| Objective To analyze the clinical outcomes and toxicity of patients with lung metastases.Methods and Materials From October 1,2003 to August 31,2016,381 ung metastases patients with total 54 1esions treated with intensity-modulated radiotherapy were retrospectively reviewed.The most primary diagnosis was lung cancer in 8 patients and nasopharyngeal carcinoma in 8 patients.There were 27 patients(71.1%)with solitary pulmonary metastasis and 11 patients(28.9%)with multiple lung metastases.The median total dose of 58.25Gy(range:30-67 Gy)in 22 fractions(range,6-31).Results The median follow-up was 18.8 months(range,6.2-81.1months).The median diameter of the lesions was 2 cm(range,0.5-6.5cm),with a median target volume of 5.53 cm3(range,0.54-155.53 cm3).The median survival time was 18.8 months.The 1 years,2 years and 5 year overall survivalwere 71.4%,54.3% and 25.6%,the univariate analysis showed that pulmonary lesions controlled before radiotherapy was a statistically significant difference(1year overall survival rate of 80.3% vs 50%,p=0.048).The 1 years,2 years and5 years of progression-free survival were 39.9%,33.3% and 15.2%.In the univariate analysis,smoking patients with worse progression-free survival than no smokers(1 year progression free survival rate of 15.4% vs 53.4%,p=0.076).The multivariate analysis showed that smoking was an independent prognostic factor for progression-free survival(p=0.036).The 1 years,2 years and 5 year local control were 91.4%,91.4% and 68.5%,In the univariate analysis,there was no significant difference in the factors of local control.No grade 3 or more radiation related toxicity occurred.Conclusions Intensity-modulated radiation therapy is safe and effective in the treatment of lung metastases.The side effects can be accepted.Objective The purpose of this study is to evaluate the efficacy and toxicity of intensity modulated radiotherapy(IMRT)for treatment of unresectable hepatic metastases.Methods and Materials The records of 25 patients with 38 metastatic liver lesions treated with SBRT between January 2003 and September 2016 were reviewed.The most common primary tumors were nasopharynx(n = 7),colorectal(n = 5)and lung(n = 5).The median longest diameter of the lesions was 3.3cm(range,1.6-16.7cm).Median tumor volume was 15.39 ml(range,3.15-2,214.75 ml).Dose per fraction ranged from 2 Gy to 5.2 Gy,with a median total dose of 50Gy(range,30-60 Gy).Results The median follow-up was 9.2 months(range,2.1-48.8 Gy)and the median survival was 17.6 months.Overall survival(OS)at 1 and 2 years were46.4% and 27.4%,respectively.One-year local control(LC)was 69.8%.The1-year progression-free-survival(PFS)was 26.3%.One grade 4 liver enzyme and bilirubin changes occurred,but no radiation-induced liver disease(RILD).One patient had grade 4 leukopenia.One patient had grade 3 leukopenia,whereas another patient had grade 3 leukopenia and thrombocytopenia.Conclusions IMRT of liver metastases is an effective and safe treatment modality for inoperable liver metastases,which can be used as the first choice.The relatively low total dose and fractionated dose can also obtain good effect.Objective To analyze Analysis the effect and prognostic factors of nasopharyngeal carcinoma patients with lung metastasis.Methods and Materials From January 1,2005 to December 31,2015,74 nasopharyngeal carcinoma patients with 1ung metastases were retrospectively reviewed.Chemotherapy in 38,chemotherapy + radiotherapy in 8,radiotherapy alone in 4,surgery + chemotherapy,surgery and chemotherapy +radioactive particle in each of 1.Results The median follow-up time was 14.2 months(1.5-84.0 months).Median survival time was 31.7 months,2 year and 5 year survival rates were81.1% and 31.3%,the median survival time after lung metastasis was 14.2months,the overall survival of patients with 1,2,5 years were 67.3%,45.8%and 26.2%.The 1,2 and 5 year progression-free survival for patients with lung metastases were 55%,30.7%,and 20.1%,respectively.Univariate analysisshowed that there were statistically significant differences in age,number of lung metastases and treatment patterns among all patients.Univariate analysis was performed on the influencing factors of progression free survival,and there was a significant difference in progression free survival rate between the number of lung metastases and the presence of extrapulmonary metastases.Multivariate analysis showed that age,T stage,whether extrapulmonary metastases and treatment patterns were independent prognostic factors for overall survival,the number of lung metastases,whether pulmonary metastasis and treatment patterns is independent prognostic factors for progression free survival rate.Conclusions Pulmonary metastasis of nasopharyngeal carcinoma should be treated actively,The effect of combined therapy is better than that of chemotherapy alone. |
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