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find Keyword "放射治疗" 97 results
  • Zoledronic Acid Combined with Radiotherapy for Bone Metastases of Malignant Tumor: A Meta-Analysis

    Objective To systematically evaluate the effectiveness and safety of zoledronic acid combined with radiotherapy in treating bone metastasis of malignant tumor. Methods Such databases as PubMed, EMbase, The Cochrane Library (Issue 10, 2012), CBM, CNKI, VIP and WanFang Data were searched to collect randomized clinical trials (RCTs) on bone metastasis of malignant tumor from inception to October, 2012. References of included studies were also retrieved. Two reviewers independently screened studies according to exclusion and inclusion criteria, extracted data, and assessed the methodological quality. Then, meta-analysis was performed using RevMan 5.1 software. Results Twenty nine trials were included involving 2 021 patients. The results of meta-analysis showed that, compared with the radiotherapy alone group, zoledronic acid combined with radiotherapy improved the effectiveness rate of pain relieving at the end of treatment (OR=3.08, 95%CI 2.30 to 4.12, Plt;0.000 01), the effectiveness rate of pain relieving two weeks after treatment (OR=3.39, 95%CI 2.52 to 4.56, Plt;0.000 01), the quality of life (OR=2.74, 95%CI 1.66 to 4.52, Plt;0.000 01) and the ability of movement (OR=2.96, 95%CI 2.16 to 4.05, Plt;0.000 01). Zoledronic acid combined with radiotherapy also reduced the incidence of new bone metastasis (OR=0.21, 95%CI 0.10 to 0.45, Plt;0.000 1) and the incidence rate of bone-related events (OR=0.17, 95%CI 0.03 to 0.92, P=0.04). The adverse reactions of zoledronic acid combined with radiotherapy such as fever (OR=11.92, 95%CI 6.31 to 22.48, Plt;0.000 01) and hypocalcaemia (OR=8.82, 95%CI 1.61 to 48.36, P=0.01), significantly increased. Conclusion Compared with radiotherapy alone, zoledronic acid combined with radiotherapy can relieve bone metastatic pain, effectively enhance patients’ ability of movement, improve quality of life, and decrease new bone metastasis and the occurrence of bone-related events.

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  • Impacts of Gravity on the Verification of Intensity-modulated Radiotherapy Plans with 2-Dimensional Detector Arrays

    【摘要】 目的 分析重力因素对二维探测器阵列验证静态调强计划的影响,判断机架角度归为0°的测量方法是否安全可靠。 方法 在0°机架角和实际治疗机架角分别测量静态调强计划的剂量分布,以3 mm范围内偏差lt;3%(3% 3 mm)标准进行γ分析,获得相对于参考剂量分布的通过率,分析通过率变化规律。分析两种方法测量的等中心点绝对剂量的差异。 结果 通过率的变化呈随机分布,96.9%的照射野偏差lt;2.5%。所有计划的85.7%绝对剂量偏差lt;2%,最大偏差为4.75%。 结论 使用二维探测器阵列在0°角进行调强计划的日常验证是安全可靠的。【Abstract】 Objective To analyze impacts of gravity on the verification of IMRT plans with 2-Dimensional detector arrays and to evaluate the reliability of the measurements in vertical direction (gantry angle=0). Methods The dose distributions for each beam in IMRT plans were measured with 0 degree gantry angle and actual gantry angle respectively. The γ percentage pass rate (according to 3% 3 mm) for each beam under each angle condition was obtained by the comparison between the measured dose distribution and the calculated dose map from the treatment planning system which was treated as the reference distribution. Then the absolute dose at the isocenter for each plan was measured at each angle condition and was analyzed. Results The variations of γ percentage pass rates between the two types of measurements were randomly distributed, and the deviations for 96.9% beams were less than±2.5%. The differences between absolute doses for 85.7% beams were less than±2% and the biggest deviation was -4.75%. Conclusion Verification of IMRT plans for the radiotherapy quality assurance using 2-Dimensional detector arrays in 0 degree gantry angle is safe and reliable.

