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Sun Y, Ni YA, Xu HJ, Wang LZ, Yang J, Jiang J, Zhong R. [Two cases of refractory childhood acute B-lymphoblastic leukemia with positive KMT2A-USP2 treated with Belintouximab]. Zhonghua Er Ke Za Zhi 2023; 61:930-932. [PMID: 37803862 DOI: 10.3760/cma.j.cn112140-20230406-00244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/08/2023]
Affiliation(s)
- Y Sun
- Pediatric Hematology and Oncology Department, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Y A Ni
- Pediatric Hematology and Oncology Department, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - H J Xu
- Pediatric Hematology and Oncology Department, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - L Z Wang
- Pediatric Hematology and Oncology Department, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - J Yang
- Pediatric Hematology and Oncology Department, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - J Jiang
- Pediatric Hematology and Oncology Department, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - R Zhong
- Pediatric Hematology and Oncology Department, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
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Chen XQ, Zhang S, Gou X, Zeng N, Duan B, Wang H, Dai J, Shen K, Zhong R, Tian R, Chen N, Yan D. Tumor Treatment Response Assessed During the Concurrent Chemoradiotherapy for Nasopharyngeal Patients. Int J Radiat Oncol Biol Phys 2023; 117:e652-e653. [PMID: 37785939 DOI: 10.1016/j.ijrobp.2023.06.2078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To evaluate intratumoral treatment response distribution with using FDG-PET/CT during the chemoradiotherapy of nasopharyngeal patients (NPC). MATERIALS/METHODS A total of 5 of 30 patients with stage III-IVA NPC were enrolled in the institutional protocol for induction/concurrent chemoradiotherapy with radiation dose of 70 Gy in 33 fractions. For each patient, a pre-radiation treatment FDG-PET/MRI image (SUV0) and a mid-treatment image (SUVm) at the treatment dose of 31.8 Gy were obtained. Followed by deformable PET/MRI registration between SUV0 and SUVm, the tumor voxel SUV reduction ratio was obtained to construct a tumor dose response matrix (DRM). Tumor SUVavid was also constructed by limiting tumor voxel SUVm > a given value. Spatial correlations of the tumor SUV0, SUVm, SUVavid and DRM were determined. RESULTS The mean and coefficient variation (CV) of the SUV0, SUVm and DRM for all tumors were 5.05 (52%), 2.72 (49%) and 0.64 (63%) (Table contains the individual data), which were smaller than those on the SUVs of head-n-neck HPV+ patients reported previously due to the induction chemotherapy, but had much larger DRM mean and CV. The inter-tumoral CVs of SUV0 and DRM were 29% and 27%, which were much lower than those of the intra-tumoral CVs 43% and 57%. Meanwhile, the intra-tumoral variations on SUV0 was smaller than the one of head-neck HPV+ patients, but the DRM intra-variation was much larger. There was a weak correlation between SUV0 and SUVm with the correlation coefficient 0.13, a medium correlation of -0.55 between SUV0 and DRM, but a strong correlation, 0.72, between SUVm and DRM. However, the spatial correlation between tumor DRM and SUVavid was getting weaker as the SUVavid value increasing and equal 0.47 with SUVavid value > 3. CONCLUSION The spatial dose response DRM for NPC in the concurrent chemoradiotherapy was relatively high, while had relatively low baseline tumor metabolic activity SUV0. It was most likely due to the induction chemotherapy. In addition, the tumor dose response showed vary large intra-tumoral variation. The high correlations between DRM and SUVm imply that SUVavid could be used partially to guide adaptive modification of NPC treatment with carefully selected boundary value.
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Affiliation(s)
- X Q Chen
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - S Zhang
- Department of Head and Neck Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - X Gou
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - N Zeng
- Department of Head and Neck Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - B Duan
- Department of Head and Neck Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - H Wang
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - J Dai
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - K Shen
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - R Zhong
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - R Tian
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - N Chen
- Department of Head and Neck Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - D Yan
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Beaumont Health, Royal Oak, MI
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Song Y, Dai J, Liu Q, Wang J, Wang H, Gou X, Xiao Q, Wang H, Zhong R, Xu F, Li Y, Tian R, Yan D. Tumor Treatment Response Assessed During the Chemo-Radiotherapy for Locally Advanced NSCLC. Int J Radiat Oncol Biol Phys 2023; 117:e720. [PMID: 37786103 DOI: 10.1016/j.ijrobp.2023.06.2227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To evaluate the capability of assessing intratumoral treatment response distribution with using FDG-PET/CT during the chemoradiotherapy of locally advanced NSCLC. MATERIALS/METHODS Twelve of total 50 patients with stage III NSCLC were enrolled in the institutional protocol for concurrent chemoradiotherapy with treatment dose of 54-60 Gy in 27-30 fractions. For each patient, a pre-treatment FDG-PET/CT image (SUV0) and a mid-treatment image (SUVm) obtained within the treatment dose of 24 ∼ 46 Gy were obtained. Followed by deformable PET/CT registration between SUV0 and SUVm, the tumor voxel SUV reduction ratio was obtained to construct a tumor dose response matrix (DRM). Tumor SUVavid was also constructed by limiting tumor voxel SUVm > a given value. Spatial correlations of the tumor SUV0, SUVm, SUVavid and DRM were determined. RESULTS The mean and coefficient variation (CV) of the SUV0, SUVm and DRM for all tumors were 6.56(64%), 2.82(59%) and 0.52(70%) (Table contains the individual data), which were like those on the SUVs and the mean DRM of head-neck HPV- patients reported previously, but much larger on the DRM variation. The inter-tumoral CVs of SUV0 and DRM were 17% and 43%, which were much smaller than those of the intra-tumoral CVs 61% and 55%. Meanwhile, the intra-tumoral variations on both SUV0 and DRM were much larger than those of head-neck HPV- patients. There was a weak correlation between SUV0 and SUVm with the correlation coefficient 0.32, a medium correlation of -0.51 between SUV0 and DRM; 0.58 between SUVm and DRM. It implies that the rule of tumor dose response DRM on treatment modification decision cannot be fully replaced by either SUV0 or SUVm. The spatial correlation between tumor DRM and SUVavid was 0.23 with SUVavid value > 3, which was getting weaker when increasing SUVavid value. CONCLUSION Spatial dose response for NSCLC assessed using FDG-PET/CT feedback demonstrated high treatment resistant patterns, which had a large intra-tumoral variation. In addition, the medium correlations of DRM vs SUV0 and DRM vs SUVm imply that all these factors could be used to guide adaptive modification of NSCLC treatment.
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Affiliation(s)
- Y Song
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - J Dai
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Q Liu
- Department of Radiotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - J Wang
- Lung cancer center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - H Wang
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - X Gou
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Q Xiao
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - H Wang
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - R Zhong
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - F Xu
- Lung cancer center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Y Li
- Lung cancer center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - R Tian
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - D Yan
- Tumor Adaptive Treatment Research Group, West China Hospital, Sichuan University, Chengdu, China
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Luo R, Su Z, Kang K, Yu M, Zhou X, Wu Y, Yao Z, Xiu W, Zhang X, Yu Y, Zhou L, Na F, Li Y, Xu Y, Liu Y, Zou B, Peng F, Wang J, Zhong R, Gong Y, Huang M, Bai S, Xue J, Yan D, Lu Y. Hybrid Immuno-RT for Bulky Tumors: Standard Fractionation with Partial Tumor SBRT. Int J Radiat Oncol Biol Phys 2023; 117:S166. [PMID: 37784416 DOI: 10.1016/j.ijrobp.2023.06.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Bulky tumors remain challenging to be treated. Stereotactic body radiation therapy (SBRT) is effective against radioresistant tumor cells and can induce immunogenic cell death (ICD) that leads to T-cell-mediated antitumor effects. Low-dose radiation (LDRT) can inflame the tumor microenvironment (TME) by recruiting T cells. We designed a novel radiotherapy technique (RT, ERT) whose dose distribution map resembles the "eclipse" by concurrently delivering LDRT to the whole tumor, meanwhile SBRT to only a part of the same tumor. This study examined the safety and efficacy of ERT to bulky lesions with PD-1 inhibitors in mice and patients. MATERIALS/METHODS In mice with CT26 colon or LLC1 lung bulky tumors (400 - 500 cm3), the whole tumor was irradiated by LDRT (2 Gy x 3), meanwhile the tumor center was irradiated by SBRT (10 Gy x 3); αPD-1 was given weekly. The dependence of therapeutic effects on CD8+ T cells was determined using depleting antibodies. Frequencies of CD8+ T cells and M1 macrophages (Mφ) were determined by flow cytometry. Multiplex Immunohistochemistry (mIHC) was applied to analyze the number and the location of CD8+ T cells and their subpopulations, as well as the phospho-eIF2α level (the ICD marker) of tumor cells in TME. Patients with advanced lung or liver bulky tumors who failed standard treatment or with oncologic emergencies were treated. Kaplan-Meier method was applied to estimate patients' progression-free survival (PFS) and overall survival (OS). RESULTS ERT/αPD-1 is superior to SBRT/αPD-1 or LDRT/αPD-1 in controlling bulky tumors in both mouse models in a CD8+ T-cell dependent manner. In the CT26 model, ERT/αPD-1 resulted in complete tumor regression in 3/11 mice and induced more CD8+ T cells and M1 Mφ in TME compared to other groups. mIHC analysis showed that ERT/αPD-1 induced higher bulk, stem-like (TCF1+ TIM3- PD-1+), and more differentiated (TCF1- TIM3+ PD-1+) CD8+ T cells infiltration into the tumor center and periphery compared to other groups. Compared to untreated or LDRT-treated tumor centers, tumor centers irradiated with ERT or SBRT showed elevated phospho-eIF2α accompanied by higher dendritic cell infiltration. In total, 39 advanced cancer patients were treated with ERT/αPD-1 or plus chemotherapy. Radiation-induced pneumonitis occurred in 1 of 26 patients receiving thoracic ERT. There were two cases of grade III toxicity associated with PD-1 inhibitors. No toxicity above grade III was observed. The objective response rate was 38.5%. The median PFS was 5.6 months and median OS was not reached at a median follow-up of 11.7 months. CONCLUSION ERT/αPD-1 showed superior efficacy in controlling bulky tumor in two mouse models. The hybrid immuno-RT (ERT) combing PD-1 inhibitors was safe and effective in patients with bulky tumors. Further clinical trials in combination with bioimaging to identify the optimal SBRT target region for the bulky tumor are warranted.
