Excessive parotid gland doses secondary to the regression of enlarged neck nodes could be mitigated by replanning after 45 Gy. However, recontouring of large lymph nodes that regress during therapy has a risk of under-dosing extracapsular extension of lymph node metastases. Therefore, recontouring should be done with extreme caution.

BackgroundIn view of the limited knowledge of plasma biomarkers relating to cancer resistance to radiotherapy, we have set up screening, training and testing stages to investigate the microRNAs (miRNAs) expression profile in plasma to predict between the poor responsive and responsive groups after 6 months of radiotherapy.MethodsPlasma was collected prior to and after radiotherapy, and the microRNA profiles were analyzed by quantitative reverse transcription polymerase chain reaction (qRT-PCR) arrays. Candidate miRNAs were validated by single qRT-PCR assays from the training and testing set. The classifier for ancillary prognosis was developed by multiple logistic regression analysis to correlate the ratios of miRNAs expression levels with clinical data.ResultsWe revealed that eight miRNAs expressions had significant changes after radiotherapy and the expression levels of miR-374a-5p, miR-342-5p and miR-519d-3p showed significant differences between the responsive and poor responsive groups in the pre-radiotherapy samples. The Kaplan–Meier curve analysis also showed that low miR-342-5p and miR-519d-3p expressions were associated with worse prognosis. Our results revealed two miRNA classifiers from the pre- and post-radiotherapy samples to predict radiotherapy response with area under curve values of 0.8923 and 0.9405.ConclusionsThe expression levels of miR-374a-5p, miR-342-5p and miR-519d-3p in plasma are associated with radiotherapy responses. Two miRNA classifiers could be developed as a potential non-invasive ancillary tool for predicting patient response to radiotherapy.Electronic supplementary materialThe online version of this article (10.1186/s12967-018-1711-4) contains supplementary material, which is available to authorized users.

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We present the case of a 79-year-old female with symptomatic cavernous haemangioma of the liver. The patient had experienced progressive right lateral abdominal pain for years despite increased painkiller use. Surgical resection or transarterial embolisation was not recommended because of the patient's age, cardiovascular comorbidities and large tumour size. Therefore, the patient was treated with 3-dimensional conformal radiotherapy (RT) with a total dose of 30 Gy in 15 fractions. Following RT, the painkillers were tapered from the third month, and complete symptomatic remission was achieved after the ninth month. The measured tumour volume from serial images pre-RT and 3, 9 and 15 months post-RT was 400 ml, 372 ml, 185 ml and 140 ml, respectively. The most dramatic volumetric reduction was found between 3 and 9 months post-RT, whereas the change before or after this period was minimal. The time course of the radiological volumetric changes correlated with that of the clinical symptoms. In addition, the observed vascular changes on serial imaging studies were consistent with the assumed radiobiological effects after fractionated RT.