The Study of the Distribution of Dose in Radiotherapy with the Aid of Electronic Computers

The authors comment on the utilization of electronic computers as a means of obtaining, quickly and efficiently, the distribution of dose in radiotherapy, with consequent facilitation of the planning procedure. The authors describe the plan of operation and its flow chart. During recent years, electronic computers have been the object of studies with a view to using them in the planning of teleradiation treatment. In this respect much work was done by Tsien, by Professor Theodor Sterling and associates of the University of Cincinnatti, by research workers from the University of Gothenburg, by Dr. Ruheri Perez-Tamayo and companions from the Penrose Cancer Hospital, and by Dr. J. Laughlin and collaborators of the New York Memorial Hospital. As we know, the planning of radiotherapy for deep lesions is quite complex, due to the slight difference in sensitivity between the malignant tissues which should be destroyed and the circumjacent healthy ones, which are often vital and more sensitive than the blastoma itself, and which should be protected. It is up to the radiotherapist, after exhaustively studying the structure and location of the tumour and its relations with the surrounding tissues, to divide the amount of radiation into several “entrance doors”– fields situated at various places on the surface of the body and which, from different angles, shed their rays in the direction of the neoplasia. In determining the openings of the diaphragm, the angles of incidence, and the weights of the contributions from each field, he should concentrate on the region aimed at, the sum of the destructive effects of such radiation beams, since their doses are summable. In order to know the distribution of the dose throughout the irradiated region, it is necessary to verify the values of the sums of the various beams in a sufficiently large number of points and situated not only on the tumour but also on the adjacent healthy structures. Sometimes, once the disposition is known (the isodose curves having been made), points. of overdosage, distortions, deviations and other defects are noted. It is up to the radiotherapist to analyse and find the cause of error and to make a new distribution, thus reinitiating the planning process and studying the new procedure. If it is true that the intensity diminishes-in relation to the distance of the source, the distribution of the amount of radiation in one beam is, however, complex: it depends on the dimensions of the source, on the collirnation device, on the distance source-skin, on the medium, on the spectral composition of the radiation. On a plane perpendicular to the axis the dose varies up to more than 20%, since the radiation emission is not isotropic and the distance to the source is greater on the borders, the diffusion is quantitatively different in the centre and on the limits of the field, and the more peripheral rays go through a greater thickness of filter, as they go through it at an oblique angle. Consequently, the action of the various beams on the region treated produces a distribution of dose which is difficult to calculate and entails a great deal of work. Lack of means capable of making the calculations quickly leads the radiotherapist to the repetition of pre-established techniques (often without the required exactitude), giving rise to the error resulting from the alterations proper to each case, of the dimensions of the patient and of the lesion and its relations with adjacent tissues. The alternative, the solution by graphic method starting from curves traced on transparent paper, is an exceedingly slow process, tiring, and not very exact, for it is impossible to calculate in this way more than a small number of doses in spaced points. Electronic computers fulfil the need for performing these complicated and slow mathematical operations in short periods of time. The utilization of the computer makes it possible to determine, within a short time, the dose in a great number of points; it gives the specialist the opportunity to make several studies for the same case and select the most convenient planning, thus perfecting the techniques; it also brings about greater safety, both in the number of points calculated and in the precision of the results.     