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Affiliation(s)
- R Luo
- Thoracic Oncology Ward, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Radiotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Z Su
- Thoracic Oncology Ward, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - K Kang
- Thoracic Oncology Ward, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Laboratory of Clinical Cell Therapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - M Yu
- Thoracic Oncology Ward, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - X Zhou
- Thoracic Oncology Ward, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Radiotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Y Wu
- Thoracic Oncology Ward, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Laboratory of Clinical Cell Therapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Z Yao
- Thoracic Oncology Ward, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Laboratory of Clinical Cell Therapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - W Xiu
- Thoracic Oncology Ward, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - X Zhang
- Thoracic Oncology Ward, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Radiotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Y Yu
- Thoracic Oncology Ward, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - L Zhou
- Thoracic Oncology Ward, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Radiotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - F Na
- Thoracic Oncology Ward, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Y Li
- Thoracic Oncology Ward, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Y Xu
- Thoracic Oncology Ward, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Radiotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Y Liu
- Thoracic Oncology Ward, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Radiotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - B Zou
- Thoracic Oncology Ward, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Radiotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - F Peng
- Thoracic Oncology Ward, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - J Wang
- Thoracic Oncology Ward, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Radiotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - R Zhong
- Division of Radiation Physics, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Y Gong
- Thoracic Oncology Ward, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Radiotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - M Huang
- Thoracic Oncology Ward, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - S Bai
- Division of Radiation Physics, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - J Xue
- Thoracic Oncology Ward, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Laboratory of Clinical Cell Therapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - D Yan
- Division of Radiation Physics, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Y Lu
- Thoracic Oncology Ward, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Radiotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Zhang X, Liu W, Xu F, He W, Song Y, Li G, Zhang Y, Dai G, Xiao Q, Meng Q, Zeng X, Bai S, Zhong R. Neural signals-based respiratory motion tracking: a proof-of-concept study. Phys Med Biol 2023; 68:195015. [PMID: 37683675 DOI: 10.1088/1361-6560/acf819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 09/08/2023] [Indexed: 09/10/2023]
Abstract
Objective.Respiratory motion tracking techniques can provide optimal treatment accuracy for thoracoabdominal radiotherapy and robotic surgery. However, conventional imaging-based respiratory motion tracking techniques are time-lagged owing to the system latency of medical linear accelerators and surgical robots. This study aims to investigate the precursor time of respiratory-related neural signals and analyze the potential of neural signals-based respiratory motion tracking.Approach.The neural signals and respiratory motion from eighteen healthy volunteers were acquired simultaneously using a 256-channel scalp electroencephalography (EEG) system. The neural signals were preprocessed using the MNE python package to extract respiratory-related EEG neural signals. Cross-correlation analysis was performed to assess the precursor time and cross-correlation coefficient between respiratory-related EEG neural signals and respiratory motion.Main results.Respiratory-related neural signals that precede the emergence of respiratory motion are detectable via non-invasive EEG. On average, the precursor time of respiratory-related EEG neural signals was 0.68 s. The representative cross-correlation coefficients between EEG neural signals and respiratory motion of the eighteen healthy subjects varied from 0.22 to 0.87.Significance.Our findings suggest that neural signals have the potential to compensate for the system latency of medical linear accelerators and surgical robots. This indicates that neural signals-based respiratory motion tracking is a potential promising solution to respiratory motion and could be useful in thoracoabdominal radiotherapy and robotic surgery.
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Affiliation(s)
- Xiangbin Zhang
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Wenjie Liu
- Machine Intelligence Laboratory, College of Computer Science, Sichuan University, Chengdu, People's Republic of China
| | - Feng Xu
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Weizhong He
- Magstim Electrical Geodesics, Inc, Plymouth, MA, United States of America
| | - Yingpeng Song
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Guangjun Li
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yingjie Zhang
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Guyu Dai
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Qing Xiao
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Qianqian Meng
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Xianhu Zeng
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Sen Bai
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Renming Zhong
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
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Li G, Xiao Q, Dai G, Wang Q, Bai L, Zhang X, Zhang X, Duan L, Zhong R, Bai S. Guaranteed performance of individual control chart used in gamma passing rate-based patient-specific quality assurance. Phys Med 2023; 109:102581. [PMID: 37084678 DOI: 10.1016/j.ejmp.2023.102581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 03/20/2023] [Accepted: 04/06/2023] [Indexed: 04/23/2023] Open
Abstract
PURPOSE To assess the effect of sampling variability on the performance of individual charts (I-charts) for PSQA and provide a robust and reliable method for unknown PSQA processes. MATERIALS AND METHODS A total of 1327 pretreatment PSQAs were analyzed. Different datasets with samples in the range of 20-1000 were used to estimate the lower control limit (LCL). Based on the iterative "Identify-Eliminate-Recalculate" and direct calculation without any outlier filtering procedures, five I-charts methods, namely the Shewhart, quantile, scaled weighted variance (SWV), weighted standard deviation (WSD), and skewness correction (SC) method, were used to compute the LCL. The average run length (ARL0) and false alarm rate (FAR0) were calculated to evaluate the performance of LCL. RESULTS The ground truth of the values of LCL, FAR0, and ARL0 obtained via in-control PSQAs were 92.31%, 0.135%, and 740.7, respectively. Further, for in-control PSQAs, the width of the 95% confidence interval of LCL values for all methods tended to decrease with the increase in sample size. In all sample ranges of in-control PSQAs, only the median LCL and ARL0 values obtained via WSD and SWV methods were close to the ground truth. For the actual unknown PSQAs, based on the "Identify-Eliminate-Recalculate" procedure, only the median LCL values obtained by the WSD method were closest to the ground truth. CONCLUSIONS Sampling variability seriously affected the I-chart performance in PSQA processes, particularly for small samples. For unknown PSQAs, the WSD method based on the implementation of the iterative "Identify-Eliminate-Recalculate" procedure exhibited sufficient robustness and reliability.
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Affiliation(s)
- Guangjun Li
- Radiotherapy Physics & Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Qing Xiao
- Radiotherapy Physics & Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Guyu Dai
- Radiotherapy Physics & Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Qiang Wang
- Radiotherapy Physics & Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Long Bai
- Radiotherapy Physics & Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xiangbin Zhang
- Radiotherapy Physics & Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xiangyu Zhang
- Radiotherapy Physics & Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Lian Duan
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia 19104, United States
| | - Renming Zhong
- Radiotherapy Physics & Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Sen Bai
- Radiotherapy Physics & Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Department of Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
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Lu X, Wang R, Li J, Lyu S, Zhang J, Wang Q, Chi W, Zhong R, Chen C, Wu X, Hu R, You Z, Mai Y, Xie S, Lin J, Zheng B, Zhong Q, He J, Liang W. 144P Exposure-lag response of surface net solar radiation on lung cancer incidence: A worldwide interdisciplinary and time-series study. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00399-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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Pan L, Du B, Zhu Z, Meng Q, Zhong R, Wang S. A comparative study of volumetric modulated arc therapy plans based on the equivalent uniform dose optimization for left-sided breast cancer. Radiat Phys Chem Oxf Engl 1993 2023. [DOI: 10.1016/j.radphyschem.2023.110945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
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Jiang Y, Lin Y, Fu W, Zhong R, He Q, He J, Liang W. 85P The impact of adjuvant EGFR-TKIs and 14-gene molecular assay on patients with stage I non-small cell lung cancer harboring sensitive EGFR mutations. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00340-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
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Ling X, Zhong R, Cao S, Zhang L, Xu J, Zhang B, Zhang X, Wang H, Han B, Zhong H. 45P DCVAC/LuCa with chemotherapy in patients with stage IV, non-squamous NSCLC without EGFR/ALK aberrations: Five-year survival update. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00299-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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Meng Q, Li J, Jiang W, Hu B, Xu F, Shi X, Zhong R. Prediction of proton beam range in phantom with metals based on monochromatic energy CT images. J Radiat Res 2022; 63:828-837. [PMID: 36109316 PMCID: PMC9726739 DOI: 10.1093/jrr/rrac051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/30/2022] [Indexed: 06/15/2023]
Abstract
The purpose of the study was to evaluate the accuracy of monochromatic energy (MonoE) computed tomography (CT) images reconstructed by spectral CT in predicting the stopping power ratio $( SP{R}_w)$ of materials in the presence of metal. The CIRS062 phantom was scanned three times using spectral CT. In the first scan, a solid water insert was placed at the center of the phantom $(C{T}_{no\ metal})$. In the second scan, the solid water insert was replaced with a titanium alloy femoral head $(C{T}_{metal})$. The metal artifact reduction (MAR) algorithm was used in the last scan $(C{T}_{metal+ MAR})$. The MonoE-CT images of 40 keV and 80 keV were reconstructed. Finally, the single-energy CT method (SECT) and the dual-energy CT method (DECT) were used to calculate the $SP{R}_w$. The mean absolute error (MAE) of the $SP{R}_w$ of the inner layer inserts calculated by the SECT method were 3.19%, 13.88% and 2.71%, corresponding to $C{T}_{no\ metal}$, $C{T}_{metal}$ and $C{T}_{metal+ MAR}$, respectively. For the outer layer inserts, the MAE of $SP{R}_w$ were 3.43%, 5.42% and 2.99%, respectively. Using the DECT method, the MAE of the $SP{R}_w$ of the inner layer inserts was 1.30%, 3.69% and 1.46% and the MAE of the outer layer inserts- was 1.34%, 1.36% and 1.05%. The studies shows that, compared with the SECT method, the accuracy of the DECT method in predicting the $SP{R}_w$ of a material is more robust to the presence of metal. Using the MAR algorithm when performing CT scans can further improve the accuracy of predicting the SPR of materials in the presence of metal.
