2015年 · 第24卷第06期

In recent years, with the application of radiotherapy in the treatment of soft tissue sarcoma, the LC rate and OS rate of soft tissue sarcoma have been significantly improved, and the 5-year OS rate has reached 60% ~70%. IMRT allowed the target area to be accurately irradiated, but due to normal tissue limits affected further increase in external irradiation dose. Post-loading therapy belongs to brachytherapy, which can kill tumor cells to the maximum extent without affecting normal tissues such as peripheral blood vessels and nerves, and improve tumor LC rate and limb-saving effect. IMRT combined with post-loading therapy is expected to increase the irradiation dose and reduce the adverse reactions of radiotherapy, but there are few studies in this field at home and abroad. Therefore, the effects of IMRT combined with post-loading therapy on LC and OS rates of soft tissue sarcoma were studied.

TPS is an important part of IMRT. The author reports the acceptance work of undergraduate Oncentra TPS to provide some experience for TPS acceptance.

The Varian iX linear accelerator generates a pulsed high voltage by a modulator. When the high-voltage circuit of the modulator works abnormally and overcurrent occurs, the accelerator may report an error and produce HVOC interlocking. Now, the repair method of this fault is introduced as follows.

In the past ten years, the research of signaling pathway in regulating tumor cell radiosensitivity has become one of the research hotspots in tumor radiobiology, and related research results have been applied in clinical practice, such as the combined application of EGFR inhibitor cetuximab in combination with radiotherapy for locally advanced head and neck phosphorus carcinoma can increase its LC rate and OS rate^[1]。 At present, the research on the role of HGF/c-Met signaling pathway in regulating the radiosensitivity of tumor cells has attracted increasing attention. Therefore, the structure and biological function of HGF/c-Met and its important role in regulating the radiosensitivity of tumor cells are reviewed.

Following the Human Genome Project, President Barack Obama announced in his 2015 State of the Union address: "Tonight, I will launch a new precision medicine initiative (PMI) that will bring us closer to curing tumors, diabetes and other diseases, while getting personalized information that will ensure better health for ourselves and our families."^[1]。 The plan will focus on tumor treatment in the near future, and will cover the whole field of human health and disease in the long term. Correspondingly, in 2016, the U.S. fiscal budget plans to allocate $215 million to fund precision medicine programs, including $130 million to the National Institutes of Health (NIH) to establish a "national research cohort" of at least one million people. At the same time, the National Cancer Institute (NCI) is funding $70 million for tumor genomics research to develop new cancer treatments and establish a nationwide "cancer knowledge network"^[1,2]。 At present, domestic discussions on precision medicine have also begun, and national policies are about to come out.

At present, the quality management methods of radiotherapy used in clinical practice pay attention to the detection of equipment performance indicators, neglecting the relationship between projects and the detection of equipment application process, and there is the possibility of missing potential risk factors. Therefore, it is necessary to use scientific and effective quality management methods to thoroughly analyze and understand the possible errors and potential clinical impacts of each link in the course of radiotherapy, assess its risks, and take corresponding risk management measures. Ford and Terezakis^[1]It is reported that the probability of radiotherapy error in US patients is about 0.2% (1/600). However, the gold standard industry for risk analysis, the aviation industry, also has a passenger death or injury probability of only one in ten million, which is 16,000 times less likely than radiation therapy to go wrong. If the severity of the event or even the characteristics of death are considered, about 6% of the radiotherapy error events are serious injury events^[2]。 It is calculated that the probability of serious injury events in patients treated with radiotherapy in the United States is 1,000 times higher than that in the aviation industry. Radiological accidents were reported continuously in the New York Times in January 2010. In January 2013, the British Daily Mail reported that excessive use of radiation caused the death of 12 cancer patients in France. It can be seen that the safety of radiotherapy needs to be improved urgently. The author reviews some new quality management methods introduced in the field of radiotherapy in recent years, which can be used for reference by domestic peers.