Sequential Radiotherapy Research Articles

Synergistic Radiation Effects on PNP Transistors Caused by Protons and Electrons

This paper examines individual radiation effects caused by 110 KeV electrons, 70 KeV electrons and 170 KeV protons, and combined radiation effects induced by 110 KeV electrons together with 170 KeV protons and 70 KeV electrons with 170 KeV protons on the forward current gain of bipolar junction transistors (3CG130, PNP). The combined radiation effects include simultaneous and sequential radiation effects. Key parameters were measured in-situ and the change in current gain of the PNP transistors is obtained at a fixed voltage of emitter-base junction . Experimental results show that the current gain degradation of the PNP transistors is sensitive to both of ionization and displacement damage. The ionization damage is primarily caused by 110 KeV and 70 KeV electrons, while the displacement damage is mainly induced by 170 KeV protons in this investigation. Based on the simultaneous and sequential exposure results, the ionization damage caused by 110 KeV and 70 KeV electrons could give annealing-like and enhancing effects to displacement damage induced by 170 KeV protons for PNP BJTs.

Sequential Adjuvant Chemotherapy and Radiotherapy in Treatment of Early Stage Endometrial Carcinoma: Single Institutional Experience

Background: Aim was to evaluate the additional benefit of adjuvant chemotherapy in patients of early stage endometrial carcinoma (EC) with adverse features. Materials and methods: Between June 2006 and July 2011, 56 patients with EC after surgery were randomized to receive either adjuvant radiotherapy (RT) [35 patients] or adjuvant sequential chemotherapy and radiotherapy (CRT) [21 patients]. Median age was 57.6 years (40-80). Predominant stages were FIGO IB (44.6%) and IIA (26.7%). Mean body mass index was 35.9 kg/m2 (23-72). Results: Median follow-up was 55 months (6-60). The Kaplan-Meier estimates for loco regional control (LRC), distant metastasis control (DMC) and overall survival (OS) for RT and CRT arms were; 85.7% vs. 74.2% (p 0.04), 85.7% vs. 85.7% (p 0.9) and 82.8% vs. 81% (p 0.8) respectively. Patients in CRT arm had earlier and higher pelvic recurrences {hazard ratios of 2.21 (1.45-7.85)}. Acute hematological grade3 toxicity was higher in CRT arm (9.5%) and no difference in acute or delayed non-hematological toxicities was seen between two arms. Conclusion: Adjuvant chemotherapy in patients with EC after surgery is associated with inferior LRC and no additional benefit in DMC and OS. If adjuvant chemotherapy is considered it shall be given after adjuvant radiotherapy.

Radiotherapy for Inoperable Non-Small Cell Lung Cancer using Helical Tomotherapy

To investigate the impact of tomotherapy on the dose delivered to the lungs and other normal tissues. From February 2008 to May 2009, 35 patients with stage IIIA/IIIB non-small cell lung cancer were treated with helical tomotherapy at the S. Camillo-Forlanini Hospital. For our study we selected 20 patients who underwent chemotherapy followed by sequential radiotherapy. The planning target volume was delineated using planning CT scan and FDG-PET. The mean prescribed radiation dose was 67.5 Gy delivered in 30 fractions at a dose of 2.25 Gy per fraction. Median follow-up was 12.3 months. All patients developed acute esophageal toxicity, 15 of RTOG grade 1 and 5 of RTOG grade 2. At first follow-up 15 patients presented stable disease or partial response, 4 patients presented complete response, and 1 patient presented disease progression. Helical tomotherapy is useful to achieve dose-per-fraction escalation without increasing the treatment-related morbidity. Our results applying dose escalation were encouraging considering that we delivered doses that may be difficult to achieve with 3-dimensional treatments with no excessive complication rates.