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Affiliation(s)
- Qianqian Meng
- Radiophysical Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Jing Li
- Radiophysical Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Wei Jiang
- Department of Radiotherapy, Yantai Yuhuangding Hospital, Yantai, 264000, China
- Academy of Medical Engineering and Translational Medicine, Department of Biomedical Engineering, School of Precision Instrument and Opto-electronics Engineering, Tianjin University, Tianjin, 300072, China
| | - Birong Hu
- Department of Radiotherapy, Chengdu Second People’s Hospital, Chengdu, 610021, China
| | - Feng Xu
- Lung Cancer Center & Institute, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xiaomeng Shi
- CT Imaging Research Center, GE Healthcare China, Shanghai, 201203, China
| | - Renming Zhong
- Corresponding author. Department of Radiotherapy, Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China. Tel: +8628-85422568, E-mail:
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Gong P, Dai G, Wu X, Wang X, Xie L, Xu S, Zhong R. Application of thermoplastic elastomer (TPE) bolus in postmastectomy radiotherapy. Breast 2022; 66:317-323. [PMID: 36463642 PMCID: PMC9719108 DOI: 10.1016/j.breast.2022.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/10/2022] [Accepted: 11/27/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To assess the planned dose, in vivo dosimetry, acute skin toxicity, pain, and distress using Thermoplastic Elastomer (TPE) bolus for postmastectomy radiotherapy (PMRT). MATERIAL AND METHODS Thirty-two PMRT patients with TPE bolus (17 patients for 25 fractions, 15 patients for the first 20 fractions) were selected for the study. The acute skin toxicity, pain, and psychological distress were assessed from the first treatment week to the fourth week after the end of treatment. At the first treatment, the MOSFET was used in vivo dosimetry measurement. RESULTS In vivo dosimetry with the bolus, the dose deviation ranged from -6.22% to -1.56% for 5 points. The presence of grade 1 and 2 skin toxicity reached its peak (70.0% and 13.3%) in the sixth week. Two patients (6.6%) with 25 fractions bolus experienced moist desquamation in the fifth and seventh week, with pain score 2 and 3, and interruptions of 3 and 5 days, respectively. The incidence of pain score 1, 2, and 3 peaked in the fifth (33.3%), fourth (33.3%), and seventh (10.0%) week. No patients experienced grade 3 skin toxicity and severe pain. One patient had significant anxiety, and two patients had significant depression. CONCLUSION The TPE bolus can accurately fit skin and improve the surface dose to more than 90%. Twenty fractions with TPE bolus had similar skin toxicity and pain to those without bolus and did not increase patients' distress and clinical workload, compared with the literature's data, which is an alternative to the 3D printing bolus for PMRT.
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Affiliation(s)
- Pan Gong
- Radiotherapy Physics and Technology Center, Cancer Center, West China School of Medicine, West China Hospital of Sichuan University, Chengdu, 610041, PR China
| | - Guyu Dai
- Radiotherapy Physics and Technology Center, Cancer Center, West China School of Medicine, West China Hospital of Sichuan University, Chengdu, 610041, PR China
| | - Xiaoyu Wu
- Department of Respiratory Critical Care Medicine/Thoracic Surgery, West China School of Medicine, West China Hospital of Sichuan University, Chengdu, 610041, PR China
| | - Xuetao Wang
- Radiotherapy Physics and Technology Center, Cancer Center, West China School of Medicine, West China Hospital of Sichuan University, Chengdu, 610041, PR China
| | - Li Xie
- Department of Radiotherapy/Department of Head and Neck Oncology, West China School of Medicine, West China Hospital of Sichuan University, Chengdu, 610041, PR China
| | - Shuni Xu
- Radiotherapy Physics and Technology Center, Cancer Center, West China School of Medicine, West China Hospital of Sichuan University, Chengdu, 610041, PR China
| | - Renming Zhong
- Radiotherapy Physics and Technology Center, Cancer Center, West China School of Medicine, West China Hospital of Sichuan University, Chengdu, 610041, PR China.
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Li J, Chen Q, Li G, Li Y, Zhang Y, Li C, Bai L, Zhong R, He Y, Xu F, Yang Q, Bai S. Stereotactic arrhythmia radiotherapy: a case study of real-time image-guided noninvasive treatment for ventricular tachycardia. Quant Imaging Med Surg 2022; 12:2607-2615. [DOI: 10.21037/qims-21-1025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/10/2021] [Indexed: 11/06/2022]
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Zhang X, Wang X, Li X, Zhou L, Nie S, Li C, Wang X, Dai G, Deng Z, Zhong R. Evaluating the impact of possible interobserver variability in CBCT-based soft-tissue matching using TCP/NTCP models for prostate cancer radiotherapy. Radiat Oncol 2022; 17:62. [PMID: 35365155 PMCID: PMC8973574 DOI: 10.1186/s13014-022-02034-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 03/15/2022] [Indexed: 12/15/2022] Open
Abstract
Abstract
Background
Prostate alignment is subject to interobserver variability in cone-beam CT (CBCT)-based soft-tissue matching. This study aims to analyze the impact of possible interobserver variability in CBCT-based soft-tissue matching for prostate cancer radiotherapy.
Methods
Retrospective data, consisting of 156 CBCT images from twelve prostate cancer patients with elective nodal irradiation were analyzed in this study. To simulate possible interobserver variability, couch shifts of 2 mm relative to the resulting patient position of prostate alignment were assumed as potential patient positions (27 possibilities). For each CBCT, the doses of the potential patient positions were re-calculated using deformable image registration-based synthetic CT. The impact of the simulated interobserver variability was evaluated using tumor control probabilities (TCPs) and normal tissue complication probabilities (NTCPs).
Results
No significant differences in TCPs were found between prostate alignment and potential patient positions (0.944 ± 0.003 vs 0.945 ± 0.003, P = 0.117). The average NTCPs of the rectum ranged from 5.16 to 7.29 (%) among the potential patient positions and were highly influenced by the couch shift in the anterior–posterior direction. In contrast, the average NTCPs of the bladder ranged from 0.75 to 1.12 (%) among the potential patient positions and were relatively negligible.
Conclusions
The NTCPs of the rectum, rather than the TCPs of the target, were highly influenced by the interobserver variability in CBCT-based soft-tissue matching. This study provides a theoretical explanation for daily CBCT-based image guidance and the prostate-rectum interface matching procedure.
Trial registration: Not applicable.
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Yu L, Xu J, Qiao R, Han B, Zhong H, Zhong R. 148P Pathological stage N1 limited-stage small-cell lung cancer patients can benefit from surgical resection. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Wang H, Li J, Xiong S, Yu Z, Li F, Zhong R, Li C, Liang H, Deng H, Chen Z, Cheng B, Liang W, He J. 199P The relative impact of surgery history on cancer risk in patients less than 60 years old. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Zhong R, Ling X, Cao S, Xu J, Zhang B, Zhang X, Wang H, Han B, Zhong H. Safety and efficacy of dendritic cell-based immunotherapy (DCVAC/LuCa) combined with carboplatin/pemetrexed for patients with advanced non-squamous non-small-cell lung cancer without oncogenic drivers. ESMO Open 2021; 7:100334. [PMID: 34959168 PMCID: PMC8718955 DOI: 10.1016/j.esmoop.2021.100334] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/28/2021] [Accepted: 11/15/2021] [Indexed: 12/25/2022] Open
Abstract
Background Our prospective, open-label, single-arm phase II study investigated the safety and efficacy of DCVAC/LuCa (dendritic cell vaccines for lung cancer) combined with standard carboplatin/pemetrexed in advanced non-squamous (nsq) non-small-cell lung cancer (NSCLC). Patients and methods Eligible patients had stage IV nsq NSCLC without oncogenic drivers and had not received prior systemic cancer therapy. Treatment consisted of carboplatin/pemetrexed for up to 6 cycles followed by 21 cycles of pemetrexed maintenance or until progression or intolerance. Non-progression patients after two cycles of chemotherapy started to receive DCVAC/LuCa subcutaneously (s.c.) on day 15 of cycle 3, and thereafter q3w (day 15 of chemotherapy cycles) for up to 15 doses. Dosing of DCVAC/LuCa s.c. varied among patients depending on the baseline number of leucocytes but remained constant for each single patient. Safety was assessed by adverse events (AEs), treatment-related adverse events (TRAEs), serious adverse events (SAEs), and adverse events of special interest (AESIs). Efficacy was measured by overall survival (OS), progression-free survival (PFS), time to progression (TTP), and objective response rate (ORR). Results Sixty-one patients were enrolled. In the safety population (n = 60), eight patients (13.33%) had grade 3 or greater TRAEs, and six patients (10.0%) showed SAEs which were not related to leukapheresis or DC vaccination. Six grade 1 AEs were considered to be related to leukapheresis. No AESIs or DCVAC/LuCa-induced AEs were observed. The 2-year survival rate in the modified intention-to-treat population (n = 44) was 52.57%. Median OS was not reached. Median PFS was 8.0 months, median TTP was 10.2 months, and the ORR was 31.82%. Conclusion In treatment-naïve stage IV nsq NSCLC patients without oncogenic drivers, the combination of carboplatin/pemetrexed and DCVAC/LuCa was well tolerated and showed promising efficacy. Therefore, a study to prove our immunotherapeutic concept in a randomized phase III trial is planned. We investigated the safety and efficacy of DCVAC/LuCa combined with standard carboplatin/pemetrexed in nsq NSCLC. The combination therapy showed a favorable tolerability profile in a selected Chinese population. The 2-year survival rate in the modified intention-to-treat population (n = 44) was 52.57%.
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Affiliation(s)
- R Zhong
- Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
| | - X Ling
- Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
| | - S Cao
- Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
| | - J Xu
- Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
| | - B Zhang
- Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
| | - X Zhang
- Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
| | - H Wang
- Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
| | - B Han
- Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China.
| | - H Zhong
- Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China.
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Xiao Q, Bai L, Li G, Zhang X, Li Z, Duan L, Peng R, Zhong R, Wang Q, Wang X, Bai S. A robust approach to establish tolerance limits for the gamma passing rate-based patient-specific quality assurance using the heuristic control charts. Med Phys 2021; 49:1312-1330. [PMID: 34778963 DOI: 10.1002/mp.15346] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Establishing the tolerance limits of patient-specific quality assurance (PSQA) processes based on the gamma passing rate (GPR) by using normal statistical process control (SPC) methods involves certain problems. The aim of this study was threefold: (a) to show that the heuristic SPC method can replace the quantile method for establishing tolerance limits in PSQA processes and is more robust, (b) to introduce an iterative procedure of "Identify-Eliminate-Recalculate" for establishing the tolerance limits in PSQA processes with unknown states based on retrospective GPRs, and (c) to recommend a workflow to define tolerance limits based on actual clinical retrospective GPRs. MATERIALS AND METHODS A total of 1671 volumetric-modulated arc therapy (VMAT) pretreatment plans were measured on four linear accelerators (linacs) and analyzed by treatment sites using the GPRs under the 2%/2 mm, 3%/2 mm, and 3%/3 mm criteria. Normality testing was performed using the Anderson-Darling (AD) statistic and the optimal distributions of GPRs were determined using the Fitter Python package. The iterative "Identify-Eliminate-Recalculate" procedure was used to identify the PSQA outliers. The tolerance limits of the initial PSQAs, remaining PSQAs after elimination, and in-control PSQAs after correction were calculated using the conventional Shewhart method, two transformation methods, three heuristic methods, and two quantile methods. The tolerance limits of PSQA processes with different states for the respective methods, linacs, and treatment sites were comprehensively compared and analyzed. RESULTS It was found that 75% of the initial PSQA processes and 63% of the in-control processes were non-normal (AD test, p < 0.05). The optimal distributions of GPRs for the initial and in-control PSQAs varied with different linacs and treatment sites. In the implementation of the "Identify-Eliminate-Recalculate" procedure, the quantile methods could not identify the out-of-control PSQAs effectively due to the influence of outliers. The tolerance limits of the in-control PSQAs, calculated using the quantile of optimal fitting distributions, represented the ground truth. The tolerance limits of the in-control PSQAs and remaining PSQAs after elimination calculated using the heuristic methods were considerably close to the ground truth (the maximum average absolute deviations were 0.50 and 1.03%, respectively). Some transformation failures occurred under both transformation methods. For the in-control PSQAs at 3%/2 mm gamma criteria, the maximum differences in the tolerance limits for four linacs and different treatment sites were 3.10 and 5.02%, respectively. CONCLUSIONS The GPR distributions of PSQA processes vary with different linacs and treatment sites but most are skewed. In applying SPC methodologies to PSQA processes, heuristic methods are robust. For in-control PSQA processes, the tolerance limits calculated by heuristic methods are in good agreement with the ground truth. For unknown PSQA processes, the tolerance limits calculated by the heuristic methods after the iterative "Identify-Eliminate-Recalculate" procedure are closest to the ground truth. Setting linac- and treatment site-specific tolerance limits for PSQA processes is necessary for clinical applications.
