Objective
To compare the dosimetric difference between volumetric modulated arc therapy (VMAT) and static intensity modulated radiotherapy (IMRT) for esophageal carcinoma.
Methods
Thirty patients were selected in this study, including 5 cases in the cervical, 5 the lower thorax, 10 the upper thorax and 10 the middle thorax. VMAT plans with a single arc and IMRT plans with five fields designed for each patients. Planning target volume (PTV) were prescribed to 60 Gy in 30 fractions. Delta 4 was used to verifie the dosimetric of treatment plans. Using paired t-test or Wilcoxon signed-test to compare the dose distribution on planning and organs at risk (OAR). The monitor units and treatment time were also evaluated to measure the treatment efficiency.
Results
All the VMAT and IMRT plans can satisfy the clinical dosimetry requirements. VMAT had better conformal index for PTV than IMRT (P = 0. 008 ). VMAT was better than IMRT by reducing the Dmax of spinal cord (P = 0. 032), while the V30, V40 and Dmean of heart were significantly higher (P = 0. 041,0. 012,0. 002). For cervicals, the V5, V10, V15 and mean dose of lung were significant higher in VMAT than those in IMRT (P = 0. 002 -0. 002, 0. 002). For uppers, the values of heart V30 and Dmean were significantly larger in VMAT than IMRT (P = 0. 030,0. 026). However, the Dmax of spinal cord in VMAT was lower than IMRT (P = 0. 006). For middles, VMAT reduced V10, V15, V20 of lung (P = 0. 015, 0. 028,0. 041). There were no significant differences between VMAT and IMRT in the lowers (P=0. 262-0. 998). The 3 mm/3% γ pass rate was 92. 75% for VMAT and 92. 98% for IMRT (P=0.826). The average MU of VMAT (460. 66 MU) was reduced by 11. 84% compared with IMRT (522.55 MU) (P= 0.001). The delivery time of VMAT (139.6 s) compared with IMRT (298. 73 s) was reduced by an average of 53. 27% (P = 0. 000) .
Conclusions
Compared with IMRT, VMAT improved the OARs dose sparing and the target CI with similar dose distribution to the target. VMAT required fewer MU, shorten the treatment time significantly. The implementation of Synergy is stable and reliable.
Key words:
Esophageal neoplasms/volumetric modulated arc therapy; Esophageal neoplasms/ intensity-modulated radiotherapy; Dosimetry; γ pass rate
<div>AbstractPurpose:<p>To investigate the efficacy and safety of the novel orally active PI3Kδ inhibitor in relapsed and/or refractory patients with follicular lymphoma (FL) who had received at least two prior systemic treatments.</p>Patients and Methods:<p>Histologically confirmed relapsed and/or refractory patients with FL with disease progression after receiving second-line or greater systemic therapy were enrolled. Linperlisib was administered at 80 mg every day, orally in a 28-day cycle until disease progression or intolerable toxicity occurred. The primary outcome for the study was the objective response rate (ORR), with secondary outcomes including the duration of response (DOR), progression-free survival (PFS), overall survival (OS), disease control rate, and drug safety profile.</p>Results:<p>Of 114 screened relapsed and/or refractory patients with FL, 84 were enrolled in the full analysis set (FAS). The ORR of the 84 FAS patients was 79.8% [95% confidence interval (CI), 69.6–87.8, 67 patients], with 13 patients (15.5%) achieving a complete response and 54 patients (64.3%) with a partial response. The median DOR was 12.3 months (95% CI, 9.3–15.9). The median PFS was 13.4 months (95% CI, 11.1–16.7). The 12-month OS rate was 91.4% (95% CI, 82.7–95.8) and a median OS not reached by 42 months. The most frequent (>3%) treatment-related adverse events Grade ≥3 were infectious pneumonia (19.0%), neutropenia (15.5%), decreased lymphocyte count (4.8%), decreased leukocyte count (4.8%), increased lipase (3.6%), decreased platelet count (3.6%), hypertriglyceridemia (3.6%), and interstitial lung disease (3.6%).</p>Conclusions:<p>Linperlisib demonstrated compelling clinical activity and manageable tolerability for relapsed and/or refractory patients with FL who had received at least two prior systemic therapies.</p></div>
At present, the use of the common chemotherapy regimen CHOP/R-CHOP for diffuse large B-cell lymphoma (DLBCL) has some shortcomings, especially for relapsed and refractory DLBCL. CD47 is now considered as a prominent target in cancer therapies, and CD47 blockade mainly inhibits the CD47-SIRPα axis to prevent tumor immune escape. Here, we evaluated the effects of the latest CD47 antibodies reported and the correlations of closely related genes with CD47 in this disease. In the future, therapeutic strategies for DLBCL will focus on multitarget antibody combined treatment and multigene joint attacks.