Sequential chemotherapy and radiotherapy as sandwich therapy for the treatment of high risk endometrial cancer

ObjectiveThe purpose of this retrospective study was to assess the tolerability and efficacy of sequential chemotherapy and radiotherapy for the treatment of high risk endometrial cancer.MethodsWe conducted a retrospective study of previously untreated high risk endometrial cancer patients who received sequential chemotherapy and radiotherapy in accordance with the sandwich approach from June 2008 until June 2011. High risk endometrial cancer patients underwent complete surgical staging followed by adjuvant therapy encompassing sequential chemotherapy, radiation therapy and consolidation chemotherapy.ResultsThe study analysis comprised 32 endometrial cancer patients. All subjects were treated with carboplatin and paclitaxel chemotherapy; currently, 186 cycles have been administered and 94% of patients have completed the planned number of cycles. Grade 3 neutropenia developed in 1 (3.1%) patient; there was no incidence of grade 4 neutropenia. Moreover, we observed grade 3 anemia in four (12.5%) patients and grade 4 anemia in one (3.1%) patient. One (3.1%) patient developed grade 3 thrombocytopenia; grade 4 thrombocytopenia was not observed. Five patients exhibited progressive disease, three of whom have since expired; mean progression free survival and follow-up were 17.4 months and 18.9 months, respectively.ConclusionThe preliminary results from our study suggest that the sandwich approach to treating high risk endometrial cancer patients is feasible. Hematologic toxicity was well tolerated and non-hematologic toxicity was mild and easily managed. Further study of this novel regimen in a larger patient population with extended follow-up is necessary.

Multiple brain metastases from primary gall bladder carcinoma treated by sequential surgery, radiotherapy and chemotherapy

Abstract Gallbladder carcinoma tends to be an aggressive tumour that spreads early and leads to rapid death after diagnosis as compared to other gastrointestinal carcinomas. Brain metastasis in such patients further cuts short their

172 Best practice in small cell lung cancer: Are we meeting national guidance? A 3 year audit of treatment and outcomes in Bournemouth, Dorset, UK

Introduction: Small Cell Lung Cancer is an aggressive malignancy with a poor prognosis. Treatment delays and non-adherence to evidence based practice guidelines can lead to poorer outcome. Method: All patients with a confirmed pathological diagnosis of small cell carcinoma between 1st January 2007 and 31st December 2009 were eligible. Data from our electronic patient record system, chemotherapy prescribing system, lung cancer data base and the clinical notes was evaluated. Data was compared to NICE guidelines and the NHS National Lung Cancer Audit recommendations. Results: Forty one patients were identified. Completeness for key data fields was 100%. Median age at diagnosis was 70 years (range 50 91 years); 27 males and 14 females. Forty (98%) were discussed at MDT. Limited-stage (LD) was diagnosed in 11 (27%) and extensive-stage (ED) in 30 (73%). Nine (82%) patients with LD received chemotherapy (including 6 who received radical concurrent or sequential chemoradiotherapy). 22 (73%) patients with ED received chemotherapy (including 5 who received palliative sequential thoracic radiotherapy). Median time from diagnosis to chemotherapy was 12 days (range 3 29). 26 patients (84%) receiving chemotherapy had radiological evidence of disease response. In line with evidence available at the time, prophylactic cranial irradiation (PCI) was considered for eligible patients, although only 8 patients (47%) went on to complete treatment. Median survival for all patients was 9 months (range 0 46 months), rising to 11 months for those receiving at least one cycle of chemotherapy. Conclusions: Overall clinical outcome for this unselected population is in keeping with published literature. Chemotherapy rates exceed the recommended 62% suggesting prompt diagnosis and timely referral to commence treatment where appropriate. PCI rates were lower than might be expected. Data capture for patients with SCLC at RBH is excellent with key demographic and clinical parameters recorded.

P3-16-11: Prospective Evaluation of Radiation Pneumonitis in Neoadjuvant Concurrent Docetaxel and Radiation Therapy for Locally Advanced Breast Cancer.

