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Neoadjuvant chemotherapy followed by surgery (NCS) is a common therapy pattern of non-small cell lung cancer (NSCLC). However, patients treated with NCS still suffer from relatively high locoregional recurrence. Postoperative radiotherapy (PORT) plays an important role in improving locoregional control, whereas its effect on survival remains controversial. Some studies propose that PORT yields no survival benefits for stage Ⅱ-Ⅲ A(N 2) patients treated with NCS, whereas other researches indicate that PORT can bring survival benefits for high-risk patients. The indications of PORT include R 1/R 2 resection and ypN 2. PORT is recommended with three-dimensional conformal therapy (3D-CRT) or intensity-modulated radiotherapy (IMRT) within the dose range of 50-54 Gy (R 0 resection). The target volume is inconclusive and the irradiation range of mediastinum involving with the metastatic lymph node regions is recommended in many studies. The adverse effects of PORT are acceptable in most studies.Nevertheless, the evidence level of relevant studies is relatively low. These results remain to be clarified by prospective randomized clinical trials.
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Objective:To establish the mouse model with radiation-induced pulmonary fibrosis, and to identify and analyze it from the aspects of function, imaging and pathology.Methods:Thirty C57BL/6 mice were randomly divided into the control group, 16 Gy irradiation group and 20Gy irradiation group. The mice in the irradiation groups received a single 16 Gy or 20 Gy chest X-ray irradiation, and underwent functional examination, imaging examination and pathological examination at 3 and 6 months after irradiation.Results:At 6 months after irradiation, hair on the chest and back of the mice turned white and fell off, and the airway resistance was increased significantly. CT images showed extensive patch shadows and consolidation in the lung. Three dimensional reconstruction suggested that the lung of mice was distorted and deformed, and the volume was decreased significantly. Pathological examination confirmed that there was extensive pulmonary fibrosis.Conclusions:Significant pulmonary fibrosis occurs after 6 months of chest irradiation in mice. The animal model of radiation-induced pulmonary fibrosis in C57BL/6 mice was successfully established.
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For non-small cell lung cancer (NSCLC) patients with positive surgical margins, the survival rates can be dramatically decreased. However, high-level evidence is lacking in the standard adjuvant treatment for NSCLC patients with positive surgical margins. In this article, consensus and disputes on the adjuvant therapy for NSCLC patients with positive surgical margins were reviewed.
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Objective:To investigate the killing effect of radiation on echinococcus in vitro culture and its effect on the mRNA expression of growth arrest and DNA damage 45 alpha (Gadd45α) gene. Methods:Echinococcus from naturally infected sheep liver was cultured in vitro and divided into 7 groups. The echinococcus was irradiated with 6 MeV at doses of 0 (control), 20, 40, 60, 80, 100, and 120 Gy, respectively. The growth of echinococcus was observed under light microscope at 1, 3, 5 and 7 d after the radiation. The expression of Gadd45α mRNA in control, 20, 40 and 60 Gy groups of echinococcus was detected by RT-PCR technique at 7 d after the radiation. Results:The disintegration and exfoliation of echinococcus were observed under light microscope at 1, 3, 5 and 7 d after the radiation, and the death rate of echinococcus was positively correlated with the radiation dosages ( r = 0.81, P < 0.05). After the radiation at 7 d, compared with the control group (100.00 ± 0.00), the mRNA expression levels of Gadd45α in echinococcus of 20, 40, and 60 Gy groups were significantly increased (279.74 ± 80.08, 759.38 ± 160.98, 1 666.68 ± 316.36, P < 0.01), and it was positively correlated with the radiation dosages ( r = 0.93, P < 0.01). Conclusion:Radiation has a certain killing effect on echinococcus cultured in vitro, and there is a certain dose-effect relationship with the radiation dosages, and Gadd45α gene may be involved in the molecular mechanism of radiation-induced killing of echinococcus in vitro.
