.

Real-time assessment of therapeutic response in patients with advanced lung cancer presents a major challenge throughout the treatment process. Currently, computed tomography imaging is often used; however, it is radiation-based and hysteretic and is not suitable for repeated use as a real-time assessment. Blood biomarkers represent a novel solution for assessing therapeutic response in patients with advanced lung cancer. In the present study, the efficacy of a methylation marker [methylated prostaglandin E receptor 4 (mPTGER4)] and four protein markers [carcinoma antigen 125 (CA125), carcinoembryonic antigen (CEA), cytokeratin 19-fragments (cyfra21-1) and neuron-specific enolase (NSE)] were simultaneously evaluated to determine their potential in facilitating therapeutic response monitoring as well as their prognostic values in patients with stage IV lung cancer. The results indicated that, following treatment, the blood levels of methylated PTGER4 and NSE had significantly decreased, and mPRGER4, CA125, CEA and NSE exhibited a significant decrease in percentage level. Since mPTGER4 exhibited a higher rate of positive detection prior to therapy, and a greater response of sensitivity to therapy compared to the protein markers, it may represent an improved marker for the monitoring of therapeutic response. The efficacy of the markers in predicting the overall survival (OS) rate of patients with stage IV lung cancer was also assessed. Results from the follow-up of patients (up to 891 days) revealed that the blood levels of mPTGER4, CA125 and NSE before treatment were able to predict overall survival (OS) rate. Additionally, the percentage change in expression levels of CA125, CEA and NSE was also able to predict the OS rate. In conclusion, the present results indicate that mPTGER4 represents an improved biomarker for monitoring therapeutic efficacy compared with CA125, CEA, Cyfra21-1 and NSE. In predicting the long-term survival of patients with stage IV lung cancer; however, the pre-treatment levels of mPTGER4, CA125 and NSE and the percentage changes of CA125, CEA and NSE may be used as the markers.

Objective To compare the efficacy and safety of two concurrent chemoradiotherapy regimens between paclitaxel plus fluorouracil( TF) and cisplatin plus fluorouracil ( PF) in the treatment of locally advanced esophageal squamous carcinoma. Methods 103 patients with locally advanced esophagus carcinoma were treated in Affiliated Hospital of Jiangnan University from December 2014 to February 2016, and randomly assigned to either study group ( TF ) or control group ( PF ) according to random number table, of which 52 patients in the TF group while 51 patients in the PF group. The primary outcome was overall survival(OS), and secondary outcomes include progression-free survival(PFS), local progression-free survival( LPFS) and side effects. Results The 1-year OS for TF group was 76. 9％ versus 74. 5％ for PF group( P>0. 05 ) , and the 2-year OS for TF group was 59. 6％ versus 56. 9％ for PF group ( P >0. 05). The 1-year LPFS for TF group and PF group were 71. 2％ and 66. 7％ respectively(P>0. 05), and the 2-year LPFS for TF group and PF group were 61. 5％ and 58. 8％ respectively(P>0. 05). The 1-year PFS for TF group was 63. 5％ versus 62. 7％ for PF group ( P>0. 05 ) , and the 2-year PFS for TF group was 51. 9％ versus 39. 2％ for PF group ( P>0. 05 ) . The incidence rate of serious ( grade 3- 4 ) leukopenia for TF group was 36. 5％ versus 17. 6％ for PF group(χ2 =4. 642, P<0. 05). The incidence rate of serious (grade 3-4) acute radiation pneumonitis was 15. 4％ in the TF group, higher than that in the PF group with the rate of 3. 9％(χ2 =3. 859, P<0. 05), while the incidence rate of severe nausea and vomiting for PF group was 17. 6％ versus 1. 9％ for TF group(χ2 =7. 262, P <0. 05). The difference between the two groups was statistically significant. Conclusions Patients who were treated with two concurrent chemoradiotherapy regimens showed no difference in OS, PFS and LPFS. The regimen on the basis of Paclitaxel has higher risk of adverse effects incidence rates of hematological toxicity and acute radiation pneumonitis, while digestive system toxicity must be concerned when concurrent chemoradiotherapy is performed on the basis of cisplatin plus fluorouracil.

目的 观察双花百合片对头颈部肿瘤患者放疗引起的口腔黏膜炎、 溃疡及疼痛的影响.方法 2014年1月—2017年5月于该院行放射治疗的头颈部肿瘤患者80例,随机分为服用双花百合片组(40例)和对照治疗组(40例),观察双花百合片组和对照治疗组发生口腔黏膜炎、 口腔溃疡的平均发生率、 疼痛程度以及愈合情况.结果 双花百合片治疗组患者口腔黏膜炎、口腔溃疡发生率显著低于对照治疗组(47.5％vs 70.0％,P<0.05),口咽部疼痛程度低于对照治疗组(55.0％vs 77.5％,P<0.05),溃疡愈合快于对照治疗组(9.1±3.3)d vs(13.2±3.9)d,P<0.05).结论 双花百合片可以减轻头颈部肿瘤患者放疗引起的口腔黏膜炎及溃疡,降低口咽部疼痛,促进愈合.

