Dosimetric effect of multi-leaf collimator angle change on the left-sided breast hypofractionated radiotherapy with simultaneous integrated boost

This study aimed to evaluate the effects of multi-leaf collimator angle change on the dosimetric parameters of the medial, central, and lateral tumor bed boost in hypofractionated left whole-breast irradiation with dynamic multi-leaf collimator technology. Sixty patients with early breast cancer following conservative surgery who underwent hypofractionated radiotherapy with tumor bed boost were enrolled from The First People’s Hospital of Zunyi between January 2018 and January 2023. All patients were classified into three groups according to the location of the tumor bed: medial, central, and lateral. The differences in target volume and cardiopulmonary dosimetric parameters between the plan of multi-leaf collimator angle change (labeled as Plan-A) and the original plan of 0° multi-leaf collimator angle (labeled as Plan-O) were compared in each group. The results did not show any significant differences in the coverage of the target prescription, conformability index, and homogeneity index between Plan-A and Plan-O of the three groups. In the medial group, the left lung V5, V10, and Dmean; heart V8 and Dmean; and left anterior descending artery (LAD) Dmax and Dmean of Plan-A were significantly lower than those of Plan-O (p<0.05). Meanwhile, in the central and lateral groups, only the LAD Dmax and Dmean of Plan-A decreased significantly in the lateral group, and no differences were observed in other cardiopulmonary parameters compared to those in Plan-O (p<0.05). In conclusion, the change in collimator angle did not have a significant effect on the target dosimetric parameters of hypofractionated radiotherapy with tumor bed boost for the left breast. On the contrary, it could significantly reduce the cardiopulmonary dose in the medial group compared to the original radiotherapy plan. Given this information, it is recommended to change the multi-leaf collimator angle for the radiotherapy plan of the medial tumor bed group in left whole-breast hypofractionated radiotherapy

The Adler grade by Doppler ultrasound is associated with clinical pathology of cervical cancer: Implication for clinical management.

OBJECTIVE:To analyze the relationship of Adler grade by transvaginal color Doppler flow imaging (TV-CDFI) and the clinical pathological parameters of patients with cervical cancer, and to identify the value of Adler grade in the diagnosis and treatment of cervical cancer. METHODS:Patients with cervical cancer diagnosed pathologically in our hospital from January 1, 2019 to December 31, 2019 were included, All patients underwent TV-CDFI examination, and the images were divided into 0 to III grades according to the Adler grades, and the correlations between the Adler classification and clinical pathological parameters (clinical stage, mass size, pathological type, squamous cell carcinoma subtype, CA125, CA199) were analyzed. RESULTS:A total of 162 patients with cervical cancer were included. With the increase of Adler severity, the clinical stage of cervical cancer increased accordingly. the cancer size differed significantly in patients with different Adler grade (p = 0.004); There were significant differences in the level of CA125, CA199 between the squamous cell carcinoma and adenocarcinoma (all p0.05). The area under ROC curve of the cervical squamous cell carcinoma predicted by Adler grade based on FIGO results and pathological results was 0.811and 0.762 respectively (all p<0.05). CONCLUSIONS:Adler grades are closely associated with the clinical pathology of cervical cancer, which may be a convenient and effective approach for the assisting assessment of cervical cancer