Abstract Background: Taxanes are known to have radiosensitizing properties, by causing cell arrest in the G2 and M phases of the cell cycle. As taxanes have become integrated into routine oncologic use, concerns have arisen over the association between taxanes and radiation toxicities such as pneumonitis. Pneumonitis has been reported to occur both with taxane administration alone or, more commonly, with concurrent or sequential radiation. The purpose of this study is to evaluate radiation pneumonitis from our institutional phase I/II protocol of neoadjuvant FEC chemotherapy followed by weekly docetaxel concurrent with radiotherapy in the treatment of locally advanced breast cancer (LABC). Materials and Methods: Since August 2009, thirty-two LABC patients with stage IIB, IIIA, IIIB, or IIIC invasive breast cancer were enrolled to receive protocol based treatment consisting of 3 cycles of intravenous (IV) fluorouracil 500 mg/m2, epirubicin 100 mg/m2, and cyclophosphamide 500 mg/m2 (FEC) every 3 weeks. Following this, weekly IV docetaxel 35 mg/m2 was administered concurrently with locoregional external beam radiotherapy to a total dose of 45 Gy in 25 fractions followed by a boost of 5.4-9 Gy in 3–5 fractions to gross residual disease. Adverse events were scored using the National Cancer Institute Common Terminology Criteria for Adverse Events v3.0. A linear regression model was built used to evaluate potential parameters predictive of clinical pneumonitis (grade ≥2). Results: Of the 32 patients enrolled on this prospective protocol, 7 were excluded from analysis (n = 6, follow-up < 4 weeks; n = 1, converted to palliative radiotherapy due to metastatic disease). Twenty-five patients remained for analysis. The median age was 48 years (range 26 to 64). Thirteen patients were treated with intensity modulated radiation therapy while 12 were treated using 3D conformal radiotherapy. In total 13 patients (52%) experienced clinical pneumonitis with 6 of these patients (24%) transiently requiring supportive oxygen (grade 3). On linear regression modeling, the use of IMRT (p = 0.08), grade 3 skin toxicity (p = 0.08), and baseline left ventricular ejection fraction (LVEF, p = 0.05) were potentially predictive of symptomatic pneumonitis. Conversely, various heart and lung dose-volume histogram parameters, trastuzumab use, bolus use, disease laterality, total docetaxel dose, were not predictive of symptomatic pneumonitis (p > 0.10). In multivariable modeling, the use of IMRT (p = 0.05) and baseline LVEF (0 = 0.03) remained predictive of symptomatic pneumonitis. Conclusion: The use of concurrent weekly docetaxel-based chemoradiotherapy in LABC is associated with significant symptomatic pneumonitis and may be related to low baseline LVEF and the use of IMRT. However, conventional parameters of low dose volumes of lung and heart irradiated were not predictive of pneumonitis. The relationship of the use of IMRT and taxanes in the development of pnemonitis is likely complex and warrants further investigation. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P3-16-11.

Prognosis comparison of three-dimensional conformal radiotherapy/intensity modulated radiation therapy for esophageal carcinoma with localregional lymph node metastasis

