Short-term clinical effect of conformal radiotherapy combined with tegafur gimeracil oteracil potassium in treating recurrent esophagus cancer

Multiple regression analysis of risk factors related to radiation pneumonitis

BACKGROUND

Radiation pneumonitis (RP) is a severe complication of thoracic radiotherapy that may lead to dyspnea and lung fibrosis, and negatively affects patients’ quality of life.

AIM

To carry out multiple regression analysis on the influencing factors of radiation pneumonitis.

METHODS

Records of 234 patients receiving chest radiotherapy in Huzhou Central Hospital (Huzhou, Zhejiang Province, China) from January 2018 to February 2021, and the patients were divided into either a study group or a control group based on the presence of radiation pneumonitis or not. Among them, 93 patients with radiation pneumonitis were included in the study group and 141 without radiation pneumonitis were included in the control group. General characteristics, and radiation and imaging examination data of the two groups were collected and compared. Due to the statistical significance observed, multiple regression analysis was performed on age, tumor type, chemotherapy history, forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), carbon monoxide diffusion volume (DLCO), FEV1/FVC ratio, planned target area (PTV), mean lung dose (MLD), total number of radiation fields, percentage of lung tissue in total lung volume (vdose), probability of normal tissue complications (NTCP), and other factors.

RESULTS

The proportions of patients aged ≥ 60 years and those with the diagnosis of lung cancer and a history of chemotherapy in the study group were higher than those in the control group (P < 0.05); FEV1, DLCO, and FEV1/FVC ratio in the study group were lower than those in the control group (P < 0.05), while PTV, MLD, total field number, vdose, and NTCP were higher than in the control group (P < 0.05). Logistic regression analysis showed that age, lung cancer diagnosis, chemotherapy history, FEV1, FEV1/FVC ratio, PTV, MLD, total number of radiation fields, vdose, and NTCP were risk factors for radiation pneumonitis.

CONCLUSION

We have identified patient age, type of lung cancer, history of chemotherapy, lung function, and radiotherapy parameters as risk factors for radiation pneumonitis. Comprehensive evaluation and examination should be carried out before radiotherapy to effectively prevent radiation pneumonitis.

Swainsonine Inhibits Invasion and the EMT Process in Esophageal Carcinoma Cells by Targeting Twist1

Esophageal cancer is a common gastrointestinal cancer, with a very high mortality rate in patients with metastasis. Swainsonine, a cytotoxic fungal alkaloid, has been shown to inhibit cell growth in esophageal cancer. In the present study, we explored the effects of swainsonine on cell invasion and metastasis in esophageal cancer cells. Human esophageal carcinoma cells were treated with different doses of swainsonine, and then cell viability, invasion, and apoptosis were measured. The mRNA and protein expressions of Twist1, apoptosis- and EMT-related factors, and PI3K/AKT pathway factors were detected by qRT-PCR and Western blot. Swainsonine had no effect on esophageal cancer cell viability and apoptosis, but it significantly decreased cell invasion in a dose-dependent manner. Swainsonine increased the expression of E-cadherin but decreased the expression of N-cadherin, vimentin, ZEB1, and snail in a dose-dependent manner, thereby inhibiting EMT. Last, we found that swainsonine inhibits cell invasion and EMT in the esophageal carcinoma cells by downregulation of Twist1 and deactivation of the PI3K/AKT signaling pathway.