Objective To investigate the value of the measurement of urinary hyaluronic acid (HA) levels for the diagnosis of bladder cancer and the possibility of replacing ELISA-like assay with radioimmunoassay to detect the l...Objective To investigate the value of the measurement of urinary hyaluronic acid (HA) levels for the diagnosis of bladder cancer and the possibility of replacing ELISA-like assay with radioimmunoassay to detect the levels of urinary HA. Methods Using the ELISA-like assay and radioimmunoassay at the same time to measure the HA levels in the urine specimens from 49 bladder cancer patients, 12 benign bladder tumor patients, 30 other genitourinary disease patients and 20 normal controls. Results There is not much difference between the consequences of the urinary HA levels whether we used the ELISA-like assay or radioimmunoassay to detect every specimen (P>0.05). When we used the results with radioimmunoassay for analysis, we found the levels of urinary HA of bladder cancer patients were 2–4 times than those of the benign bladder tumor patients, other genitourinary disease patients or normal individuals (P<0.01); With 137.5 ngHA/mg protein (113.6±23.9 ng/mg) as a minimum cutoff limit, this assay had a good sensitivity (91.8%) and specificity (91.9%) for the diagnosis of bladder cancer. Its difference in sensitivity meant a lot when compared with urine cytology (48.9%,P<0.01). Conclusion The urinary HA assay is a simple, convenient, noninvasive credible and cheap method with satisfactory sensitivity and specificity for the diagnosis of bladder carcinoma; radioimmunoassay is also a good means to measure the urinary HA levels. Key words Bladder carcinoma - Hyaluronic acid - Urine展开更多
Objective: To study the role of 125 I and 125 I plus gemcitabine (GEM) in treatment of unresectable carcinoma of pancreas. Methods: From April 2000 to April 2003, 38 untreated patients with locally advanced pan...Objective: To study the role of 125 I and 125 I plus gemcitabine (GEM) in treatment of unresectable carcinoma of pancreas. Methods: From April 2000 to April 2003, 38 untreated patients with locally advanced pancreatic cancer (LAPC) were collected and randomized into two groups: Arm A 125 I (18 patients) and Arm B 125 I+GEM (20 patients). Eligibility criteria were: cytologically and pathologically proven pancreatic carcinoma, Karnofsky performance status (kps) 60 80, age 18 75 years, adequate hematological, renal and liver function, and controllable pain. Arm A patients were treated with 125 I implants. Arm B patients started chemotherapy within 10 14 d post operatively following the implant procedure. Chemotherapy doses were as follows: GEM 1 000 mg/m 2 weekly × 3 followed by 1 week of rest for 3 cycles. In addition, all patients underwent laparotomy and surgical staging. The surgical procedures performed were biopsy, gastric bypass and biliary bypass. The total activity and number of seeds used were as recommended by Anderson. The mean activity, minimal peripheral dose (MPD), and volume of implants were 20 mCi, 14 000 cGy, and 53 cm 3, respectively. Results: Overall response rate (CR+PR) in Arm A was 37.6% and in Arm B it was 44.5% ( P >0.05). PR median duration in Arm A was 6.7 months and in Arm B it was 4.8 months ( P <0.05). Clinical benefit response was experienced by 11.7 % of Arm A compared with 42.1% of Arm B ( P <0.05). The incidences of hematological toxicity (such as neutropenia) between Arm A and Arm B were 5.8% and 21.1%, respectively ( P >0.05). The survival rates of 12 and 24 month were 32.5%, 16.3% for Arm A and 61%, 38.7% for Arm B ( P =0.04). The rate of complication of Arm A was lower than that of Arm B without statistical significance. Conclusion: To some extent, 125 I or 125 I plus GEM is able to lead to a moderate objective response for LAPC with obstructive jaundice on the base of biliary bypass or/and gastric bypass, but 125 I plus GEM is more effective than 125 I in improvement of the quality of life and survival rate in patients with LAPC.展开更多
Objective: The aim of our study was to assess and compare the potential dosimetric advantages and drawbacks of photon beams and electron beams as a boost for the tumor bed in superficial and deep seated early-stage b...Objective: The aim of our study was to assess and compare the potential dosimetric advantages and drawbacks of photon beams and electron beams as a boost for the tumor bed in superficial and deep seated early-stage breast cancer. Methods: We planned CTs of 10 women with early breast cancer underwent breast conservative surgery were selected. Tumor bed was defined as superficial and deep with a cut of point 4 cm, those with less than 4 cm were defined as superficial tumors representing 4 patients and those with depth of 4 cm or more were classified as deep tumors representing 6 patients. The clinical target volume (C'I'V) was defined as the area of architectural .distortion surrounded by surgical clips. The plan- ning target volume (PTV) was the C'I'V plus margin 1 cm. A dose of 10 Gy.in 2 Gy fractions was given concurrently at the last week of treatment. Organs at risk (OARs) were heart, lungs, contra-lateral breast and a 5 mm thick skin segment of the breast surface. Dose volume histograms were defined to quantify the quality of concurrent treatment plans assessing target coverage and sparing OARs. The following treatment techniques were assessed: photon beam with 3D-conformal technique and a single electron beam. Results: For superficial tumors better coverage for CTV and P'I'V with good homogeneity with better CI was found for the 3D conformal radiotherapy (3DCRT) but with no significant planning objectives over electron beam. For deep tumors, the 3DCRT met the planning objectives for C'I'V, PTV with better coverage and fewer hot spots with better homogeneity and CI. For superficial tumors, OARs were spared by both techniques with better sparing for the electron beam where as for deep tumors also OARs were well spared by both techniques. Conclusion: Boosting the tumor bed in early- stage breast cancer with optimized photon may be preferred to electron beam for both superficial and deep tumors. The OARs dose sparing effect may allow for a potential long-term toxicity risk reduction and better cosmesis.展开更多
