台湾地区肿瘤放射治疗发展简史

顾台湾地区肿瘤放射治疗设备、人员、技术等情况的进展,可为广大读者提供一个简单清晰的脉络,并帮助了解台湾地区肿瘤放射治疗学创建与发展过程。此报告是对台湾地区肿瘤放射治疗学发展的宣传与肯定,也更是为扩大放射肿瘤学科交流和发展提供契机。     

澳门地区肿瘤放射治疗发展简史

澳门地区肿瘤放射治疗设备、人员、技术等情况的进展,简单描述澳门地区肿瘤放射治疗学创建与发展过程,为广大读者提供一个简单清晰的脉络。这样即是对澳门地区肿瘤放疗学发展的宣传与肯定,也更是为扩大放射肿瘤学科交流和发展提供契机。     

CT／MRI图像融合在肿瘤三维适形放射治疗中的应用

影像学与放射治疗学密不可分,在放射治疗的整个过程中,影像学承担着诊断、定位、疗效观察及随诊的全过程,为放射治疗提供肿瘤形态、解剖、功能等影像监控,以协助治疗计划的制定与修改。     

CT/MRI图像融合在肿瘤三维适形放射治疗中的应用

影像学与放射治疗学密不可分,在放射治疗的整个过程中,影像学承担着诊断、定位、疗效观察及随诊的全过程,为放射治疗提供肿瘤形态、解剖、功能等影像监控,以协助治疗计划的制定与修改.     

放射治疗学在中国大陆的早期建立和发展(一)

1986年11月中华医学会放射肿瘤学分会成立，到今年11月整20年了。在近20年时间里，中国大陆的肿瘤放射治疗学在前辈们的引导和推动下得到了突飞猛进的发展，这与老一辈放射学家早期在中国大陆就建立了放射治疗学科是分不开的。而每一位放射治疗工作者也应了解中国大陆放射治疗学的建立和发展过程，借此20周年之际，分两期刊载“放射治疗学在中国大陆早期的建立和发展”一文，以飨读者[编者按]     

第十二届泛珠江区域放射肿瘤学学术大会纪要

由泛珠江区域肿瘤放射治疗协作组(PPRA-RTOG)、海南省抗癌协会肿瘤放射治疗专业委员会、海南省人民医院、中国抗癌协会肿瘤放射治疗专业委员会共同主办的“第十二届泛珠江区域放射肿瘤学学术大会暨第二届海南省抗癌协会肿瘤放射治疗学学术大会”于2017年4月20-23日在海南省海口市成功召开。今年的第十二届学术会议主题为“发挥区域优势,促进学科发展”。会议由中华医学会放射肿瘤学分会主任委员郎锦义教授、香港大学临床肿瘤系主任李咏梅教授和美国MD安德森肿瘤中心韦雄教授分别报道了人工智能时代放射治疗的挑战与思考、Concurrent-adjuvant chemo-radiotherapy for locoregionally advanced nasopharyngeal cancer 10 year efficacy and late toxicities及现代放疗技术对提高放疗生存质量及减少放疗损伤的思考。     

快中子治疗癌瘤的研究

氧与肿瘤放射敏感性的重要关系很早就受到人们的普遍重视。长期以来,国内外许多学者围绕着肿瘤的氧效应问题进行了大量的临床研究工作。在常规放射治疗中,采用增加肿瘤的氧含量、降低正常组织的供氧、改变时间—剂量关系、肿瘤放射致敏剂、肿瘤富氧细胞保护剂与乏氧细胞中毒剂等方法,试图来提高射线对肿瘤细胞的杀伤和降低正常组织的损伤。然而,近代高能物理学的发展,为解决肿瘤的氧效应问题又提供了新的途径。高LET放射,即高线性能量传递放射治疗设备的研制已受到一些治疗中心的重视。据报道应用高LET放射治疗某些晚期癌瘤已获得令人十分鼓舞的疗效。高LET放射系指快中子、负兀介子或其他重离子放射,它们的共同特点是氧效应     

本科生放射肿瘤学双语教学的探讨

双语教学是近年来医学教学的新模式,肿瘤放射治疗学是医学院校肿瘤学方向本科生的必修科目,文章就如何将双语教学运用于肿瘤放射治疗学中以提高学生学习的兴趣和教学质量作一初步探讨。     

