Efficacy of transcatheter arterial chemoembolization using pirarubicin-loaded microspheres combined with lobaplatin for primary liver cancer

BACKGROUND Drug-eluting beads show good safety and promising efficacy when used as part of a transarterial chemoembolization regimen for primary liver cancer.However,data on the clinical efficacy and safety of pirarubicin-loaded beads combined with lobaplatin are lacking in China.AIM To evaluate the efficacy and safety of transcatheter arterial chemoembolization using pirarubicin-loaded beads combined with lobaplatin for primary liver cancer.METHODS Between January 2019 and March 2020,60 patients with primary liver cancer were selected at Hebei North University Affiliated First Hospital.According to different treatment methods,the participants were categorized into two groups with 30 patients treated with pirarubicin-loaded microspheres combined with lobaplatin included in an observation group and 30 patients treated with pirarubicin emulsion with lipiodol combined with lobaplatin were included in a control group.The progression-free survival,overall survival,clinical response rate,disease control rate,liver and kidney function and adverse reactions were compared between the two groups.RESULTS The progression-free survival was 14 mo in the observation group,which was significantly higher than 9 mo of the control group(P<0.05).The 6-mo,12-mo and 18-mo survival rates were 93.33%(28/30),66.67%(20/30)and 23.33%(7/30),respectively in the observation group,which were significantly higher than 83.33%(25/30),50.00%(15/30)and 13.33%(4/30),respectively,of the control group(all P<0.05).The clinical efficacy rate and disease control rate were 73.33%and 93.33%,respectively,in the observation group,which were significantly higher than those of the control group(53.55%and 80.00%,respectively,all P<0.05).There was no significant difference in alpha-fetoprotein between the two groups before the treatment(P>0.05).After the treatment,alpha-fetoprotein was 289.06±76.21 ng/m L in the observation group and 365.01±73.11 ng/m L in the control group,which were low in both groups compared with those before the treatment(all P<0.05).The incidence of nausea and vomiting was significantly lower in the observation group than in the control group(P<0.05).There was no significant difference for the adverse reactions of pain and fever between the two groups(P<0.05).CONCLUSION The combination of pirarubicin-loaded beads and lobaplatin can improve treatment efficacy resulting in mild liver function damage and postoperative complications in patients with primary liver cancer.It can be used in clinical practice.

Efficacy and safety of short duration radiotherapy combined with chemotherapy for advanced rectal cancer

BACKGROUND Radiotherapy or chemoradiotherapy is widely used for the treatment of rectal cancer preoperatively.Although the combination of radiotherapy and chemotherapy as an established preoperative neoadjuvant therapy shows high efficacy in the treatment of rectal cancer,some patients experience a response of poor tolerance and outcomes due to the long duration radiotherapy.The study compared short duration radiotherapy plus chemotherapy vs long duration radiotherapy plus chemotherapy for rectal cancer to determine whether short duration radiation treatment should be considered to diminish complications,reduce risk of recurrence and improve survival in patients with rectal cancer.AIM To evaluate the efficacy and safety of short duration radiotherapy combined with chemotherapy for the treatment of advanced rectal cancer.METHODS One hundred patients with stage IIIB or higher severe rectal cancer were selected as the study subjects at The First Affiliated Hospital of Hebei North University between December 2018 and December 2019.The patients were assigned to different groups based on the treatment regimens.Fifty patients who received preoperative short durations of radiotherapy plus chemotherapy were enrolled in an observation group and fifty patients who received conventional radiotherapy and chemotherapy were enrolled in a control group.Colonoscopic biopsy was performed for all patients with pathological diagnosis of rectal cancer.The expression of tumor-related factors such as RUNX3 and Ki-67 was quantitatively analyzed using immunohistochemistry in the tissues of the patients before and after treatment.Moreover,the duration of procedure,the amount of bleeding during the operation,the anus-conserving rate,the incidence of postoperative complications(wound infection,anastomotic leakage,postoperative intestinal obstruction,etc.)and postoperative pathology were compared between the two groups.The overall survival rate,recurrence rate and distant metastasis rate were also compared through postoperative reexamination and regular follow-up.RESULTS There was no significant difference in the positive expression rate of RUNX3 and Ki-67 between the two groups before the treatment(P>0.05).Compared with the pretreatment value,the positive rate of RUNX3 was increased and the positive rate of Ki-67 was decreased in both groups after the treatment(all P<0.05).The incidence of leukopenia,thrombocytopenia,neutropenia and diarrhea were higher in the observation group than in the control group(all P<0.05).There was no significant difference in the incidence of anemia,fatigue,neurotoxicity and nausea and vomiting between the two groups(all P>0.05).No significant difference was observed in the duration of procedure,intraoperative bleeding,the anus-conserving rate and the incidence of postoperative complications between the two groups(P>0.05).After 1 year of follow-up,the 1-yr survival rate was 80.0%in the observation group and 68.0%in the control group,the recurrence rate was 8.0%in the observation group and 10.0%in the control group,the distant metastasis rate was 6.0%in the observation group and 8.0%in the control group difference(all P<0.05).CONCLUSION Short duration radiotherapy combined with chemotherapy can improve the cure rate,prolong the survival time and reduce the incidence of complications in patients with advanced rectal cancer.