{"title":"Radiation dose control for CT urography based on different body mass index","authors":"Haijing Qiu, Yong Chen, T. Ren, Yu Gao, Wenjie Sun, Zhiling Gao","doi":"10.3760/CMA.J.ISSN.0254-5098.2020.01.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-5098.2020.01.012","url":null,"abstract":"Objective \u0000To explore the optimization of CT urography imaging parameters and the control measures of radiation dose to patients with different body mass index. \u0000 \u0000 \u0000Methods \u0000A total of 133 patients who were required to undergo CT urography were prospectively selected in terms of three different types of CT urography scan; firstly, conventional parameter scan (120 kV, CARE Dose4D); secondly, low kV scan (BMI ≤ 22.9∶80 kV, 22.9 < BMI < 30∶100 kV, BMI ≥ 30∶120 kV, CARE Dose4D) and thirdly, low mAs scan (120 kV, 40% reduction in mAs on CARE Dose4D). Noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of all images were measured as objective evaluation indicators of image quality. The subjective evaluation of the images was performed by two radiologists who had been working for more than five years using a double-blind method and a 5-score system evaluation. The effective dose values (CTDIvol, DLP, E) in each group were measured. \u0000 \u0000 \u0000Results \u0000Patients′ effective dose was decreased by 77.7% in 80 kV group and 38.3% in 100 kV group, with a statistical difference between the two groups (Z=-3.330, -5.559, P 0.05). There was a statistically significant difference in renal cortex noise and SNR between the 100 kV scan group and the routine scan group (Z=-5.096, -3.566, P 0.05). The effective dose from low mAs scan in the three types of patients was decreased by 38.3%, 32.0%, and 34.7%, respectively, with a statistical difference between them (P 0.05) besides ureteral CNR in the 22.9 < BMI < 30 group (Z=-2.587, P<0.05). The subjective evaluation scores of all images were greater than 3 points. \u0000 \u0000 \u0000Conclusions \u0000In this study, the scan method for low kV and low mAs used for patients with different body mass index can effectively reduce the radiation dose to patients and meet the requirements of clinical diagnosis. \u0000 \u0000 \u0000Key words: \u0000Body mass index; CT urography; Low-dose scan; Urinary system disease","PeriodicalId":36403,"journal":{"name":"中华放射医学与防护杂志","volume":"3 1","pages":"64-70"},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88028083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
中华放射医学与防护杂志Pub Date : 2020-01-25DOI: 10.3760/CMA.J.ISSN.0254-5098.2020.01.011
Qiang Zhao, Xiangyang Wu, Xiao-long Chang, Tao Feng, Di Yang, Kun Zhang, X. Qu, Xuemin Wang
{"title":"Feasibility study of using two dimensional array ion-chamber to verifiy relative dose distribution calculated with Acuros BV","authors":"Qiang Zhao, Xiangyang Wu, Xiao-long Chang, Tao Feng, Di Yang, Kun Zhang, X. Qu, Xuemin Wang","doi":"10.3760/CMA.J.ISSN.0254-5098.2020.01.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-5098.2020.01.011","url":null,"abstract":"Objective \u0000To study the feasibility of using the PTW729 2D array ion-chamber to verify the relative dose distribution calculated with the Acuros BV algorithm. Both advantages and disadvantages of the method were analyzed to provide reference for practical clinical practices. \u0000 \u0000 \u0000Methods \u0000Based on self-built measurement phantoms, the dose distribution on the same slice of the phantom was measured with PTW729 and film, respectively, under the same measurement condition and plan. The dose distributions obtained by the two method were compared with the result calculated with Acuros BV, separately, by using γ analytical tool. And the stability of the PTW729 was tested. \u0000 \u0000 \u0000Results \u0000The γ comparison value was 95.9% between the film and Acuros BV, 98.9% between the PTW729 and Acuros BV and 88.0% between the film and PTW729, with 95.0%, 100.0%, and 100.0%, in their stability test respectively. \u0000 \u0000 \u0000Conclusions \u0000PTW729 2D array ion-chamber can be applied to the rapid verification of Acuros BV algorithm-calculated relative dose distribution. \u0000 \u0000 \u0000Key words: \u00002D array ion-chamber; Acuros BV; Brachy therapy","PeriodicalId":36403,"journal":{"name":"中华放射医学与防护杂志","volume":"11 1","pages":"59-63"},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89105834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