Objective: In this study, we compared the effects of combination of celecoxib, intensity-modulated radiation therapy (IMRT) and hippocampal sparing, IMRT with hippocampal sparing and IMRT only on cognitive function, life quality and therapeutic effects in patients with nasopharyngeal carcinoma (NPC). Methods: From June 2015 to December 2016, 177 cases with NPC in our hospital were finally enrolled and randomly divided into three groups: IMRT only group (I group), hippocampal sparing IMRT (H group) and celecoxib combined with hippocampal sparing IMRT group (Ce group). Cognitive function and life quality were evaluated three months after treatment via Mini-Mental State Examination (MMSE) and Quality of life questionnaire (QLQ C30) respectively. Indicators for therapeutic effects including complete remission (CR), partial remission (PR), stable disease (SD), progressive disease (PD), adverse reactions, recurrence and metastasis of tumor and serum tumor marker carcinoembryonic antigen (CEA) level of patients were also compared. Results: Before the intervention, there was no difference in cognitive function score among all the patients (P = 0.876). After the treatment, no significant difference was found for RR among groups (P = 0.245), however, patients in the Ce group showed the highest cognitive function score (P < 0.001); the differences in adverse reactions including dry mouth (P = 0.026, Ce vs. H; P = 0.000, Ce vs. I; P = 0.000, H vs. I), oral mucositis (P = 0.060, Ce vs. H; P = 0.008, Ce vs. I; P = 0.396, H vs. I), skin reaction (P = 0.654, Ce vs. H; P = 0.027, Ce vs. I; P = 0.065, H vs. I), irradiation otitis media (P = 0.097, Ce vs. H; P = 0.009, Ce vs. I; P = 0.051, H vs. I) had statistical significance, and their incidence rates in Ce group were lowest. Meanwhile, recurrence and metastasis were less in the Ce group although the differences were insignificant (P = 0.302 and 0.638). The serum level of CEA was notably lower in Ce group (P = 0.031, Ce vs. H; P = 0.020, Ce vs. I; P = 0.512, H vs. I). Life quality scores about cognitive function and role function of H group and Ce group were higher than that of I group while Ce group was the highest (Cognitive function: P = 0.020, Ce vs. H; P = 0.015, Ce vs. I and P = 0.023, H vs. I; role function: P = 0.039, Ce vs. H; P = 0.011, Ce vs. I and P = 0.031, H vs. I). Conclusion: Celecoxib combined with hippocampus sparing IMRT for the treatment of NPC patients could drastically alleviate cognitive dysfunction, improve life quality and reduce the occurrence of adverse events compared with hippocampal sparing IMRT and IMRT only.

目的观察术后放疗加小剂量奈达铂节律化疗治疗中晚期术后喉癌的疗效及不良反应。方法 70例中晚期术后喉癌患者随机分成两组,治疗组行术后放疗加奈达铂节律化疗,对照组行单纯术后放疗。对比两组患者的CR、PR百分率、不良反应发生率以及治疗效果。结果治疗组CR、PR百分率分别为54.29%、31.43%,对照组分别为20.00%、57.14%,两组CR比较差异有统计学意义（P＜0.05）。两组不良反应发生率无统计学差异。结论近期疗效CR（完全缓解率）:节律化疗加术后放疗组高于单纯术后放疗组,且不良反应无明显增加。

目的 观察体部立体定向放射治疗(SBRT)周围型肺癌的近期疗效和副反应.方法 46例周围型肺癌患者行静态调强适形放疗(IMRT),DT50 Gy/4fx/2W,2～3次/周,95％以上PTV满足处方剂量,90％的处方等剂量线完全覆盖PTV,最大剂量点在靶区内,并控制在10％以内,严格控制肺V5＜55％,V20＜20％,心脏和脊髓等危及器官受量控制在正常范围,所有患者在投照前均行摄片和锥形束CT(CBCT)精度验证和配准.随访观察患者放疗的副反应和近期疗效.结果 治疗后3～36个月,所有患者均获得随访,中位随访时间18个月,其中完全缓解(CR)率为50％ (23/46),部分缓解(PR)率为43.5％(20/46),总有效率为93.5％ (43/46).1年生存率为94.7％ (36/38),1年局控率为100％ (38/38),2年生存率为52％(13/25),2年局控率为84％(21/25);放疗期间未出现严重的放疗副反应,放射性肺炎发生率为4.35％ (2/46),为Ⅱ级以下,未出现严重的Ⅲ级和Ⅳ放射性肺炎,出现3例肋骨疼痛.结论 周围型肺癌行SBRT能够有效地提高肺癌的局部控制率和生存率,且并发症发生率较低,值得临床推广应用.

Objective To study and compare the dose difference of intensity modulated radiation therapy (IMRT) and conventional radiation therapy(CRT) affecting tumor and normal tissues. Methods Thirty nasopharyngeal carcinoma patients in stage T3N1M0 received IMRT and CRT with CMS system. The dose affecting tumor and normal tissues was calculated respectively. Results There was no significant difference of the dose between IMRT and CRT, but the dose affecting the normal tissue was lower in IMRT than that in CRT. Conclusions The dose distribution to tumor target area is more precise with IMRT than that with CRT. The dose to the normal tissues is controlled more effectively with IMRT than that with CRT.

目的观察根治性放疗加低剂量节律化疗治疗恶性肿瘤的疗效及其不良反应。方法54例恶性肿瘤患者随机分成两组,对照组行单纯根治性放疗,治疗组行根治性放疗加低剂量节律化疗。放疗肿瘤临床病灶剂量为65~70 Gy/6.5~7周,亚临床病灶剂量为45~50 Gy/4.5~5周。化疗顺铂(DDP)10 mg/次,3次/周,每周1、3、5进行化疗,共6~7周。结果治疗组CR、PR百分率分别为53.57%、32.14%,对照组分别为38.46%、19.23%,两组比较差异有统计学意义(P<0.05)。两组不良反应发生率无统计学差异。结论节律化疗加根治性放疗比单纯根治性放疗疗效好,且不良反应无明显增加。