Objective To explore the prognosis and related factor of esophageal carcinoma with locoregional lymph node metastasis ( N1 ) treated with three-dimensional conformal radiotherapy (3DCRT) or intensity modulated radiation therapy (IMRT).Methods From January 2001 to December 2008,60 patients of esophageal carcinoma with localregional lymph node metastasis were treated with 3DCRT and 52 with IMRT.For all patients,dose of tumor was 56 - 70 Gy/28 - 35 fraction/5.6 - 7.0 weeks.Among them,58 cases was treated with chemotherapy including cisplatin and 5-fluorouracil;40 with concurrent chemoradiotherapy and 18 with sequential radiotherapy and chemotherapy.Results After radiotherapy,the total efficiency rate was 98.2％,96.7％ in 3DCRT and 100％ in IMRT ( x2 =1.77,P =0.184 ).The follow-up rate was 99.1％.The number of patients completed follow-up were 68 and 53,respectively at 2-year and 3-year.The 1 and 3-year overall survival rates were 62.5％,23.7％,respectively; the median survival time was 17 months.The 1and 3-year survival rates and median were 52％,19％ and 12.4 months in 3DCRT and 75％,40％ and 17 months in IMRT,respectively (x2 =4.74,P =0.030).The 1 and 3-year free-recurrence survival rates were 64％,45％ in 3DCRT and 72％,59％ in IMRT ( x2 =2.27,P =0.132),respectively.With uninvariate analysis,for female,ages ≤ 65,tumor located in cervical and upper-thoracic,＞5 cm lesion length in barium esophagogram,≤4 cm the largest diameter of lesion in CT scanning image,T4 stage,or semiliquid or liquid diet before radiotherapy,survival rate were higher in IMRT than in 3DCRT group (x2 =4.63,5.56,7.19,5.08,4.43,4.48,8.25;P=0.031,0.018,0.007,0.025,0.035,0.034,0.004,respectively) ; but for male,ages ＞ 65,tumor located in middle and lower-thoracic,≤5 cm lesion length in barium esophagogram,＞4 cm the largest diameter of lesion in CT scanning image,T1 -3 stage,or normal diet before radiotherapy,chemotherapy and dose of radiotherapy ( ＜66 Gy vs ≥66 Gy),no significant difference were found between IMRT and 3DCRT (x2 =1.28,0.27,0.17,0.03,1.98,0.01,0.43,2.45,1.73,1.24,2.64;P=0.258,0.602,0.684,0.859,0.160,0.973,0.511,0.117,0.189,0.234,0.104,respectively).By Cox multivariable regression,only T stage was independent prognostic factor (x2=9.50,P =0.002 ).Conclusions There was some advantage treated with IMRT compared with 3DCRT in patients of esophageal cancer with locoregional lymph node metastasis,but further prospective clinical study is needed to support the conclusion. Key words: Esophageal neoplasms/three-dimensional radiotherapy; Neoplasms metastasis,lymph node; Prognosis

Successful management of primary non Hodgkins lymphoma of the cranial vault

Primary bone lymphoma (PBL) is a relatively uncommon entity. However, involvement of the cranial vault is an unusual manifestation of aggressive non-Hodgkin's lymphoma. We report the case of a 42-year old immunocompetent woman who presented with an enlarging mass involving the right parietal bone. Magnetic resonance imaging (MRI) of the brain revealed an expansive tumor that affects the right parietal bone. Computed tomographic (CT) scans of the abdomen, chest and pelvis were negative for lymphadenopathy or organomegaly. Biopsy of the mass showed diffuse large B-cell non-Hodgkin's lymphoma confirmed by immunohistochemical study. The patient had a complete response after 4 cycles of chemotherapy followed by external beam radiotherapy. After a follow-up of more than 9 months the patient is still in good local control without distant metastasis. The aim of our work is to report a case of Primary bone lymphoma of the cranial vault with good response to treatment combining sequential chemotherapy and radiotherapy.

Concurrent or Sequential Adjuvant Letrozole and Radiotherapy after Conservative Surgery for Early-stage Breast Cancer: Long-term Results of the Cohort Phase 2 Randomized Trial

