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Objective: To evaluate the safety and feasibility of intraoperative radiotherapy during breast-conserving surgery instead of whole breast radiotherapy in early breast cancer patients., Methods: From July 2008 to December 2012, 36 early breast cancer patients underwent breast-conserving surgery plus interoperative radiotherapy on a Mobetron 1000 mobile electron accelerator. Postoperative recurrence and metastases, complications and cosmetic outcomes were recorded and analyzed., Results: During a median follow-up period of 27.9 months, 2 patients (5.56%) underwent mastectomy after local relapses. There was no occurrence of distant metastasis or mortality. Their average wound healing time was 17 days and 2 of them (5.56%) developed infection while another 2 (5.56%) had delayed wound healing. And 1 patient (2.78%) showed wound edema and neither necrosis nor hematoma was found. The evaluation of cosmetic outcome shows 32 patients (88.89%) were graded as excellent or good while another 4 (11.11%) fair or poor. None had radiotherapy-related acute hemotological toxicity and 2 patients (5.56%) developed skin pigmentation., Conclusion: Intraoperative radiotherapy during breast-conserving surgery instead of whole breast radiotherapy in early breast cancer patients is both safe and reliable with better cosmetic outcomes.

Objective: The purpose of this study was to investigate the association between single nucleotide polymorphism (SNP) of CCND1 A870G and acute adverse events (AEs) in postoperative rectal cancer patients who received capecitabine-based postoperative chemoradiotherapy (CRT)., Methods: Four hundred patients with stage II and III rectal cancer received postoperative CRT of capecitabine with or without oxaliplatin were accumulated and prostectively studied in this study. The patients were randomly divided into two groups. Two hundred and twenty-eight patients were treated with concurrent capecitabine and radiotherapy (Cap-CRT), and 172 patients were treated with capecitabine and oxaliplatin plus radiotherapy (Cap-Oxa-CRT). Adverse events were graded according to the Common Terminology Criteria for Adverse Events, v. 3.0 (CTCAE v3.0). The genotype of CCND1 A870G in the patients was detected by polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP) analysis. The associations between the SNP and acute AEs were indicated by odds ratios (ORs) and 95% confidence intervals (CIs), which were computed with logistic regression model., Results: A total of 136 patients presented severe AEs. Among them the frequencies of the three genotypes GG, GA and AA were 16.9%, 50.7% and 32.4%, compared with 24.6%, 48.1% and 27.3%, respectively, among the patients without severe AEs. Diarrhea was the most common AE, and severe diarrhea occurred in 109 patients. The frequencies of the three genotypes GG, GA and AA were 15.6%, 47.7% and 36.7% among these patients, compared with 24.4%, 49.5% and 26.1%, respectively, among patients without severe diarrhea. Multivariate logistic regression analysis showed a 1.66-fold increased risk for severe diarrhea in patients with AA genotype (95%CI 1.03 - 2.67, P = 0.038) compared with the cases with GG or GA genotypes. Stratified analysis showed that in the Cap-Oxa-CRT group, patients with AA genotype showed a 2.34-fold increased risk for severe diarrhea (95%CI 1.16 - 4.76, P = 0.018) compared with those with GG or GA genotypes, but in the Cap-CRT group, the SNP was not associated with the risk of severe diarrhea., Conclusions: The genetic polymorphism of CCND1 A870G might be a potential biomarker for predicting acute AEs in postoperative stage II and III rectal cancer patients treated with adjuvant concurrent chemoradiotherapy of capecitabine and oxaliplatin.