骨陛关节炎滑膜组织中16种元素的分析

目的骨性关节炎（osteoarthritis,OA）是一种退行性骨关节病,该病病因和发病机制尚不明确。微量元素能通过参与人体内的新陈代谢、各种生物和化学反应等,维持机体正常生理活动,如果体内各种微量元素含量失调,就有可能引发多种疾病。本研究通过测定骨性关节炎滑膜组织中B、Mg、A1、K、Ca、n、Cr、Mn、Fe、Ni、Cu、Zn、Se、Sr、Ba、Pb等16种元素含量,探讨OA患者滑膜组织中这些元素的水平和疾病发生、发展的关系,为OA的机制研究和诊治提供相关的理论依据。方法选择骨性关节炎患者为实验组,单纯外伤引起的半月板损伤患者为对照组。术中采集患者滑膜组织样本,经微波消解处理,用电感耦合等离子体质谱（ICP—MS）测定组织中16种元素含量,数据经SAS9．0软件统计分析。结果实验组滑膜组织中硒（se）、铁（Fe）、锌（Zn）、铜（Cu）、硼（B）、钙（Ca）和钾（K）7种元素含量与对照组比较,差异均有统计学意义（P〈0．05）,其中实验组滑膜组织中Fe、B、Se元素含量低于对照组,而Ca、K、Cu、Zn元素的含量高于对照组;锰（Mn）、铬（Cr）、锶（Sr）、镍（Ni）、钡（Ba）、铝（A1）、铅（Pb）、锑（Sb）、镁（Mg）元素含量没有明显变化。结论骨性关节炎患者滑膜中硒、铁、锌、铜、硼、钙和钾7种元素含量变化明显,这些元素都是机体的必需元素,它们可能通过影响蛋白质、酶的代谢导致骨性关节病的发生。     

痰涂片肺癌脱落细胞巴氏染色色度学定量研究

目的定量揭示痰涂片中肺癌脱落细胞巴氏染色的色度学特征,筛选对肺癌诊断分类有重要价值的色度学参数。方法取痰涂片中正常的柱状上皮细胞、鳞状上皮细胞、组织细胞和肺的鳞癌、腺癌、大细胞癌及小细胞癌细胞,用计算机图像分析技术分别测试上述7类细胞的色度学参数值,包括细胞的红、绿、蓝三基色(Rc、Gc、Bc)及其三基色系数(rc、gc、bc),核的红、绿、蓝三基色(Rn、Gn、Gn)及其三基色系数(rn、gn、bn)。结果正常细胞的Rc、Gc、Bc、rc、Rn、Gn、rn均高于癌细胞,bc、bn则低于癌细胞,差异均有统计学意义;在正常细胞中,SqE的Rc、Gc、Rn、Gn、Bc和Bn均为最高,CE的Gc、Rn、Gn、Bc和Bn最小,Rc为HC最小,差异均有统计学意义;在癌细胞中,大细胞癌的Rc、Gc、Rn、Gn、rc、rn均为最高,bc、bn则最低,差异均有统计学意义;上述7类细胞间均有部分参数的差异有统计学意义。结论巴氏染色痰涂片中脱落细胞的色度学参数Rc、Rn、Gc、Gn、Bc、Bn及rc、rn、gc、gn、bc、bn在不同类型细胞间有显著性差异,这些参数及其差异不但可用于判别鳞癌、腺癌、小细胞癌与大细胞癌细胞的研究,还可用于判别柱状上皮细胞、组织细胞与鳞状上皮细胞以及正常与肺癌细胞的研究。     

Education and cancer risk.

BACKGROUND. Socioeconomic factors have been associated, to a variable degree, with the risk of serious cancers. METHODS. The relationship between education and cancer risk was analyzed using data from a series of case-control studies conducted in northern Italy between 1983 and 1990, including 119 histologically confirmed cancers of the oral cavity and pharynx, 294 of the esophagus, 564 of the stomach, 673 of the colon, 406 of the rectum, 258 of the liver, 41 of the gallbladder, 303 of the pancreas, 149 of the larynx, 2860 of the breast, 692 of the cervix, 567 of the corpus uteri, 742 of the ovary, 107 of the prostate, 365 of the bladder, 147 of the kidney, and 120 of the thyroid, 72 Hodgkin diseases, 173 non-Hodgkin lymphomas, 117 myelomas, and a total of 6147 control subjects admitted to the same network of hospitals for acute, non-neoplastic conditions. RESULTS. Nine types of cancer were inversely related to education. Those were oral cavity and pharynx, with a relative risk (RR) of 0.3 for the highest versus the lowest level; esophagus, RR = 0.6; stomach, RR = 0.5; liver, RR = 0.7; gallbladder, RR = 0.5; larynx, RR = 0.3; cervix, RR = 0.7; endometrium, RR = 0.5; and non-Hodgkin lymphomas, RR = 0.6. Five cancer sites were directly related to education: colon, RR = 1.3; pancreas, RR = 1.3; breast, RR = 1.5; kidney, RR = 1.3; and thyroid, RR = 1.5. No consistent gradient in risk with education was observed for the six other neoplasms considered, including rectum, prostate, bladder, Hodgkin disease, and multiple myeloma. The patterns of risk for education were consistent in men and women for most cancer sites except colon, for which the direct relationship was stronger in males. CONCLUSIONS. This study confirms the existence of and quantifies a number of strong socioeconomic correlates of cancer risk and indicates a few points open to additional investigation, such as the different pattern of risk for rectal and colon cancer, the strong negative gradient for endometrial cancer, and the absence of any clear association with education for cancers of the ovary, prostate, urinary tract, lymphomas, and myeloma.     