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Objective@#To investigate the effect of different mechanisms of liver-protection drugs in clinic and compare which one is best for the proliferation of irradiated HL-7702, laying the basis of liver-protection drugs choose in clinic on theory and practice.@*Methods@#Human liver parenchyma cells HL-7702 were given single 6 MV X ray irradiation at a dose of 10Gy, the cells’ morphology were detected under an inverted microscope at 24h, 48h and 72h. Then, MTT was used to assess the survival rate of the cells to evaluate the effect of the X ray. The representive medicines which mechanism may relate to RILD were chosen and diluted into various concentrations with culture medium according to clinical and relative reports. Different concentrations of medicines were used to protect the cells damaged by the X ray. Comparing the effect with MTT and measure SOD, MDA for the best one. Further research on its protection of oxidative damage. T-test, F test and non- paramiter test were used for statistical analysis.@*Results@#2.5 mg/ml and 1 mg/ml of magnesium isoglycyrrhizinate both have an effect on the proliferation of liver cells, especially the concentration of 1 mg/ml. The injection of polyene phosphatidyl choline show trivial effect at the concentrations of 250 μmol/L and reduced glutathione(GSH) did not demonstrate relative functions. Further research on the magnesium isoglycyrrhizinate, found its protection at 48h to oxidative damage (P < 0.05), but the effect is weak at 24h and 48h.@*Conclusions@#In three kinds of representing medicines, magnesium isoglycyrrhizinate has preferable effects on liver parenchyma cells and show a bright future in the treatment of RILD.
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Objective To observe the effects of Coix seed injection on the cell viability and radiosensitivity of human hepatoma cell line Bel-7402.Methods Bel-7402 cells were irradiated by X-rays,or treated with Coix seed injection,or treated with both of them.The cells proliferation and apoptosis were detected by MTT and by flow cytometry respectively.Cell cloning was used to observe the number of viable cells and to draw the cell survival curve.The mRNA and protein level of Bax,Bcl-2 were detected by RT-PCR and Western blot respectively.Results It was found that the Coix seed injection group (12 μmol/L) and X-ray group (8 Gy) had a significant inhibitory effect on the growth of hepatocellular carcinoma cells (t =17.03,11.26,P ＜ 0.05).And compared with Coix group and irradiation group,the combined treatment group showed higher inhibition rate (t =24.80,20.19,P ＜0.05).The mRNA and protein levels of Bax were gradually elevated (F =437.92,67.91,P ＜ 0.05),while the expressions of Bcl-2 reflected a decreased trend (F =31.18,48.50,P ＜ 0.05).The D0 values of pure irradiation group and combined treatment group were 4.27 and 3.34,respectively,and the sensitization enhancement ratio was 1.27.Conclusions The Coix seed injection inhibit cell growth and induce apoptosis,as well as increase radiative sensitization may via the apoptosis related factors Bax and Bcl-2 in hepatocellular carcinoma.
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Objective To study the recogniting patients identity for the safety and reliability of radiotherapy. Methods Through PDCA 4 footwork, namely, plan, do, check, action the technicians in the hospital to improve patients' identity verification.Results After 4 months of PDCA cycle,the patient identity verification qualified rate increase gradually,from 88.17% up to 99.07%,the privacy of patients satisfaction rate rose from 52. 69% to 98. 15%. The patients identification accuracy rate of 100%, technicians working efficiency has been greatly improved. Conclusions The measure of patient identification can improve the working process of radiotherapy for safety and efficiency and can get better privacy protection.
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Objective To investigate the prognostic factors of survival time of the Uygur and Han nation-ality elderly patients( over 60 years) with pancreatic cancer in Xinjiang.Methods We carried on a retrospective study of 313 aged patients diagnosed with pancreatic cancer in The First Affiliated Hospital of Xinjiang Medical University from January 1st,2003 to May 30th,2015.We used Kpalan-Meier method for calculation of survival, used Log-rank method for those factors which could affect the prognosis of patients,at last we used Cox propor-tional risk model for those multiple factors which match the role.Results Three hundred and thirteen cases with pancreatic cancer had a median survival of 157 days,and survival rates of half a year,1 and 2 year were 34.8%, 18.5%,7.0%.There was a statistic difference between Uygur patients′and Han patients′survival time(P<0.05).Single factor analysis showed the nationality,tumor size,surgery,ZPS(ECOG),Clinical stage(TNM), chemotherapy and radiotherapy,carcino-embryonic antigen(CEA)level and cancer antigen 199(CA199)level before treatment with outcome(P<0.05).Multiple factor analysis showed that the clinical stage,surgery(P<0.05)can be regarded as independent prognostic decision factors.Conclusion The clinical staging,surgical treatment could be regarded as independent prognostic factors for the elderly prognosis of pancreatic cancer.Both of the Han and Uygur patients,earlier discovered and more appropriate surgery treatment are the key for the elder-ly patients with pancreatic cancer.