Objective: To evaluate the prognostic value of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (Her-2) in node-positive breast cancer patients treated by mastectomy., Methods: The clinicopathological data of 835 breast cancer patients treated by mastectomy from January 2000 to December 2004 were retrospectively analyzed. All had positive axillary nodes without distant metastases and with the immunohistochemistry staining of ER, PR and Her-2 available. 764 (91.5%) patients received anthracycline- and/or taxanes-based chemotherapy. 464 (55.6%) patients received hormonal therapy. Eight (1%) patients received trastuzumab. Postmastectomy radiotherapy were given to 352 out of 437(80.5%)patients with T3-T4 and/or N2-N3 disease and 68 out of 398(20.9%)patients with T1-2N1 disease. Patients were classified into 4 subgroups according to the status of hormone receptors (ER and PR, Rec) and Her-2: Rec(-)/Her-2(-) (triple negative), Rec(-)/Her-2(+), Rec(+)/Her-2(+) and Rec(+)/Her-2(-). End points were isolated locoregional recurrence (LRR), distant metastases (DM), disease-free survival (DFS) and overall survival (OS)., Results: 141 (16.9%) patients were Rec(-)/Her-2(-), 99 (11.9%) Rec(-)/Her-2(+), 157 (18.8%) Rec(+)/Her-2(+) and 438 (52.5%) Rec(+)/Her-2(-). Patients with Rec(+)/Her-2(-) breast cancer had a significantly lower 5-year LRR rate than others (6.2% vs. 12.9%, P = 0.004). Compared with patients with Rec(+) breast cancer, patients with Rec(-) breast cancer had significantly higher 5-year DM rate (26.4% vs. 19.7%, P = 0.0008), lower DFS rate (66.7% vs. 75.6%, P = 0.0001) and lower OS rate (71.4% vs. 84.2%, P = 0.0000). In multivariate analysis, Rec(+)/Her-2(-) was significantly associated with lower risk of LRR. Rec(-) was an independent prognostic factor for higher risk of DM, decreased DFS and OS., Conclusion: ER, PR and Her-2 are independent prognostic factors for locoregional recurrence and survival in node-positive breast cancer patients treated by mastectomy.

Objective: To study the role of (125)I seed implantation in the treatment of unresectable pancreatic cancer., Methods: From April 2004 to march 2006, 66 untreated patients with locally advanced pancreatic cancer (LAPC) were randomized into two groups: Group A: (125)I seeds implantation (n = 31) and Group B: control (n = 34). The objective tumor response, clinical benefit response, toxicity, complications and survival of two groups were observed., Results: In Group A, the overall response rate (PR + NC) was 80.6%. Clinical benefit response rate was 54.8%. No toxicity was observed. Gastrointestinal hemorrhage and pancreatic fistula occurred in 1 patient respectively in Group A. The survival rates of 6 and 12 months were 56.0% vs 31.4% and 16.8% vs 2.9% respectively in two groups (P < 0.05). The median survival time of two groups was 8.0 months vs 4.0 months (P < 0.05)., Conclusion: (125)I seed implantation is a simple, safe and effective method in the treatment of locally advanced pancreatic cancer.

Objective: To analyze the role of postmastectomy radiotherapy (PMRT) in moderate- and high-risk elderly breast cancer patients., Methods: The clinicopathological data of 874 breast cancer patients treated with mastectomy and axillary dissection were retrospectively analyzed. The T1-2N1 patients were defined as moderate- risk (IR) group, and T3-4 and/or N2-3 cases as high-risk (HR) group. The locoregional recurrence (LRR) and overall survival (OS) rates were calculated and compared according to different age groups and radiotherapy status. Kaplan-Meier method and Log-rank test was used for calculation and comparison of the survival curves of different patient groups., Results: The median follow up time was 47 months. 108 (12.4%) patients were > or = 65 years. For patients who were < 65 and > or = 65 years, 18.1% and 15.3% received PMRT in the IR group, and 82.7% and 52.2% received PMRT in the HR group, respectively. For patients > or = 65 years, the 5-year LRR rates were 0% and 14.2% (P = 0.242) and 5-year OS rates were 100% and 75.2% (P = 0.159) for the PMRT-IR and non-PMRT-IR groups, respectively. The 5-year LRR rates were 0% and 14.1% (P = 0.061), 5-year OS rates were 84.6% and 77.4% (P = 0.597) for the PMRT-HR and non-PMRT-HR groups, respectively. For patients < 65 years, the 5-year LRR rates were 0% and 9.9% (P = 0.035) and 5-year OS rates were 87.0% and 82.1% (P = 0.739) for the PMRT-IR and non-PMRT-groups, respectively. The 5-year LRR rates were 7.2% and 26.1% (P = 0.000), 5-year OS rates were 79.2% and 57.7% (P = 0.000) for the PMRT-HR and non-PMRT-HR groups, respectively., Conclusion: With the increasing of age, there is a trend of decreasing use of postmastectomy radiotherapy in high-risk breast cancer patients. Postmastectomy radiotherapy can improve the locoregional control for high-risk patients and maybe considered even for those who are > or = 65 years.