1324例住院癌症患者近期疗效统计

目的 探讨癌症住院病人的终末医疗质量。方法 对陕西省肿瘤医院1324例出院病历记录，按照国际疾病分类：ICD-9，统计分析住院病人的治愈、好转、未愈、病死率及癌症类型。结果 全年住院超过百例以上的癌症依次为肺癌、食管癌、宫颈癌、胃癌、恶性淋巴瘤、肝癌和乳腺癌，癌症病人的平均治愈率为19．34％，好转率为60．20％，未愈率为14．5％，病死率为5．96％。结论 由于受多因素影响，癌症的治疗效果还不如人意，要提高治愈率，降低病死率仍需继续努力。     

食管癌术后患者生存情况及其影响因素分析

目的 探讨影响食管癌术后患者预后的影响因素,为制定山西省食管癌的综合防治措施提供依据.方法 对在山西省肿瘤医院手术治疗的641例食管癌患者临床资料和随访结果进行回顾性、分析.采用Kaplan-Meier法、Log-rank法进行生存分析,在单因素分析的基础上,应用Cox回归模型进行预后影响因素的多因素分析.结果 全组食管癌术后患者1、2、3、4、5年累积生存率分别为73.92％、56.21％、43.75％、41.31％、37.52％,中位生存期为887.56 d.年龄、工作状态、经济状况、肿瘤解剖部位、分化程度、侵犯层次、淋巴结转移情况、远处转移情况、治疗方式、手术方式、病理形态、肿瘤大小、阳性淋巴结转移数、上消化道癌家族史各水平间生存差异有统计学意义（P＜0.05）.性别、婚姻状况、受教育程度、细胞类型、切缘情况、食管癌家族史各水平间生存差异无统计学意义（均P＞ 0.05）.Cox模型多因素分析显示,年龄、经济状况、解剖部位、侵犯层次、治疗方式、手术方式、淋巴结转移数量是影响预后的独立因素（均P＜ 0.05）.结论 食管癌侵犯层次越深、淋巴结转移越多,预后越差.早期治疗对食管癌患者预后有重要意义,应提高早期发现率和早期诊断率.     

Research trends in the treatment of prostatic neoplasms

Prostatic carcinoma, in the male population ranks first as incidence and second as cause of oncologic mortality. In the last decades, significantly better clinical results were achieved both in diagnosis and therapy. The latter covers a broad range of possibilities, including standard surgery, nerve-sparing surgery, combined surgery and hormonotherapy, cryosurgery, external beam radiotherapy, brachytherapy, conformal radiotherapy, combined hormone and radiation therapy, as well as conventional hormonotherapy. However, there is still much controversy on the role of the screening, the most appropriate staging modalities, the most adequate treatment in the various presentations of the disease. The present trends of the clinical research in this field are directed towards the identification of factors involved in the onset of this neoplasm and the possibility of decreasing its incidence with programs of chemoprevention, the identification of new biological markers able to assess the biological potential of the disease, the comparison between the main treatment modalities of localized carcinoma (surgery, brachytherapy, external beam radiotherapy) and the definition of parameters predictive of the response to the various treatments to better personalize the therapy of the single patient, the development of treatments based on genetic therapy and of effective systemic therapies able to control the hormone-resistant advanced disease and to clarify the impact of the different therapies on the quality of life and health care costs.     