中华放射医学与防护杂志Pub Date : 2020-01-25DOI: 10.3760/CMA.J.ISSN.0254-5098.2020.01.007
李文炎, Liu Wenyan, 张贵英, Zhang Guiying, 王志超, Wang Zhichao, 郭泽钦, Guo Ze-qin, 康梦霄, Kang Mengxiao, 刘传业, Liu Chuanye, 盛文涛, Shen Wentao, 曾粤, Zeng Yue, 罗希, L. Xi, 岳琳琳, Yue Linlin
{"title":"Research of TLD calibrated in different standard X-ray RQR radiation field in terms of eye lens dose Hp(3)","authors":"李文炎, Liu Wenyan, 张贵英, Zhang Guiying, 王志超, Wang Zhichao, 郭泽钦, Guo Ze-qin, 康梦霄, Kang Mengxiao, 刘传业, Liu Chuanye, 盛文涛, Shen Wentao, 曾粤, Zeng Yue, 罗希, L. Xi, 岳琳琳, Yue Linlin","doi":"10.3760/CMA.J.ISSN.0254-5098.2020.01.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-5098.2020.01.007","url":null,"abstract":"Objective \u0000To compare the calibration result of standard X-ray RQR radiation field between SSDL (NIRP) and CEA LIST LNHB(France), and to explore the feasibility of calibrating Hp(3) in standard X-ray RQR radiation field of SSDL(NIRP). \u0000 \u0000 \u0000Methods \u0000Using a column model with a diameter and high of 20 cm, TLD was calibrated in SSDL (NIRP) and CEA LIST LNHB (France) to measure the personal dose equivalent eye lens dose Hp(3), X-ray RQR radiation field included RQR4(60 kV), RQR7(90 kV), RQR9(120 kV), with energy response, angle response and linear response. \u0000 \u0000 \u0000Results \u0000In terms of energy response, the calibration results of TLD in both SSDL (NIRP) and CEA LIST LNHB (France) were in good agreement. The difference between exposure value and response value was less than 10%. In terms of angle response, the calibration result of TLD in CEA LIST LNHB (France) was better in SSDL(NIRP). The difference between exposure value and response value in CEA LIST LNHB (France) was less than 6%, while the difference between exposure value and response value in SSDL(NIRP) was more than 10% at angle of 20°. In terms of linear response, both calibration result of SSDL (NIRP) and CEA LIST LNHB (France) were in good agreement. \u0000 \u0000 \u0000Conclusions \u0000The standard X-ray RQR field in SSDL (NIRP) can be used for the calibration of Hp(3). \u0000 \u0000 \u0000Key words: \u0000Eye lens; RQR field; Hp(3); Thermoluminescent dosimeter(TLD)","PeriodicalId":36403,"journal":{"name":"中华放射医学与防护杂志","volume":"34 1","pages":"42-46"},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85081197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
中华放射医学与防护杂志Pub Date : 2020-01-25DOI: 10.3760/CMA.J.ISSN.0254-5098.2020.01.001
Xiaolan He, Chenying Ma
{"title":"Correlation between the expression of metabolites and acute radiation enteritis in patients with cervical cancer","authors":"Xiaolan He, Chenying Ma","doi":"10.3760/CMA.J.ISSN.0254-5098.2020.01.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-5098.2020.01.001","url":null,"abstract":"Objective \u0000To investigate the relationship between the metabolites in the fecal samples from cervical cancer patients and radiation-induced acute intestinal symptoms during radiotherapy. \u0000 \u0000 \u0000Methods \u0000A total of 51 cervical cancer patients who received radiotherapy in our hospital from September 2017 to June 2018 were enrolled. One patient was excluded due to efficiant sample failure, so a total of 50 patients were included in the study. Totally 200 fecal samples were collected at four time points, i. e. before radiotherapy, 2 weeks post radiotherapy starting, 4 weeks post radiotherapy starting and end of radiotherapy. These fecal samples were analyzed by non-targeted metabolomics using liquid chromatography-mass spectrometry (LC-MS). Data were analyzed with statistical method including partial least squares-discriminant analysis (PLS-DA), agglomerate hierarchical clustering to investigate the trend of metabolites expression in feces. \u0000 \u0000 \u0000Results \u0000A total of 5 770 metabolic peaks were detected and 121 biomarkers were identified, of which 77 biomarkers were up-regulated and 44 biomarkers were down-regulated. Nineteen biomarkers were significantly changed at four time points after radiotherapy, including 1-methylxanthine, linoleic acid, 5-aminopentanoic acid, phenethylamine, styrene, N-acetylglutamate, nandrolone, 4-acetylaminobutyric acid, N-acetyl-L-phenylalanine, daidzein, cholic acid, arachidonic acid, methyl leucine, N-formyl-L-methionine, quercetin, phenylalanine, gluconic acid, melibiose and α-CMBHC. Four metabolic pathways of phenylalanine tyrosine, niacin and nicotinamide, linoleic acid and lysine degradation (Pathway imPact >0.1) were found to be related to acute radiation enteritis. \u0000 \u0000 \u0000Conclusions \u0000The metabolites in the feces of cervical cancer patients change significantly during radiotherapy, and some biomarkers in the fecal supernatant are up- or down-regulated to varying degrees as doses increase, which provides new ideas and method for the prediction of acute radiation enteritis. \u0000 \u0000 \u0000Key words: \u0000Cervical cancer; Metabolomics; Radiation-induced acute intestinal symptoms","PeriodicalId":36403,"journal":{"name":"中华放射医学与防护杂志","volume":"7 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87255563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
