OBJECTIVE. Percutaneous microwave coagulation wasperformed witha modified system in animal experiments and in a clinical study to evaluatethis technique as a treatment op tion for liver cancer. SUBJECTS AND METHODS. As an in vitro study,a microwaveelectrodewasinserted5â€"6 cm into separated egg white, homogenate of pig liver, and pig liver, with different power outputs and different lengths of inner conductors. In the animal experiment, the sonographi cally guided coagulation was performed percutaneously nine times and at laparotomy 43 times on 17 adult dogs. The thermal needleswere placed parallel to and 5 mm, 8â€"12 mm, and 15 mm from the electrode. Clinically, 41 patients with hepatocellular carcinoma and 10 pa tients with hepatic metastaseswere treated with a 60-W microwave emission for 240â€"300 sec.RESULTS. Microwave coagulation using themodified system at60W for300sec produced a necrosis volume of 3.7 x 2.6 x 2.6 cm. The coagulated volume was elliptic when the exposed inner conductor of the electrodewas 27 mm. All tumors showeddecreaseddensity on unenhancedCT, and 84% (32/38) of tumors showedno enhancementon contrast-enhancedCT. In 21 patients with an elevateda-fetoprotein level, the level decreasedin all 21 and was normalized in 17.A secondbiopsy on 19patientsshowedcom plete destruction of tumor in 18. In 10 patientswith hepatic metastases, the mean follow-up pe riod was 13 months. Shrinkage oflesions occurred in 84% (21/25), and the blood flow inside the tumor disappearedin 75% (12116)oflesions. Seventy-threepercent(8/11)of the nodulesshowed no enhancement. A secondbiopsy on six patientsshowedcomplete necrosisin five. CONCLUSION.Sonographicallyguided microwavecoagulationperformed with this modified system was an effective and safe treatment for liver cancer. Microwave coagulation has been used in liver cancer resection for tissue coagulation and in attempts to reduce bleeding. A monopolar microwave electrodeproducesa thin cylindric coagulation volume 1 cm in diameter extending from the liver surface inward. This process is not suit able for treatment of deep-seatedcarcinomas when adjacent normal tissue, especially the su perficial tissue,is to be spared [1]. To optimize this percutaneoustechnique for the treatment of liver cancer and to get a better coagulation effect, a modified microwave system and a se ries of parameters were tested by in vitro and in vivo animal experiments with a sonographi cally guided percutaneous operation. The rela tionship among microwave energy, thermal distribution, and hepatic tissue coagulation, and the sonographic characteristics of the co agulatedarea,were examined.On the basisof the experiments, a modified sonographically guided percutaneous microwave coagulation therapywas studiedclinically. Subjects and Methods EquipmentMicmwave systemâ€"Weused a UMC-l (Ultra sound-guided MicrowaveCoagulator) designed by our department andInstitute207of theAerospace Industry Company (Beijing, People's Republic of China). Our parameters were a microwave fre quency of 2450 MHz and a ran...

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Radiotherapy is widely applied for treatment of esophageal squamous cell carcinoma (ESCC). The Rad51‐related protein XRCC3 plays roles in the recombinational repair of DNA double‐strand breaks to maintain chromosome stability and repair DNA damage. The present study aimed to investigate the effect of XRCC3 on the radiotherapy response of ESCC and the underlying mechanisms of the roles of XRCC3 in ESCC radiosensitivity. XRCC3 expression in ESCC cells and tissues was higher than that in normal esophageal epithelial cells and corresponding adjacent noncancerous esophageal tissue. High XRCC3 expression was positively correlated with resistance to chemoradiotherapy in ESCC and an independent predictor for short disease‐specific survival of ESCC patients. Furthermore, the therapeutic efficacy of radiotherapy in vitro and in vivo was substantially increased by knockdown of XRCC3 in ESCC cells. Ectopic overexpression of XRCC3 in both XRCC3‐silenced ESCC cells dramatically enhanced ESCC cells' resistance to radiotherapy. Moreover, radiation resistance conferred by XRCC3 was attributed to enhancement of homologous recombination, maintenance of telomere stability, and a reduction of ESCC cell death by radiation‐induced apoptosis and mitotic catastrophe. Our data suggest that XRCC3 protects ESCC cells from ionizing radiation‐induced death by promoting DNA damage repair and/or enhancing telomere stability. XRCC3 may be a novel radiosensitivity predictor and promising therapeutic target for ESCC.

Background and AimA matched-pair comparison was performed to compare the efficacy and safety of sublobar resection versus radiotherapy for high-risk elderly patients with Stage I non-small cell lung cancer (NSCLC).Patients and MethodsWe searched the Cochrane Library, MEDLINE, CENTRAL, EMBASE and manual searches. The meta-analysis was performed to compare overall survival, pattern of failure, and toxicity among the homogeneous studies. Subdivided analyses were also performed.ResultsSixteen studies containing 11540 patients were included in the meta-analysis. Among these studies, 9 were propensity-score matched (PSM) cohort studies, and 7 were cohort studies. Sublobar resection, compared with radiotherapy (either conventional fraction radiation therapy or stereotactic body radiation therapy), significantly improved the overall survival regardless in both PSM and non-PSM analyses (all p < 0.05). However, the difference in the pattern of failure and toxicity were not significant (all p > 0.05).ConclusionsSublobar resection was associated with improved outcomes in high-risk elderly patients with Stage I NSCLC, which supports the need to compare both treatments in large prospective, randomized, controlled clinical trials.