Objective To evaluate the clinical effectiveness and safety of radiotherapy (RT) combined with hyperthermia (HT) for locally-advanced non-small cell lung cancer (NSCLC). Methods The randomized controlled trials (RCTs) on RT plus HT vs. RT alone for locally-advanced NSCLC were searched in PubMed, The Cochrane Library, EMbase, VIP, CNKI, CBM and other electronic databases from inception to November 2011. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and assessed quality of the included studies independently. Then meta-analyses were performed using RevMan 5.0.2. Results A total of 9 RCTs involving 527 cases were included. The results of meta-analyses showed that compared with the RT alone group, the RT plus HT group could increase the total effective rate (OR=2.08, 95%CI 1.44 to 3.02, P=0.000 1) and the progression-free survival rate (OR=4.85, 95%CI 1.88 to 12.48, P=0.001). However, there were no significant differences between the two groups in the overall survival rate (OR=1.13, 95%CI 0.64 to 1.98, P=0.68), symptoms improve rate (OR=3.37, 95%CI 1.68 to 6.78, P=0.000 6), and other acute adverse reactions. Conclusion Current results of systematic review show that radiotherapy combined with hyperthermia can obviously increase the total effective rate and improve the progression-free survival rate for locally-advanced NSCLC, and doesn’t increase the incidence of adverse reaction. Therefore, radiotherapy combined with hyperthermia is a fairly reasonable and effective treatment method for locally-advanced NSCLC.
Objective To observe the therapeutic effect of plaque radiotherapy (PRT) on choroidal melanoma. Methods PRT was performed on 21 patients (21 eyes) with chroidal melanoma who had been examined by ophthalmoscopy, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), and B-scan echography. The visual acuity was le;0.05 in 3 eyes, 0.06-0.2 in 4 eyes, and ge;0.3 in 14 eyes before the treatment. Choroidal melanoma, round or oval brown solid hunch, was located at the area around macula in 7 eyes, around the optic disc in 7 eyes, at or near the vascular arcade in 5 cases, and at the periphery in 2 eyes. The maximum length、width and thickness of tumor was 13 mm, 11.6 mm, and 9.59 mm. The isotope we used was125I, and the quantum of designed radiation was 100-120 Gy. Fourteen patients with choroidal melanoma at the macular area or around the optic disc underwent plaque radiotherapy associated with transpupillary thermotherapy (TTT). The average follow-up duration was 12 months with the longest duration of 3 years. The basis and thickness (height) of tumors were measured by B-scan echography. The aggrandizement of the tumor would be regarded if the height increased 15% or the basis boundary aggrandized 250mm. Results The visual acuity after the treatment decreased in 9 eyes, remained unchanged in 10, and increased in 2. The dimension of tumo increased in 6 eyes, remained unchanged in 12, and decreased in 3. The complication was vitreous hemorrhage in 2 eys, vascular occlusion in 1, branch retinal venous occlusion in 1, macular pucker in 1, retinal hemorrhage in 3, partial optic atrophy in 3, neovascular glaucoma in 1, and extraction of eye in 3. Conclusion The domestic plaque design is effective on choroidal melanoma, and is of a sort on the thick tumor and the tumor located at macula or beside the optic disc. (Chin J Ocul Fundus Dis, 2006, 22: 157-160)
目的：探讨ⅢA-N2期非小细胞肺癌（NSCLC）完全切除术后三维适形放疗联合辅助化疗疗效。方法:对48例ⅢA-N2期NSCLC完全切除术后患者，术后病理为腺癌18例、鳞癌27例、腺鳞癌3例，按信封法随机分为放疗组（24例）与非放疗组（24例）。放疗组采用术后三维适形放疗，4～5个非共面野，以90%～95%等剂量曲线包绕PTV，每次2 Gy，1次/日，5次/周，共照射25次，总剂量DT 50 Gy，放疗后予TP方案化疗3~4周期；非放疗组术后予TP方案化疗3~4周期。结果：放疗组1、2、3年生存率分别为95.8%、79.2%、62.5%，非放疗组分别为91.7%、58.3%、37.5%；放疗组1、2、3年无病生存率分别75.0%、58.3%、45.8%，非放疗组分别为54.2%、41.7%、25.0%；放疗组与非放疗组3年胸腔内复发分别12.5%和37.5%；放疗组与非放疗组中位生存时间分别为28个月和18个月；放疗组白细胞减少、急性放射性肺炎、气管炎发生率分别为25.0%、8.3%、12.5%，均为Ⅰ或Ⅱ级；Ⅰ级急性放射性食管炎发生率为20.8%。结论：ⅢA-N2期非小细胞肺癌完全切除术后三维适形放疗联合辅助化疗，可以降低患者胸腔内肿瘤复发、提高术后生存率。