中华放射医学与防护杂志Pub Date : 2020-01-25DOI: 10.3760/CMA.J.ISSN.0254-5098.2020.01.005
F. Wu, Min Liu, Shengwei Kang, Pei Wang, Jie Li, B. Tang
{"title":"Dosimetric comparison among volumetric modulate arc therapy plans with different fluence smoothing in the treatment of patients with middle and upper thoracic esophageal carcinoma","authors":"F. Wu, Min Liu, Shengwei Kang, Pei Wang, Jie Li, B. Tang","doi":"10.3760/CMA.J.ISSN.0254-5098.2020.01.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-5098.2020.01.005","url":null,"abstract":"Objective \u0000To compare the dosimetric differences of volumetric modulated arc therapy (VMAT) plans optimized with 3 different fluence smoothing parameters using Monaco treatment planning system. \u0000 \u0000 \u0000Methods \u0000A total of 15 patients with middle and upper esophageal carcinoma were planned with Low fluence smoothing (Low), Medium fluence smoothing (Medium) and High fluence smoothing(High) during VMAT optimization. The dosimetric differences in D95, Dmean, conformity index (CI), homogeneity index (HI) of targets, dose volume histogram (DVH) of organs at risk (OARs), and monitor unit (MU) were compared. \u0000 \u0000 \u0000Results \u0000There were no significant differences in D95, Dmean, CI and HI of targets, as well as in V40 and Dmean of the heart, V10, V20 and Dmean of the lung , and segment number among plans optimized with different fluence smoothing techniques (P>0.05). Plans with high fluence smoothing achieved less V30 of heart, Dmax of cord PRV(t=-2.167, -0.999, P<0.05), lower MU (t=-3.148, -6.692, P<0.05), but increased V5 of both lungs (t=1.306, -2.027, P<0.05) compared with plans with Medium and Low fluence smoothing. Plans with low fluence smoothing irradiated higher dose to the V30 and Dmean to heart (t=0.411, 0.589, 0.013, P<0.05), but less V5 of the lungs (t=0.423, P<0.05) compared with plans with medium fluence smoothing. \u0000 \u0000 \u0000Conclusions \u0000All VMAT plans with 3 different fluence smoothing can meet the clinical requirements. VMAT plans optimized with high fluence smoothing are recommended in the treatment of patients middle and upper thoracic esophageal carcinoma. \u0000 \u0000 \u0000Key words: \u0000Dosimetry; Monaco; Middle-upper esophageal carcinoma; Fluence smoothing; VMAT","PeriodicalId":36403,"journal":{"name":"中华放射医学与防护杂志","volume":"11 1","pages":"32-35"},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75104294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
中华放射医学与防护杂志Pub Date : 2020-01-25DOI: 10.3760/CMA.J.ISSN.0254-5098.2020.01.010
Jian-guo Zhu, Tao Wang, Shuhui Yang, Lin Zhang, Fei Niu, Nan Min
{"title":"Simulated experimental measurement of exposure dose to patients from endoscopic retrograde cholangiopancreatography operation","authors":"Jian-guo Zhu, Tao Wang, Shuhui Yang, Lin Zhang, Fei Niu, Nan Min","doi":"10.3760/CMA.J.ISSN.0254-5098.2020.01.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-5098.2020.01.010","url":null,"abstract":"Objective \u0000To estimate the doses to patients from ERCP operation through experimental measurements. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was made of 56 ERCP operations in three hospitals, and meanwhile, the tube voltage and current, fluoroscopy time, accumulated doses, DAPs (dose-area product) and photographic frames were also recorded for statistical analysis. Three cases of RECP operation that had led to high, medium and low DAP values were selected, respectively, as high, medium and low dose groups based on anthropomorphic phatom (AP). ERCP operation was simulated on AP on the basis of putting TLDs in it. The absorbed doses of organs were measured while effective doses while calculated. \u0000 \u0000 \u0000Results \u0000The effective doses for high, medium and low groups were 2.69, 11.52 and 39.27 mSv, respectively. The