恶性肿瘤放射增敏剂研究进展简

放射治疗是治疗恶性肿瘤的重要手段。随着精确放疗技术的发展,放射治疗的疗效和精确性已取得长足的进步。然而,如何在不增加周围正常组织毒副反应的基础上,进一步提高放疗疗效仍是目前肿瘤放射治疗学领域亟待解决的难题。放射增敏剂作为解决以上难题的重要方法之一,正越来越成为放射治疗学的研究热点。合理应用放射增敏剂将有效地提高恶性肿瘤放射敏感性,从而改善患者生活质量,减少肿瘤局部复发,延长患者的生存时间。     

第八届全国肿瘤放疗及综合治疗会议暨第三届东部肿瘤放射治疗协作组(EROG)会议圆满结束

由上海市医学会肿瘤放射治疗专科分会主办、EROG协办并由复旦大学附属肿瘤医院承办的第八届全国肿瘤放疗及综合治疗会议暨第三届EROG会议,于2014年8月15—17日在上海隆重召开,来自全国各地的专家和代表济济一堂,共同探讨肿瘤放射治疗学领域的发展趋势、技术进展,交流和分享各中心的应用经验。本次大会学术报告内容精彩,紧贴肿瘤治疗和放疗专业发展的前沿,并从临床应用、放射生物、放射物理、放射治疗基础研究等几个方面全面系统地介绍了我国放射治疗的现状及展望。大会还特设了青年论坛及专家点评环节,让来自全国各地的青年医师及物理师有展示自己科研成果并与同行交流的宝贵机会。     

Colorectal carcinoma in Hong Kong: epidemiology and genetic mutations.

The incidence of colorectal carcinoma is rising at an alarming pace in Asian urban societies such as Hong Kong. Detailed examination of the epidemiological pattern and genetic mutation of colorectal cancer in the Hong Kong Chinese population is overdue. We compared the reported age incidence of colorectal carcinoma in Hong Kong with that of Scotland and other countries. Hong Kong showed a much higher incidence of colorectal carcinoma among the young age groups. By comparison with other countries, this raised incidence among the young appeared to be related to southern Chinese societies. The recent dramatic rise in colorectal cancer in Hong Kong was largely attributable to an increase in the over 50 years age group, while the young incidence remained unchanged. We also defined the mutation spectrum of p53 and Ki-ras in 67 unselected cases by direct DNA sequencing. Interestingly, insertion/deletion mutations in p53 from colorectal carcinoma in Hong Kong showed a significantly higher frequency (17.2%) than the Scottish data (0%) and the world database (6.6%), although the overall frequency of p53 mutation (43%) in Hong Kong was similar to others. The high incidence of colorectal carcinoma in young people and the raised proportion of frameshift mutations in p53 encourage further search for a genetic basis for susceptibility to this disease in the Hong Kong Chinese population.     

Phenotypic alterations induced by the Hong Kong-prevalent Epstein-Barr virus-encoded LMP1 variant (2117-LMP1) in nasopharyngeal epithelial cells

Epstein-Barr virus (EBV) is closely associated with nasopharyngeal carcinoma (NPC), a common cancer in Hong Kong. The EBV-encoded LMP1 protein is believed to play an important role in cell transformation. We have previously identified a prevalent LMP1 variant (2117-LMP1) that is expressed in 86% of primary NPC in Hong Kong. In this study, the biologic phenotypes induced by 2117-LMP1 were compared with those of the prototypic B95.8-LMP1 in an immortalized nasopharyngeal epithelial cell line, NP69. The 2117-LMP1 could induce cell proliferation and resistance to apoptosis induced by growth factor deprivation. Expression of 2117-LMP1 also suppressed expression of p16, p21 and Bax but induced expression of CDK2 and A20. Compared with B95.8-LMP1, 2117-LMP1 could induce a higher migration ability in NP69 cells but was less efficient in inducing morphologic changes, anchorage-independent growth and cell invasion. Relatively weaker ability of 2117-LMP1 than B95.8-LMP1 in upregulation of vimentin, VEGF and MMP9 as well as in downregulation of E-cadherin was observed. 2117-LMP1 could activate higher level of NF-kappaB activity in HEK 293 cells than B95.8-LMP1. The present study supports a role of 2117-LMP1 in NPC development by enhancing cell proliferation, cell death inhibition and migration in premalignant nasopharyngeal epithelial cells. Furthermore, our study reveals significant functional differences between 2117-LMP1 and the prototypic B95.8-LMP1. Our results provide insights into the pathologic significance of this prevalent LMP1 variant, 2117-LMP1, in the development of NPC in the Hong Kong population.     