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Objective To systematically evaluate the efficacy and safety of stereotactic body radiotherapy (SBRT) for resectable stage Ⅰ non-small cell lung cancer (NSCLC).Methods Clinical trials of SBRT or surgery for resectable stage Ⅰ NSCLC were collected by computerized search of Cochrane Library,MEDLINE,EMbase,CBM,CNKI,and VIP.Literature selection,quality evaluation,and data extraction were performed by two inspectors based on the inclusion and exclusion criteria.A meta-analysis was performed on the enrolled studies using RevMan 5.3 software.Results A total of four clinical trials involving 410 patients were included.The results of meta-analysis showed that there was no significant difference in 3-year overall survival rate between SBRT and surgery (RR=1.13,95％ CI=0.66-1.94,P=0.66);there was no significant difference in local control rate between SBRT and surgery (RR=0.71,95％ CI=0.26-1.93,P=0.50);patients treated with SBRT had significantly lower incidence rates of grade 3-4 adverse reactions than those treated with surgery (RR=0.29,95％ CI=0.16-0.53,P=0.000).Conclusions SBRT shows equivalent efficacy to surgery in the treatment of resectable stage Ⅰ NSCLC.However,due to the limitations in this systematic evaluation,the conclusion needs to be further confirmed by large randomized controlled trials.
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Objective To analyze the clinical epidemiology of primary hepatocellular carcinoma (PHC) in the Xinjiang region. Methods Clinical data of the patients with PHC were collected at First Affiliated Hospital of Xinjiang Medical University from 5 577 cases from January 2002 to December 2014, their gender, race, age, household distribution, hepatitis virus-positive rate were analyzed retrospectively. Results Among the 5 577 eases, the men/women gender ratio was 3.45∶1;the proportion of Han, Uighur, Kazakh, and other ethnic groups (Hui, Mongolian, Manchu, Xibo) was 79.67%, 9.86%, 4.55%, 3.31%and 2.61%, respectively. The Constituent ratio difference between Uighur and Han was significant (P<0.05);4 232 patients had hepatitis B surface antigen (HBsAg) detection, and 3 833 patients had HCV antibody (HCV-Ab) detection. HBsAg was positive in 2 560 cases (60.49%), HCV-Ab was positive in 490 cases (12.78%). Hepatitis B virus detection positive rate in Uygur was 35.52%, in Kazak was 40.00%, which was lower than the Han's (65.68%, P<0.05). Urban and rural population had 3589 cases (64.35%) and 1988 cases (35.65%). Conclusion An increased risk for PHC was found in hepatitis virus-positive patients, the Xinjiang Uygur and Kazak people had significantly lower prevalence of HBV infection than the Han's. Appropriate measures should be taken for clinical diagnosis, treatment and prevention of PHC.
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Objective To investigate the relationship of PI3K/Akt signaling pathway with the activation of hepatic stellate cells (HSC) and its role in radiation-induced hepatic fibrosis.Methods HSC was treated with 6 MV X-ray irradiation (IR) together with the inhibitor of PI3K/Akt signaling pathway.The cells were divided into inhibitor group,10 Gy IR group,10 Gy + inhibitor group,20 Gy IR group,an 20 Gy + inhibitor group and blank control group.Then cell apoptosis rate was detected,the expression of transforming growth factor β1 (TGF-β1) in cell supernatant and the mRNA expressions of α-smooth muscle actin (α-SMA) and phosphorylation protein kinase B (p-Akt) were measured.Results Compared with the control group,the apoptosis rate of 10 and 20 Gy IR group increased with irradiation dose (t =8.43,11.63,P ＜0.05) but they were reduced by the inhibitor of PI3K/Akt (t =8.09,4.88,P ＜0.05).The expressions of TGF-β1,α-SMA,and p-Akt also increased with irradiation dose (t =6.91,7.80,9.28,P＜0.05) but they were declined by this inhibitor for both 10 Gy IR (t =6.17,15.11,10.34,P＜0.05) and 20 Gy IR (t =10.04,6.85,23.84,P＜0.05).Conclusions X-ray irradiation could activate HSC through PI3K/Akt signaling pathway,which may further result in hepatic fibrosis.