Objective: To evaluate the potential benefit of carbon ion radiotherapy (C-ion RT) through comparison with photon intensity-modulated radiotherapy (IMRT) in dose distribution for prostatic adenocarcinoma., Methods: In randomly selected 5 patients, treatment planning of C-ion RT (4 coplanar beams) and IMRT (7 coplanar fields) were worked out by computer working station. In order to make a meaningful comparison, it was defined that the 95% isodose surface had to cover 100% of the PTV in each plan; all dose was given as normalized dose with the definition of the minimum dose of the PTV being equal to 95% of prescribed dose. Dose-volume histograms (DVHs) of the tumor and organ-at-risks (OARs) were calculated. Volume irradiated more than or equal to some specified doses, conformity index ( CI) , and inhomogeneity coefficient (IC) of each treatment plan was compared, respectively., Results: With C-ion RT, the mean irradiated volumes (in %) of the rectum were significantly smaller than that with IMRT except for 95% dose level, and C-ion RT could provide complete protection to the posterior rectal wall. In addition, C-ion RT could also remarkably reduce the dose to the bladder, femoral heads and non-target normal tissues at each dose level. Dose conformation and homogeneity in the target volume of C-ion RT were better than that in IMRT (mean CI50%, 3.36 vs. 5.04, mean CI95%, 1.20 vs. 1.46, mean IC, 0.03 vs. 0.12)., Conclusion: Compared with IMRT, C-ion RT can obtain better dose distribution, and may reduce tumor recurrence and radiation-induced complications in prostatic adenocarcinoma.

Objective: To investigate the changes of gene expression profile in nasal NK/T cell lymphoma., Methods: Total RNA was extracted from the fresh nasal NK/T cell lymphoma tissue and normal lymph node. Fluorescent labeled cDNA was obtained through synthesizing process by reverse transcription. After hybridization in the two identical microarrays consisting of 4096 genes, overexpressed or underexpressed tumor related genes were analyzed., Results: In both experimental group and control group, there were six samples. A total of 365 (8.9%) genes was found to be differentially expressed by a factor of twofold or greater in both of two identical cDNA microarrays, which included oncogenes, tumor supressor genes, cell cycle regulators, apoptotic and antiapoptotic factors, DNA transcription factors, DNA repair and recombination factors, signal transduction genes, protein translation genes, as well as a large number of metabolic genes. Thirty-seven of these genes were found to be differentially expressed by a factor of fourfold or greater. The biochemical functions of these differentially expressed genes were diverse., Conclusion: This study demonstrates that many different kinds of genes are possibly involved in the initiation and progression of nasal NK/T lymphoma. cDNA microarray technique is useful in screening cancer gene expression for nasal NK/T lymphoma.

Objective: This phase I study is to determine the maximal tolerated dose and the dose-limiting toxicity of capecitabine combined with standard radiotherapy (RT) as postoperative adjuvant treatment for rectal cancer patients., Methods: Stage II/III rectal cancer patients 18 - 75 years of age had undergone curative surgery with Karnofsky score > or = 70% were eligible to be included in this study. Total dose of RT DT 50 Gy was delivered to the pelvic area in fraction of 2.0 Gy per day for 5 weeks. Capecitabine was orally administered concurrently with radiotherapy for a total of 2 cycles in escalating doses: twice daily at 12 hour interval for consecutive 14 days as one cycle, separated by a seven day rest, then followed by another cycle. From March 2004 to May 2005, 24 patients were included and treated at the following dose levels: daily 1000 mg/m(2) (3 patients), 1200 mg/m(2) (3 patients), 1400 mg/m(2) (3 patients), 1500 mg/m(2) (3 patients), 1600 mg/m(2) (6 patients), and 1700 mg/m(2) (6 patients). Dose-limiting toxicities (DLT) including grade 3 or grade 4 hematologic and nonhematologic toxicity were observed., Results: Dose-limiting toxicity was observed in one patient treated at dose of 1600 mg/m(2) with grade 3 diarrhea, and in 2 patients at dose of 1700 mg/m(2) with one grade 3 and one grade 4 diarrhea., Conclusion: Diarrhea is the most common dose-limiting toxicity. In our study, the maximal tolerated dose (MTD) of capecitabine given concurrently with radiotherapy was daily 1600 mg/m(2), from D1 to D14 separated by 7-day rest for 2 cycles. Capecitabine given concurrently with standard radiotherapy is safe and tolerable for operated stage II/III rectal cancer patients.

