Comparison between pelvic MRI, CT, and PET/CT in baseline staging and radiation planning of anal squamous cell carcinoma.

PURPOSE: To investigate the differences in baseline staging of anal squamous cell carcinoma based on CT, MRI, and PET/CT, and the resultant impact on the radiation plan. METHODS: This retrospective study included consecutive patients with anal squamous cell carcinoma who underwent baseline pelvic MRI, CT, and PET/CT (all examinations within 3 weeks of each other) from January 2010 to April 2020. CTs, MRIs, and PET/CTs were re-interpreted by three separate radiologists. Several imaging features were assessed; tumor stage was determined based on the eight edition of the American Joint Committee on Cancer (AJCC) staging manual; and T (tumor), N (node), and M (metastasis) categories were determined based on National Comprehensive Cancer Network (NCCN) guidelines. Radiologist assessments were then randomly presented to a radiation oncologist who formulated the radiation plan in a blinded fashion. RESULTS: Across 28 patients (median age, 62 years [range, 31-78], T-category classification was significantly different on PET/CT compared to MRI and CT (p = 0.037 and 0.031, respectively). PET/CT staged a higher proportion of patients with T1/T2 disease (16/28, 57%) compared to MRI (11/28, 39%) and CT (10/28, 36%). MRI staged a higher proportion of patients with T3/T4 disease (14/28, 50%) compared to CT (12/28, 43%) and PET/CT (11/28, 39%). However, there was no significant difference between the three imaging modalities in terms of either N-category, AJCC staging, or NCCN TNM group classification, or in treatment planning. CONCLUSION: Our exploratory study showed that MRI demonstrated a higher proportion of T3/T4 tumors, while PET/CT demonstrated more T1/T2 tumors; however, MRI, CT, and PET/CT did not show any significant differences in AJCC and TNM group categories, nor was there any significant difference in treatment doses between them when assessed independently by an experienced radiation oncologist.

Traditional Chinese medicine syndrome-related herbal prescriptions in treatment of malignant tumors.

OBJECTIVE: To investigate the distribution characteristics of TCM syndromes and the related herbal prescriptions for malignant tumors (MT). METHODS: A clinical database of the TCM syndromes and the herbal prescriptions in treatment of 136 MT patients were established. The data were then analyzed using cluster and frequency analysis. RESULTS: According to the cluster analysis, the TCM syndromes in MT patients mainly included two patterns: deficiency of both Qi and Yin and internal accumulation of toxic heat. The commonly-prescribed herbs were Huangqi (Astraglus), Nüzhenzi (Fructus Ligustri Lucid), Lingzhi (Ganoderma Lucidum), Huaishan (Dioscorea Opposita), Xiakucao (Prunella Vulgaris), and Baihuasheshecao (Herba Hedyotidis). CONCLUSION: Deficiency of Qi and Yin is the primary syndrome of MT, and internal accumulation of toxic heat is the secondary syndrome. The herbs for Qi supplementation and Yin nourishment are mainly used, with the assistance of herbs for heat-clearance and detoxification.