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<p><b>OBJECTIVE</b>This study was aimed to understand the clinical characteristics and prognosis in Uighur patients with Non-B Non-C hepatocellular carcinoma (HCC) and virus-related HCC.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 301 Uighur HCC patients, among them, there were 145 NBC-HCC cases and 156 virus-related HCC cases. The overall survival rates of the patients were analyzed by Kaplan-Meier method, and the factors that may influence the prognosis and survival of NBC-HCC patients were analyzed using univariate (Log rank test) and multivariate Cox proportional hazard model.</p><p><b>RESULTS</b>The differences of the gender, living region, history of diabetes, body mass index (BMI), history of cirrhosis, TNM stage, Child-Pugh scores, total bilirubin, and AFP level between the NBC-HCC group and viral-HCC group were statistically significant (P < 0.05 for all). The 1-, 2-, 3- and 5-year survival rates were 35.6%, 20.3%, 12.6%, and 4.5%, respectively, for all the 301 patients, and no significant difference between these two groups in terms of OS (P > 0.05). Multivariate analysis by Cox model showed that age, TNM staging, PVTT, Child-Pugh scores, TACE combined with radiotherapy or RFA were significant independent prognostic factors (all P < 0.05).</p><p><b>CONCLUSIONS</b>The clinical characteristics in Uighur patients with non-B non-C HCC and hepatitis virus-related HCC are not all the same and HCC in Xinjiang region has certain regional characteristics and features. Age, TNM stages, portal vein tumor thrombus, Child-Pugh scores, and TACE combined with radiotherapy or RFA are significant independent prognostic factors.</p>
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Female , Humans , Male , Age Factors , Carcinoma, Hepatocellular , Ethnology , Mortality , Therapeutics , Virology , Hepatitis C , Virology , Kaplan-Meier Estimate , Liver Neoplasms , Ethnology , Mortality , Therapeutics , Virology , Multivariate Analysis , Neoplasm Staging , Portal Vein , Prognosis , Proportional Hazards Models , Retrospective Studies , Sex Factors , Survival Rate , Thrombosis , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To discuss the effect of limited head and neck squamous cell carcinomas human papillomavirus(HPV) infection status on the prognosis in different nationalities of Xinjiang.</p><p><b>METHODS</b>The clinical data of 149 cases of head and neck squamous cell carcinoma from Uighur, Han and Kazak was analyzed. The HPV16/18 infection and viral load was examined.The prognosis was analyzed by cox multiIvar-Iate model. The effect of HPV infection status on prognosis was evaluated.</p><p><b>RESULTS</b>In this study, Oropharyngeal HPV infection rate was 35.0%, followed by hypopharynx 30.0%, oropharyx was 16.0%. The overall survival rate of 3 years and 5 years was 66.4%, and 39.2% respectively. The clinical stage,N stage and HPV were influencing factors for the prognosis of patients with head and neck squamous cell carcinoma (P< 0.05). N stage and HPV were independent prognostic factors for the prognosis of patients with head and neck squamous cell carcinoma (P< 0.05).</p><p><b>CONCLUSIONS</b>There is a high rate of HPV infection in oropharynx in head and neck cancer. HPV positive is a protective factor for the prognosis of head and neck cancer, and the risk of death in patients with HPV was 3/5 lower than that of HPV negative patients. HPV viral load may be positively related to the total survival rate. N stage is a risk factor for the prognosis of head and neck cancer. Different nationalities have little influence on prognosis.</p>
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Humans , Carcinoma, Squamous Cell , Ethnology , Mortality , Pathology , Virology , China , Ethnicity , Head and Neck Neoplasms , Ethnology , Mortality , Pathology , Virology , Human papillomavirus 16 , Human papillomavirus 18 , Neoplasm Staging , Papillomavirus Infections , Diagnosis , Mortality , Virology , Prognosis , Proportional Hazards Models , Survival Rate , Time Factors , Viral LoadABSTRACT
Objective To analyze the therapeutic effects of different treatment modalities in patients with tongue squamous cell carcinoma.Methods A retrospective analysis was performed on the complete clinical and follow-up data of 132 patients with pathologically confirmed tongue squamous cell carcinoma,who were initially treated at the First Affiliated Hospital of Xinjiang Medical University from 2003 to 2011.The Kaplan-Meier method was used to calculate the overall survival (OS) rates for patients who received surgery alone (S),radiotherapy alone (R),surgery plus radiotherapy (S + R),chemotherapy plus surgery (C + S),chemotherapy plus radiotherapy (C + R),and surgery,radiotherapy,and chemotherapy (S + R + C).The OS was compared between these groups by log-rank test.Multivariate analysis was performed using the Cox proportional hazard model to establish independent treatment modalities as prognostic factors.Results The follow-up rate was 100％.The 3-year sample size was 94.The 3-year OS rate for all patients was 72.7％.The univariate analysis showed that among 70 stage Ⅰ and Ⅱ patients,the S,R,S + R,C + S,and S + R + C groups had 3-year OS rates of 86％,67％,97％,100％,and 82％,respectively (P =0.018) ;among 62 stage Ⅲ and Ⅳ patients,the S,R,S + R,C + S,C + R,and S + R + C groups had 3-year OS rates of 38％,14％,92％,40％,14％,and 67％,respectively (P =0.000).The multivariate analysis showed that S + R and S + R + C were independent prognostic factors (P =0.000 and 0.005).onclusions Surgery alone or combination therapy including surgery has a good therapeutic effect for stage Ⅰ-Ⅱ tongue squamous cell carcinoma,while S + R and S + R + C are better treatment modalities for stage Ⅲ-Ⅳ disease;however,advanced patients have a poor prognosis after being treated with R and C + R modalities.