石家庄市区户籍人口2012年恶性肿瘤发病分析

目的:研究石家庄市区户籍人口2012年恶性肿瘤发病情况。方法:2012年石家庄市区237 万户籍人口医疗保险覆盖率达99% 以上。将2012年1 月1 日至12月31日于石家庄市医保中心首次报销的住院恶性肿瘤个案经与医院数据核对后作为分子,市公安局2012年中户籍人口数作为分母,计算发病率,分析性别、年龄别和部位别肿瘤的发病特点。结果:2012年石家庄市区户籍人口恶性肿瘤粗发病率为237.53/10万,中国人口年龄调整发病率（中调率）为129.86/10万,世界人口年龄调整发病率（世调率）为167.71/10万。发病率随年龄增加而增加,男女均于75~79岁组达到高峰,分别为1 729.42/10万和867.35/10万。男性前10位的恶性肿瘤依次为肺癌、胃癌、结直肠癌、肝癌、食管癌、肾癌、前列腺癌、白血病、膀胱癌、淋巴瘤;女性分别为乳腺癌、肺癌、结直肠癌、胃癌、宫颈癌、子宫体癌、卵巢癌、淋巴瘤、食管癌及肝癌。石家庄市区户籍人口男性恶性肿瘤的粗发病率、世调率分别为269.05/10万、187.52/10万,女性分别为207.57/10万、150.44/10万。与全国31个城市2009年的世调率相比,男性肺癌、胃癌、结直肠癌与全国水平相近,女性乳腺癌高于全国水平;与北京市相比,石家庄市区男性胃癌、食管癌世调率分别约为北京市男性的2倍,但北京市男性胰腺癌、前列腺癌,女性甲状腺癌的世调率分别是石家庄市区的2 倍。结论:石家庄市区户籍人口2012年主要恶性肿瘤如肺癌、胃癌、结直肠癌、乳腺癌的世调率与全国31个城市2009年的水平相当;与北京市相比,食管癌、胃癌高发,但甲状腺癌、前列腺癌、胰腺癌低发。      

食管癌患者尿液微量元素分析

目的　了解尿液微量元素含量与食管癌发病的关系。方法　采用精确的ＩＣＰ－ ＡＥＳ法（ 高频电感耦合等离子体－ 原子发射光谱法） 和双向蒸发发射光谱法,测定了正常人和食管癌病人各１０ 例尿液中Ｐｂ、Ｚｎ、Ｔｉ、Ｍｎ、Ｆｅ、Ａｌ、Ｂ、Ｓｉ、Ａｇ 微量元素和Ｃａ、Ｐ、Ｍｇ 常量元素的含量。结果　食管癌尿液中的Ｐｂ、Ｚｎ 、Ｃｕ 、Ｔｉ、Ｍｎ、Ｆｅ、Ａｌ、Ｍｇ、Ｂ、Ｓｉ、Ａｇ 含量增高;Ｃａ、Ｐ含量减低。结论　食管癌病人尿液中铜含量增高,钙含量降低,经统计学处理,差异显著,与食管癌的发生有一定关系。     

Understanding the gastrointestinal tract of the elderly to develop dietary solutions that prevent malnutrition

Although the prevalence of malnutrition in the old age is increasing worldwide a synthetic understanding of the impact of aging on the intake, digestion, and absorption of nutrients is still lacking. This review article aims at filling the gap in knowledge between the functional decline of the aging gastrointestinal tract (GIT) and the consequences of malnutrition on the health status of elderly. Changes in the aging GIT include the mechanical disintegration of food, gastrointestinal motor function, food transit, chemical food digestion, and functionality of the intestinal wall. These alterations progressively decrease the ability of the GIT to provide the aging organism with adequate levels of nutrients, what contributes to the development of malnutrition. Malnutrition, in turn, increases the risks for the development of a range of pathologies associated with most organ systems, in particular the nervous-, muscoskeletal-, cardiovascular-, immune-, and skin systems. In addition to psychological, economics, and societal factors, dietary solutions preventing malnutrition should thus propose dietary guidelines and food products that integrate knowledge on the functionality of the aging GIT and the nutritional status of the elderly. Achieving this goal will request the identification, validation, and correlative analysis of biomarkers of food intake, nutrient bioavailability, and malnutrition.     

