Analyses of the factors influencing the accuracy of three-dimensional ultrasound in comparison with cone-beam CT in image-guided radiotherapy for prostate cancer with or without pelvic lymph node irradiation.

BACKGROUND: Three-dimensional ultrasound (3DUS) is an attractive option in image-guided radiotherapy (IGRT) for prostate cancer (PCa) patients. However, the potential factors influencing the accuracy of 3DUS in comparison with cone-beam CT (CBCT) in IGRT for PCa patients haven't been clearly identified. METHODS: The differences between US/US and CBCT/CT registrations were analyzed over 586 and 580 sessions for 24 and 25 PCa patients treated with or without pelvic lymph node irradiation, respectively. The clinical factors that may influence registration differences were also evaluated. RESULTS: The average discrepancies between US/US and CBCT/CT registrations were - 0.28 ± 5.28 mm, - 0.16 ± 3.48 mm, and - 0.47 ± 4.31 mm in the superior-inferior (SI), left-right (LR), and anterior-posterior (AP) directions, respectively. The discrepancies were respectively less than 5 mm longitudinally, laterally, and vertically in 64.4 and 70.1%, 84.9 and 89.2%, and 75.9 and 79.1% of the patients treated with or without pelvic lymph node irradiation, respectively. The registration differences were significantly smaller at least in one direction in patients younger than 70 years, without pelvic lymph node irradiation, guided by transperineal ultrasonography and had a bladder volume smaller than 300 mL. CONCLUSIONS: Age, irradiated regions, 3DUS modality, and bladder volume are important factors that may influence the differences between US/US and CBCT/CT registrations. 3DUS guidance is more feasible for younger PCa patients with a better control of bladder volume during the treatment and those who did not undergo pelvic lymph node irradiation.

Antioxidant capacity of anthocyanins from Rhodomyrtus tomentosa (Ait.) and identification of the major anthocyanins.

The anthocyanins in the fruits of Rhodomyrtus tomentosa (ACN) were extracted by 1% TFA in methanol, and then purified by X-5 resin column and C18 (SPE) cartridges. The purified anthocyanin extract (ART) from the fruits of R. tomentosa showed strong antioxidant activities, including DPPH radical-scavenging capacity, ABTS radical scavenging capacity, reducing power and oxygen radical absorbance capacity (ORAC). The purified anthocyanin extract was analyzed by high performance liquid chromatography (HPLC). The major anthocyanins were purified by semi-preparative HPLC and Sephadex LH-20 column chromatography, and were identified as cyanidin-3-O-glucoside, peonidin-3-O-glucoside, malvidin-3-O-glucoside, petunidin-3-O-glucoside, delphinidin-3-O-glucoside and pelargonidin-3-glucoside by HPLC-ESI/MS and nuclear magnetic resonance spectroscopy (NMR). Cyanidin-3-O-glucoside was considered as the most abundant anthocyanin, which was 29.4 mg/100 g dry weight of R. tomentosa fruits. Additionally, all the major anthocyanins were identified from R. tomentosa fruit for the first time.

Locoregional recurrence of pT3N0M0 breast cancer after mastectomy is not higher than that of pT1-2N0M0: an analysis for radiotherapy.

The purpose of this study was to investigate the value of post-operative radiotherapy in the treatment of pT3N0M0 breast cancer after mastectomy. We analyzed the clinical data of 1390 patients with pT1-3N0M0 breast cancer who were admitted and treated from 1998 to 2007 at the Sun Yat-sen University Cancer Center. All patients underwent mastectomy and did not receive radiotherapy. The locoregional recurrence-free survival, distant metastasis-free survival and overall survival of different T stages of breast cancer were compared. The median follow-up duration was 72 months. The 10-year locoregional recurrence-free survival patients with pT1N0, pT2N0 and pT3N0 breast cancers were 95.3, 91.9 and 93.6%, respectively (χ(2) = 2.550, P = 0.279). The 10-year distant metastasis-free survival rates of patients with pT1N0, pT2N0 and pT3N0 breast cancers were 88.1%, 81.0% and 78.4%, respectively (χ(2) = 8.254, P = 0.016). The 10-year overall survival rates of patients with pT1N0, pT2N0 and pT3N0 breast cancers were 91.9%, 83.5% and 73.0%, respectively (χ(2) = 12.403, P = 0.002). Univariate analyses failed to identify any prognostic factors for locoregional recurrence in pT3N0 patients. Multivariate analysis showed that the T stage had no effect on locoregional recurrence. The locoregional recurrence rate in patients with pT3N0M0 breast cancer who underwent mastectomy and did not receive postoperative radiotherapy was not higher than that in patients with pT1-2N0M0 breast cancer who received the same treatment, suggesting that routine adjuvant post-operative radiotherapy should not be recommended in this patient population.