Treatment results of radiotherapy to both the prostate and metastatic sites in patients with bone metastatic prostate cancer

Although systemic therapy is the standard treatment for metastatic prostate cancer, a randomized controlled trial showed radiotherapy to the prostate improved overall survival of metastatic prostate cancer patients with the low metastatic burden. Additionally, a randomized phase II trial showed that metastasis-directed therapy for oligo-recurrent prostate cancer improved androgen-deprivation therapy (ADT)-free survival. Therefore, administering radiotherapy to both prostate and metastatic regions might result in better outcomes. Thus, we report the treatment results of radiotherapy to both prostate and metastatic regions. Our institutional database was searched for patients who received radiotherapy to the prostate and metastatic regions. We summarized patient characteristics and treatment efficacy and performed statistical analysis to find possible prognostic factors. A total of 35 patients were included in this study. The median age was 66 years, and the median initial prostate-specific antigen (PSA) level was 32 ng/ml. The Gleason score was 7 in 10 patients, 8 in 13 patients, and 9 in 12 patients. The median radiotherapy dose was 72 Gy to the prostate and 50 Gy to the metastatic bone region. The 8-year overall survival, cause-specific survival, progression-free survival, and freedom from biochemical failure rate were 81, 85, 53, and 57%. Among the 35 patients, 12 were disease-free even after ADT was discontinued. In selected patients with metastatic prostate cancer, ADT and radiotherapy to the prostate and metastatic sites were effective. Patients with good response to ADT may benefit from radiotherapy to both prostate and metastatic regions.     

Postoperative hypofractionated radiotherapy versus conventionally fractionated radiotherapy in malignant gliomas. A preliminary report on a randomized trial

A prospective randomized study of 108 patients with cerebral malignant gliomas was carried out at the Department of Radiation Oncology of Maria Sklodowska-Curie Memorial Center in Kraków. 44 patients with histologically proven glioblastoma multiforme and 64 patients with anaplastic astrocytoma received postoperative radiotherapy. Patients were randomized to two treatment arms: Conventionally Fractionated Radiotherapy (CFR) and Hypofractionated Radiotherapy (HF). In the CFR group, the whole brain was irradiated to the total dose of 50 Gy in 25 fractions over 5 weeks, then a 10 Gy boost in 5 fractions in 5 days was delivered to the site of the primary lesion. In the HF group, there were 3 courses of irradiation separated by a one month interval. In each of the two first series the patients received 20 Gy in 5 fractions in 5 days to the whole brain, and in the third course, 10 Gy boost in 5 days was delivered as in the CFR regimen. The tolerance to treatment has been found to be good in both groups. The 2-year actuarial survival rate for patients with anaplastic astrocytoma was 22% for CFR and 18% for HF. Patients with glioblastoma multiforme treated with HF had a better prognosis in comparison to the CFR group with the two-year actuarial survival rates being 23% and 10%, respectively. This difference is statistically significant at the 0.05 level.     

Management of hemangiopericytomas in the central nervous system

目的　血管外皮细胞瘤是少见的中枢神经系统肿瘤 ,由于其易复发和转移而预后不良。本文介绍 2 6例血管外皮细胞瘤的处理经验并结合文献复习其诊治要点。方法　回顾性分析 1993年 1月至 1999年 6月华山医院收治的 2 6例血管外皮细胞瘤 ,其中 5例为复发肿瘤 ,1例为术后残留。结果　 2 6例中 2 4例病灶全切除 ,2例次全切除。术后 2 1例症状好转或不变 ,4例加重 ,1例手术后死于并发症。18例术后放疗。 18例获随访 ,随访期 1- 5 8个月 ,其中 15例恢复良好 ,2例发现转移肿瘤 ,1例复发再次手术后死亡。结论　手术全切是主要治疗方法 ,术后放疗可延缓肿瘤复发。     

薏苡仁酯对人鼻咽癌细胞的放射增敏作用

【目的】探讨薏苡仁酯 (CXL)对人鼻咽癌细胞CNE 2Z辐射效应的影响。【方法】以60 Co为放射源 ,采用微量细胞克隆形成法检测CNE 2Z对γ射线的敏感性。【结果】CXL使CNE 2Z的放射—存活曲线左移 ,Do 和Dq 值下降。不同浓度的CXL(10 -7～ 10 -6mol/L)使辐射剂量减少 7 45 %～ 17 31% (在D37水平 ) ,其增敏比 (SER) :Do 比值 1 11～ 1 46 ,Dq 比值1 0 2～ 1 11。【结论】CXL能提高CNE 2Z的放射敏感性。     

俄歇电子发射体67Ga-EDTMP 对骨肉瘤细胞株辐射效应的形态学变化

目的　研究俄歇电子发射体67Ga-EDTMP对人骨肉瘤细胞株 (HOS - 86 0 3)的辐射效应 ,探讨67Ga作为原发肿瘤和骨转移癌内照射治疗核素的可能性。方法　用成集落实验和透射电镜研究受照细胞的形态变化。结果　发现67Ga-EDTMP对肿瘤细胞有明显的杀伤和抑制增殖作用 ,并随剂量的加大 ,抑制效率增加 ;倒置显微镜下细胞集落数量减少 ,集落偏小 ,细胞稀疏。电镜下胞浆中空泡形成 ,细胞溶解、坏死 ,细胞核固缩 ,出现典型的细胞凋亡改变 ,形成凋亡小体。结论　67Ga可能是一种有前途的骨肉瘤和骨转移癌的放射性治疗核素     