Background & Objective: The prognosis of primary non-Hodgkin's lymphoma (NHL) of the nasal cavity was poor, and the distant metastasis and local relapse rates are high. This study was to analyze the prognostic factors of this disease., Methods: Clinical data of 129 patients with pathologically confirmed nasal NHL, treated from Jan. 1996 to Dec. 2002, were retrospectively reviewed. Of the 129 patients, 116 were diagnosed as nasal NK/T-cell lymphoma. According to the Ann Arbor staging system, 102 patients had stage IE disease, 22 stage IIE, and 5 stage IVE. Among the 124 patients with stage IE or IIE disease, 22 received radiotherapy alone, 7 received chemotherapy alone, and 95 received combined modality therapy (CMT). Of the patients received CMT, 45 received radiotherapy followed by chemotherapy, and 50 received chemotherapy followed by radiotherapy. The stage IVE patients received chemotherapy with or without radiotherapy., Results: The 5-year overall survival (OS) and disease-freely survival (DFS) rates for all patients were 68.0% and 55.8%, respectively. The 5-year OS and DFS rates were 71.7% and 60.9% for stage IE patients, and 70.6% and 47.0% for stage IIE patients, respectively (P>0.05). The 5-year OS and DFS rates were significantly higher in the patients who achieved complete response (CR) than in those who didn't (83.1% vs. 18.0%, 68.0% vs. 15.5%, P<0.01). The 5-year OS rates of the patients with international prognostic index (IPI) score of 0, 1, and > or =2 were 81.1%, 60.1%, and 14.3% (P<0.01), respectively; the 5-year DFS rates were 68.8%, 44.6%, and 22.5% (P<0.01), respectively. Thirty-eight patients developed progression or relapse, with distant extranodal dissemination (78.9%) as the primary pattern of failure. Univariate analysis showed that CR rate, PS, IPI, and modified IPI were related to prognosis. Multivariate analysis showed that CR rate was an independent prognostic factor., Conclusions: CR rate after treatment is an important prognostic factor of nasal NHL. Distant metastasis is the main failure pattern of nasal NHL.

Objective: To analyze initial response rate of radiotherapy and chemotherapy for early nasal NK/T-cell lymphoma, and its prognostic factors., Methods: From January 1996 to December 2002, 116 patients with nasal NK/T-cell lymphoma were diagnosed pathologically. Immunophenotyping was performed in 50 cases. According to Ann Arbor staging classification, 95 patients were stage I(E) and 21 II(E). Of the 116 patients, 22 received radiotherapy alone, 6 chemotherapy alone and 88 combined modality therapy (CMT), including, 41 radiotherapy followed by chemotherapy, and 47 chemotherapy followed by radiotherapy., Results: The 5-year overall survival (OS) rate and disease free survival (DFS) rate for all patients was 74.1% and 61.5%, respectively. For stage I(E) and II(E) patients, the 5-year OS rate was 75.1% and 68% (P = 0.45), and DFS rate was 64.7% and 47.8%, respectively (P = 0.07). The 5 year OS rate and DFS rate were 86.5% and 71.5% for patients who achieved complete response (CR), and 18.4% and 17.2% for those who didn't, respectively (P = 0.000). Sixty-three patients were treated with radiotherapy alone or radiotherapy followed by chemotherapy, while 53 with chemotherapy followed by radiotherapy or chemotherapy alone. The CR rate for radiotherapy was 74.6% while for chemotherapy was 20.8% (P = 0.000). The 5-year OS rate and DFS rate were 76.8% and 65.4% for radiotherapy with or without chemotherapy, and 78.8% and 61.8% for chemotherapy followed by radiotherapy (P > 0.05). Multivariate analysis by COX regression showed that CR rate was the only independent prognostic factor., Conclusion: The CR rate of radiotherapy is much higher than that of conventional chemotherapy. Addition of chemotherapy to radiotherapy do not improve the survival of patients with early stage nasal NK/T-cell lymphoma. Radiotherapy is the primary treatment for stage I and II nasal NK/T-cell lymphoma.