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Affiliation(s)
- Qing Xiao
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, P. R. China
| | - Long Bai
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, P. R. China
| | - Guangjun Li
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, P. R. China
| | - Xiangbin Zhang
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, P. R. China
| | - Zhibin Li
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, P. R. China
| | - Lian Duan
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, P. R. China
| | - Ruilin Peng
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, P. R. China
| | - Renming Zhong
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, P. R. China
| | - Qiang Wang
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, P. R. China
| | - Xuetao Wang
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, P. R. China
| | - Sen Bai
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, P. R. China
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Xiong A, Li C, Xu J, Yang X, Nie W, Zhong H, Chu T, Zhang W, Zhong R, Pan F, Shen Y, Lou Y, Zhang B, Han B, Zhang X. FP12.06 Solid Subtype Predicts Early Bone Metastases in Sensitive EGFR-Mutated Lung Adenocarcinoma Patients After Surgery. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Li J, Xiao Q, Zhang X, Dai G, Bai S, Zhong R. [Application of Virtual Monochromatic Images Reconstructed by Dual-energy Computed Tomography in Radiotherapy Treatment Planning System]. Zhongguo Yi Liao Qi Xie Za Zhi 2021; 45:568-572. [PMID: 34628775 DOI: 10.3969/j.issn.1671-7104.2021.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Virtual monochromatic images (VMI) that reconstructed on dual-energy computed tomography (DECT) have further application prospects in radiotherapy, and there is still a lack of clinical dose verification. In this study, GE Revolution CT scanner was used to perform conventional imaging and gemstone spectral imaging on the simulated head and body phantom. The CT images were imported to radiotherapy treatment planning system (TPS), and the same treatment plans were transplanted to compare the CT value and the dose distribution. The results show that the VMI can be imported into TPS for CT value-relative electron density conversion and dose calculation. Compared to conventional images, the VMI varies from 70 to 140 keV, has little difference in dose distribution of 6 MV photon treatment plan.
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Affiliation(s)
- Jing Li
- Department of Radiation Oncology, West China Hospital of Sichuan University, Chengdu, 610041
| | - Qing Xiao
- Department of Radiation Oncology, West China Hospital of Sichuan University, Chengdu, 610041
| | - Xiangbin Zhang
- Department of Radiation Oncology, West China Hospital of Sichuan University, Chengdu, 610041
| | - Guyu Dai
- Department of Radiation Oncology, West China Hospital of Sichuan University, Chengdu, 610041
| | - Sen Bai
- Department of Radiation Oncology, West China Hospital of Sichuan University, Chengdu, 610041
| | - Renming Zhong
- Department of Radiation Oncology, West China Hospital of Sichuan University, Chengdu, 610041
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Zhang X, Dai G, Zhong R, Zhou L, Xiao Q, Wang X, Lai J, Zhao J, Li G, Bai S. Radiomics analysis of EPID measurements for patient positioning error detection in thyroid associated ophthalmopathy radiotherapy. Phys Med 2021; 90:1-5. [PMID: 34521015 DOI: 10.1016/j.ejmp.2021.08.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/24/2021] [Accepted: 08/27/2021] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Electronic portal imaging detector (EPID)-based patient positioning verification is an important component of safe radiotherapy treatment delivery. In computer simulation studies, learning-based approaches have proven to be superior to conventional gamma analysis in the detection of positioning errors. To approximate a clinical scenario, the detectability of positioning errors via EPID measurements was assessed using radiomics analysis for patients with thyroid-associated ophthalmopathy. METHODS Treatment plans of 40 patients with thyroid-associated ophthalmopathy were delivered to a solid anthropomorphic head phantom. To simulate positioning errors, combinations of 0-, 2-, and 4-mm translation errors in the left-right (LR), superior-inferior (SI), and anterior-posterior (AP) directions were introduced to the phantom. The positioning errors-induced dose differences between measured portal dose images were used to predict the magnitude and direction of positioning errors. The detectability of positioning errors was assessed via radiomics analysis of the dose differences. Three classification models-support vector machine (SVM), k-nearest neighbors (KNN), and XGBoost-were used for the detection of positioning errors (positioning errors larger or smaller than 3 mm in an arbitrary direction) and direction classification (positioning errors larger or smaller than 3 mm in a specific direction). The receiver operating characteristic curve and the area under the ROC curve (AUC) were used to evaluate the performance of classification models. RESULTS For the detection of positioning errors, the AUC values of SVM, KNN, and XGBoost models were all above 0.90. For LR, SI, and AP direction classification, the highest AUC values were 0.76, 0.91, and 0.80, respectively. CONCLUSIONS Combined radiomics and machine learning approaches are capable of detecting the magnitude and direction of positioning errors from EPID measurements. This study is a further step toward machine learning-based positioning error detection during treatment delivery with EPID measurements.
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Affiliation(s)
- Xiangbin Zhang
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Guyu Dai
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Renming Zhong
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Li Zhou
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Qing Xiao
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xuetao Wang
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Jialu Lai
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Jianling Zhao
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Guangjun Li
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
| | - Sen Bai
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
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Zhou J, Li S, Ye C, Shen K, Li A, Chen G, Li X, Bai S, Wang W, Zhong R. Analysis of local setup errors of sub-regions in cone-beam CT-guided post-mastectomy radiation therapy. J Radiat Res 2021; 61:457-463. [PMID: 32100830 PMCID: PMC7299271 DOI: 10.1093/jrr/rraa007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 11/27/2019] [Indexed: 02/05/2023]
Abstract
The purpose of the study was to quantify local setup errors and evaluate the planning target volume (PTV) margins for sub-regions in cone-beam computed tomography (CBCT)-guided post-mastectomy radiation therapy (PMRT). The local setup errors of 20 patients undergoing CBCT-guided PMRT were analysed retrospectively. Image registration between CBCT and planning CT was performed using four sub-regions of interest (ROIs): the supraclavicular area (SROI), ipsilateral chest wall region (CROI), ipsilateral chest wall plus supraclavicular region (SROI + CROI) and vertebral region (TROI). Bland–Altman analysis, correlation, local setup errors and PTV margins among these ROIs were evaluated. There was no significant consistency or correlation for registration results between the TROI and the CROI or SROI regions on any translational axis. When using the SROI + CROI as the ROI, the systematic error (Σ) and random error (σ) of the local setup errors for the CROI region were 1.81, 1.19 and 1.76 mm and 1.84, 2.64 and 3.00 mm along the medial–lateral (ML), superior–inferior (SI) and anterior–posterior (AP) directions, respectively. The PTV margins for the CROI region were 5.80, 4.82 and 6.50 mm. The Σ and σ of the local setup errors for the SROI region were 1.29, 1.15 and 0.77 mm and 1.96, 2.65 and 2.2 mm, respectively, and the PTV margins were 4.59, 4.73 and 3.47 mm. Large setup errors and local setup errors occur in PMRT. The vertebral body should not be a position surrogate for the supraclavicular region or chest wall. To compensate for the local setup errors, different PTV margins are required, even with CBCT guidance.
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Affiliation(s)
- Jidan Zhou
- Department of Radiotherapy, Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Shuai Li
- Department of Radiotherapy, Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Chengwei Ye
- Department of Radiotherapy, Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Konglong Shen
- Department of Radiotherapy, Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - An Li
- Department of Radiotherapy, Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Gang Chen
- Department of Radiotherapy, Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Xiaoyu Li
- Department of Radiotherapy, Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Sen Bai
- Department of Radiotherapy, Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Weifeng Wang
- Department of Radiotherapy, Jingzhou Central Hospital, the Second Clinical Medical College, Yangtze University, Jingzhou 434020, P.R. China
| | - Renming Zhong
- Department of Radiotherapy, Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
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Zhang Y, Zhang X, Li J, Zeng L, Wang X, Wu X, Li Y, Li X, Zhong R. Analysis of the Influence of Peripheral Anatomical Changes for CBCT-Guided Prostate Cancer Radiotherapy. Technol Cancer Res Treat 2021; 20:15330338211016370. [PMID: 33982618 PMCID: PMC8127575 DOI: 10.1177/15330338211016370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Purpose: To analyze the influence of the bladder and rectum filling and the body contour changes on the prostate target dose. Methods: A total of 190 cone-beam CT (CBCT) image data sets from 16 patients with prostate cancer were used in this study. Dose reconstruction was performed on the virtual CT generated by the deformable planning CT. Then, the effects of the bladder filling, rectal filling, and the patient’s body contour changes of the PCTV1 (the prostate area, B1) and PCTV2 (the seminal vesicle area, B2) on the target dose were analyzed. Correlation analysis was performed for the ratio of bladder and rectal volume variation and the variation of the bladder and rectal dose. Results: The mean Dice coefficients of B1, B2, bladder, and rectum were 0.979, 0.975, 0.888 and 0.827, respectively, and the mean Hausdorff distances were 0.633, 1.505, 2.075, and 1.533, respectively. With the maximum volume variations of 142.04 ml for the bladder and 40.50 ml for the rectum, the changes of V100, V95, D2, and D98 were 1.739 ± 1.762 (%), 0.066 ± 0.169 (%), 0.562 ± 0.442 (%), and 0.496 ± 0.479 (%) in PCTV1 and 1.686 ± 1.051 (%), 0.240 ± 0.215 (%), 1.123 ± 0.925 (%), and 0.924 ± 0.662 (%) in PCTV2, respectively. With a 10% increase in the volume of the bladder and rectum, the V75, V70, and V65 of rectum increased at 0.73 (%), 0.71 (%), and 1.18 (%), and the V75, V70, and V65 of bladder changed at −0.21 (%), −0.32 (%), and −0.39 (%), respectively. Conclusion: Significant correlations were observed between the volume variation and the dose variation of the bladder and rectum. However, when a bladder and rectal filling protocol was adopted, the target dose coverage can be effectively ensured based on CBCT guidance to correct the prostate target position.