<div>AbstractPurpose:<p>To investigate the efficacy and safety of the novel orally active PI3Kδ inhibitor in relapsed and/or refractory patients with follicular lymphoma (FL) who had received at least two prior systemic treatments.</p>Patients and Methods:<p>Histologically confirmed relapsed and/or refractory patients with FL with disease progression after receiving second-line or greater systemic therapy were enrolled. Linperlisib was administered at 80 mg every day, orally in a 28-day cycle until disease progression or intolerable toxicity occurred. The primary outcome for the study was the objective response rate (ORR), with secondary outcomes including the duration of response (DOR), progression-free survival (PFS), overall survival (OS), disease control rate, and drug safety profile.</p>Results:<p>Of 114 screened relapsed and/or refractory patients with FL, 84 were enrolled in the full analysis set (FAS). The ORR of the 84 FAS patients was 79.8% [95% confidence interval (CI), 69.6–87.8, 67 patients], with 13 patients (15.5%) achieving a complete response and 54 patients (64.3%) with a partial response. The median DOR was 12.3 months (95% CI, 9.3–15.9). The median PFS was 13.4 months (95% CI, 11.1–16.7). The 12-month OS rate was 91.4% (95% CI, 82.7–95.8) and a median OS not reached by 42 months. The most frequent (>3%) treatment-related adverse events Grade ≥3 were infectious pneumonia (19.0%), neutropenia (15.5%), decreased lymphocyte count (4.8%), decreased leukocyte count (4.8%), increased lipase (3.6%), decreased platelet count (3.6%), hypertriglyceridemia (3.6%), and interstitial lung disease (3.6%).</p>Conclusions:<p>Linperlisib demonstrated compelling clinical activity and manageable tolerability for relapsed and/or refractory patients with FL who had received at least two prior systemic therapies.</p></div>
Abstract Purpose: To investigate the efficacy and safety of the novel orally active PI3Kδ inhibitor in relapsed and/or refractory patients with follicular lymphoma (FL) who had received at least two prior systemic treatments. Patients and Methods: Histologically confirmed relapsed and/or refractory patients with FL with disease progression after receiving second-line or greater systemic therapy were enrolled. Linperlisib was administered at 80 mg every day, orally in a 28-day cycle until disease progression or intolerable toxicity occurred. The primary outcome for the study was the objective response rate (ORR), with secondary outcomes including the duration of response (DOR), progression-free survival (PFS), overall survival (OS), disease control rate, and drug safety profile. Results: Of 114 screened relapsed and/or refractory patients with FL, 84 were enrolled in the full analysis set (FAS). The ORR of the 84 FAS patients was 79.8% [95% confidence interval (CI), 69.6–87.8, 67 patients], with 13 patients (15.5%) achieving a complete response and 54 patients (64.3%) with a partial response. The median DOR was 12.3 months (95% CI, 9.3–15.9). The median PFS was 13.4 months (95% CI, 11.1–16.7). The 12-month OS rate was 91.4% (95% CI, 82.7–95.8) and a median OS not reached by 42 months. The most frequent (>3%) treatment-related adverse events Grade ≥3 were infectious pneumonia (19.0%), neutropenia (15.5%), decreased lymphocyte count (4.8%), decreased leukocyte count (4.8%), increased lipase (3.6%), decreased platelet count (3.6%), hypertriglyceridemia (3.6%), and interstitial lung disease (3.6%). Conclusions: Linperlisib demonstrated compelling clinical activity and manageable tolerability for relapsed and/or refractory patients with FL who had received at least two prior systemic therapies.
In this paper, we find a new tensor which is responsible for Finsler metrics with reversible geodesics. Using this tensor, we can prove that Finsler metrics are Douglas metric if and only if they have reversible geodesics and Douglas curvature. Further, we focus on the Finsler metrics with reversible Douglas curvature.
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