局部野放射治疗骨转移瘤的经验分析

目的 通过对比分析局部野放射治疗骨转移瘤的3种分割方法,以寻求产生最好效果的方法。材料和方法 104例骨转移患者,其中30例单次放疗8 Gy,31例4 Gy×5次,43例2 Gy×20次。结果与结论 2 Gy×20次的放疗方法产生较高的疼痛缓解率,较低的疼痛复发率,说明较高剂量的、分割照射疗效较佳。     

鼻咽癌放射治疗前后鼻窦炎的CT观察

目的：研究鼻咽癌放射治疗与鼻窦炎的关系。方法：对１２７例鼻咽癌放疗前、后病人的鼻咽ＣＴ进行观察,并对鼻窦炎的发病情况及其相关因素进行分析。结果：放疗前鼻窦炎发病率为４９％,放疗后鼻窦炎发病率为８６％,其中放疗前无鼻窦炎者放疗后７２％患有鼻窦炎。放疗后６个月至１年是发生鼻窦炎的高峰期。结论：鼻咽癌患者的鼻窦炎的发病率较高,其发病与肿瘤的Ｔ分期、肿瘤的发生部位等因素有关。放疗可便鼻窦炎的发病率增加,谚     

晚期和复发头颈癌立体定向放射治疗近期疗效观察

目的 探讨晚期和复发头颈癌立体定向放射治疗的近期疗效、并发症等。方法 １９９７年１０月至１９９８年１０月采用立体定向放射治疗（ＳＲＴ）晚期和复发的头颈癌２８例,其中ＮＰＣ１７例,鼻腔副鼻窦肿瘤４例,舌根癌３例,喉癌２例、颈段椎管内髓外肿瘤术后残留外侵１例,软腭癌１例,肿瘤体积在,最大径２．５￣７．０ｃｍ,中位数４．５ｃｍ,１５例患者有严重的局部疼产能等闰状,３例有鼻阻塞、照射剂量４￣８Ｇｙ／次,隔     

鼻咽癌放疗后局部复发和纤维化的增强CT鉴别诊断价值

目的探讨鼻咽癌放疗后出现块影时,ＣＴ检查对鉴别肿瘤局部复发和放射性纤维化的价值。方法收集１５９例经ＣＴ检查的鼻咽癌,其中放疗后局部复发（ＲＴ）３７例,放射性纤维化（ＲＦ）５４例,以６８例未经放疗的鼻咽癌（ＰＴ）作对比。使用ＥＬＳｃｉｎｔｓｐｒｉｎｔ２０００型ＣＴ机,测量放疗后出现的块影平扫和强化的ＣＴ值,用统计学的方差分析法处理增强前后的ＣＴ值差异。结果ＲＴ组平扫ＣＴ值为５０．４０±８．１０Ｈｕ,增强为７３．７４±７．３７Ｈｕ;ＲＦ组平扫为４８．６２±１０．１５Ｈｕ,增强为５６．７４±８．６９Ｈｕ;对照组（ＰＴ）病变区平扫为４８．３２±９．２０Ｈｕ,增强为７２．３８±７．７５Ｈｕ。测量表明ＲＴ组有明显强化,ＲＴ组与ＲＦ组强化后ＣＴ值差异有非常显著性（Ｐ＜０．０１）。结论鼻咽癌放疗后出现块影时,ＣＴ增强扫描可作为鉴别诊断的重要方法。     

PF方案化放治疗晚期鼻咽癌的远期疗效

目的探索用ＰＤＤ／５－Ｆｕ方案化放治疗晚期鼻咽癌的疗效。方法１９８９年１２月～１９９０年１２月间,选择７６例Ⅲ、Ⅳ期鼻咽癌患者,先作３周期ＰＤＤ（２０ｍｇ（ｍ２）－１ｄ－１,ｉｖ,第１～５天）和５－Ｆｕ［７００ｍｇ（ｍ２）－１ｄ－１,连续静脉滴注,第１～５天］诱导化疗,随后尽快作放疗,此为综合治疗组。以１９８９年作单纯放疗的８６例晚期鼻咽癌患者作对照组。两组放疗方法、时间／剂量分割均相同。结果化疗有效率为８９．３％,完全缓解率为１８．４％。综合治疗组（综合组）总的５年生存率为４８．７％,对照组为３３．７％（Ｐ＞０．０５）。综合组Ｔ２Ｎ３和Ｔ２～４Ｎ３患者的５年生存率为４４．１％和３９．５％,均明显高于对照组的２１．６％及２０．４％（Ｐ＜０．０５）。结论ＰＦ方案化放治疗提高了Ｔ２～４Ｎ３患者的５年生存率。