RESUMO
Owing to the complex anatomical structure and biomechanics, the current standard palliative treatments for cervical spinal metastases are associated with a high risk of recurrence and complications. Stereotactic body radiotherapy (SBRT) can provide radical dose to tumors while protecting normal organs to the maximum extent. However, the efficacy and safety of SBRT for cervical spinal metastases is not well characterized. Data from 71 patients with cervical spine metastases who were treated with SBRT using CyberKnife between 2006 and 2021 were obtained from our prospectively maintained database. Primary endpoint was pain response at 12 weeks following SBRT completion; secondary endpoints included local control (LC), overall survival (OS), and adverse events. Standard-risk patients were planned to receive 30 Gy (range 21-36) with median fractions of 3 (range 1-3) and high-risk patients 35 Gy (range 24-50) with median fractions of 5 (range 4-5) according to the spinal cord and esophagus dose constraints. The median follow-up time was 17.07 months (range 3.1-118.9). After 12 weeks of SBRT completion, 54 (98.2%) of 55 patients with baseline pain achieved pain response and 46 (83.6%) achieved complete pain response. LC rates were 93.1% and 90% at 1 year and 2 year, respectively. The 1-year and 2-year OS rates were 66.2% and 37.4%, respectively. Eight patients experienced grades 1-4 adverse events (six vertebral compression fracture [VCF], five of them had VCF before SBRT; and two hemiparesis). No grade 5 adverse events were observed. Therefore, risk-adapted SBRT for cervical spine metastases achieved high pain control and LC rates with acceptable adverse events.
Assuntos
Carcinoma , Fraturas por Compressão , Radiocirurgia , Fraturas da Coluna Vertebral , Neoplasias da Coluna Vertebral , Humanos , Radiocirurgia/efeitos adversos , Fraturas por Compressão/complicações , Neoplasias da Coluna Vertebral/radioterapia , Neoplasias da Coluna Vertebral/secundário , Fraturas da Coluna Vertebral/complicações , Dor/complicaçõesRESUMO
To determine the therapeutic efficacy and safety of risk-adapted stereotactic body radiation therapy (SBRT) schedules for patients with early-stage central and ultra-central inoperable non-small cell lung cancer. From 2006 to 2015, 80 inoperable T1-2N0M0 NSCLC patients were treated with two median dose levels: 60 Gy in six fractions (range, 48-60 Gy in 4-8 fractions) prescribed to the 74% isodose line (range, 58%-79%) for central lesions (ie within 2 cm of, but not abutting, the proximal bronchial tree; n = 43), and 56 Gy in seven fractions (range, 48-60 Gy in 5-10 fractions) prescribed to the 74% isodose line (range, 60%-80%) for ultra-central lesions (ie abutting the proximal bronchial tree; n = 37) on consecutive days. Primary endpoint was overall survival (OS); secondary endpoints included progression-free survival (PFS), tumor local control rate (LC), and toxicity. Median OS and PFS were 64.47 and 32.10 months (respectively) for ultra-central patients, and not reached for central patients. Median time to local failure, regional failure, and any distant failures for central versus ultra-central lesions were: 27.37 versus 26.07 months, 20.90 versus 12.53 months, and 20.85 versus 15.53 months, respectively, all P < .05. Multivariate analyses showed that tumor categorization (ultra-central) and planning target volume ≥52.76 mL were poor prognostic factors of OS, PFS, and LC, respectively (all P < .05). There was one grade 5 toxicity; all other toxicities were grade 1-2. Our results showed that ultra-central tumors have a poor OS, PFS, and LC compared with central patients because of the use of risk-adapted SBRT schedules that allow for equal and favorable toxicity profiles.