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Affiliation(s)
- Yingjie Zhang
- Division of Radiation Physics, Department of Radiotherapy, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Xiangbin Zhang
- Division of Radiation Physics, Department of Radiotherapy, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Jing Li
- Division of Radiation Physics, Department of Radiotherapy, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Liang Zeng
- Institute of Radiation Medicine, Fudan University, Shanghai, P.R. China
| | - Xuetao Wang
- Division of Radiation Physics, Department of Radiotherapy, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Xiaohong Wu
- Department of Oncology, The Affiliated Hospital of Panzhihua University, Panzhihua, P.R. China
| | - Yan Li
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Cancer Hospital Affiliate to School of Medicine, UESTC, Chengdu, P.R. China
| | - Xiaoyu Li
- Division of Radiation Physics, Department of Radiotherapy, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Renming Zhong
- Division of Radiation Physics, Department of Radiotherapy, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, P.R. China
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Lai J, Zhong R. [Two-Dimensional Electron Beam Radiotherapy Planning System with Modeling Function]. Zhongguo Yi Liao Qi Xie Za Zhi 2021; 45:163-166. [PMID: 33825375 DOI: 10.3969/j.issn.1671-7104.2021.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In order to adapt to different target shapes and protect the surrounding normal tissues, the design of two-dimensional electron beam radiotherapy planning requires additional lead blocks. But the Pinnacle treatment planning system can not directly shape the lead block conformity to the size of the beam field given by the doctor. Every time, physicists need to manually drag the lead block to form the required beam field. When meeting a two-dimensional electron beam treatment planning with the same field parameters as before, physicists need to rearrange the field for dose calculation, which greatly reduces the design efficiency of the two-dimensional electron beam treatment planning. In this study, we independently developed a two-dimensional electron beam radiotherapy planning system based on Qt Creator. The system can quickly design a two-dimensional electron beam radiotherapy plan, which reduces the repeated work of physicists.
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Affiliation(s)
- Jialu Lai
- Department of Radiotherapy, West China Hospital, Sichuan University, Chengdu, 610041
| | - Renming Zhong
- Department of Radiotherapy, West China Hospital, Sichuan University, Chengdu, 610041. E-mail:
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Ling X, Xu J, Zhong R, Zhong H, Han B. 101MO Efficacy and safety of DCVAC/LuCa with chemotherapy for patients with stage IV NSCLC: A prospective, open-label, single-arm, phase II study. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01943-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Yu L, Xu J, Qiao R, Zhong H, Han B, Zhong R. 59P Patterns of recurrence and survival after complete resection of pathological stage N2 small cell lung cancer. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01901-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chu T, Zhang W, Zhang B, Zhong R, Shi C, Zhang X, Qian J, Han B. P76.10 Erlotinib Plus Anlotinib as First-Line Therapy in Advanced Non-Small-Cell Lung Cancer Harboring EGFR Mutations: An Open-Label, Phase 2 Study. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Han B, Chu T, Zhong R, Zhong H, Zhang B, Zhang W, Shi C, Qian J, Zhang Y, Chang Q, Zhang X, Dong Y, Teng J, Gao Z, Qiang H, Nie W, Zhao Y, Han Y, Chen Y. OA07.09 Sintilimab in Combination with Anlotinib as First-Line Therapy for Advanced NSCLC: Final Analysis of Primary Endpoints. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Han B, Hu M, Zhong R. P14.29 Toripalimab in Combination with CIK Cells in Patients with Advanced NSCLC: An Exploratory Study. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Han B, Zhang B, Shi C, Gao Z, Zhong H, Xiong L, Gu A, Wang W, Chu T, Zhang W, Wang H, Zhang X, Zhong R. P76.59 Rationale and Design of a Phase II Trial of Dacomitinib in Advanced NSCLC Patients with Uncommon EGFR Mutations. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Li G, Jiang W, Li Y, Wang Q, Xiao J, Zhong R, Bai S. Description and evaluation of a new volumetric-modulated arc therapy plan complexity metric. Med Dosim 2020; 46:188-194. [PMID: 33353791 DOI: 10.1016/j.meddos.2020.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 10/14/2020] [Accepted: 11/17/2020] [Indexed: 02/05/2023]
Abstract
This study describes a new plan complexity metric for volumetric-modulated arc therapy (VMAT) and evaluates the relationship of this metric with the VMAT dosimetric accuracy. The new modulation complexity score for VMAT (NMCSv) that is based on the aperture shape and multi-leaf collimator (MLC) leaf travel is described. Its performance is evaluated through correlation and receiver operating characteristic (ROC) analyses with patient-specific gamma passing rates using 2 3-dimensional diode arrays. For comparison, the following metrics are evaluated using the same correlation analyses: average field width, average leaf travel, modulation complexity score, and leaf travel modulation complexity score. Spearman's rank correlation analysis is performed to examine any relationships between the complexity metrics and the patient-specific gamma passing rates. ROC curves are used to assess the performance of the plan metrics using a gamma passing rate of 3%/3 mm criterion with a 95% tolerance level. In both the diode arrays, the gamma passing rates (3%/3 mm and 2%/2 mm) for patient-specific dosimetric verification of VMAT plans are moderately or weakly correlated to all the complexity metrics. NMCSv demonstrates the highest correlation with the passing rates (r = 0.652, p < 0.001 for Delta4 and r = 0.499, p < 0.001 for ArcCheck) and the highest area under the curve value (0.809, p < 0.01 for Delta4 and 0.734, p < 0.01 for ArcCheck). While using the Delta4 system, NMCSv exhibits an excellent classification performance with area under the curves of 0.926 (sensitivity: 0.913; specificity: 0.860; p < 0.01) and 0.918 (sensitivity: 0.943; specificity: 0.720; p < 0.01) for rectal and cervical cancer plans, respectively. NMCSv as a novel potential clinical plan complexity metric is moderately correlated with the gamma passing rate. It demonstrates the best performance with respect to distinguishing the dosimetric accuracy of VMAT plans among the evaluated metrics. The classification performance of complexity metrics can be affected by various dosimetry verification devices and treatment sites.
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Affiliation(s)
- Guangjun Li
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Wei Jiang
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, 300072, China; Department of Radiotherapy, Yantai Yuhuangding Hospital, Qingdao University School of Medicine, Yantai, Shandong, 264000, China
| | - Yanlong Li
- Department of Oncology, the Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Qiang Wang
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Jianghong Xiao
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Renming Zhong
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
| | - Sen Bai
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
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Shen K, Xiong J, Wang Z, Wang W, Li W, Zhou J, Deng Z, Li B, Zhong R. Design of a new breast vacuum bag to reduce the global and local setup errors and to reduce PTV margin in post-mastectomy radiation therapy. J Radiat Res 2020; 61:985-992. [PMID: 32823282 PMCID: PMC7674700 DOI: 10.1093/jrr/rraa066] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/09/2020] [Indexed: 02/05/2023]
Abstract
To design a new breast vacuum bag to reduce global and local setup errors in post-mastectomy radiation therapy (PMRT). A total of 24 PMRT patients were immobilized with an old vacuum bag and 26 PMRT patients were immobilized with a new vacuum bag. The registration results were analysed using four regions of interest (ROI): the global ROI [including the whole region of the planning target volume (PTV), GROI], the supraclavicular area (SROI), the ipsilateral chest wall region (CROI) and the ipsilateral arm region (AROI). The global and local setup errors of the two groups were compared. The global setup errors of the new vacuum group were significantly smaller than those in the old vacuum group with the exception of yaw axes (P < 0.05). The systematic error (Σ) and random error (σ) ranged from 1.21 to 2.13 mm. In the new vacuum group, the local setup errors in the medial-lateral (ML) direction and roll axes for CROI (the Σ and σ ranged from 0.65 to 1.35 mm), and the local setup errors in ML and superior-inferior (SI) directions for SROI were significantly smaller than those in the old vacuum group. The total required PTV margins for the chest wall in ML, SI, and anterior-posterior (AP) were 4.40, 3.12 and 3.77 mm respectively. The new vacuum bag can significantly reduce the global setup errors and local setup errors in PMRT. The respiratory motion of the chest wall was negligible, and the 5 mm PTV margin could cover the local setup errors in PMRT using the new vacuum bag with cone beam CT (CBCT) correction.
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Affiliation(s)
- Konglong Shen
- Department of Radiotherapy, Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Jie Xiong
- Radiology Department, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Zhiguo Wang
- Department of Radiotherapy, Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Weifeng Wang
- Jingzhou Central Hospital, the Second Clinical Medical College, Yangtze University, Jinzhou 121001, P.R. China
| | - Wan Li
- Department of Radiotherapy, Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Jidan Zhou
- Department of Radiotherapy, Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Zhonghua Deng
- Department of Radiotherapy, Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Bin Li
- Department of Radiotherapy, Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Renming Zhong
- Department of Radiotherapy, Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
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El-Battrawy I, Maywald L, Cyganek L, Zhong R, Zhang F, Kleinsorge M, Dinkel H, Lan H, Li X, Huang M, Liao Z, Moscu-Gregor A, Borggrefe M, Zhou X, Akin I. Gen-editing to model Short QT syndrome type 5 using human-induced pluripotent stem cell-derived cardiomyocytes. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aims
Short QT syndrome (SQTS), a disorder associated with characteristic electrocardiogram QT-segment abbreviation, predisposes afflicted patients to sudden cardiac death. Despite some progress in assessing the organ level pathophysiology and genetic changes of the disorder, the understanding of the human cellular phenotype and discovering of an optimal therapy has lagged due to a lack of appropriate human cellular models of the disorder. The aim of this study was to establish a cellular model of SQTS type 5 using human-induced pluripotent stem cell–derived cardiomyocytes (hiPSC-CMs) and gene-edited cell line using CRISPR/CAS9.
Methods and results
This study recruited one patient with short QT syndrome type 5 carrying a mutation in CACNb2 gene as well as one healthy control subject. We generated hiPSCs from their skin fibroblasts, and differentiated hiPSCs into cardiomyocytes (hiPSC-CMs) for physiological. Isogenic control hiPSC-CMs generated by the CRISPR/CAS9 technique were also used for the study.