CT在原发性气管肿瘤诊断中的价值

目的 探讨CT技术在诊断原发性气管肿瘤中的应用价值.方法 回顾性分析20例气管肿瘤患者的临床资料及CT表现.结果 20例患者中气管下段肿瘤9例,中段肿瘤5例,上段肿瘤6例;2例气管良性肿瘤均较小,18例气管恶性肿瘤大小不一.恶性肿瘤形状各异,其中乳头状者4例,息肉状者4例,分叶状者6例,扁平附壁状生长者2例,沿管壁环状浸润者2例.肿瘤以软组织密度为主.结论 CT能够显示气管肿瘤的位置、大小、形状、密度,肿瘤向气管腔内外生长情况及气管狭窄的程度,气管肿瘤沿气管壁纵向、环状浸润范围,肿瘤浸润周围器官及与周围组织器官的关系;有助于治疗方案的制订.     

A Controlled Study on Comparing Differences in CT Perfusion Imaging between Rabbits inoculated with VX2 Lung Tumor and Patients with Squamous Cell Carcinoma of the Lung

OBJECTIVE By analysis and evaluation of the perfusion images and perfusion parameters of the rabbits with VX2 lung tumor,the association between the perfusion parameters and tumor angiogenesis of patients with squamous cell carcinoma of the lung has been studied in order to establish a non-invasive and effective way to detect tumor blood supply, which is be able to exhibit hemodynamic data in tumors during cancer treatments.METHODS Fifteen Netherlands rabbits inoculated with VX2 lung tumor (rabbit group) and 25 patients with squamous cell carcinoma of the lung (patient group) received a multi-slice spiral CT perfusion imaging test using the Netherlands PHILIPS Brilliance 16-slice spiral CT and a U.S. MEDRAD binocular highpressure syringe. Image postprocessing was done using the special perfusion software and EBW 4.0 Workstation. Perfusion volume (PV), peak enhanced increment (PEI), transit time peak (TTP), and blood volume (BV) were measured and analyzed.RESULTS In the rabbit group, the values of the PV, PEI, TTP,and BV of the tumor margin were (53.89 ± 13.38) mL/(min·mL),(45.71 ± 15.52) Hu, (39.29 ± 10.10) sec, and (31.45 ± 18.19) mL/100 g,respectively; these values of the tumor center were (36.57 ± 14.17)mL/(min·mL), (28.64 ± 11.74) Hu, (39.00 ± 9.78) sec, and (19.76± 13.95) mL/100 g, respectively; the values of the muscles were (12.45 ± 4.38) mL/(min·mL), (10.98 ± 5.03) Hu, (38.86 ± 10.04) sec,and (5.38 ± 2.87) mL/100 g, respectively. The values of the relative perfusion volume (RPV), relative peak enhanced increment (RPEI),and relative blood volume (RBV) of the tumor margin were 4.38 ± 1.45, 3.96 ± 1.45, 9.99 ± 11.7, respectively; these values of the tumor center were 2.14 ± 1.08, 1.83 ± 1.45, 4.17 ± 3.39, respectively. The values of the PV, PEI, BV of the tumor margin vs. the values of the muscles developed t-values, which were 15.028, 10.79, and 5.88,respectively (P ≤ 0.01), with statistical significance; the values of the PV, PEI, BV of the tumor center vs. the values of the muscles produced t-values, which were 8.67, 7.49, and 4.55, respectively (P≤ 0.01), with statistical significance. The values of the TTP of the tumor margin vs. TTP values of the muscles, and the TTP values of the tumor center vs. TTP values of the muscles developed t-values, which were 1.7 and 0.806, respectively (P ≥ 0.05), without statistical significance. In the patient group, the values of the PV, PE, TTP, and BV of the tumor margin were (88.95 ± 30.89)mL/(min·mL), (61.87 ± 27.31) Hu, (37.72 ± 12.53) sec, and (18.38± 7.2) mL/100 g, respectively; these values of the tumor center were (39.77 ± 18.29) mL/(min·mL), (14.57 ± 8.1) Hu, (35.64 ± 12.41)sec, and (11.22 ± 6.02) mL/100 g, respectively; these values of the muscles were (12.45 ± 6.5) mL/(min·mL), (6.14 ± 2.66) Hu, (35.68± 12.35) sec, and (2.23 ± 1.11) mL/100 g, respectively. The values of the RPV, RPEI, and RBV of the tumor margin were 8.05 ± 5.04, 8.87 ± 4.32, and 12.16 ± 8.49, respectively;these values of the tumor center were 2.39 ± 1.68, 2.97± 2.1, 3.53 ± 2.82, respectively. The values of the PV,PEI, BV of the tumor margin in the patient group vs. the values of the muscles produced t-values,which were 13.8, 10.85, and 12.22, respectively (P <0.01), with significant differences; these values of the tumor center vs. the values of the muscles developed t-values, which were 9.158, 6.26, 8.654, respectively (P < 0.01), with significant differences. The TTP value of the tumor margin vs. that of the muscles produced t-value, which was 0.371, and the TTP value of the tumor center vs. that of the muscles developed t-value, which was 1 (P > 0.05), without statistical difference. CONCLUSION CT perfusion imaging technics demonstrates directly dynamic changes of blood flow to tumors, which assists in identifying tumor growth and necrosis, therefore, this research provides an evidence-based guidelines for the treatment of human lung squamous cell carcinoma and has far-reaching clinical significance.     

