The Association Of Serum Let-7i-5p And Let-7i-3p In Pathological Types And Prognosis For The Patients With Lung Cancer And The Effect And Dosimetric Analysis Of Domestic Radiotherapy Equipment In Liver Cancer

Objective This work aimed to investigate the relationship between the expression levels of let-7i-5p and let-7i-3p and pathological types,clinical stage,tumor metastasis and patient prognosis,which were detected in serum of patients with lung cancer.This study conveyed the potential role of let-7i-5p and let-7i-3p in the diagnosis and prognosis of lung cancer.Methods The expression levels of let-7i-5p and let-7i-3p in the serum were detected by real-time quantitative PCR(RT-q PCR)assay in 99 lung cancer patients and 32 healthy donors from in the department of clinical oncology of ** Hospital.The clinical information was collected,including pathological types,clinical stage,treatment and survival.The correlations between the expression levels of let-7i-5p and let-7i-3p and the pathological types and clinical indicators in lung cancer were respectively analyzed by using SPSS 22.0 software.Results The expression levels of let-7i-3p in lung squamous cell carcinoma(SCC),adenocarcinoma(ADC)and small cell lung cancer(SCLC)patients were 1.43,2.12 and 0.88,respectively.Significant difference was observed between SCC and ADC groups(P = 0.049),ADC and SCLC groups(P = 0.036).The expression levels of let-7i-5p in SCC,ADC and SCLC patients were 1.12,1.93 and 1.03,respectively.However,no significant difference was obtained between any two of SCC,ADC and SCLC groups(P = 0.355).The expression levels of let-7i-5p in serum of patients varied with clinical stage and distant metastasis.The expression levels of let-7i-5p in stage Ⅰ,stage Ⅲand stage Ⅳ were 5.74,2.74 and 1.18,respectively.There were significant differences between stage Ⅰ and stage Ⅳ,stage Ⅲ and stage Ⅳ.The expression levers of let-7i-5p were negatively correlated with clinical stage(r =-0.263,P = 0.009).The expression levels of let-7i-5p in distant and non-distant metastasis groups were 4.10 and 1.18,respectively.The difference between the two groups was statistically significant(P = 0.009).The expression levels of let-7i-3p in radiotherapy and non-radiotherapy groups were 2.05 and 1.05,respectively.The expression levels of let-7i-3p was significantly up-regulated in radiotherapy group,and the difference was statistically significant between radiotherapy and non-radiotherapy groups(P =0.032).In SCLC,the overall survival of patients with high-expressed let-7i-5p(47months)was significantly higher than that of low-expressed(12 months),indicating that the expression levels of let-7i-5p were significantly correlated with prognosis(P = 0.018).Conclusions This work revealed the first evidence that the expression levels of let-7i-3p in ADC patients was significantly higher than those in SCC and SCLC patients.This suggests that let-7i-3p may be a potential biomarker for pathological diagnosis of lung cancer.The expression levels of let-7i-5p showed no significant difference in different pathological types of lung cancer.The expression levels of let-7i-5p in serum of patients with lung cancer were negatively correlated with clinical stage.In addition,the expression levels of let-7i-5p were significantly reduced in patients with distant metastases compared with those non-distant metastases.These results demonstrate that let-7i-5p may be a potential and even valuable biomarker for lung cancer staging and distant metastasis.The up-regulation of let-7i-3p expression was significantly correlated with radiotherapy,revealing its possibility or potential of a biomarker for the radiosensitivity of lung cancer.The expression levels of let-7i-5p in SCLC patients were significantly correlated with the overall survival of patients,indicating its potential and even valuable role in the prognosis of SCLC patients.Objective The purpose of this study is to investigate the effect of gross tumor volume(GTV)and radiotherapy dose on the prognosis of patients with hepatocellular carcinoma(HCC)treated by body gamma knife and the related factors.Methods In total,69 HCC patients who underwent body gamma knife treatment in radiotherapy department of ** Hospital from 2012 to 2015 were enrolled into this study,and the clinical data were retrospectively analyzed.The planning target volume(PTV)was covered with 50% or 60% isodose curve with a single dose of4-5 Gy and a total marginal dose of 36-50 Gy(median 45 Gy).The short-term efficacy,overall survival,and adverse reactions were observed,respectively.The best cutoff values of GTV and greatest tumor diameter(GTD)were determined by ROC curve.Survival analysis was performed by