Objective: To evaluate whether involved-field (IF) radiotherapy is equally effective and less toxic in comparison with extended-field (EF) radiotherapy for patients with early-stage Hodgkin's disease (HD) who received combined modality therapy., Methods: The data of 88 early-stage HD patients treated with combined modality therapy were retrospectively reviewed. According to Ann Arbor classification, 12 patients (13.7%) had stage IA disease, 56 stage IIA (63.6%), and 20 IIB (22.7%). Forty-two (47.7%) patients underwent involved field radiotherapy (IF group), whereas the other 46 (52.3%) received extended field radiotherapy (EF group)., Results: Of 6 patients who developed recurrence, 3 (7.1%) were in IF group and the other 3 (6.5%) in EF group. Only one patient's recurrence developed inside the radiation field in EF group. Three patients (7.2%) in IF group and 9 (19.5%) in EF group had WHO grade 1 and 2 leukopenia (P = 0.089). Overall survival rate at 1-, 2- and 3-year was 100.0%, 97.1%, and 97.1% in IF group versus 100.0%, 100%, and 95.8% in EF group (P = 0.86), respectively. Freedom from progression survival rate at 1-, 2- and 3-year was 97.6%, 94.8%, and 91.7% in IF group versus 97.8%, 93.2%, and 93.2% in EF group (P = 0.65), respectively., Conclusion: Compared with extended-field radiotherapy, involved-field radiotherapy is equally effective and less toxic for patient with early-stage Hodgkin's disease treated with combined modality therapy.

Objective: The optimal treatment for primary non-Hodgkin's lymphoma (NHL) of the nasal cavity remains controversial. This study was to analyze the initial response rate of radiotherapy and chemotherapy, and the influence of different treatment modalities on prognosis., Methods: From January 1996 to December 2002, the clinical data of 129 patients with previously untreated nasal NHL were retrospectively reviewed with all lesions confirmed by pathology. 116 patients were morphologically diagnosed as having nasal NK/T cell lymphoma. The immunophenotype was available in 57 cases and 52 (91.2%) of them were confirmed as NK/T-cell lymphoma. According to the Ann Arbor Staging System, 102 patients had stage I(E), 22 stage II(E), and 5 stage IV(E) disease. Among the 124 patients with stage I(E) and II(E) diseases, 22 patients received radiotherapy alone, 7 chemotherapy alone, and 95 combined modality therapy (CMT). Of these 95 patients treated with CMT, 45 patients were treated with radiotherapy followed by chemotherapy, and 50 with chemotherapy followed by radiotherapy. The primary treatment for stage IV(E) patients was chemotherapy with or without radiotherapy to the primary tumor., Results: The overall 5-year survival (OS) and disease free survival (DFS) for all patients was 68.0% and 55.8%, respectively. It was 71.7% and 60.9% for stage I(E), and 70.6% and 47.0% for stage II(E), respectively (P > 0.05). The OS and DFS at the 5th year were 83.1% and 68.0% for patients who achieved complete response (CR), and 18.0% and 15.5% for those who did not, respectively (P = 0.000). Of the 124 patients with stage I(E) and II(E) disease, 67 patients were treated with radiotherapy alone (22 patients) or radiotherapy followed by chemotherapy (45), whereas 57 were treated with chemotherapy followed by radiotherapy (50) or chemotherapy alone (7). The CR rate after radiotherapy was 74.7%, however, it was only 19.3% after chemotherapy (P = 0.000). Of the 46 patients with PR, SD or PD after chemotherapy, 42 still had locoreginally localized lesion and 31 of these patients achieved CR by following radiotherapy which revealed satisfactory results. For stage I(E) and II(E) disease, the 5-year OS and DFS were 76.0% and 65.0% for radiotherapy with or without chemotherapy, and 74.4% and 56.2% for chemotherapy followed by radiotherapy. The difference was statistically not significant. However, 7 stage I(E) and II(E) patients were treated with chemotherapy alone, and 4 of them died of disease progression, with 1-year survival of 26.7%., Conclusion: The majority of Chinese patients with primary nasal NHL are NK/T cell in origin. The complete response rate by radiotherapy is much higher than that by chemotherapy. The addition of chemotherapy to radiotherapy did not improve the survival of patients with early stage nasal lymphoma. Radiotherapy is suggested as the primary treatment for stage I(E) and II(E) nasal NK/T cell lymphoma.

