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Yu Y.,Shandongs Key Laboratory of Radiation Oncology | Guan H.,Shandongs Key Laboratory of Radiation Oncology | Xing L.-G.,University of Jinan | Xiang Y.-B.,Shanghai JiaoTong University
Clinical Therapeutics | Year: 2015

Purpose Three-dimensional conformal radiotherapy (3D-CRT) has become widely applied in patients with non-small cell lung cancer (NSCLC), and gross tumor volume (GTV) is a reliable index for predicting prognosis in patients with NSCLC. This meta-analysis investigated the association between GTV and prognosis in patients with NSCLC after 3D-CRT. Methods Electronic bibliographic databases were searched to identify articles related to NSCLC and 3D-CRT. The search results were carefully screened, using predetermined selection criteria, to select the most relevant studies. Newcastle-Ottawa Scale criteria were applied by 2 reviewers independently to evaluate the quality of the methodology of each included article., Based on GTV, each patient was assigned to either the study group (large GTV [≥112 cm3]) or the control group (small GTV [<112 cm3]), and the mean rates of overall survival (OS) and survival at 1, 3, and 5 years were calculated in each group. Summary hazard ratio (HR) with 95% CI was calculated. Findings The data from 10 cohort studies were incorporated into the current meta-analysis (1473 patients; study group, 773; control group, 700). The OS in the study group was significantly less than that in the control group (HR = 1.52; 95% CI, 1.10-1.94; P < 0.01). The study and control groups also had significantly different survival rates at 1 year (HR = 1.27; 95% CI, 1.10-1.46, P = 0.01), 3 years (HR = 2.06; 95% CI, 1.63-2.61; P < 0.01), and 5 years (HR = 2.25; 95% CI, 1.63-3.10; P < 0.01). Findings from funnel plots and Egger tests of the OS and 3-year survival rate suggested no publication bias. With respect to the 1- and 5-year survival rates, however, the funnel plots and Egger tests demonstrated publication bias among the included studies. Implications The relatively small number of studies and small sample size, as well as the lack of a specific and standard method of defining small and large GTV, may have influenced the credibility and reliability of our results. The findings suggest that GTV influences prognosis in patients with NSCLC after 3D-CRT. However, further studies with larger sample sizes are needed to confirm our finding that a larger GTV is negatively associated with NSCLC prognosis after 3D-CRT. © 2015 Elsevier HS Journals, Inc.

Zhang J.,Shandong Academy of Sciences | Zhang J.,Shandongs Key Laboratory of Radiation Oncology | Zhang J.,Tianjin Medical University | Li B.,Shandong Academy of Sciences | And 13 more authors.
Radiotherapy and Oncology | Year: 2014

Background and purpose Nitric oxide (NO), mainly synthesized by inducible nitric oxide synthase (NOS2) in pathological conditions, plays an important role in cytotoxicity, inflammation and fibrosis. Elevations in exhaled NO after thoracic radiation have been reported to predict radiation-induced lung injury (RILI). This study examined whether genetic variations in NOS2 gene is associated with the risk of RILI. Material and methods A cohort of 301 patients between 2009 and 2011 were genotyped for 21 single nucleotide polymorphisms (SNPs) in the NOS2 gene by the Sequenom MassArray system. Kaplan-Meier cumulative probability was used to assess RILI risk and Cox proportional hazards analyses were performed to evaluate the effect of NOS2 genotypes on RILI. Results Multivariate analysis found that three SNPs (rs2297518, rs1137933 and rs16949) in NOS2 were significantly associated with risk of RILI ≥ 2 (P value = 0.001, 0.000092, 0.001, respectively) after adjusting for other covariates. Their associations were independent of radiation dose and mean lung dose. Further haplotype analysis indicated that the ATC haplotype of three SNPs is associated with reducing the risk of developing RILI. Conclusion Our results demonstrate that genetic variants of NOS2 may serve as a reliable predictor of RILI in lung cancer patients treated with thoracic radiation. © 2014 Elsevier Ireland Ltd. All rights reserved.

Zhang J.,Tianjin Medical University | Zhang J.,Shandong Academy of Sciences | Zhang J.,Shandongs Key Laboratory of Radiation Oncology | Yang F.,Tianjin Medical University | And 15 more authors.
International Journal of Radiation Oncology Biology Physics | Year: 2011

