放疗对喉癌患者T淋巴细胞亚群、IL-2、TNF及Bcl-2表达的影响

目的:探讨放疗对喉癌患者T淋巴细胞(T-LC)亚群、白细胞介素-2(IL-2)、肿瘤坏死因子(TNF)及B cl-2表达量的影响。方法:对40例喉癌患者血CD 4、CD 8、IL-2、TNF及肿瘤组织中B cl-2采用单克隆抗体碱性磷酸酶法、EL ISA放免法和免疫组化法进行检测,并与30例正常人作对照。结果:喉癌患者血CD 4、IL-2及TNF含量均明显低于正常者(P<0.01),放疗后CD 4、IL-2及TNF含量低于放疗前;喉癌患者放疗前血CD 8含量与正常人比较差异无显著性(P>0.05),放疗后则明显升高(P<0.05);放疗后喉癌组织中B cl-2表达水平低于放疗前(P<0.05)。结论:检测喉癌患者T-LC亚群、IL-2及TNF,对评价患者免疫状况及活体病变程度、判断疗效有指导意义;B cl-2则对判断肿瘤细胞存活状况有指导意义。     

Treatment outcomes and target delineation utilizing CT and MRI in 13 dogs treated with a uniform stereotactic radiation therapy protocol (16 Gy single fraction) for pituitary masses: (2014‐2017)

Canine pituitary tumours are increasingly treated with stereotactic radiotherapy (SRT). Here, we report clinical outcomes in dogs treated with single‐fraction SRT; we also explore technical aspects of SRT treatment planning. A single‐institution retrospective study was performed, including any dog with a pituitary mass (PM) that was treated using a standardized single‐fraction (16 Gy) SRT protocol between 2014 and 2017. Via medical records review, 13 cases were identified. Nine dogs neurologically improved after SRT. Four dogs experienced MRI‐documented tumour volume reduction. Nine dogs experienced neurologic decline in 1.5 to 18 months after SRT and were euthanized. The median overall survival time was 357 days, with 15% alive 18 months after SRT. To better understand whether SRT target delineation is predictably altered by use of magnetic resonance imaging (MRI) in addition to computed tomography (CT), two radiation oncologists (RO) retrospectively re‐evaluated all imaging studies used for SRT planning in these 13 cases. Gross tumour volume (GTV) was contoured on co‐registered CT and MRIs for each case. In seven cases, CT alone was deemed inadequate for GTV contouring by at least one RO. T1 post‐contrast MRI was considered the ideal image for GTV contouring in 11 cases. Contouring on MRI yielded larger GTV than CT for 11 cases. Inter‐observer variability existed in each case and was greater for MRI. In summary, use of co‐registered CT and MRI images is generally considered advantageous for PM delineation when using SRT. Notably, survival times reported herein are shorter than what has previously been reported for PM treated with finely fractionated full‐course RT protocols.