Objective: To investigate the clinical characteristics, treatment modalities and prognostic factors of chordoma in the skull base., Methods: The data of 37 patients with chordoma in the skull base treated from 1970 to 2002 were retrospectively reviewed. Twenty-eighty received surgery plus radiotherapy, 8 radiotherapy alone and 1 surgery alone. The total dose of irradiation ranged from 30 - 75 Gy with a median of 60 Gy., Results: The rates of symptom relief and remarkable tumor regression at the end of radiotherapy were 86.5% and 48.6%, respectively. The nerve and endocrine function recovery was observed in some patients within six months to two years after treatment. The overall 1-, 3-, 5- and 10-year survival were 97.3%, 87.3%, 71.5% and 41.0%, respectively. The overall 1-, 3-, 5- and 10-year survival were 100.0%, 92.9%, 85.7% and 50.8% in patients with palsies of cranial nerves II-VIII, but 100.0%, 75.0%, 45.0% and 0 in patients with dysfunction of cranial nerves IX-XII, respectively (P = 0.04)., Conclusion: Surgery is the first option for chordoma, but resection with a safe margin is difficult to achieve due to the special anatomical location of the skull base. Local failure is the main cause of death. Radiotherapy is an important adjuvant for local control. The total dose should not be less than 60 Gy for prophylactic purpose, and more than 70 Gy should be given to patients with recurrence, residual lesions after surgery or those not operated. The injury of cranial nerves IX-XII suggests a poor prognosis.

Background & Objective: Irradiation often causes cell cycle arrest in tumor cells. This study was to observe the abrogation of radiation-induced G(2) phase arrest of p53 mutated human cancer cell lines by 7-hydroxystaurosporine (UCN-01), and explore the mechanism., Methods: Human nasopharyngeal carcinoma cell line CNE-1 and human lung adenocarcinoma cell line 973, both with p53 mutation, were used in this study. Human fibroblastoma cell line HT-1080 was used as control. Flow cytometry was used to observe the effects of irradiation on cell cycle of these 3 cell lines, and abrogation effect of UCN-01 on radiation-induced G(2) phase arrest. Western blot was used to detect phosphorylated CDC2-Tyr15 during the abrogation process., Results: Irradiation resulted in G(2) phase arrest in CNE-1 cells and 973 cells. Proportion of cells in G(2) phase increased from 18.4% to 43.6% in CNE-1 cell line, and from 14.8% to 42.8% in 973 cell line after 2 Gy of irradiation. G(1) phase arrests, measured by "S phase cells consumption", of CNE-1 cells and 973 cells were much lower than that of HT-1080 cells (14.8% and -1.2% vs. 57.0%). Radiation-induced G(2) phase arrests were abrogated by UCN-01 from 63.5% to 16.1% in CNE-1 cell line, and from 35.4% to 16.3% in 973 cell line. UCN-01 suppressed the expression of radiation-induced phosphorylation of CDC2-Tyr15, which was in accordance with the abrogation of radiation-induced G(2) phase delay., Conclusions: Main effect of irradiation on cell cycle of p53 mutated CNE-1 cells and 973 cells is G(2) phase arrest. UCN-01 is able to abrogate radiation-induced G(2) phase, which is associated with the reduction of phosphorylated CDC2-Tyr15.

