影响颅内室管膜瘤患者生存和预后的相关因素分析

目的:研究影响颅内室管膜瘤患者生存和预后的相关因素,为临床治疗提供理论依据。方法:回顾性分析2008年1月至2018年1月中南大学湘雅医院收治的颅内室管膜瘤患者276例,分析性别、年龄、肿瘤部位、肿瘤直径、手术切除程度、病理分级、Ki-67指数、术后是否放疗、术后是否化疗对颅内室管膜瘤患者总生存时间和无进展生存时间的影响。结果:肿瘤部位、手术切除程度、术后是否放疗均能影响颅内室管膜瘤患者总生存时间和无进展生存时间(P<0.001),并且是影响总生存时间(P<0.001,P<0.001,P=0.002)和无进展生存时间(P<0.001,P<0.001,P<0.001)的独立因素;Ki-67指数是影响颅内室管膜瘤患者无进展生存的独立因素(P<0.001)。肿瘤位于幕上、Ki-67指数≥10%是提示预后不佳的独立危险因素(P<0.001),肿瘤全切、术后行放疗是保护因素(P<0.001,P=0.001)。结论:肿瘤部位、手术切除程度、Ki-67指数、术后是否放疗是响颅内室管膜瘤预后的独立因素,尽可能的肿瘤全切和术后放疗有助于延长患者的无进展生存时间和总生存时间。

Three-Dimensional Conformal Radiotherapy for Rectal Cancer and the Changes in Cancer Multi-biomarkers

OBJECTIVE To investigate the clinical efficacy of three-dimensional conformal radiotherapy(3D-CRT)for local y advanced or postoperatively relapsed rectal cancer,and to examine the changes in cancer multi-biomarkers. METHODS Sixty patients with locally advanced or postoperatively relapsed rectal cancer were randomly divided into two groups after 40 Gy external radiation,namely a late-course 3D-CRT group and a conventional radiotherapy group that served as the control.There were 30 patients in each group.For patients in the 3D-CRT group,multi-biomarkers were measured before and after radiotherapy and after relapse. RESULTS Response rates in the 3D-CRT and the control groups were 86.7%(26/30)and 70%(21/30)respectively,without a significant difference (P>0.05).The 1-,2-and 3-year survival rates were 80%,53.3%and 36.7% in the 3D-CRT group;in the control group the rates were 56.7%,40%and 13.3%respectively,with a significant difference(P=0.0213).CEA,CA19-9, CA242 and FER decreased after radiotherapy in the 3D-CRT group,P<0.01, indicating a significant difference.The values after relapse were higher than those without relapse,P<0.01,indicating a significant difference. CONCLUSION Conventional radiotherapy with a 3D-CRT boost gives better therapeutic effect to patients with locally advanced or postoperatively local y relapsed rectal cancer.A multi-biomarker protein chip diagnosis system can be utilized as an effective tool to determine the therapeutic effect and prognosis.

Penpulimab,an anti-PD-1 antibody,for heavily pretreated metastatic nasopharyngeal carcinoma:a single-arm phase II study

Penpulimab is an anti-programmed cell death-1(PD-1)IgG1 antibody with no Fc gamma receptor(FcγR)binding activity,and thus theoretically reduced immune-related adverse events(irAEs)while maintaining efficacy.This single-arm,phase II trial conducted across 20 tertiary care centers in China enrolled adult patients with metastatic nasopharyngeal carcinoma(NPC)who had failed two or more lines of previous systemic chemotherapy.Patients received 200-mg penpulimab intravenously every 2 weeks(4 weeks per cycle)until disease progression or intolerable toxicities.The primary endpoint was objective response rate(ORR)per RECIST(version 1.1),as assessed by an independent radiological review committee.The secondary endpoints included progression-free survival(PFS)and overall survival(OS).One hundred thirty patients were enrolled and 125 were efficacy evaluable.At the data cutoff date(September 28,2022),1 patient achieved complete response and 34 patients attained partial response.The ORR was 28.0%(95%CI 20.3–36.7%).The response was durable,with 66.8%still in response at 9 months.Thirty-three patients(26.4%)were still on treatment.The median PFS and OS were 3.6 months(95%CI=1.9–7.3 months)and 22.8 months(95%CI=17.1 months to not reached),respectively.Ten(7.6%)patients experienced grade 3 or higher irAEs.Penpulimab has promising anti-tumor activities and acceptable toxicities in heavily pretreated metastatic NPC patients,supporting further clinical development as third-line treatment of metastatic NPC.