Role of MR-DWI and MR-PWI in the radiotherapy of implanted pulmonary VX-2 carcinoma in rabbits

Objective： To detect the activity of tumor cells and tumor blood flow before and after the radiotherapy of implanted pulmonary VX-2 carcinoma in rabbit models by using magnetic resonance diffusion-weighted imaging（MR-DWI） and magnetic resonance perfusion weighted imaging（MR-PWI）, and to evaluate the effectiveness and safety of the radiotherapy based on the changes in the MR-DWI and MR-PWI parameters at different treatment stages.
Methods： A total of 56 rabbit models with implanted pulmonary VX-2 carcinoma were established, and then equally divided into treatment group and control group. MR-DWI and MR-PWI were separately performed using a Philips Acheiva 1.5T MRI machine（Philips, Netherland）. MRI image processing was performed using special perfusion software and the WORKSPACE advanced workstation for MRI. MRDWI was applied for the observation of tumor signals and the measurement of apparent diffusion coefficient（ADC） values; whereas MR-PWI was used for the measurement of wash in rate（WIR）, wash out rate（WOR）, and maximum enhancement rate（MER）. The radiation treatment was performed using Siemens PRIMUS linear accelerator. In the treatment group, the radiotherapy was performed 21 days later on a once weekly dosage of 1,000 c Gy to yield a total dosage of 5,000 c Gy.
Results： The ADC parameters in the region of interest on DWI were as follows： on the treatment day for the implanted pulmonary VX-2 carcinoma, the t values at the center and the edge of the lesions were 1.352 and 1.461 in the treatment group and control group（P〉0.05）. During weeks 0-1 after treatment, the t values at the center and the edge of the lesions were 1.336 and 1.137（P〉0.05）. During weeks 1-2, the t values were 1.731 and 1.736（P〈0.05）. During weeks 2-3, the t values were 1.742 and 1.749（P〈0.05）. During weeks 3-4, the t values were 2.050 and 2.127（P〈0.05）. During weeks 4-5, the t values were 2.764 and 2.985（P〈0.05）. The ADC values in the treatment group were significantly     

Efficacy of potential chemopreventive agents on rat colon aberrant crypt formation and progression