Background & Objective: Primary thyroid lymphoma (PTL) is a rare disease. It is likely to be misdiagnosed, and its treatment remains controversy. This study was to investigate clinicopathologic features of PTL, and explore proper treatments., Methods: Records of 22 patients with PTL treated in Cancer Hospital, Chinese Academy of Medical Sciences from Jan.1990 to Jan. 2004 were retrospectively analyzed., Results: Of the 22 patients, 18 were women, 4 were men. The median age is 55 (33-80) years. All patients were B-cell original; according to WHO classification, 16 (72.7%) were diffuse large B-cell lymphoma (DLBCL), and 6 (27.3%) were mucosa associated lymphoid tissue (MALT) lymphoma. Five patients received surgery alone; 7 received radiotherapy after surgery, 6 received chemotherapy after surgery, 4 received chemotherapy and radiotherapy after surgery. With a median follow-up of 42 (1-168) months, 5-year relapse-free survival rate was 34.78%, and 5-year overall survival rate was 37.36%., Conclusions: PTL typically occurs in women. The majority of PTL is B-cell original; DLBCL, and MALT lymphoma were the most common histological subtypes. Patients with PTL of stage IE or IIE should be treated with surgery-based combined modality.

Objective: To investigate the clinical characteristics, international prognostic index and treatment of primary non-Hodgkin's lymphoma (NHL) of the nasopharynx., Methods: From January 1983 to December 1997, 136 patients with previously untreated NHL of the nasopharynx were retrospectively reviewed. All patients were confirmed pathologically and classified by Working Formulation system. There were 18 patients with high-grade, 77 intermediate, 2 low-grade and 39 unclassifiable lymphoma. According to Ann Arbor classification, 25 patients had stage I, 91 stage II, 12 stage III and 8 stage IV lesions. Primary therapy was radiotherapy alone in 13 patients and radiotherapy combined with chemotherapy in 12 patients with stage I disease. In 88 patients with stage II, radiotherapy alone was given to 31 patients, and a combination of radiotherapy and chemotherapy to 57 patients. Chemotherapy was primary treatment for advanced stage III/IV diseases., Results: The overall survival rate (OS), cancer specific survival rate (CSS) and disease-free survival rate (DFS) at 5 and 10 years for all patients were 56.2%, 61.2%, 51.1% and 48.3%, 58.0%, 46.5%, respectively. As for international prognostic index (IPI), the 5-year CSS was 70.9% for 0 risk factor, 44.9% for 1 risk factor, 30.0% for 2 or 3 risk factors, respectively (P = 0.004). For stage I patients, the 5-year CSS was 83.1% for RT alone and 82.2% for combined modality therapy, respectively (P = 0.779). For patients with stage II, the 5-year CSS was 46.0% for radiotherapy alone and 70.9% for combined modality therapy. There was significant difference between them (P = 0.04). Multivariate analysis by Cox regression showed that Ann Arbor stage, B symptom and IPI were independent prognostic factors., Conclusion: International prognostic index is an important prognostic factor for Non-Hodgkin's lymphoma of the nasopharynx and the combined modality therapy may be optimal for the stage II patients.

