鼻咽癌调强放疗对腮腺功能的影响

Objective To evaluate the effect of intensity-modulated radiation therapy(IMRT) on parotid function in nasopharyngeal carcinoma(NPC). Methods Eighty-three NPC patients received prima-ry IMRT between 2001 and 2003. Xerostomia before radiotherapy, at the end of radiotherapy, at 6-month, 1-,2-,3-,4- and 5-year after radiotherapy were investigated, respectively. The relation between xerostomia and parotid dose distribution was analyzed. Results Of all the patients,4,31,31 and 17 had stage Ⅰ,Ⅱ,Ⅲ and ⅣA disease, respectively. Sixteen patients received chemo-radiotherapy. The median followed-up time was 65 months. The 5-year local control and regional control rate were 96% and 95% ,respectively. The 5-year overall survival rate was 80%. The mild xerostomia rate at the seven time points was 42%, 51%, 71%, 77%, 58%, 38% and 26%. The corresponding moderate xerostomia rate was 52%, 53%, 21%,8%, 3%, 2% and 2%, respectively. No serious xerostomia was observed. The mean dose of the bilateral parotid glands was 34.34 Gy. Xerostomia at 6-month after radiotherapy was positively correlated with the mean dose of the parotid glands, and D50 was the independent factor in predicting the xerostomia. Parotid function was well protected when the mean dose and D50 were no more than 33 Gy and 29 Gy,respectively. Conclusions IMRT can improve the local-regional control of NPC and protect the parotid glands from radiation-induced in-jury.     

食管癌淋巴结转移的CT诊断标准与病理对照研究

目的 通过将薄层CT图像所见与病理结果相对照，探讨其对淋巴结转移诊断标准的合理性。方法 对43例胸段食管癌患者术前1周内行薄层CT扫描，观察不同短径大小标准对淋巴结转移诊断的价值，并将两种标准的诊断结果进行对照分析。结果使用短径≥0．8cm标准较使用短径≥1．0cm标准诊断各组淋巴结转移的敏感性由30％增加到60％，特异性和准确性无明显变化，Youden指数J值由0．29增加到0．56；两种标准的诊断结果进行ROC验证，机会曲线下方的面积为分别为0．638和0．591。结论 本组病人用短径t〉0．8cm标准诊断淋巴结转移时其诊断意义更大。     

加强药品质量管理的新思考

本文基于药品的概念及其特殊性,探讨了加强药品质量管理的新思路,论述了现代药品质量管理体系的重要组成部分,提出＂良好的药品设计是药品质量控制的最高境界＂的新观点。