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Objective To evaluate the treatment outcome and prognostic factors in patients with grade Ⅲ/Ⅳ glioma following postoperative chemoradiotherapy.Methods A retrospective analysis was performed on the medical records of 119 patients with grade Ⅲ/Ⅳ glioma who received treatment in our hospital from January 2007 to April 2012.Of the 119 patients,49 received radiotherapy alone,21 received radiotherapy combined with nitrosoureas,and 49 received radiotherapy combined with temozolomide.The Kaplan-Meier method was used to calculate overall survival (OS) rates and recurrence rates.The Cox regression model was used for multivariate prognostic analysis.Results The follow-up rate was 94.1％.Fifty-three patients were followed up for at least 1 year,and 10 for at least 2 years.The overall recurrence rate was 69.7％.The 1-and 2-year OS rates were 44.5％ and 8.4％,respectively.The multivariate analysis showed that age,presence or absence of seizures before surgery,extent of tumor resection,and radiotherapy plus concurrent and adjuvant temozolomide were the main prognostic factors for tumor recurrence (P =0.002,0.005,0.000,and 0.000).The above factors and the pathological grade of tumor were the independent prognostic factors for patients' survival (P =0.006,0.010,0.000,0.000,and 0.001).Conclusions Postoperative radiotherapy plus concurrent and adjuvant temozolomide produce a good clinical effect in patients with grade Ⅲ/Ⅳ glioma.Age of ＜ 60 years,no seizures before surgery,total tumor resection,and pathological grade Ⅲ of tumor are the favorable prognostic factors for the long-term survival in patients with malignant glioma.
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it was 4% (3/75). GP73-positive rate in HCC was higher than that of the normal liver tissues (χ2=73.60, P0.05). GP73 was associated with survival but not sCLU. Conclusion:GP73 and sCLU have higher positive rates in HCC and GP73 is positively correlated with sCLU. The expression of GP73 and sCLU are probably closely related with the invasion of HCC, which can help evaluate the prognosis of the patients.
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10.3969/j.issn.1007-3969.2013.05.008
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Objective To compare the treatment outcome and prognostic factors in patients with advanced cervical cervical cancer between Han and Uygur in Xinjiang district.Methods 204 patients with advanced cervical cancer were retrospectively analyzed.Eighty patients were Han 80 and 124 were Uyghur.100 patients received radiotherapy alone and 49 with concurrent radiochemotherapy,and 55 had brachytherapy followed by surgery.The survival rate was calculated by Kaplan-Meier method and the difference was compared by Logrank test.Multivariate analysis was performed using Cox regression model.Results The follow-up rate was 97.5％.The number of patients with at least 5 years of follow up was 102.The 1-,3-and 5-year overall survival rates in Han and Uygur patients were 81.2％,66.3％,51.4％ and 83.4％,62.8％,49.2％,respectively (x2 =3.21,P =0.273).Univariate analysis showed that parity,geographical distribution,pathological type,clinical stage,lymph node involvement and treatment were prognostic factors for overall survival (x2 =2.35,11.34,7.12,6.73,4.79,13.60,P=0.049,0.029,0.031,0.037,0.041,0.021).Multivariate analysis showed that parity,geographical distribution,pathological type,clinical stage,lymph node involvement and treatment were independent prognostic factors for overall survival (x2 =8.36,24.94,10.69,5.63,9.50,P =0.002,0.001,0.021,0.018,0.031).Conclusions There is no significant difference in overall survival rate of patients with advanced cervical cancer between Han and Uighur.Patients with parity more than or equal to 3 times,advanced clinical stage or adenocarcinoma have poor prognoses.