Letrozole radiosensitizes breast cancer cells in vitro. In clinical settings, no data exist for the combination of letrozole and radiotherapy. We assessed concurrent and sequential radiotherapy and letrozole in the adjuvant setting. The present study is registered with ClinicalTrials.gov, number NCT00208273. This Phase 2 randomized trial was undertaken in two centers in France and one in Switzerland between January 12, 2005, and February 21, 2007. One hundred fifty postmenopausal women with early-stage breast cancer were randomly assigned after conserving surgery to either concurrent radiotherapy and letrozole (n = 75) or sequential radiotherapy and letrozole (n = 75). Randomization was open label with a minimization technique, stratified by investigational centers, chemotherapy (yes vs. no), radiation boost (yes vs. no), and value of radiation-induced lymphocyte apoptosis (≤16% vs. >16%). The whole breast was irradiated to a total dose of 50 Gy in 25 fractions over 5 weeks. In the case of supraclavicular and internal mammary node irradiation, the dose was 44 – 50 Gy. Letrozole was administered orally once daily at a dose of 2 – 5 mg for 5 years (beginning 3 weeks pre-radiotherapy in the concomitant group, and 3 weeks postradiotherapy in the sequential group). The primary endpoint was the occurrence of acute (during and within 6 weeks of radiotherapy) and late (within 2 years) radiation-induced Grade 2 or worse toxic effects of the skin and lung (functional pulmonary test and lung CT-scan). Analyses were by intention-to-treat. The long-term follow-up after 2 years was only performed in Montpellier (n = 121) and evaluated skin toxicity (clinical examination every 6 months), lung fibrosis (one CT-scan yearly), cosmetic outcome. All patients were analyzed apart from 1 in the concurrent group who withdrew consent before any treatment. Within the first 2 years (n = 149), no lung toxicity was identified by CT scan and no modification from baseline was noted by the lung diffusion capacity test. Two patients in each group had Grade 2 or worse late effects (both radiation-induced subcutaneous fibrosis [RISF]). After 2 years (n = 121), and with a median follow-up of 50 months (38-62), 2 patients (1 in each arm) presented a Grade 3 RISF. No lung toxicity was identified by CT scan. Cosmetic results (photographies) and quality of life was good to excellent. All patients who had Grade 3 subcutaneous fibrosis had an RILA value of 16% or less, irrespective of the sequence with letrozole. With long-term follow-up, letrozole can be safely delivered shortly after surgery and concomitantly with radiotherapy.

9028 POSTER Gemcitabine and Cisplatin Followed by Concurrent Gemcitabine and Radiotherapy or Sequential Radiotherapy Alone in Unresectable Stage III Non-small Cell Lung Cancer (NSCLC)

9028 POSTER Gemcitabine and Cisplatin Followed by Concurrent Gemcitabine and Radiotherapy or Sequential Radiotherapy Alone in Unresectable Stage III Non-small Cell Lung Cancer (NSCLC)

Long-Term Results of a Randomized Trial on the Sequencing of Radiotherapy and Chemotherapy in Breast Cancer

A prospective, phase III randomized study was undertaken to compare the outcomes of 2 different radiotherapy and chemotherapy sequences in conservatively treated patients with breast cancer. Between January 1997 and November 2002, 206 patients operated of quadrantectomy and axillary dissection for breast cancer, candidates to receive adjuvant CMF chemotherapy (cyclophosphamide, methotrexate, and fluorouracil) were assigned to concurrent or sequential radiation treatment by using a balanced randomization method. Before randomization patients were stratified by tumor diameter, age, and lymph node status. The primary end point was the freedom from breast recurrence, and secondary end points were overall and disease-free survival. Overall outcomes were analyzed according to the intention-to-treat principle. All 206 patients enrolled and randomized in the trial were analyzed. The median follow-up was 111 months, with no patient lost for follow-up. No difference in 10-years breast recurrence-free, disease-free, metastasis-free, and overall survival rates was observed in the 2 treatment sequence groups. The Hazard Ratios, calculated for each prognostic factor, showed no difference in all outcomes between the 2 treatment sequences. No influence of the treatment sequence on long-term outcomes was observed in this trial. This finding suggests that to avoid an increased risk of distant recurrence or an excessive toxicity, radiation therapy may be delayed until after the end of the more, recently used, anthracycline-based chemotherapy without increasing the risk of breast recurrences, thus allowing the delivery of full-dose chemotherapy in patients at risk for systemic disease spread.

The effect of bioequivalent radiation dose on survival of patients with limited-stage small-cell lung cancer