The hiPSC-CMs from the patient showed a reduced calcium current (ICa-L) density and shortened action potential duration (APD) compared with healthy control hiPSC-CMs and isogenic hiPSC-CMs. Furthermore, they demonstrated abnormal rhythmic activities. Carbachol increased the arrhythmic events in SQTS significantly but not in healthy and isogenic control cells. Gene and protein expression profiling showed a decreased CACNb2 expression in SQTS cells. Quinidine prolonged the APD and abolished arrhythmic activity.
Conclusions
Patient-specific hiPSC-CMs are able to recapitulate single-cell phenotype features of SQTS type 5 and provide novel opportunities to further elucidate the cellular disease mechanism and test drug effects.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- I El-Battrawy
- University Medical Centre of Mannheim, Mannheim, Germany
| | - L Maywald
- University Medical Centre of Mannheim, Mannheim, Germany
| | - L Cyganek
- University Hospital Gottingen, Stem Cell Unit, Clinic for Cardiology and Pneumology, Goettingen, Germany
| | - R Zhong
- University Medical Centre of Mannheim, Mannheim, Germany
| | - F Zhang
- University Medical Centre of Mannheim, Mannheim, Germany
| | - M Kleinsorge
- University Hospital Gottingen, Stem Cell Unit, Clinic for Cardiology and Pneumology, Goettingen, Germany
| | - H Dinkel
- University Medical Centre of Mannheim, Mannheim, Germany
| | - H Lan
- University Medical Centre of Mannheim, Mannheim, Germany
| | - X Li
- University Medical Centre of Mannheim, Mannheim, Germany
| | - M Huang
- University Medical Centre of Mannheim, Mannheim, Germany
| | - Z Liao
- University Medical Centre of Mannheim, Mannheim, Germany
| | - A Moscu-Gregor
- Center for Human Genetics and Laboratory Medicine, Martinsried, Germany
| | - M Borggrefe
- University Medical Centre of Mannheim, Mannheim, Germany
| | - X Zhou
- University Medical Centre of Mannheim, Mannheim, Germany
| | - I Akin
- University Medical Centre of Mannheim, Mannheim, Germany
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Li Y, Shui L, Wang X, Sun Y, Zhong R, Shui P, Chen N. Long-Term Results of Partial Breast Irradiation After Breast-Conserving Surgery for Early Stage Breast Cancer: A Prospective Phase II Trial in China. Front Oncol 2020; 10:550950. [PMID: 32984062 PMCID: PMC7492676 DOI: 10.3389/fonc.2020.550950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 08/13/2020] [Indexed: 02/05/2023] Open
Abstract
Background Partial breast radiotherapy (PBI) has emerged as an option after breast-conserving surgery for early stage breast cancer patients. Methods A total of 55 patients with early stage breast cancer between 2009 and 2013 were enrolled in this single-institutional phase II prospective clinical trial. All patients received adjuvant PBI-IMRT after lumpectomy, with the prescription of 48 Gy in 12 fractions at 4 Gy per fraction, 5 days a week. The primary endpoint was ipsilateral breast tumor recurrence (IBTR), the other endpoints were a regional nodal failure (RNF), distant metastasis (DM) rate, disease-free survival (DFS), and overall survival (OS). These endpoints were used to evaluate clinical outcomes. The cosmetic effects and the late toxicity were assessed according to Harvard standard scale and CTCAE 3.0, respectively. Results In our cohorts, the median age was 45.60 years old (range 31-65 years) and 29.09% of these patients were post-menopause (n = 16). Most patients were T1 stage (65.45%) or N0 stage (70.91%). 80% of patients were ER-positive, 67.27% PR positive, and 61.82% HER2 negative. At the median follow-up of 9.25 years, RNF was 0% and IBTR occurred in only one patient (1.82%) to the chest wall. Except for one patient (1.82%) had DM to lung and pleura and died from disease progression, the remaining patients were alive at the end of the 10-year follow-up. The 10-year DFS and OS were 94.55 and 98.18%. One patient (1.82%) was diagnosed with endometrial cancer after PBI. Except for 9 patients who declined the cosmetic assessment, the rest of the 46 patients (83.64%) were all rated as good and well-satisfied with the appearance of the irradiated breast. No breast retraction and fibrosis were observed in any of the patients. Additionally, only 4 patients experienced grade 1 late toxicity (7.28%). None had grade 3 or higher late toxicity. Conclusion This is the first study to report the 10-year results of PBI after breast-conserving surgery in Chinese patients. Our study suggested that PBI had durable local control and maintained good cosmetic outcomes with minimal late toxicity at long term follow up for the early stage breast cancer patients.
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Affiliation(s)
- Yan Li
- Radiation Oncology, Lung Cancer Center and State Key Laboratory of Biotherapy West China Hospital, Sichuan University, Chengdu, China
| | - Lin Shui
- Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaodong Wang
- Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yu Sun
- Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Renming Zhong
- Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Pixian Shui
- School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Nianyong Chen
- Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
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Dai G, Xu X, Wu X, Lei X, Wei X, Li Z, Xiao Q, Zhong R, Bai S. Application of 3D-print silica bolus for nasal NK/T-cell lymphoma radiation therapy. J Radiat Res 2020; 61:920-928. [PMID: 32960262 PMCID: PMC7674672 DOI: 10.1093/jrr/rraa084] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/28/2020] [Accepted: 06/23/2020] [Indexed: 02/05/2023]
Abstract
The aim of the study was to evaluate the clinical feasibility of a 3D-print silica bolus for nasal NK/T-cell lymphoma radiation therapy. Intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) plans were designed using an anthropomorphic head phantom with a 3D-print silica bolus and other kinds of bolus used clinically, and the surface dose was measured by a metal oxide semiconductor field-effect transistor (MOSFET) dosimeter. Four nasal NK/T patients with or without 3D-print silica bolus were treated and the nose surface dose was measured using a MOSFET dosimeter during the first treatment. Plans for the anthropomorphic head phantom with 3D-print bolus have more uniform dose and higher conformity of the planning target volume (PTV) compared to other boluses; the homogeneity index (HI) and conformity index (CI) of the VMAT plan were 0.0589 and 0.7022, respectively, and the HI and CI of the IMRT plan were 0.0550 and 0.7324, respectively. The MOSFET measurement results showed that the surface dose of the phantom with 3D-print bolus was >180 cGy, and that of patients with 3D-print bolus was higher than patients without bolus. The air gap volume between the 3D-print bolus and the surface of patients was <0.3 cc. The 3D-print silica bolus fitted well on the patient’s skin, effectively reducing air gaps between bolus and patient surface. Meanwhile, the 3D-print silica bolus provided patients with higher individuation, and improved the conformity and uniformity of the PTV compared to other kinds of boluses.
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Affiliation(s)
- Guyu Dai
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Xin Xu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Xiaohong Wu
- Department of Oncology, The affiliated Hospital of Panzhihua University, Panzhihua, China
| | - Xiaolin Lei
- Department of Oncology, The affiliated Hospital of Panzhihua University, Panzhihua, China
| | - Xing Wei
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Zhibin Li
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Qing Xiao
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Renming Zhong
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Sen Bai
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
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Song Y, Zhang W, Zhang H, Wang Q, Xiao Q, Li Z, Wei X, Lai J, Wang X, Li W, Zhong Q, Gong P, Zhong R, Zhao J. Low-dose cone-beam CT (LD-CBCT) reconstruction for image-guided radiation therapy (IGRT) by three-dimensional dual-dictionary learning. Radiat Oncol 2020; 15:192. [PMID: 32787941 PMCID: PMC7425566 DOI: 10.1186/s13014-020-01630-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/29/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND To develop a low-dose cone beam CT (LD-CBCT) reconstruction method named simultaneous algebraic reconstruction technique and dual-dictionary learning (SART-DDL) joint algorithm for image guided radiation therapy (IGRT) and evaluate its imaging quality and clinical application ability. METHODS In this retrospective study, 62 CBCT image sets from February 2018 to July 2018 at west china hospital were randomly collected from 42 head and neck patients (mean [standard deviation] age, 49.7 [11.4] years, 12 females and 30 males). All image sets were retrospectively reconstructed by SART-DDL (resultant D-CBCT image sets) with 18% less clinical raw projections. Reconstruction quality was evaluated by quantitative parameters compared with SART and Total Variation minimization (SART-TV) joint reconstruction algorithm with paired t test. Five-grade subjective grading evaluations were done by two oncologists in a blind manner compared with clinically used Feldkamp-Davis-Kress algorithm CBCT images (resultant F-CBCT image sets) and the grading results were compared by paired Wilcoxon rank test. Registration results between D-CBCT and F-CBCT were compared. D-CBCT image geometry fidelity was tested. RESULTS The mean peak signal to noise ratio of D-CBCT was 1.7 dB higher than SART-TV reconstructions (P < .001, SART-DDL vs SART-TV, 36.36 ± 0.55 dB vs 34.68 ± 0.28 dB). All D-CBCT images were recognized as clinically acceptable without significant difference with F-CBCT in subjective grading (P > .05). In clinical registration, the maximum translational and rotational difference was 1.8 mm and 1.7 degree respectively. The horizontal, vertical and sagittal geometry fidelity of D-CBCT were acceptable. CONCLUSIONS The image quality, geometry fidelity and clinical application ability of D-CBCT are comparable to that of the F-CBCT for head-and-neck patients with 18% less projections by SART-DDL.