    Release date:2016-08-26 02:21 Export PDF Favorites Scan
  • Influence of Segment Number on the Planning of Intensity-modulated Radiotherapy for Postoperative Adjuvant Radiotherapy for Rectal Cancer

    【摘要】 目的 调强放射治疗(IMRT)能较好的保护危及器官并给予肿瘤足够的致死剂量,基于多叶准直器(MLC)分步照射的IMRT技术对复杂病例需要更多子野。研究对直肠癌术后放射治疗使用不同子野数目的IMRT计划进行比对,选择合理的子野数。 方法 选取2010年4-8月入院的直肠癌术后患者10例,保持射野入射角度及优化目标参数相同,仅改变MLC子野数目,设计不同IMRT对每一患者治疗计划的靶区适形指数(CI)、均匀性指数、最大剂量、最小剂量、平均剂量,危及器官关注体积的受照剂量,机器跳数及治疗时间进行分析。 结果 所有治疗计划中靶区及危及器官的剂量学评估指标无统计学意义(Pgt;0.05),只有亚临床计划靶区(PTV)CI在15个子野的方案中(0.74±0.06)明显差于25个子野方案(0.82±0.03)、40个子野方案(0.81±0.06)及60个子野方案(0.84±0.03),有统计学意义(Plt;0.05);治疗机器跳数(MU)随子野数目增多明显增大,15、20、40及60个子野方案所需MU分别为(458±56)、(559±62)、(614±74)、(622±82),有统计学意义(Plt;0.05),但40个子野方案与60个子野方案间无统计学意义。治疗时间明显随子野数增加而增大。 结论 直肠癌术后IMRT计划使用25个子野能满足临床剂量要求,同时能有效降低治疗时间,可作为临床应用参考值。【Abstract】 Objective The intensity modulated radiotherapy (IMRT) can deliver tumor enough doses and protect risk organs as much as possible at the same time. The MLC-based step and shoot IMRT(sIMRT) plan needs much more segment member to meet clinical aims. In this study, several sIMRT plans using different segment number for postoperative rectal cancer were compared to find out the most reasonable segment number setting. Methods Ten patients with rectal carcinoma underwent postoperative adjuvant radiotherapy for rectal cancer from April to August 2010 were selected. For each patient, the angle of field, the prescription expected and the physical parameters optimized were kept the same, while only the number of segments was changed in sIMRT plans. The dose volume histogram-based parameters [conformity index (CI) and homogeneous index (HI)]  and other parameters concerned were compared and analyzed. Results The indexes of dosimetry associated with the targets and risk organs showed no significant statistical difference among the 4 sIMRT plans with different segment numbers. The index CI of PTV in the sIMRT plan with 15 segments (CI 0.74±0.06) was less than that in the sIMRT plan with 25 segments (CI 0.82±0.03), the sIMRT plan with 40 segments plan (CI 0.81±0.06), and the sIMRT plan with 60 segments (CI 0.84±0.03) (Plt;0.05). There were significant differences in MU among the sIMRT plans with 15 segments (average MU: 458±56) , with 25 segments (average MU: 559±62 ), and with 40 segments (average MU: 614±74)or with the 60 segments (average MU: 622±82 (Plt;0.05). The more segments meant more MU and more irradiation time. Conclusion The sIMRT plan for patients of rectal cancer to receive postoperative adjuvant radiotherapy may require at least 25 segments to balance the accepted dose results and efficient delivering.

    Release date:2016-08-26 02:21 Export PDF Favorites Scan
  • 基于蒙特卡罗算法的肿瘤放射治疗计划系统的研究进展

    【摘要】蒙特卡罗剂量计算法一直被公认为是最精确的辐射输运计算工具,因此很早就成为模拟辐射治疗粒子输运的重要方法之一。但真正能应用于肿瘤放射治疗临床工作的基于蒙特卡罗算法的放射治疗计划系统的推出却经历了一个漫长的时间过程,目前仍在进一步开发和优化中。现就通用蒙特卡罗应用程序的发展历史,介绍基于蒙特卡罗算法的放射治疗计划系统的研究基础;描述放射治疗过程中完整的辐射输运的组成部分;总结此类系统的优势、研发难点和特有的限制条件;介绍能使蒙特卡罗算法应用于临床的主要途径;并指出仍需要努力研究从而充分发挥其潜力的领域。

    Release date:2016-08-26 02:21 Export PDF Favorites Scan
  • Efficacy of High-dose Three-dimensional Conformal Radiotherapy Combined with Surgery on Primary Retroperitoneal Soft Tissue Sarcoma