Objective To observe the macular morphological changes of choroidal melanoma with coherence tomography (OCT) after plaque radiotherapy (PRT). Methods A total of 48 patients (48 eyes) with choroidal melanoma who underwent125I PRT were enrolled in this study. All the patients were examined documenting OCT to get the image of macula. The macula of all the patients was not involved. The median visual acuity was 0.4plusmn;0.2, which ranged from 0.02 to 1.0. There were 18 eyes (37.5%) with retinal detachment, 12 eyes (25.0%) with retinal pigment epithelium (RPE) changes, seven eyes (14.6%) with macular edema, epimacular membrane, detachment combined with edema, exudation and RPE changes, 11 eyes (22.9%) with normal macular structure. The median follow-up time was (10.4plusmn;5.9) months, which ranged from one to 24 months. The tumor control situation and visual acuity were observed in follow-up period. The same equipment and methods of OCT were used to return visit in follow-up period. The macular morphological changes at the final visit and its relationship with PRT and visual acuity were contrastively analyzed. Results All the patients had good control of tumor. The vision acuity improved in two eyes (4.2%), unchanged in 10 eyes (20.8%), and decreased in 36 eyes (75.0%). The differences of the visual acuity was statistically significant between before and after treatment (Z=-3.778,P＜0.05). There were 13 eyes (27.1%) with retinal detachment; nine eyes (18.8%) with RPE changes; 17 eyes (35.4%) with macular edema, detachment combined with edema, exudation and RPE changes; six eyes (12.5%) with proliferation, atrophy, detachment combined with edema, exudation and epimacular membrane;three eyes (6.3%) with normal macular structure. There were 15 patients (31.3%) with two or more abnormal macular morphology after PRT. Conclusions Retinal detachment, RPE changes, macular edema and exudation are common abnormal macular morphology after PRT. The incidence rate of abnormal macular morphology is increased. There are 31.3% patients with two or more abnormal macular morphology.
Objective:To observe the therapeutic effi cacy of chemotherapy combin ed with ophthalmic therapy on retinoblastoma (RB). Methods:The survival rate, eye ball remaining rate, and the control of the disease condition of 37 patients (56 eyes) with RB were retrospectively analyzed. The standard of the well contr ol of the disease included: (1) the ocular tumor shrank or even disappeared, and the tumor had creamlike changes or calcification and cicatrisation; (2) no oc u lar tumor recurrence in patients who had undergone enucleation; (3) no metastasi s found in the followup period. All of the patients had at least one eye with RB (ge;Ⅲb stage) underwent c hemotherapy. According to the response of the tumor to the chemotherapy, the pat ients generally underwent 6 times of systemic chemotherapy at regular intervals of 3-4 weeks. The medicines for chemotherapy included vincristine, cyclohosphamide , etoposide phosphate, and carboplatin. According to the self condition, the pati ents underwent chemotherapy combined with several ophthalmic therapies like phot ocoagulation, cryotherapy, transpupillary thermotherapy, 106Ru brachytherapy, en ucleation, etc. The observation duration lasted 2-59 months, with the average o f 35 months. Results:Thirty patients (83.3%) survived and were followed up, and 6 died (16.6%). One patient with bilateral tumor couldn't be followed up afte renucleation of both eyes. Among these 30 patients (45 eyes), eye ball remainin g rate at stage I-Ⅱ, Ⅲ-Ⅳ, and Ⅴ was 100% (10 eyes), 70% (10 eyes), and 14 .3% (21 eyes), respectively. In the followup duration, the disease in all of the 3 0 patients was controlled well. Conclusions:Chemotherapy combi ned with ophthalmic therapy is effective on RB.