文摘Objective To investigate the value of the measurement of urinary hyaluronic acid (HA) levels for the diagnosis of bladder cancer and the possibility of replacing ELISA-like assay with radioimmunoassay to detect the levels of urinary HA. Methods Using the ELISA-like assay and radioimmunoassay at the same time to measure the HA levels in the urine specimens from 49 bladder cancer patients, 12 benign bladder tumor patients, 30 other genitourinary disease patients and 20 normal controls. Results There is not much difference between the consequences of the urinary HA levels whether we used the ELISA-like assay or radioimmunoassay to detect every specimen (P>0.05). When we used the results with radioimmunoassay for analysis, we found the levels of urinary HA of bladder cancer patients were 2–4 times than those of the benign bladder tumor patients, other genitourinary disease patients or normal individuals (P<0.01); With 137.5 ngHA/mg protein (113.6±23.9 ng/mg) as a minimum cutoff limit, this assay had a good sensitivity (91.8%) and specificity (91.9%) for the diagnosis of bladder cancer. Its difference in sensitivity meant a lot when compared with urine cytology (48.9%,P<0.01). Conclusion The urinary HA assay is a simple, convenient, noninvasive credible and cheap method with satisfactory sensitivity and specificity for the diagnosis of bladder carcinoma; radioimmunoassay is also a good means to measure the urinary HA levels. Key words Bladder carcinoma - Hyaluronic acid - Urine
文摘Objective: To study the role of 125 I and 125 I plus gemcitabine (GEM) in treatment of unresectable carcinoma of pancreas. Methods: From April 2000 to April 2003, 38 untreated patients with locally advanced pancreatic cancer (LAPC) were collected and randomized into two groups: Arm A 125 I (18 patients) and Arm B 125 I+GEM (20 patients). Eligibility criteria were: cytologically and pathologically proven pancreatic carcinoma, Karnofsky performance status (kps) 60 80, age 18 75 years, adequate hematological, renal and liver function, and controllable pain. Arm A patients were treated with 125 I implants. Arm B patients started chemotherapy within 10 14 d post operatively following the implant procedure. Chemotherapy doses were as follows: GEM 1 000 mg/m 2 weekly × 3 followed by 1 week of rest for 3 cycles. In addition, all patients underwent laparotomy and surgical staging. The surgical procedures performed were biopsy, gastric bypass and biliary bypass. The total activity and number of seeds used were as recommended by Anderson. The mean activity, minimal peripheral dose (MPD), and volume of implants were 20 mCi, 14 000 cGy, and 53 cm 3, respectively. Results: Overall response rate (CR+PR) in Arm A was 37.6% and in Arm B it was 44.5% ( P >0.05). PR median duration in Arm A was 6.7 months and in Arm B it was 4.8 months ( P <0.05). Clinical benefit response was experienced by 11.7 % of Arm A compared with 42.1% of Arm B ( P <0.05). The incidences of hematological toxicity (such as neutropenia) between Arm A and Arm B were 5.8% and 21.1%, respectively ( P >0.05). The survival rates of 12 and 24 month were 32.5%, 16.3% for Arm A and 61%, 38.7% for Arm B ( P =0.04). The rate of complication of Arm A was lower than that of Arm B without statistical significance. Conclusion: To some extent, 125 I or 125 I plus GEM is able to lead to a moderate objective response for LAPC with obstructive jaundice on the base of biliary bypass or/and gastric bypass, but 125 I plus GEM is more effective than 125 I in improvement of the quality of life and survival rate in patients with LAPC.
文摘Objective: The aim of our study was to assess and compare the potential dosimetric advantages and drawbacks of photon beams and electron beams as a boost for the tumor bed in superficial and deep seated early-stage breast cancer. Methods: We planned CTs of 10 women with early breast cancer underwent breast conservative surgery were selected. Tumor bed was defined as superficial and deep with a cut of point 4 cm, those with less than 4 cm were defined as superficial tumors representing 4 patients and those with depth of 4 cm or more were classified as deep tumors representing 6 patients. The clinical target volume (C'I'V) was defined as the area of architectural .distortion surrounded by surgical clips. The plan- ning target volume (PTV) was the C'I'V plus margin 1 cm. A dose of 10 Gy.in 2 Gy fractions was given concurrently at the last week of treatment. Organs at risk (OARs) were heart, lungs, contra-lateral breast and a 5 mm thick skin segment of the breast surface. Dose volume histograms were defined to quantify the quality of concurrent treatment plans assessing target coverage and sparing OARs. The following treatment techniques were assessed: photon beam with 3D-conformal technique and a single electron beam. Results: For superficial tumors better coverage for CTV and P'I'V with good homogeneity with better CI was found for the 3D conformal radiotherapy (3DCRT) but with no significant planning objectives over electron beam. For deep tumors, the 3DCRT met the planning objectives for C'I'V, PTV with better coverage and fewer hot spots with better homogeneity and CI. For superficial tumors, OARs were spared by both techniques with better sparing for the electron beam where as for deep tumors also OARs were well spared by both techniques. Conclusion: Boosting the tumor bed in early- stage breast cancer with optimized photon may be preferred to electron beam for both superficial and deep tumors. The OARs dose sparing effect may allow for a potential long-term toxicity risk reduction and better cosmesis.