the Kaplan-Meier survival analysis.Difference intwo groups was evaluated by Log-rank test.Cox regression model was used in multivariate factor prognostic analysis.Results The total effective rate of 69 patients treated by radiotherapy was 67%.The1-year and 2-year of overall survival(OS)accounted for 62% and 40%,respectively,and the median survival for patients was 18.6 months.The best cutoff values of GTV and GTD were 93cm3 and 5.5cm,respectively.Univariate analysis showed that patients with BCLC staging,portal vein tumor thrombus,GTV,GTD,radiotherapy dose and short-term efficacy were prognostic factors in HCC patients.Their corresponding P values were 0.022,0.018,0.002,0.041,0.035,and 0.001,respectively.Multivariate factor prognostic analysisshowed that GTV <93cm3(P = 0.013)and the short-term efficacy of radiotherapy(P =0.001)were independent risk factors for the survival of HCC patients treated by body gamma knife.In the small volume group(GTV <93 cm3),the prognosis of subgroups with dose≥45Gy was significantly better than those with dose<45Gy.Additionally,the median survival time was 33 and 12 months,respectively.The difference between two groups was statistically significant(P<0.05).In the large volume group(GTV>93 cm3),no significant difference in the prognosis between subgroups with dose ≥45Gy and those with dose <45Gy was detected.Correlational analysis showed the obvious association between portal vein tumor thrombus,GTV,radiotherapy dose and the short-term efficacy.The Pvalues were 0.039,0.017,and 0.024,respectively.All patients were observed with minor adverse reactions.No adverse reactions with no less than grade III were examined in patients in the small volume group.However,a small number of patients in the large volume group had adverse reactions with no less than grade III.Conclusions GTV is an important indicator to predict the survival of patients with locally advanced liver cancer undergoing radiotherapy.In the small volume group(GTV<93 cm3),high-dose radiotherapy was beneficial to the survival of patients.It may be attributed to the significant association of GTV and radiotherapeutic doses with short-timeefficacy.In the large volume group(GTV>93 cm3),no survival advantage was evaluated as a result of increased radiation dose.Meanwhile,adverse reaction was increased in the largevolume groupcompared with the small volume group.By this token,these results demonstrated that patients with larger tumors should not be forced to adopthigh-dose irradiation.Objective Analysis of the feasibility of domestic medical accelerators in the treatment of hepatocellular carcinoma(HCC)was performed by comparing the dosimetry parameters of domestic and imported medical accelerators in intensity-modulated radiotherapy(IMRT)for HCC.Methods A total of 10 patients with HCC who had received radiotherapy in the ** Hospital between 2012 and 2016 were selected for this study.Medical Science MONACO5.11 planning system and Sichuan University COL/3D-RTPS/D planning system were applied to design IMRT plans for each patient under the same optimized conditions,respectively.The total prescribed dose for the target area is60Gy/30 F.The dose volume histograms(DVHs)were used to analyze the dosimetry parameters of target volume and organs at risk(OARs)in domestic and imported medical accelerators.SPSS 22.0 software was used for statistical analysis.Results No significant difference was observed in V95,V98,Conformal index(CI)and Homogeneity index(HI)of planning target volume(PTV)between domestic and imported devices.Dmax,V105 and V110 of imported devices were all superior to those in domestic devices.The total liver dose V5 and V10 of domestic devices were evidently lower than those in imported devices with significance.For the average normal liver dose and the whole liver V20,V30,V40,no significant difference was observed in these two devices.In terms of the dosage parameters of OARs involved in kidneys,stomach,intestine,spinal and duodenum,no significant difference between domestic and imported devices was detected.In addition,low monitor unit(Mu)and instrument dose were detected in domestic devices,exhibiting no obvious advantage of treatment time compared to imported devices.Conclusions In spite of some shortcomings,the current domestic medical accelerator could basically meet the clinical requirements and complete HCC radiotherapy plan.We evidenced the feasibility of domestic devices in the radiation therapy of HCC by comparing the differencesin the target area and OARs between domestic and imported medical accelerators.However,domestic planning system is difficultly available in complex target areas,such as multi-target or area closed to the duodenum.