We assessed the effects of 78 potential chemopreventive agents in the F344 rat using two assays in which the inhibition of carcinogen-induced aberrant crypt foci (ACF) in the colon was the measure of efficacy. In both assays ACF were induced by the carcinogen azoxymethane (AOM) in F344 rats by two sequential weekly injections at a dose of 15 mg/kg. Two weeks after the last AOM injection, animals were evaluated for the number of aberrant crypts detected in methylene blue stained whole mounts of rat colon. In the initiation phase protocol agents were given during the period of AOM administration, whereas in the post-initiation assay the chemopreventive agent was introduced during the last 4 weeks of an 8 week assay, a time when ACF had progressed to multiple crypt clusters. The agents were derived from a priority listing based on reports of chemopreventive activity in the literature and/or efficacy data from in vitro models of carcinogenesis. During the initiation phase carboxyl amidoimidazole, p-chlorphenylacetate, chlorpheniramine maleate, D609, diclofenac, etoperidone, eicosatetraynoic acid, farnesol, ferulic acid, lycopene, meclizine, methionine, phenylhexylisothiocyanate, phenylbutyrate, piroxicam, 9-cis-retinoic acid, S-allylcysteine, taurine, tetracycline and verapamil were strong inhibitors of ACF. During the post-initiation phase aspirin, calcium glucarate, ketoprofen, piroxicam, 9-cis-retinoic acid, retinol and rutin inhibited the outgrowth of ACF into multiple crypt clusters. Based on these data, certain phytochemicals, antihistamines, non-steroidal anti-inflammatory drugs and retinoids show unique preclinical promise for chemoprevention of colon cancer, with the latter two drug classes particularly effective in the post-initiation phase of carcinogenesis.     

Evaluation of Quality of Life in Turkish Patients with Head and Neck Cancer

Background: In this study, our aim was to investigate the effect of factors, such as radiotherapy, the doseof radiotherapy, the region of radiotherapy, the age of the patient, performance, co-morbidity, the stage of thedisease and the therapy modalities on the quality of life of patients with head and neck cancer. Materials andMethods: Eighty-two patients who were treated by either chemoradiotherapy or radiotherapy, at the CumhuriyetUniversity Faculty of Medicine, Department of Radiation Oncology, between February 2007 and September 2010,for head and neck cancer were included. The quality of life European Organisation for Research and Treatmentof Cancer, Questionnaire module to be used in Quality of Life assessments in Head and Neck Cancer (EORTCQLQ-H&N35) questionnaire was conducted in all patients before starting the radiotherapy, in the middle, at theend, at 1 month and at 6 months after the treatment. Results: According to the questionnaires at the end and atthe 6th month after the radiotherapy, it was found that the age of the patient, co-morbidity, ECOG performancestate, localization, type of treatment, the stage of the disease, the dose and the region of radiotherapy affect someof the symptom scales for quality of life. Conclusions: Quality of life was affected negatively during and afterthe radiotherapy. However, in the 6th month after the therapy, a significant improvement was observed in mostsymptoms.     

Incidence, mortality or prevalence as indicators of the cancer problem.

The magnitude of the cancer problem, as conveyed by the incidence, mortality and prevalence figures, was studied by analysis of the material of the Finnish Cancer Registry from 1953-1970. The prevalence was defined as the number of persons who had cancer, or had ever had cancer, and were living on December 31, 1970. The incidence and mortality of cancer in males exceeded those in respect of females, whereas the prevalence with females was clearly higher than that with males. According to all 3 indices, the commonest site of cancer was in the lungs in males. In females, cancer of the breast was the commonest malignant neoplasm measured by incidence and prevalence, where as in mortality statistics it was second to cancer of the stomach. Cancers with poor prognosis such as cancer of the lung, stomach, pancreas and esophagus, and leukemia, exhibited relatively low prevalence figures, whereas cancers with good prognosis, such as cancer of the breast, uterus, larynx and lip, showed relatively large numbers of prevalent cases. In females, cancer of the genitals, including the breasts, constituted nearly as may prevalent cases as did the total figure in males. As the 3 cancer indices measure different things, the nature of the index used should be taken into account in evaluation of the magnitude of the cancer problem.     