BackgroundTo investigate the biological radiation dose-response for patients of limited-stage small-cell lung cancer (LS-SCLC) treated with high radiation dose.MethodsTwo hundred and five patients of LS-SCLC treated with sequential chemotherapy and thoracic radiotherapy with involved-field between 1997 and 2006 were reviewed retrospectively. Biologically effective dose (BED) was calculated for dose homogenization and was corrected with the factor of overall radiation time. Patients were divided into low BED group (n = 70) and high BED group (n = 135) with a cut-off of BED 57 Gy (equivalent to 60 Gy in 30 fractions over 40 days). Outcomes of the two groups were compared.ResultsMedian follow-up was 20.7 months for all analyzable patients and 50.8 months for surviving patients. Considering all patients, median survival was 22.9 months (95% confidence interval, 20.6-25.2 months); 2- and 5-year survival rates were 47.2% and 22.3%, respectively. Patients in high BED group had a significantly better local control (p = 0.024), progression-free survival (p = 0.006) and overall survival (p = 0.005), with a trend toward improved distant-metastasis free survival (p = 0.196). Multivariable Cox regression demonstrated that age (p = 0.003), KPS (p = 0.009), weight loss (p = 0.023), and BED (p = 0.004) were significant predictors of overall survival.ConclusionsOur data showed that a high BED was significantly associated with favourable outcomes in the Chinese LS-SCLC population, indicating that a positive BED-response relationship still existed even in a relatively high radiation dose range.

Lack of sequential radiation in a parasitoid of a host-associated aphid

Sequential radiation occurs when novel biodiversity at low trophic levels ‘cascades' up to high trophic levels generating further biodiversity. When putatively generalist herbivore species comprise host-plant specialized populations, sequential radiation can be tested for their parasites and predators. We tested for sequential radiation in Aphelinus perpallidus Gahan (Hymenoptera: Aphelinidae), a parasitoid wasp of the yellow pecan aphid, Monelliopsis pecanis Bissel (Hemiptera: Drepanosiphidae). This aphid has been shown to consist of at least two genetically distinct host-tree-associated populations, one feeding on pecan, Carya illinoinensis (Wangenh.) K. Koch (Juglandaceae), and one feeding on water hickory, Carya aquatica (Michx. f.) Nutt. We found that this wasp consists of three genetically distinct populations with unique molecular phenotypes, but these populations did not correspond to host-plant species of origin. Collecting site accounted for 20% of the molecular variance found. Sequential radiation may be less common in aphid parasitoids than in other parasitoid groups because of specific aspects of their biology, namely parasitization of externally feeding hosts, multivoltinism, and learned habitat preference.

Sequential chemotherapy and radiation therapy for the adjuvant treatment of uterine papillary serous carcinoma

Sequential chemotherapy and radiation therapy for the adjuvant treatment of uterine papillary serous carcinoma

THE IMPACT OF ADAPTIVE AND NON-TARGETED EFFECTS IN THE BIOLOGICAL RESPONSES TO LOW DOSE/LOW FLUENCE IONIZING RADIATION: THE MODULATING EFFECT OF LINEAR ENERGY TRANSFER

A large volume of laboratory and human epidemiological studies have shown that high doses of ionizing radiation engender significant health risks. In contrast, the health risks of low level radiation remain ambiguous and have been the subject of intense debate. To reduce the uncertainty in evaluating these risks, research advances in cellular and molecular biology are being used to characterize the biological effects of low dose radiation exposures and their underlying mechanisms. Radiation type, dose rate, genetic susceptibility, cellular redox environment, stage of cell growth, level of biological organization and environmental parameters are among the factors that modulate interactions among signaling processes that determine short- and long-term outcomes of low dose exposures. Whereas, recommended radiation protection guidelines assume a linear dose-response relationship in estimating radiation cancer risk, in vitro and in vivo investigations of phenomena such as adaptive responses and non-targeted effects, namely bystander effects and genomic instability, suggest that low dose/low fluence-induced signaling events act to alter linearity of the dose-response relation as supported by the biophysical argument. The latter predicts that increases in dose simply increase the probability that a given cell in a tissue will be intersected by an electron track, and by corollary, each unit of radiation, no matter how small would increases risk. These predictions assume that similar molecular events mediate both low and high dose radiobiological effects, and the cumulative risk from two sequential radiation exposures can never be less than one alone.