effective dose was 14 times higher in high dose group than that in low group. The highest organ doses for three groups were all concentrated in the irradiation fields. \u0000 \u0000 \u0000Conclusions \u0000Organ doses from ERCP phantom experiments vary largely in different groups. Compared with phantom experiments of other interventional types, ERCP can be regarded as one of interventional means leading to high-dose. It is advisable to reasonably and safely use intervention diagnosis and therapy and in order optimize radiation doses to patients. \u0000 \u0000 \u0000Key words: \u0000Endoscopicretrograde(ERCP); Phantom; Dose; Radiation protection","PeriodicalId":36403,"journal":{"name":"中华放射医学与防护杂志","volume":"62 1","pages":"55-58"},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83134512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
中华放射医学与防护杂志Pub Date : 2020-01-25DOI: 10.3760/CMA.J.ISSN.0254-5098.2020.01.002
Yidan Yao, Tingting Zhang, Kai Hu
{"title":"Protective effect of Sarcandra glabra on radiation-induced parotid injury in rats","authors":"Yidan Yao, Tingting Zhang, Kai Hu","doi":"10.3760/CMA.J.ISSN.0254-5098.2020.01.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-5098.2020.01.002","url":null,"abstract":"Objective \u0000To study the changes of inflammatory response and apoptosis in parotid gland tissues of rats after X-ray irradiation, and to explore the protective effect and possible mechanism of Sarcandra glabra on radiation-induced parotid injury in rats. \u0000 \u0000 \u0000Methods \u0000A total of 120 male rats were randomly divided into 5 groups(24 for each): control group, single irradiation group, radiation combined with a high(26.8 g·kg-1·d-1), moderate(13.4 g·kg-1·d-1) and low(6.7 g·kg-1·d-1) dosage of Sarcandra glabra group. The parotid gland of rats in the irradiation group received 15 Gy X-ray. Rats in each group were anesthetized with 2% pentobarbital sodium (0.16 ml/100 g) at 10, 40 and 70 d after irradiation and blood was collected from abdominal aorta. ROS levels in blood serum of each group were detected on the 10th, 40th and 70th days after irradiation. After parotid gland tissue was taken, the pathological changes and ultrastructural changes were observed by hematoxylin-eosin (HE) staining and transmission electron microscopy, respectively. The expression level of TNF-α in parotid gland tissue was detected by immunohistochemistry, and apoptosis of parotid cells was detected by TUNEL assay. \u0000 \u0000 \u0000Results \u0000The content of ROS and the expression of TNF-α protein in the single irradiation group were simultaneously increased compared with the control group (t=-24.723, -35.013, -19.515, P<0.05; t=-13.563, 43.519, -15.249, P<0.05), while they were reduced by Sarcandra glabra in a dosage dependent manner, especially in the high dosage group of Sarcandra glabra (t=5.295, 8.138, 6.545, P<0.05; t=10.093, -7.868, 10.539, P<0.05). In the control group, the parotid gland tissue structure was intact, without congestion, exudation, edema, etc. For the single irradiation group, the parotid gland tissue became hyperemia, edema and inflammatory cell infiltration at 10 d after irradiation followed by fibrosis at 40 d after irradiation. These pathological alterations in the parotid gland tissue were significantly recovered when the rats were treated with Sarcandra glabra before irradiation, and the tissue damage was negatively correlated with drug dosage. TUNEL assay showed that the apoptosis rate of parotid gland cells in the single irradiation groups was higher than that in the control group (t=-4.639, -3.979, P<0.05). \u0000 \u0000 \u0000Conclusions \u0000Sarcandra glabra protects parotid gland from radiation damage by scavenging radiation-induced ROS and declining inflammatory response, and thus it may be applied as a potential protective agent for radiation injury. \u0000 \u0000 \u0000Key words: \u0000Apoptosis; Sarcandra glabra; Radiation induced parotid injury; ROS; TNF-α","PeriodicalId":36403,"journal":{"name":"中华放射医学与防护杂志","volume":"88 1","pages":"11-18"},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88538349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
中华放射医学与防护杂志Pub Date : 2020-01-25DOI: 10.3760/CMA.J.ISSN.0254-5098.2020.01.008
Yan Kong, Hui Zhang, Bo Yang