    【摘要】 目的 评价大分割适形放射治疗对腹膜后软组织肿瘤术后患者的治疗作用。 方法 对1998年10月-2003年4月收治的16例腹膜后软组织急性肿瘤术后患者行大分割适形放射治疗,设计临床靶区等效生物剂量为55~62 Gy,观察放疗后2、5年局部控制率、生存率和无病生存情况。 结果 2、5年局部控制率较未行放疗患者明显提高并和其他放射治疗方式达到较高治疗剂量者近似;远期生存无改善,无病生存率较未行放疗患者有提高。 结论 大分割适形放射治疗方式对腹膜后软组织急性肿瘤术后患者有较好的局部控制作用,无瘤生存率有提高,远期生存无改善,无严重的远期放疗后遗症。【Abstract】 Objective To observe the effect of high-dose three-dimensional conformal radiotherapy combined with surgery on primary retroperitoneal soft tissue sarcoma. Methods A total of 16 patients with primary retroperitoneal soft tissue sarcoma underwent high-dose three-dimensional conformal radiotherapy after sarcoma excision from October 1998 to April 2003. The biologically effective dose was 55-62 Gy for CTV. The local control rate and long-term survival rate and disease free survival after 2 and 5 years were observed. Results The local control rate obviously raised in these patients after 2 and 5 years; but the long-term survival rate didn’t improve and the disease free survival improved in these patients compared with those wasn’t radiated. Conclusion High-dose three-dinensional comfomal radiotherapy is effective on the patients with retroperitoneal soft tissue sarcoma in local control rate and disease free survival, but long-term survival rate is not improved and the side-effect is not serious.

    Release date:2016-08-26 02:21 Export PDF Favorites Scan
  • Treatment Strategies of the Pineal Region Tumors

    目的:探讨松果体区肿瘤的治疗策略。方法:我院自2003年12月至2007年12月收治的58例松果体区肿瘤,按肿瘤标志物甲胎蛋白(AFP)和人β促绒膜性腺激素(hCG-β)将其分为标志物增高组和正常组,回顾分析两组临床资料和治疗体会。结果:肿瘤标志物正常组36例,其中27例行手术切除肿瘤,9例行伽马刀治疗(其中5例行伽马刀加脑室腹腔分流治疗)。术后4例因病理报告示生殖细胞瘤行伽马刀补充治疗,3例因梗阻性脑积水行脑室腹腔分流。增高组22例,均选用伽马刀治疗(其中17例合并梗阻性脑积水者行伽马刀加脑室腹腔分流)。治疗后3例因症状缓解不佳行手术切除肿瘤术。手术病例中24例采用经胼胝体入路,4例经枕部小脑幕入路,2例经幕下小脑上入路。手术全切24例,次全切5例,部分切除1例,术后住院期内死亡者1例。病理诊断:生殖细胞瘤14例,畸胎瘤5例,中枢神经细胞瘤4例,室管膜瘤2例,表皮样囊肿2例,脑膜瘤1例,胶质瘤1例,皮样囊肿1例。放射外科治疗病例中28例术后3个月临床症状明显改善,4例随访期内肿瘤无明显变化,3例肿瘤增大。2例放疗后出现鞍区转移。结论:松果体区肿瘤组织类型多样,应尽可能先明确肿瘤性质后选择合理治疗策略。

    Release date:2016-08-26 03:57 Export PDF Favorites Scan
  • INTERNAL RADIOTHERAPY OF LIVER CANCER

    Objective To study the development of internal radiotherapy for liver cancer and the relationship between effects and radiation doses. Methods Literature about internal radiotherapy of liver cancer were collected and reviewed. Results The rational selection of radioactive microsphere,the appropriate control of radiation dosage and the path of internal radiotherapy are crucial in improving the therapy effects and decreasing the complications. Conclusion The two-stage operation of liver cancer which is on the base of combining chemotherapy, radiotherapy and immunotherapy is the way to go of liver cancer therapy.

    Release date:2016-08-28 05:30 Export PDF Favorites Scan
  • 手术切除联合术中125Ⅰ粒子组织间植入治疗食管癌的疗效分析