Assuntos
Carcinoma Pulmonar de Células não Pequenas/radioterapia , Neoplasias Pulmonares/radioterapia , Radiocirurgia/métodos , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Carcinoma Pulmonar de Células não Pequenas/patologia , Fracionamento da Dose de Radiação , Feminino , Humanos , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prognóstico , Intervalo Livre de Progressão , Radiocirurgia/efeitos adversos , Estudos Retrospectivos , Fatores de Tempo , Falha de TratamentoRESUMO
The data of valuation of forest ecosystem service function (FESF) in 101 primary case studies of China were collected and obtained based on Specifications for Assessment of Forest Ecosystem Services in China (LY/T 1721-2008). FESF was then analyzed synthetically in terms of value coefficient. The results showed that the average value per unit area (VPUA) of FESF in China was 6.11×104 yuan·hm-2, and the order of VPUA of each service function was: water conservation (2.44×104 yuan·hm-2)> soil conservation (1.15×104 yuan·hm-2)> biodiversity conservation (1.00×104 yuan·hm-2)> carbon fixation and oxygen release (0.98×104 yuan·hm-2)> atmosphere environmental purification (0.28×104 yuan·hm-2)> forest recreation (0.23×104 yuan·hm-2)> action of forest against natural calamities (0.19×104 yuan·hm-2)> nutrient accumulation(0.16×104 yuan·hm-2). Water conservation, soil conservation, biodiversity conservation, carbon fixation and oxygen release were the four dominant service functions of forest ecosystem in China. The VPUA of FESF of the reserve level was higher than that of county level. The establishment of reserves played positive roles in biodiversity conservation and enhancement of service function, but the service function of forest recreation still existed with some insufficiency, and it needed to be further improved. Dominant service functions of forest ecosystem varied in different physicographic regions, and each type of service function presented different differentiation characteristics in space. The VPUA of FESF in South China was the highest up to 11.36×104 yuan·hm-2. The power regression correlation coefficients (R2) of the total value of FESF with forest area and forest stock volume were 0.905 (P<0.01) and 0.860 (P<0.01), respectively, indicating that forest area and forest stock volume were the two key factors affecting FESF and its total value. Moreover, latitude and mean annual precipitation also had significant effect on the VPUA of FESF.
Assuntos
Conservação dos Recursos Naturais , Agricultura Florestal , Florestas , Biodiversidade , Ciclo do Carbono , China , SoloRESUMO
The aim of this study was to evaluate the efficacy and toxicity of stereotactic body radiation therapy (SBRT) in the treatment of patients with liver metastases. Between August 2006 and July 2011, patients with 1-4 liver metastases were enrolled and treated with SBRT using the CyberKnife(®) system at Tianjin Medical University Cancer Institute and Hospital. The metastases were from different primary tumors, with a maximum tumor diameter of less than 6 cm. The primary endpoint was local control. Secondary endpoints were overall survival, progression-free survival, distant progression-free survival, and adverse events. Fifty-seven patients with 80 lesions were treated with SBRT. The 1-year and 2-year local control rates were 94.4% and 89.7%, respectively. The difference in local control between patients who received adjuvant treatment before SBRT and those who did not reached statistical significance (P=0.049). The median overall survival for the entire cohort was 37.5 months. According to the primary tumor sites, the median overall survival was not reached. The 2-year overall survival rate was 72.2% in the favorable group (primary tumors originating from the colon, breast, or stomach, as well as sarcomas); however, in the unfavorable group (primary tumors originating from the pancreas, lung, ovary, gallbladder, uterus, hepatocellular carcinoma, as well as olfactory neuroblastoma), the median overall survival and 2-year overall survival rates were 37.5 months and 55.9%, respectively (P=0.0001). Grade 1-2 fatigue, nausea, and vomiting were the most common adverse events, and no grade 3 and higher adverse events were observed. With excellent local control in the absence of severe toxicity, SBRT provides an alternative for patients with 1-4 liver metastases who cannot undergo surgery or other treatments.
Assuntos
Artroplastia de Quadril/métodos , Necrose da Cabeça do Fêmur/complicações , Fraturas do Quadril/complicações , Fraturas do Quadril/cirurgia , Acidentes por Quedas , Adulto , Artroplastia de Quadril/reabilitação , Cimentos Ósseos , Necrose da Cabeça do Fêmur/diagnóstico por imagem , Seguimentos , Fraturas do Quadril/diagnóstico por imagem , Humanos , Instabilidade Articular/complicações , Instabilidade Articular/diagnóstico por imagem , Instabilidade Articular/cirurgia , Masculino , Pessoa de Meia-Idade , Cuidados Pós-Operatórios/métodos , Amplitude de Movimento Articular/fisiologia , Recuperação de Função Fisiológica , Medição de Risco , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X/métodos , Resultado do TratamentoRESUMO
Based on the meteorological data and remote sensing data, and by using vegetation-climate comprehensive model and CASA model, this paper analyzed the climate change trend and the spatiotemporal pattern of alpine grassland potential and actual net primary productivity (NPP) in Qiantang Plateau. In 1955-2004, the mean annual temperature and annual cumulated precipitation in the Plateau increased by 1.37 degrees C and 63 mm, respectively. The climate in the central and eastern parts of the Plateau became warmer and wetter, whereas it was warmer and dryer in the western part. However, the regional climate change did not yet result in grassland degradation. The mean potential NPP of alpine grassland was in the order of eastern part > central part > western part. From 1982 to 2004, the potential NPP in the central part had the largest increment (0.55 t x hm(-2) x a(-1)), followed by in the eastern part (0.51 t x hm(-2) x a(-1)) and western part (0.21 t x hm(-2) x a(-1)), which was consequent with the spatiotemporal pattern of climate change in the study area. In contrast, the actual NPP in the eastern, central, and western parts in the past two decades was -0.19, -0.03, and 0.20 t x hm(-2) x a(-1), respectively. Overgrazing was the main reason of grassland degradation in the central and eastern parts, and the central part was the key layout area for the implement of 'grazing withdrawal and management of grassland' project.