A randomized study on the effects of paclitaxel liposme and cisplatin induction chemotherapy followed concurrent chemoradiotherapy and sequential radiotherapy on locally advanced non-small cell lung cancer patients

背景与目的序贯放化疗及同期放化疗在局部晚期肺癌治疗中得以广泛研究，而诱导加同期放化疗的研究尚少。紫杉醇脂质体副作用少，可使诱导加同期放化疗更顺利地实施。本文旨在比较紫杉醇脂质体加顺铂（TP方案）诱导加同期放化疗和序贯放化疗治疗局部晚期非小细胞肺癌（non-small cell lung cancer, NSCLC）的疗效及毒副作用。方法我院60例局部晚期NSCLC患者随机分为诱导加同期放化疗组（A组）和序贯放化疗组（B组）。A组：诱导化疗2个-3个周期后行同期放化疗，放疗的第1天及第22天予TP方案化疗（紫杉醇脂质体135 mg/m2-175 mg/m2，d1；顺铂70 mg/m2-80 mg/m2，d2），期间持续放疗。B组：化疗方案同前，化疗4个-6个周期后，行放疗。两组放疗方式均为三维适形放疗，总剂量为56 Gy-70 Gy。观察和比较两组的疗效和毒副作用。结果A组、B组总有效率分别为80.3%和60%，组间有统计学差异（P=0.042）；1年生存率分别为71.4%和53.2%，组间无统计学差异（P=0.18）；骨髓抑制发生率分别为90%和73.3%，组间无统计学差异（P=0.09）；放射性食管炎发生率分别为50%和36.7%，组间无统计学差异（P=0.147）；肺纤维化发生率分别为30%和20%，组间无统计学差异（P=0.276）。结论在晚期NSCLC的局部治疗中，TP方案诱导加同期放化疗较序贯放化疗的近期疗效好，但毒副反应无明显区别。

Histotype predicts the curative potential of radiotherapy: the example of ovarian cancers

BackgroundTo explore the influence of ovarian cancer histotype on the effectiveness of adjuvant radiotherapy (RT). MethodsA review of a population-based experience included all referred women with no reported macroscopic residuum following primary surgery who underwent adjuvant platin-based chemotherapy (CT), with or without sequential RT, and for whom it was possible to assign histotype according to the contemporary criteria. ResultsSeven hundred and three subjects were eligible, of these 351 received RT. For those with apparent stage I and II tumors, the cohort with clear cell (C), endometrioid (E), and mucinous (M) disease who additionally received RT exhibited a 40% reduction in disease-specific mortality and a 43% reduction in overall mortality. ConclusionsThe curability of those with stage I and II C-, E-, and M-type ovarian carcinomas was enhanced by RT-containing adjuvant therapy. This benefit did not extend to those with stage III or serous tumors. These findings necessitate reassessments of the role of RT and of the nonselective surgical and CT approaches that have characterized ovarian cancer care.

A prospective study on therapeutic gain by concurrent chemoradiotherapy for stage II–IV a nasopharyngeal carcinoma

The benefit achieved by concurrent chemoradiotherapy (CCR) and sequential chemoradiotherapy (SCR) vs radiotherapy (RT) alone for patients with stage II-IVa nasopharyngeal carcinoma (NPC) was compared. A total of 113 patients with stage II-IV a NPC were allotted into CCR group (n=38), SCR group (n=36) and RT alone group (n=39). All patients were irradiated with the same RT technique to ≥66 Gy at 2 Gy per fraction, conventional 5 fractions/week in all groups. The CCR group received concurrent chemotherapy of weekly cisplatin for 7 weeks, and the SCR group received neoadjuvant and (or) adjuvant chemotherapy. The results showed that the 3- and 5-year overall survival rate was significantly higher in CCR group than in RT alone group (92.16% vs 61.54%, 81.58% vs 51.28%, P<0.005). The median survival time was significantly longer in CCR group than in RT alone group (67.8 months vs 52.7 months, P<0.005). It was concluded that CCR could significantly improve overall survival rate, progression-free survival rate, and median survival time when compared with RT alone.

122 Small cell lung carcinoma: experience in patients treated with initial chemotherapy or sequential chemotherapy plus radiotherapy 2005–2010

122 Small cell lung carcinoma: experience in patients treated with initial chemotherapy or sequential chemotherapy plus radiotherapy 2005–2010