{"title":"Radiation dose evaluation to male adult reference phantom from using three types of cloths with naturally occurring radioactive material","authors":"Yan Kong, Hui Zhang, Bo Yang","doi":"10.3760/CMA.J.ISSN.0254-5098.2020.01.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-5098.2020.01.008","url":null,"abstract":"Objective \u0000To evaluate annual skin equivalent dose and annual effective dose to consumers arising from three types of cloths samples containing naturally occurring radioactive material (NORM). \u0000 \u0000 \u0000Methods \u0000Firstly, measurement of radioactivity in three types of cloths were made with γ-ray spectrometer. And then, theoretical exposure scenarios were simulated with Monte Carlo software to calculate organ dose and effective dose by using ICRP reference voxel male phantom. Finally, annual skin equivalent dose and effective dose to consumers from these cloths samples were evaluated. \u0000 \u0000 \u0000Results \u0000In the wrapped and covered estimation models used in this study, sample mass ranged from 135 to 7 197 g, annual skin equivalent dose to consumers from these cloths samples from 155.41 to 9 028.61 μSv, and annual effective dose from 11.91 to 1 234.44 μSv. \u0000 \u0000 \u0000Conclusions \u0000NORM-added consumer products would cause some radiation hazard to human body. \u0000 \u0000 \u0000Key words: \u0000NORM; Consumer products; Dose evaluation","PeriodicalId":36403,"journal":{"name":"中华放射医学与防护杂志","volume":"22 1","pages":"47-50"},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82741132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
中华放射医学与防护杂志Pub Date : 2019-12-25DOI: 10.3760/CMA.J.ISSN.0254-5098.2019.12.007
L. Bo, Z. Qu, Deng Kangli, Cui Diansheng, Xi Zhiguo, Wei Shaozhong
{"title":"Investigation on concurrent chemoradiotherapy for postoperative inguinal recurrence in penile cancer patients","authors":"L. Bo, Z. Qu, Deng Kangli, Cui Diansheng, Xi Zhiguo, Wei Shaozhong","doi":"10.3760/CMA.J.ISSN.0254-5098.2019.12.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-5098.2019.12.007","url":null,"abstract":"Objective \u0000To investigate treatment option of inguinal lymph node metastasis after inguinal lymph node dissection in patients with penile cancer. \u0000 \u0000 \u0000Methods \u0000To retrospectively analyze the efficacy and prognostic factors of cisplatin combined with fluorouracil in the concurrent chemoradiotherapy of inguinal lymph node metastasis after penile cancer surgery. Twenty-three patients with inguinal lymph node metastasis after inguinal lymph node dissection for penile squamous cell carcinoma from February 2009 to December 2015 were included.Inguinal lymph node metastasis with squamous cell carcinoma were confirmed by pathology or cytology. Metastatic lymph nodes of each patient were fixed, not less than 2, and greater than 4 cm in diameter. All patients received concurrent chemoradiotherapy with cisplatin and 5-fluorouracil.The response rate was evaluated after radiotherapy. The local control rate, survival time and the prognostic factors were also analyzed. \u0000 \u0000 \u0000Results \u0000The median time of postoperative inguinal lymph node metastasis was 6.1 months, and the recurrence rate of the patients within 16 months after the operation was 95%.The response rate was 65.2% (15/23). After treatment, the local pain was significantly relieved and 7 cases of local hemorrhage was relieved. The 1-, 2-year survival rates were 21.3% and 5.5%, respectively, with a median survival of 6.3 months(95% CI: 3.4-8.1). And local tumor response rate correlated with radiation dose. Cox multivariate analysis showed that N staging and histological grade were independent prognostic factors for survival after treatment. \u0000 \u0000 \u0000Conclusions \u0000Concurrent chemoradiotherapy is effective for postoperative inguinal lymph node metastasis, especially for the local recurrence with symptoms and for patients who are not suitable for surgical salvage regarding the local tumor control, pain relief and tumor hemorrhage. However, the overall survival rate of the patients who received treatment was still low. Lower extremity edema is the main complication of concurrent chemoradiotherapy. N staging and poor differentiation of the tissue are unfavorable prognostic factors. \u0000 \u0000 \u0000Key words: \u0000Penile cancer; Inguinal lymph node; Chemoradiotherapy; Local recurrence","PeriodicalId":36403,"journal":{"name":"中华放射医学与防护杂志","volume":"33 1","pages":"916-919"},"PeriodicalIF":0.0,"publicationDate":"2019-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81536925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}