Assuntos
Mudança Climática , Temperatura Baixa , Conservação dos Recursos Naturais , Ecossistema , Poaceae/crescimento & desenvolvimento , Altitude , Modelos Teóricos , Comunicações Via Satélite , TibetRESUMO
OBJECTIVE: To study the efficacy and toxicity of cyberknife radiosurgery for primary hepatic carcinoma. METHODS: From September 2006 to March 2008, 17 patients with clinical stage I-III primary hepatic carcinoma were treated with cyberknife at Tianjin Cancer Hospital. 12 patients received previous treatment of surgery, or interventional therapy or radiofrequency therapy before the cyberknife radiosurgery. Totally 23 lesions in the liver were treatment. The median planning target volume (PTV) was 75 ml (13 - 351 ml). Fiducials were placed in or adjacent to the tumor one week before the CT scan simulation. The median total prescription dose was 45 Gy (range: 39 - 52 Gy) at 3-8 fractions and the median prescription isodose lines was of 78.0% (range: 75.0% - 81.0%. RESULTS: The follow-up time was 3-30 months (median: 14 months). All patients finished the treatment and slightly fatigue was the most common complain. There were 12 patients alive and 5 patients died. All the lesions in liver treated by the cyberknife radiosurgery achieved local control. CONCLUSION: The cyberknife radiosurgery for primary hepatic carcinoma showed a high rate of local control and minimal toxicity. Long time follow-up is necessary to evaluate the survival data and late toxicity.
Assuntos
Carcinoma Hepatocelular/cirurgia , Neoplasias Hepáticas/cirurgia , Radiocirurgia/métodos , Adulto , Idoso , Carcinoma Hepatocelular/patologia , Feminino , Marcadores Fiduciais , Seguimentos , Humanos , Neoplasias Hepáticas/patologia , Neoplasias Pulmonares/secundário , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Indução de Remissão , Taxa de SobrevidaRESUMO
OBJECTIVE: To study the microscopical features of Scolopa chinensis. METHODS: By microscope, the tissue characteristics and the powder characteristics were studied. RESULTS: The results are accurate and practical. CONCLUSION: These Characteristics can provide evidences for the identifcation of Scolopa chinensis.
Assuntos
Plantas Medicinais/anatomia & histologia , Salicaceae/anatomia & histologia , Folhas de Planta/anatomia & histologia , Folhas de Planta/citologia , Raízes de Plantas/anatomia & histologia , Raízes de Plantas/citologia , Caules de Planta/anatomia & histologia , Caules de Planta/citologia , Plantas Medicinais/citologia , Pós , Salicaceae/citologiaRESUMO
OBJECTIVE: To established models of confirmatory factor analysis of the emotional stability criteria of flying students, and to provide an available criteria tool for evaluating the emotional stability. METHOD: "Criterion Assessment Scale of Emotional Stability of Flying Cadets" (ACSEFC) including 9 items were compiled first by interviewing with skillful pilots or flying instructors, and then the emotional stability of 153 flying students was evaluated by these pilots or instructors. RESULT: There were high level (P<0.05) of correlation coefficients between 8 items except for item 1; three-factor design appears to be the best choice for the nine items by exploratory factor analysis; model 4 appears to have the best effect by confirmatory factor analysis. CONCLUSION: The evaluation of emotional stability of flying students can be divided into 3 parts: general manifest emotion, tense before flying and flying emotion stability.