Purpose: To assess the relationship between biologically effective dose (BED) and efficacy of stereotactic body radiation therapy (SBRT) and to explore the optimal BED range for Stage I non-small-cell lung cancer (NSCLC). Methods and Materials: Eligible studies were identified on Medline, Embase, the Cochrane Library, and the proceedings of annual meetings through June 2010. According to the quartile of included studies, BED was divided into four dose groups: low (<83.2 Gy), medium (83.2-106 Gy), medium to high (106-146 Gy), high (>146 Gy). To obtain pooled estimates of overall survival (OS), cancer-specific survival (CSS), and local control rate (LCR), data were combined in a random effect model. Pooled estimates were corrected for the percentage of small tumors (<3 cm). Results: Thirty-four observational studies with a total of 2,587 patients were included in the meta-analysis. Corrected pooled estimates of 2- or 3-year OS in the medium BED (76.1%, 63.5%) or the medium to high BED (68.3%, 63.2%) groups were higher than in the low (62.3%, 51.9%) or high groups (55.9%, 49.5%), respectively (p ≤ 0.004). Corrected 3-year CSS in the medium (79.5%), medium to high (80.6%), and high groups (90.0%) were higher than in the low group (70.1%, p = 0.016, 0.018, 0.001, respectively). Conclusion: The OS for the medium or medium to high BED groups were higher than those for the low or high BED group for SBRT in Stage I NSCLC. The medium or medium to high BED (range, 83.2-146 Gy) for SBRT may currently be more beneficial and reasonable in Stage I NSCLC. © 2011 Elsevier Inc.

Wei Y.,Shandongs Key Laboratory of Radiation Oncology | Wei Y.,Tianjin Medical University | Zhou T.,Shandongs Key Laboratory of Radiation Oncology | Lin H.,Shandongs Key Laboratory of Radiation Oncology | And 4 more authors.
Tumor Biology | Year: 2013

Glutathione S-transferases play a critical role in the detoxification and elimination of electrophilic carcinogens by conjugating them to glutathione. Homozygous deletions of GSTM1 and GSTT1 have been suggested as risk factors for some cancers, including colorectal, pancreatic, and esophageal cancers. Results of previous individual studies published to estimate the associations between GSTM1/GSTT1 polymorphisms and nasopharyngeal cancer (NPC) risk remained controversial. Thus, we carried out a meta-analysis by pooling the odds ratios (ORs) with corresponding 95 % confidence intervals (95 % CIs) of all currently available case-control studies to shed some light on the contradictory finding. A comprehensive search of the PubMed, Embase, Web of Science, and China National Knowledge Infrastructure databases up to October 20, 2012 was performed to identify eligible studies. A total of 15 separate publications involving 2,226 NPC cases and 3,339 controls were finally included into this meta-analysis. The meta-analysis of total studies showed that the null genotypes of GSTM1 and GSTT1 were both significantly associated with increased risk of NPC (for GSTM1: OR = 1.54, 95 % CI 1.28-1.86, P OR < 0.001; for GSTT1: OR = 2.25, 95 % CI 1.50-3.36, P OR < 0.001). Subgroup analysis by ethnicity suggested that carriers of both GSTM1 and GSTT1 null genotypes in Asians were more susceptible to NPC. Additionally, in the subgroup analysis based on the sample size, significant associations of the GSTM1 and GSTT1 polymorphisms with NPC susceptibility were identified among studies both with larger case sample size (number of cases ≥100) and smaller case sample size (number of cases <100). Sensitivity analysis confirmed the stability of our results. These results indicate that the GSTM1 and GSTT1 polymorphisms may play crucial roles in the development of NPC, especially in Asians. © 2012 International Society of Oncology and BioMarkers (ISOBM).

Wei Y.,Shandongs Key Laboratory of Radiation Oncology | Zhou T.,Shandongs Key Laboratory of Radiation Oncology | Zhu J.,Shandongs Key Laboratory of Radiation Oncology | Zhang Y.,Shandongs Key Laboratory of Radiation Oncology | And 5 more authors.
Cell Biochemistry and Biophysics | Year: 2014

The purpose of this study is to assess the long-term effect of sensorineural hearing loss (SNHL) resulted from radiotherapy (RT) alone versus chemoradiotherapy in nasopharyngeal carcinoma patients (NPC). Seventy-two patients initially diagnosed with NPC were enrolled from Shandong Tumor Hospital between March 2003 and May 2007. They were assigned into two groups: RT alone and chemoradiotherapy according to the different treatment regimens. Intensity-modulated radiation therapy was applied for both groups, concurrent and adjuvant cisplatin were administered for chemoradiotherapy group additionally. Hearing threshold test was performed at various time periods after completion of RT. Mean radiation dose to the cochlea in each ear was calculated to determine the correlation between cochlear dose and SNHL. We found that the hearing loss is more severe in the chemoradiotherapy group compared with RT group, from completion of RT up to the 5 years of follow-up period. This is especially obvious in the high frequency range. Hearing level is seriously damaged when cochlea dose exceeds 46 GY. We concluded that concurrent/adjuvant chemotherapy plus RT aggravates SNHL in NPC patients than RT alone and thus inner ear tissue tolerance should be redefined in those patients. © 2014 Springer Science+Business Media New York.

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