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Objective To explore the application value of Golgi protein-73 (GP73)and AFP in single and combining form in the diagnosis of primary hepatocelluar carcinoma (PHC).Methods Eighty PHC,65 liver cirrhosis,54 chronic hepatitis patients and 50 controls were selected in the First Afiliated Hospital in Xinjiang Medical University from May to September in 2011,GP73 was detected by ELISA and AFP was measured by clinical chemiluminescence.The sensitivity and specificity of each parameter in single and combining form were evaluated.Results Serum GP73 in PHC group 282.0(163.6-366.7) μg/L,liver cirrhosis group 211.8(107.5-295.7) μg/L,chronic hepatitis group 100.3(61.8-191.3) μg/L and control group 58.3(43.4-83.6) μg/L was tested by Kruskal-Wallis(H =106.6,P ＜0.01).GP73 in PHC group was further compared with liver cirrhosis group,chronic hepatitis group and control group using MannWhitney test,significance was found,(U was 1796.0,826.5,154.0,respectively,all P ＜0.01).In the single form,the sensitivity of GP73 [82.5％ (66/80)] was higher than AFP [66.3％ (53/80),x2 =4.65,P ＜0.05],but the specificity of GP73 [63.3％ (107/169)] was lower than AFP [88.7％ (150/169),x2 =28.91,P ＜0.05].There were 27 AFP negative cases in PHC group,but 22 of them were GP73 positive,making the positive rate of GP73 [81.5％ (22/27)] in PHC patients with AFP negative.There were 14 GP73 negative cases of in PHC group,but 9 of them were AFP positive,making the positive rate of AFP [64.3％ (9/14)] in PHC patients with GP73 negative.In series diagnostic test,the specificity of combining form [95.9％ (162/169)] was higher than AFP [88.7 ％ (150/169),x2 =6.00,P ＜ 0.05] ; in parallel diagnostic test,the sensitivity of combining form [93.8％ (75/80)] was higher than GP73 [82.5％(66/80),x2 =4.84,P ＜0.05].In PHC group,52 patients with HBV infection,10 patients with HCV infection and 18 patients without virus infection,GP73 was 309.5 (170.5-370.5) μg/L,351.0 (274.7-397.9) μg/L and 210.1 (156.8-306.7) μg/L,respectively,no significance was found (H =4.0,P ＞0.05).Conclusion GP73 and AFP have a complementary feature of sensitivity and specificity in the early diagnosis of PHC,some PHC cases with AFP negative can be avoided missing efficiently by parallel diagnostic test.
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ObjectiveTo determine whether prophylactic cranial irradiation (PCI) has a role in the management of patients with non-small cell lung carcinoma (NSCLC)treated with radical intent.MethodsWe searched The Cochrane Library,MEDLINE,EMbase,CBM,CNKI and VIP.The quality of the includedstudieswascriticallyevaluated.Dataanalyseswereperformed usingtheCochrane Collaboration's RevMan 5.1 software.ResultsFour randomized controlled trials involving 905 patients met the inclusion criteria.The results meta-analyses showed the incidence of brain metastases was lower in PCI group compared with the observation group ( x2 =1.98,P =0.000 ) ; but there is no evidence of 1-year overall survival (OS) benefit ( x2 =1.12,P =0.880).Only RTOG 2009 provides prospective data:There were no significant differences in global cognitive function (P =0.600) or ADL ( P =0.880) after PCI,but there was a significant decline in immediate recall (P=0.030) and delayed recall (P =0.008 ) at 1 year,At 1 year,there was no significant differences in QOL after PCI ( P =0.050).Conclusions This systematic review show significantly decreases the risk of BM without improving 1-year OS in NSCLC patient receiving prophylactic cranial irradiation.There is insufficient evidence to support the use of PCI in clinical practice.Where possible,patients should be offered entry into a clinical trial.