Incidence of ras oncogene activation in lung carcinomas in Hong Kong.

BACKGROUND. In Hong Kong, lung carcinomas contribute to the majority of cancer deaths among Chinese. Point mutational activation of ras oncogenes has been observed in several populations. The incidence of these mutations in Hong Kong lung carcinomas was investigated. METHODS. Lung resections obtained from 52 Chinese patients whose conditions were newly diagnosed as non-small cell lung cancer, paraffin sections from 29 Chinese patients with previously diagnosed adenocarcinoma of the lung, and paraffin sections from 49 squamous cell carcinomas were examined for the presence of point mutations in Ki-ras codon 12, N-ras codon 61, and Ha-ras codon 12 oncogenes by allele-specific hybridization after specific amplification of appropriate regions of the DNA using the polymerase chain reaction. RESULTS. Among the 130 lung carcinomas investigated, Ki-ras point mutations were detected in seven cases, of which six were adenocarcinomas and one a squamous cell carcinoma. No mutations were detected in the N-ras and Ha-ras codons. CONCLUSIONS. The incidence of Ki-ras codon 12 point mutational activation in Chinese patients with adenocarcinomas was 6 of 63 (9.5%). The incidence of Ki-ras 12 point mutational activation among men with lung adenocarcinomas in Hong Kong (6 of 32 patients, 18.8%) is significantly different from that in women in Hong Kong (0 of 31 patients, 0%). Although ras oncogenes are implicated as having a role in the development of lung adenocarcinomas, especially among smokers, it is clear from these data that they are not associated with the unusually high incidence of lung adenocarcinomas among women in Hong Kong.     

Osteosarcoma of the maxilla in Hong Kong Chinese postirradiation for nasopharyngeal carcinoma. A report of four cases

Postirradiation osteosarcoma of the maxilla was seen in four Hong Kong Chinese patients treated for nasopharyngeal carcinoma. These cases represent four of 42 (9%) cases of osteosarcoma at all sites in this institution during the period 1979 to 1989, when more than 1000 patients were treated with radiotherapy for nasopharyngeal carcinoma. The latent periods varied from 8 to 11 years from completion of radiotherapy treatment to development of osteosarcoma. The radiation dosage varied from 6000 to 6280 cGy in three of the patients. These cases fit the criteria for diagnosis of postirradiation sarcomas. Maxillary osteosarcomas after irradiation for nasopharyngeal carcinoma do not appear to have been described. The very high incidence of nasopharyngeal carcinoma (for which radiotherapy is the treatment of choice) in Hong Kong Chinese would make the occurrence of such tumors more likely in Hong Kong, although the small risk does not contraindicate the use of radiation in the treatment of nasopharyngeal carcinoma in view of its well-documented efficacy.     

Genomic aberrations in human hepatocellular carcinomas of differing etiologies.

We sought to assess whether genetic abnormalities in hepatocellular carcinoma differed in geographic locations associated with different risk factors. Comparative genomic hybridization (CGH) was applied to the genome-wide chromosomal analysis in 83 tumor samples from four different geographic origins. Samples were obtained from regions that differed in aflatoxin exposure: China (Hong Kong with low aflatoxin exposure and Shanghai with moderate aflatoxin exposure), Japan, and the United States (negligible aflatoxin exposure). Cases from Hong Kong and Shanghai were all hepatitis B virus (HBV) related, those from Japan were hepatitis C virus related, and those from the United States were HBV negative. In parallel, the mutational pattern of the whole p53 gene (exons 1-11) was also investigated in these cases. CGH revealed a complex pattern of chromosomal gains and losses, with the commonest aberration in each geographic location being chromosome 1q copy number gain (38-60%). Shanghai cases displayed the highest number of total aberrations per sample, with significant copy losses on 4q (75%), 8p (70%), and 16q (65%). Hepatitis C virus-related samples from Japan had a characteristically high incidence of 11q13 gain. p53 mutation(s) was detected in 23% of Hong Kong cases, 40% of Shanghai, 31% of Japan, but only 6% of the United States cases. The "aflatoxin-associated" codon 249 mutation was, however, identified only in samples from China (13% Hong Kong and 20% Shanghai). This finding, together with the highly aberrant pattern of genetic changes detected in the Shanghai series, is suggestive of the genotoxic effects of aflatoxin being more broadly based. It is also likely that there is a synergistic effect of HBV infection and high aflatoxin exposure in promoting hepatocellular carcinoma development. It appears from our CGH study that individual risk factors are indeed associated with distinct genetic aberrations, although changes in 1q gain appear common to all.     