    目的 探讨手术切除联合术中125I 粒子组织间植入治疗食管癌的疗效和副作用。 方法 回顾性分析2004 年10 月至2009 年9 月61 例中、晚期食管癌患者(盐城市第五人民医院32 例,南京医科大学附属南京第一医院29 例)采用手术切除联合术中125I 粒子组织间植入或联合放疗治疗的临床资料。根据治疗方法不同,将61 例患者分为两组,125I 粒子植入组:31 例[男21 例,女10 例;年龄(59.5±1.5)岁],采用手术切除+术中125I 粒子组织间植入治疗;对照组:30 例[男19 例,女11 例;年龄(60.1±1.6)岁],术后3 ~ 4 周采用体外放射治疗。观察两组患者术前、术后白细胞(WBC)、血小板(PLT)、免疫球蛋白的变化,比较生存率、复发率和转移率。 结果 术后1 个月、3 个月和5 个月,两组患者外周血WBC、PLT 和免疫球蛋白均在正常范围内;两组间比较差异无统计学意义(P > 0.05)。两组患者均获随访,随访时间1 ~ 5 年。术后6 个月125I 粒子植入组患者行胸部X 线片检查示:均未发现粒子移位。125I 粒子植入组患者1 年、3 年和5 年生存率均明显高于对照组(3 年58.3% vs. 42.8%,P < 0.05; 5 年36.8% vs.26.6%,P < 0.05),复发率(3 年0 % vs. 6.7%,P < 0.05; 5 年3.2% vs. 13.3%, P < 0.05)和转移率(3 年12.9%vs. 20.0%,P < 0.05; 5 年16.1% vs. 33.3%,P < 0.05)明显低于对照组。 结论 手术切除结合125I 粒子组织间植入治疗食管癌,方法简单、使用安全、副作用小,可提高食管癌患者的生存率。

    Release date:2016-08-30 05:48 Export PDF Favorites Scan
  • ANALYSIS OF CURATIVE RESULT FOR KELOID WITH INTEGRATED METHODS

    Objective To study the curative effects of keloid by operation combined with postoperative β radiation and silicone gel sheeting. Methods From 1996 to 2002, 598 patients with keloid(243 males, 355 females, aging 15-55 years with an average of 28.6 years) were treated by integrated therapy. Their disease courses were from 6 months to 6 years. The keloid area ranged from 1.0 cm×1.5 cm~8.0 cm×15 cm. First, keloid was removed by operation, and then the wounds weresutured directly(group suture) or covered with skin graft(group graft). In groupsuture, the operational sites were managed by β ray radiotherapy 24-48 hours after operation. The total doses of radiation were 12-15 Gy, 5 times 1 week(group suture A) and 10 times 2 weeks (group suture B). Radiotherapy was not taken until stitches were taken out in group graft, and then the same methods were adopted as group suture B. After radiotherapy, silicone gel sheeting was used in 325 cases for 3-6 months. Results All patients were followed up for 12-18 months. (1) The overall efficacy was 91.3% in group suture A(n=196), and 95.8% in group suture B (n=383), respectively. There was significant difference between the two groups(Plt;0.01). (2) Radiotherapy was of no effect in 6 cases of group graft(n=19). (3) Silicone gel sheeting had effectivenessin 185 cases. Silicone gel sheeting had no obvious effect on the overall efficacy, but it could improve the quality of texture and color of skin. Conclusion By use of integrated methods to treat keloid, if the wound can be sutured directly, skin grafting should not be adopted. The results in group suture B are better than those in group suture A; silicone gel sheeting should be used as possible. 

    Release date:2016-09-01 09:33 Export PDF Favorites Scan
  • THE THERAPEUTIC EFFICACY OF Y KNIFE/LYMPHOKINE-ACTIVATED KILLING CELLS IN MALIGNANT MELANOMA OF CHOROID

    OBJECUIVE: To observe the therapeutic efficacy of gamma;-knife/lymphokine activated killing cells (LAK)in chorold malignant melanoma (CMM). METHODS:Five cases of CMM had keen treated by retrobulbar injection of LAK cells and gamma;-knife irradiation at multiple sites.Ophthalmologic,imageologic, fundus fluorescein angiographic and T lymphocyte subset examinations were done before and after treatment. Tile follow-up period of this series of cases was 6-24 months. RESUILS:Thc CMM of 4 in 5 treated cases became atrophic and withered up clinically after gamma;-kinfe/LAK therapy. Among the 4 cases,2 of them had been followed up for more than 2 years,and the other 2 for 20 and 14 months respectively. The tumor of the 5th patient wko was followed up for 6 months after treatment,reduced to 3/5 of the original size,and no blood flow was found within thee tumor mass under the clinical examination. CONCLUSION :The gamma;-knife/LAK therapy was effective in treating CMM in saving the affected eye from being enucleated. Chin J Ocul Fundus Dis,1997,13: 96- 98)

    Release date:2016-09-02 06:12 Export PDF Favorites Scan
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