Objective: To study the effect of post-mastectomy radiotherapy with different fractionated dose schemes for early breast cancer., Methods: From January 1987 to January 1993, 367 patients with early breast cancer were given post-mastectomy radiotherapy with three different fractionated dose schemes. 149 patients received conventional radiotherapy with 50 Gy/25 fractions/5 weeks (Group A). 177 patients received 45 Gy/15 fractions/5 weeks (Group B). Forty-one patients were treated with 23 Gy/4 fractions/17 days (Group C). 257 patients received systemic therapy (chemotherapy and/or endocrine therapy)., Results: The overall 5-year survival and 5-year disease-free survival rates were 87.4% and 89.6%. The 5-year disease-free survival rate were 90.8%, 86.5% and 84.6% for A, B and C groups (P = 0.16). The corresponding loco-regional failure rates were 2.7%, 2.8% and 2.4%, respectively. There was no statistically significant difference in the local control and efficacy of the three groups., Conclusion: With similar 5-year tumor-free survival rates by the conventional fractionation and hypofractionation, the scheme with 45 Gy/15 fractions/5 weeks has the advantage of giving less factions, which is suitable for a unit with limited radiation resources. The course of hypofractionation with 23 Gy/4 fractions/17 days is much shorter than conventional radiotherapy, which may benefit patients with higher risk of metastasis who need to undergo chemotherapy earlier. This study warrants further investigations.

Objective: To investigate the treatment for patients with early stage primary tonsil non-Hodgkin's lymphoma (NHL)., Methods: Two hundred and thirteen patients with previously untreated early stage primary tonsil NHL were reviewed. All patients were pathologically confirmed. According to Ann Arbor classification, 35 patients were stage I, 178 stage II. The primary treatment for stage I was radiotherapy alone in 12 and combined modality therapy (CMT) in 23 patients. The primary treatment for stage II was radiotherapy alone in 57,chemotherapy alone in 2, and CMT in 119 patients., Results: The 5-year overall survival, cancer specific survival (CSS) AND disease-free survival (DFS) for the early stage primary tonsil non-Hodgkin's lymphoma were 65%, 70% and 61%, respectively. The 5-year CSS was 63% for the radiotherapy alone group and 72% for the CMT group (p = 0.064), and the 5-year DFS were 56% for the radiotherapy alone group and 62% for the CMT group. For patients with stage I disease, The 5-year CSS were 100% in both radiotherapy alone and CMT groups, and the 5-year DFS were 100% and 80% in these two groups (p = 0.148), respectively. There was no significant difference of efficacy between the two treatment s for the patients with stage I disease. For the patients with stage II disease, the 5-year CSS was 58% in radiotherapy alone group and 66% in CMT group (p = 0.051). However, CMT significantly improved DFS in stage II disease, with a 5-year DFS of 46% for radiotherapy alone and 60% for CMT (P = 0.046)., Conclusion: Patients with stage I tonsil non-Hodgkin's lymphoma treated with radiotherapy alone or CMT can achieve an excellent outcome. CMT significantly improve the DFS in stage II patients. There was a trend that CMT improved the survival rates in the patient with early stage disease. It was suggested that CMT should be used for the patients with early stage primary tonsil non-Hodgkin's lymphoma.

Background & Objective: To enhance the radiosensitivity of cancer cell is one of the most important way to improve the effect of radiotherapy. This study was designed to investigate the radiosensitization of 7-hydroxystaurosporine(UCN-01) by its abrogation of radiation-induced G2 arrest., Methods: Flow cytometry was used to observe the effect of irradiation and UCN-01 on cell cycle of human nasopharyngeal carcinoma cells (CNE-1) with mutated p53. The effect on radiosensitivity was determined by clonogenic assay and was quantified by calculating the sensitive enhancement ratio (SER)., Results: Irradiation resulted in G2 arrest in a dose-dependent manner. The proportion of cells at G2 phase, comparing to the control group (18.4%), was increased to 43.6%, 77.4% and 86.4% after 12 hours with irradiation of 2, 4 and 6 Gy, respectively. Radiation-induced G2 arrest was abrogated by UCN-01 in a concentration-dependent manner. UCN-01 at the concentrations of 50, 100, 200 and 400 nmol/L decreased the proportion of cells in G2 phase from 63.5% in the control group to 28.5%, 25.0%, 16.1% and 13.7%, respectively. UCN-01 resulted in a radiosensitization in CNE-1 cells. The SERs were 2.60 and 3.09, for 100 nmol/L and 200 nmol/L of UCN-01, respectively., Conclusion: Radiosensitization of UCN-01 in CNE-1 cells characterized by mutated p53 is associated with its abrogation of radiation-induced G2 arrest.