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Affiliation(s)
- Ying Song
- Department of Radiotherapy, Cancer Center, West China Hospital, Sichuan University, No.37 Guo Xue Alley, Chengdu, 610065 P. R. China
| | - Weikang Zhang
- The School of Biomedical Engineering, Shanghai Jiao Tong University, No. 800, Dongchuan Road, Minhang District, Shanghai, 610065 P. R. China
| | - Hong Zhang
- Department of Radiotherapy, Cancer Center, West China Hospital, Sichuan University, No.37 Guo Xue Alley, Chengdu, 610065 P. R. China
| | - Qiang Wang
- Department of Radiotherapy, Cancer Center, West China Hospital, Sichuan University, No.37 Guo Xue Alley, Chengdu, 610065 P. R. China
| | - Qing Xiao
- Department of Radiotherapy, Cancer Center, West China Hospital, Sichuan University, No.37 Guo Xue Alley, Chengdu, 610065 P. R. China
| | - Zhibing Li
- Department of Radiotherapy, Cancer Center, West China Hospital, Sichuan University, No.37 Guo Xue Alley, Chengdu, 610065 P. R. China
| | - Xing Wei
- Department of Radiotherapy, Cancer Center, West China Hospital, Sichuan University, No.37 Guo Xue Alley, Chengdu, 610065 P. R. China
| | - Jialu Lai
- Department of Radiotherapy, Cancer Center, West China Hospital, Sichuan University, No.37 Guo Xue Alley, Chengdu, 610065 P. R. China
| | - Xuetao Wang
- Department of Radiotherapy, Cancer Center, West China Hospital, Sichuan University, No.37 Guo Xue Alley, Chengdu, 610065 P. R. China
| | - Wan Li
- Department of Radiotherapy, Cancer Center, West China Hospital, Sichuan University, No.37 Guo Xue Alley, Chengdu, 610065 P. R. China
| | - Quan Zhong
- Department of Radiotherapy, Cancer Center, West China Hospital, Sichuan University, No.37 Guo Xue Alley, Chengdu, 610065 P. R. China
| | - Pan Gong
- Department of Radiotherapy, Cancer Center, West China Hospital, Sichuan University, No.37 Guo Xue Alley, Chengdu, 610065 P. R. China
| | - Renming Zhong
- Department of Radiotherapy, Cancer Center, West China Hospital, Sichuan University, No.37 Guo Xue Alley, Chengdu, 610065 P. R. China
| | - Jun Zhao
- The School of Biomedical Engineering, Shanghai Jiao Tong University, No. 800, Dongchuan Road, Minhang District, Shanghai, 610065 P. R. China
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Xiao Q, Bai S, Li G, Yang K, Bai L, Li Z, Chen L, Xian L, Hu Z, Zhong R. Statistical process control and process capability analysis for non‐normal volumetric modulated arc therapy patient‐specific quality assurance processes. Med Phys 2020; 47:4694-4702. [PMID: 32677053 DOI: 10.1002/mp.14399] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 07/03/2020] [Accepted: 07/08/2020] [Indexed: 11/11/2022] Open
Affiliation(s)
- Qing Xiao
- Department of Radiation Oncology Cancer Center and State Key Laboratory of Biotherapy West China HospitalSichuan University Chengdu Sichuan610041 China
| | - Sen Bai
- Department of Radiation Oncology Cancer Center and State Key Laboratory of Biotherapy West China HospitalSichuan University Chengdu Sichuan610041 China
| | - Guangjun Li
- Department of Radiation Oncology Cancer Center and State Key Laboratory of Biotherapy West China HospitalSichuan University Chengdu Sichuan610041 China
| | - Kaixuan Yang
- Department of Radiation Oncology Cancer Center and State Key Laboratory of Biotherapy West China HospitalSichuan University Chengdu Sichuan610041 China
| | - Long Bai
- Department of Radiation Oncology Cancer Center and State Key Laboratory of Biotherapy West China HospitalSichuan University Chengdu Sichuan610041 China
| | - Zhibin Li
- Department of Radiation Oncology Cancer Center and State Key Laboratory of Biotherapy West China HospitalSichuan University Chengdu Sichuan610041 China
| | - Li Chen
- Department of Radiation Oncology Cancer Center and State Key Laboratory of Biotherapy West China HospitalSichuan University Chengdu Sichuan610041 China
| | - Lixun Xian
- Department of Radiation Oncology Cancer Center and State Key Laboratory of Biotherapy West China HospitalSichuan University Chengdu Sichuan610041 China
| | - Zhenyao Hu
- Department of Radiation Oncology Cancer Center and State Key Laboratory of Biotherapy West China HospitalSichuan University Chengdu Sichuan610041 China
| | - Renming Zhong
- Department of Radiation Oncology Cancer Center and State Key Laboratory of Biotherapy West China HospitalSichuan University Chengdu Sichuan610041 China
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Zhong R, Chen D, Cao S, Li J, Han B, Zhong H. Immune cell infiltration features and related marker genes in lung cancer based on single-cell RNA-seq. Clin Transl Oncol 2020; 23:405-417. [PMID: 32656582 DOI: 10.1007/s12094-020-02435-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 06/18/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Immune cells in the immune microenvironment of lung cancer have a great impact on the development of lung cancer. Our purpose was to analyze the immune cell infiltration features and related marker genes for lung cancer. METHODS Single cell RNA sequencing data of 11,485 lung cancer cells were retrieved from the Gene Expression Omnibus. After quality control and data normalization, cell clustering was performed using the Seurat package. Based on the marker genes of each cell type from the CellMarker database, each cell was divided into G1, G2M, and S phases. Then, differential expression and functional enrichment analyses were performed. CIBERSORT was used to reconstruct immune cell types. RESULTS Following cell filtering, highly variable genes were identified for all cells. 14 cell types were clustered. Among them, CD4 + T cell, B cell, plasma cell, natural killer cell and cancer stem cell were the top five cell types. Up-regulated genes were mainly enriched in immune-related biological processes and pathways. Using CIBERSORT, we identified the significantly higher fractions of naïve B cell, memory CD4 + T cell, T follicular helper cell, T regulatory helper cell and M1 macrophage in lung cancer tissues compared to normal tissues. Furthermore, the fractions of resting NK cell, monocyte, M0 macrophage, resting mast cell, eosinophil and neutrophil were significantly lower in tumor tissues than normal tissues. CONCLUSION Our findings dissected the immune cell infiltration features and related marker genes for lung cancer, which might provide novel insights for the immunotherapy of lung cancer.
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Affiliation(s)
- R Zhong
- Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University, Huaihai West Road No. 241, Shanghai, 200030, China
| | - D Chen
- Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University, Huaihai West Road No. 241, Shanghai, 200030, China
| | - S Cao
- Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University, Huaihai West Road No. 241, Shanghai, 200030, China
| | - J Li
- Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University, Huaihai West Road No. 241, Shanghai, 200030, China
| | - B Han
- Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University, Huaihai West Road No. 241, Shanghai, 200030, China
| | - H Zhong
- Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University, Huaihai West Road No. 241, Shanghai, 200030, China.
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Han B, Chu T, Zhong R, Zhong H, Zhang B, Zhang W, Shi C, Qian J, Han Y. JCSE01.11 Efficacy and Safety of Sintilimab with Anlotinib as First-Line Therapy for Advanced Non-Small Cell Lung Cancer (NSCLC). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.269] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Han B, Chu T, Zhong R, Zhong H, Zhang B, Zhang W, Shi C, Qian J, Han Y. P1.04-02 Efficacy and Safety of Sintilimab with Anlotinib as First-Line Therapy for Advanced Non-Small Cell Lung Cancer (NSCLC). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.905] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Han B, Chu T, Shi C, Zhong H, Zhang W, Zhang B, Zhong R, Zhang X. P2.01-21 Efficacy and Safety of Combing Anlotinib and Erlotinib as a First-Line Therapy in Patients with Advanced Non-Small Cell Lung Cancer (NSCLC). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Han B, Chu T, Zhang X, Zhong H, Zhang B, Wang H, Gu A, Zhang W, Shi C, Zhong R. P1.01-95 Efficacy and Safety of Anlotinib in Combination with Chemotherapy as First-Line Therapy in Advanced Non-Small Cell Lung Cancer (NSCLC) Patients. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Chen D, Chu T, Chang Q, Zhang Y, Xiong L, Qiao R, Teng J, Han B, Zhong R. EP1.01-65 The Relationship Between Preliminary Efficacy and Prognosis After First-Line EGFR-TKI Treatment of Advanced NSCLC. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Li X, Zhou J, Chu C, You Q, Zhong R, Rao Z, Hu W. Home enteral nutrition may prevent myelosuppression of patients with nasopharyngeal carcinoma treated by concurrent chemoradiotherapy. Head Neck 2019; 41:3525-3534. [PMID: 31301097 DOI: 10.1002/hed.25861] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 05/16/2019] [Accepted: 06/18/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The aim of this study is to assess the effect of home enteral nutrition (HEN) on the myelosuppression of patients with nasopharyngeal cancer (NPC) during the course of concurrent chemoradiotherapy (CCRT). METHODS A total of 18 outpatients with NPC administered oral nutritional supplementation intervention at home during the course of CCRT were designated as the HEN group, whereas 36 patients with NPC who had previously completed CCRT were retrospectively included as the control group. Patient Generated Subjective Global Assessment, body mass index (BMI), and blood test were evaluated prior to CCRT. During the course of CCRT, blood test was assessed every 2 weeks. RESULTS In male patients, hemoglobin (HB) and red blood cell were decreased (P < .05) in both HEN and control group after CCRT, whereas white blood cell (WBC) started to decrease since week 2 of CCRT in the control group but maintained in the HEN group which was significantly higher than the control (5.05 ± 1.29 vs 3.77 ± 1.5, P < .05). In female patients, HB and WBC were reduced in control group during CCRT, whereas these indicators also maintained in the HEN group. Surprisingly, all patients with lower BMI (<24 kg/m2 ) had a significant increase in platelet (PLT) after CCRT (200.78 ± 58.03 vs 253.00 ± 69.82, P < .05), while had steady HB and WBC values in the HEN group. At the end of CCRT, WBC and PLT of the HEN group were both higher than those in the control group (5.21 ± 1.07 vs 3.37 ± 1.52), (253.00 ± 69.82 vs 165.57 ± 59.56) (P < .05 for both). Our findings suggest that HEN is effective in preventing myelosuppression during CCRT for patients with NPC. CONCLUSION Our findings suggest that HEN is effective in preventing myelosuppression during CCRT for patients with NPC.