香港头颈外科的发展现状

头颈外科包括了头颈部肿瘤及相关疾病的诊断和治疗。香港头颈外科的起源可以追述到本世纪60年代中期。当时的香港大学玛丽医院外科学系主任王源美教授是开创这一领域的先驱。香港最初只有普外科医生涉及到这一区域肿瘤的治疗，经过多年来其它专科的发展，目前香港头颈部的疾病已经可以由三个外科次级专科处理，即耳鼻喉科、整形重建科和普外科。20年来，在外科、放射科及化疗科的共同努力下，头颈部肿瘤在诊断及治疗方面获得的迅速的发展，这就使病人的预后得到了很大程度的改善。     

香港放射治疗及医疗服务水平

全文介绍香港放射治疗发展历程、放射治疗设备及技术、放射治疗师培训、质量管理及医疗服务水平等情况,旨在了解目前香港的放射治疗状况,学习香港的优质医疗服务水平。     

Intake of Cantonese-style salted fish as a cause of nasopharyngeal carcinoma

Ho (1971) of Hong Kong first proposed consumption of Cantonese-style salted fish, a traditional food among southern Chinese, as a possible risk factor for nasopharyngeal carcinoma (NPC) in this high-risk population. Four case-control studies have examined Ho's hypothesis; all results are supportive. The most convincing evidence of a causal association between intake of salted fish and NPC derives from a recent case-control study of young Hong Kong Chinese. It is estimated that over 90% of NPC cases under age 35 in Hong Kong are due to intake of this food during childhood. Preliminary experimental data on Cantonese-style salted fish indicate that N-nitroso compounds may be involved in the carcinogenicity of this human food.     

Hereditary Colorectal Cancer Syndromes in Hong Kong: a Registry's Perspective

Established in 1995, the Hereditary Gastrointestinal Cancer Registry aimed at cancer prevention due to hereditary colorectal cancer syndromes in Hong Kong through early detection, timely treatment, education and ongoing research. This article details the history, structure and work of the Registry. A summary is also provided on the results of various research work conducted by the Registry which facilitates the clinical management of hereditary colorectal cancer syndromes in Hong Kong Chinese families.     

A pilot study of participation in faecal occult blood testing and screening colonoscopy after health education in Hong Kong.

Colorectal cancer is the second commonest cancer in Hong Kong. The screening behaviour of the Chinese population has not been assessed. The aim of this study is to report a pilot study of educating and subsequent evaluation of colorectal cancer screening behaviour in the Hong Kong Chinese population. Subjects were invited to attend a free health talk on colorectal cancer. Both self-paid faecal occult blood testing (FOBT) and free screening colonoscopy were offered after the education programme. Of the participants taking part in the education programme 113/119 (95%) completed the FOBT. Of the FOBT 8/113 (7%) showed positive result and three patients had neoplasia at colonoscopy. Twenty-five patients with negative FOBT also completed colonoscopy; two had adenomas. Screening colonoscopy after FOBT was accepted by 28% of subjects. Those younger than 65 years and those with a positive FOBT (7/8 versus 25/105 for those with negative FOBT, P=0.0003) were more likely to agree to screening colonoscopy. In conclusion, health education is important for ensuring high acceptance and implementation of colorectal cancer screening in Hong Kong Chinese. FOBT is an acceptable and feasible screening method in Hong Kong.