兆伏级锥形束CT引导的鼻咽癌放射治疗过程中的摆位精度分析

目的：应用兆伏级锥形束CT分析鼻咽癌调强放射治疗过程中体重变化对摆位精度的影响。方法：15例行逆向调强治疗的鼻咽癌患者,利用三维激光摆位,每周进行体重测量和伏级锥形束CT扫描（采用8MU）。采用smoothing H＆N滤波核函数进行三维图像重建（矩阵256×256,层厚1mm）。将重建的MV-CBCT图像与计划CT进行融合,记录等中心参考点在X、Y、Z坐标轴方向的摆位误差。在每次重建的MV-CBCT图像中都选择颅底和第1、3、5颈椎水平四个层面,测量四个层面的皮肤轮廓在身体左右方向（X轴）、头脚方向（Y轴）、前后方向（Z轴）的距离。以第1次扫描图像作为参考,计算每周皮肤轮廓缩小的距离,分析体重和皮肤轮廓缩小程度与摆位误差的关系。结果：15例患者在放疗过程中体重每周都有下降的趋势,至放疗结束,患者的体重平均下降4.5kg、其中最多消瘦15.2kg。不同层面皮肤轮廓之间的距离逐渐缩小,但第1颈椎和第3颈椎水平皮肤轮廓收缩最明显;颅底和第5颈椎层面的皮肤轮廓距离缩小相对较小。整个治疗过程中,等中心参考点在X、Y、Z坐标轴方向的平均摆位误差分别为0.15mm,0.28mm,0.21mm。随着体重的下降,X、Z轴方向的摆位误差轻微增加（P〉0.05）,但摆位误差均≤3mm;而Y轴方向的摆位误差明显增加（P〈0.05）,最大误差达到7mm。结论：鼻咽肿瘤患者放疗过程中,体重有逐渐下降的趋势,不同层面皮肤轮廓之间的距离逐渐缩小,其中第1和第3颈椎水平皮肤轮廓收缩最明显;体重下降对X、Z轴方向的摆位误差影响不明显,但对Y轴的影响较大。     

Epithelial polarity, villin expression, and enterocytic differentiation of cultured human colon carcinoma cells: a survey of twenty cell lines

Twenty human colon carcinoma cell lines were studied for their ability to develop some of the characteristics of the normal intestinal epithelium, e.g., epithelial polarity, presence of the actin-binding protein villin, or the occurrence of an enterocytic differentiation either when cultured under standard conditions, as for Caco-2 cells, or when grown in a glucose-free medium, as for HT-29 cells. Except for the regular presence of villin, which can be considered a marker of the colonic origin of the cells, the cell lines of this study could be classified into four types with regard to their differentiation characteristics. In type 1 (only one cell line, i.e., Caco-2) the cells undergo spontaneously an enterocytic differentiation characterized by a polarization of the cell layer with the formation of domes and the presence of an apical brush border the membrane of which is endowed with hydrolases such as sucrase-isomaltase, lactase, amino-peptidase N, dipeptidylpeptidase IV and alkaline phosphatase. In type 2 (three cell lines: HT-29, HCT-EB, and HCT-GEO) the cells are undifferentiated when grown in the presence of glucose but undergo an enterocytic differentiation when grown in the absence of glucose. In type 3 (eight cell lines: HCT-GLY, HCT-FET, HCT-FRI, HCT-CBS, HCT-ALA, Co-115, HRT-18, and SW-1116) the cells are organized into a polarized monolayer with the formation of domes but without any enterocytic differentiation characteristics, whatever the culture conditions. In type 4 (eight cell lines: HCT-116a, HCT-R, HCT-RCA, HCT-Moser, HCT-8R, SW-480, LS-174T, and Vaco-9P) the cells are organized into a multilayer without any feature of epithelial polarity or enterocytic differentiation, whatever the culture conditions.     

Differential effects of tobacco and alcohol in cancer of the larynx, pharynx, and mouth

Two thousand five hundred forty male patients with cancer of larynx, pharynx, and mouth were examined in the same hospital between 1975 and 1982. Different sites were compared according to alcohol and tobacco consumption: oropharynx, hypopharynx, larynx supraglottis, larynxglottis, epilarynx, lip, tongue-tip, and tongue lateral border, other tongue sites, gum, floor of the mouth, and buccal mucosa. For tobacco, the mean daily consumption of smokers and exsmokers did not differ according to location (except in patients with cancer of the lip, in whom the consumption was lowest). Cancer locations differed significantly according to the daily alcohol consumption. The consumption was the lowest for patients with cancer of the lips and the glottis, the highest for patients with cancer of the epilarynx, hypopharynx, and the floor of the mouth. Significant differences were observed in the percentage of nonsmokers or nondrinkers, even between adjacent locations: supraglottis versus glottis; tongue, tip, and lateral border versus tongue, other sites; floor of the mouth versus buccal mucosa. Some of the results might be particular to elements of the French life-style (e.g., consumption of brown tobacco, high consumption of wine).