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Affiliation(s)
- Xuemei Li
- Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, China
| | - Jidan Zhou
- Department of Radiotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Ci Chu
- Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, China
| | - Qian You
- Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, China
| | - Renming Zhong
- Department of Radiotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Zhiyong Rao
- Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, China
| | - Wen Hu
- Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, China
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Gong J, Tian J, Lou J, Wang X, Ke J, Li J, Yang Y, Gong Y, Zhu Y, Zou D, Peng X, Yang N, Mei S, Zhong R, Chang J, Miao X. A polymorphic MYC response element in KBTBD11 influences colorectal cancer risk, especially in interaction with an MYC-regulated SNP rs6983267. Ann Oncol 2019; 29:632-639. [PMID: 29267898 DOI: 10.1093/annonc/mdx789] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background MYC is a well-established cancer driver gene regulating the expression of numerous genes, indicating that polymorphisms in MYC response elements could affect tumorigenesis through altering MYC regulation. We performed integrative multistage study to evaluate the effects of variants in MYC response elements and colorectal cancer (CRC) risk. Patients and methods We systematically integrated ChIP-Seq, DNase-Seq and transcription factor motif data to screen variants with potential ability to affect the MYC binding affinity. Then, we conducted a two-stage case-control study, totally consisting of 4830 CRC cases and 4759 controls in Chinese population to identify risk polymorphisms and interactions. The effects of risk variants were confirmed by functional assays in CRC LoVo, SW480 and HCT15 cells. Results We identified a novel polymorphism rs11777210 in KBTBD11 significantly associated with CRC susceptibility (P = 2.43 × 10-12). Notably, we observed a significant interaction between rs11777210 and MYC nearby rs6983267 (P-multi = 0.003, P-add = 0.005), subjects carrying rs6983267 GG and rs11777210 CC genotypes showing higher susceptibility to CRC (2.83-fold) than those carrying rs6983267 TT and rs11777210 TT genotypes. We further demonstrated that rs6983267 T > G increased MYC expression, and MYC bound to and negatively regulated KBTBD11 expression when the rs11777210 C risk allele was present. KBTBD11 was downregulated in tumor tissues, and KBTBD11 knockdown promoted cell proliferation and inhibited cell apoptosis. Conclusion The rs11777210 is a potential predictive biomarker of CRC susceptibility, and KBTBD11 functions as a putative tumor suppressor in tumorigenesis. Our study highlighted the high CRC risk of people carrying rs6983267 G and rs11777210 C alleles, and provided possible biological mechanism of the interaction.
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Affiliation(s)
- J Gong
- Department of Epidemiology and Biostatistics, Huazhong University of Science and Technology, Wuhan, China; State Key Laboratory of Environment Health (Incubation), MOE (Ministry of Education) Key Laboratory of Environment & Health, Ministry of Environmental Protection Key Laboratory of Environment and Health (Wuhan), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - J Tian
- Department of Epidemiology and Biostatistics, Huazhong University of Science and Technology, Wuhan, China; State Key Laboratory of Environment Health (Incubation), MOE (Ministry of Education) Key Laboratory of Environment & Health, Ministry of Environmental Protection Key Laboratory of Environment and Health (Wuhan), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - J Lou
- Department of Epidemiology and Biostatistics, Huazhong University of Science and Technology, Wuhan, China; State Key Laboratory of Environment Health (Incubation), MOE (Ministry of Education) Key Laboratory of Environment & Health, Ministry of Environmental Protection Key Laboratory of Environment and Health (Wuhan), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - X Wang
- Department of Epidemiology and Biostatistics, Huazhong University of Science and Technology, Wuhan, China; State Key Laboratory of Environment Health (Incubation), MOE (Ministry of Education) Key Laboratory of Environment & Health, Ministry of Environmental Protection Key Laboratory of Environment and Health (Wuhan), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - J Ke
- Department of Epidemiology and Biostatistics, Huazhong University of Science and Technology, Wuhan, China; State Key Laboratory of Environment Health (Incubation), MOE (Ministry of Education) Key Laboratory of Environment & Health, Ministry of Environmental Protection Key Laboratory of Environment and Health (Wuhan), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - J Li
- Department of Epidemiology and Biostatistics, Huazhong University of Science and Technology, Wuhan, China; State Key Laboratory of Environment Health (Incubation), MOE (Ministry of Education) Key Laboratory of Environment & Health, Ministry of Environmental Protection Key Laboratory of Environment and Health (Wuhan), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Y Yang
- Department of Epidemiology and Biostatistics, Huazhong University of Science and Technology, Wuhan, China; State Key Laboratory of Environment Health (Incubation), MOE (Ministry of Education) Key Laboratory of Environment & Health, Ministry of Environmental Protection Key Laboratory of Environment and Health (Wuhan), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Y Gong
- Department of Epidemiology and Biostatistics, Huazhong University of Science and Technology, Wuhan, China; State Key Laboratory of Environment Health (Incubation), MOE (Ministry of Education) Key Laboratory of Environment & Health, Ministry of Environmental Protection Key Laboratory of Environment and Health (Wuhan), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Y Zhu
- Department of Epidemiology and Biostatistics, Huazhong University of Science and Technology, Wuhan, China; State Key Laboratory of Environment Health (Incubation), MOE (Ministry of Education) Key Laboratory of Environment & Health, Ministry of Environmental Protection Key Laboratory of Environment and Health (Wuhan), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - D Zou
- Department of Epidemiology and Biostatistics, Huazhong University of Science and Technology, Wuhan, China; State Key Laboratory of Environment Health (Incubation), MOE (Ministry of Education) Key Laboratory of Environment & Health, Ministry of Environmental Protection Key Laboratory of Environment and Health (Wuhan), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - X Peng
- Department of Epidemiology and Biostatistics, Huazhong University of Science and Technology, Wuhan, China; State Key Laboratory of Environment Health (Incubation), MOE (Ministry of Education) Key Laboratory of Environment & Health, Ministry of Environmental Protection Key Laboratory of Environment and Health (Wuhan), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - N Yang
- Department of Epidemiology and Biostatistics, Huazhong University of Science and Technology, Wuhan, China; State Key Laboratory of Environment Health (Incubation), MOE (Ministry of Education) Key Laboratory of Environment & Health, Ministry of Environmental Protection Key Laboratory of Environment and Health (Wuhan), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - S Mei
- Department of Epidemiology and Biostatistics, Huazhong University of Science and Technology, Wuhan, China; State Key Laboratory of Environment Health (Incubation), MOE (Ministry of Education) Key Laboratory of Environment & Health, Ministry of Environmental Protection Key Laboratory of Environment and Health (Wuhan), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - R Zhong
- Department of Epidemiology and Biostatistics, Huazhong University of Science and Technology, Wuhan, China; State Key Laboratory of Environment Health (Incubation), MOE (Ministry of Education) Key Laboratory of Environment & Health, Ministry of Environmental Protection Key Laboratory of Environment and Health (Wuhan), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - J Chang
- Department of Epidemiology and Biostatistics, Huazhong University of Science and Technology, Wuhan, China; State Key Laboratory of Environment Health (Incubation), MOE (Ministry of Education) Key Laboratory of Environment & Health, Ministry of Environmental Protection Key Laboratory of Environment and Health (Wuhan), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - X Miao
- Department of Epidemiology and Biostatistics, Huazhong University of Science and Technology, Wuhan, China; State Key Laboratory of Environment Health (Incubation), MOE (Ministry of Education) Key Laboratory of Environment & Health, Ministry of Environmental Protection Key Laboratory of Environment and Health (Wuhan), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Qian J, Nie W, Lu J, Zhang L, Zhang Y, Zhang B, Wang S, Hu M, Xu J, Lou Y, Dong Y, Niu Y, Yan B, Zhong R, Zhang W, Chu T, Zhong H, Han BH. Racial disparities in characteristics and prognosis in Asian versus white patients receiving atezolizumab: An ancillary analysis of POPLAR and OAK studies. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz063.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Yang L, Han G, Song Q, Ruan C, Li L, Shen J, LI G, Zhong R, Bai S. A Comparison of Patient Position Displacements from Catalyst™ System and Cone Beam CT Registrations for Treatment. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Zhao Z, Lan H, Li X, El-Battrawy I, Xu Q, Huang M, Zhong R, Liao Z, Lang S, Cyganek L, Zimmermann WH, Wieland T, Borggrefe M, Zhou XB, Akin I. P2866Drug-testing using human-induced pluripotent stem cell-derived cardiomyocytes from a patient with short QT syndrome. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Z Zhao
- First Department of Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - H Lan
- First Department of Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - X Li
- First Department of Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - I El-Battrawy
- First Department of Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Q Xu
- First Department of Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - M Huang
- First Department of Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - R Zhong
- First Department of Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Z Liao
- First Department of Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - S Lang
- First Department of Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - L Cyganek
- Stem Cell Unit, Clinic for Cardiology and Pneumology, University Medical Center Göttingen,, Göttingen, Germany
| | - W H Zimmermann
- Institute of Pharmacology and Toxicology, University of Göttingen,, Göttingen, Germany
| | - T Wieland
- Institute of Experimental and Clinical Pharmacology and Toxicology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - M Borggrefe
- First Department of Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - X B Zhou
- First Department of Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - I Akin
- First Department of Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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Zhong R, Song Y, Yan Y, Wang X, Li S, Zhou J, Li X, Bai S. Analysis of which local set-up errors can be covered by a 5-mm margin for cone beam CT-guided radiotherapy for nasopharyngeal carcinoma. Br J Radiol 2018; 91:20160849. [PMID: 29688742 PMCID: PMC6209481 DOI: 10.1259/bjr.20160849] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Objective: To analyse which local set-up errors can be covered by a 5-mm margin for cone beam computed tomography (CBCT)-guided radiotherapy in nasopharyngeal carcinoma (NPC). Methods: 11 regions of interest (ROIs) were registered for 24 NPC patients, with a total of 323 CBCT scans. According to the registration results, clinical target volume–planning target volume (CTV–PTV)/organs at risk-planning risk volume (OAR-PRV) margin analysis; Pearson correlation analysis; Bland–Altman plots; and a receiver operating characteristic (ROC) analysis were used to investigate which local set-up errors of substructure can be represented by the PTVROI. Results: The clinical target volume-PTV/OAR-planning risk volume margins were less than 5 mm for C1ROI-C4ROI, mandible (MROI), and sphenoid sinus (SROI) with respect to PTVROI. C1ROI-C4ROI, MROI, and SROI exhibited significant correlations and consistencies in the mediolateral, superior–inferior, and anteroposterior (AP) directions and significant receiver operating characteristic analysis results in the anteroposterior direction. Conclusion: Only the upper local set-up error of C1ROI-C4ROI, MROI, and SROI can be covered by a 5-mm margin for CBCT-guided NPC radiotherapy with a large ROI. Using these ROIs as an integral reference ROI is better than individual bony landmark. Advances in knowledge: This report is helpful to CBCT registration for NPC radiotherapy in clinical practice.
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Affiliation(s)
- Renming Zhong
- 1 Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University , Chengdu , China
| | - Ying Song
- 1 Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University , Chengdu , China
| | - Yuying Yan
- 2 Oncology Department of Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital , Chengdu , China
| | - Xuetao Wang
- 1 Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University , Chengdu , China
| | - Shuai Li
- 1 Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University , Chengdu , China
| | - Jidan Zhou
- 1 Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University , Chengdu , China
| | - Xiaoyu Li
- 1 Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University , Chengdu , China
| | - Sen Bai
- 1 Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University , Chengdu , China
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Qiao R, Xu J, Zhang Y, Yang W, Zhang B, Wang S, Zhong R, Han B. 100P Prognostic factors in surgically resected N2 small cell lung cancer: Significance of the subcarinal node. J Thorac Oncol 2018. [DOI: 10.1016/s1556-0864(18)30374-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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