Background Pulmonary embolism, a potentially fatal event, occurs more frequently in cancer patients than in the general population. To offer an accurate diagnosis and effective treatment to such patients in China, we ...Background Pulmonary embolism, a potentially fatal event, occurs more frequently in cancer patients than in the general population. To offer an accurate diagnosis and effective treatment to such patients in China, we analyzed the incidence rate and clinical features of pulmonary embolism in patients with solid tumor hospitalized in the Peking Union Medical College （PUMC） Hospital. Methods A retrospective analysis was made of the hospitalized patients with solid malignancies complicated with pulmonary embolism who had been admitted into the PUMC Hospital from January 2002 to December 2008. Results The incidence of pulmonary embolism in hospitalized patients with solid malignancies was 0.27% （120/43 967） The median age at diagnosis was 57.5 years. The male to female ratio was 1.0：1.4 （49：71）. Patients with non-small-cell lung cancer （NSCLC） constituted the largest proportion of the 120 patients （37.5%）, followed by patients with breast （9.2%）, ovarian （8.3%）, pancreatic （6.7%）, and liver cancer （6.7%）. Eighty patients （66.7%） had stage ]V cancer. Bone was the most common site of distant metastasis （46.3%）. D-dimer level was elevated in 90.9% of the 66 tested patients. The incidence of bleeding due to anti-coagulation therapy was 3.6%. Thirty-six （30.0%） of the 120 patients had concurrent deep venous thrombosis in the lower extremities. Seventeen patients developed acute pulmonary embolism within 2 weeks after surgery, 3 of whom died suddenly. Four patients presented with deep venous thrombosis and 1 with pulmonary embolism prior to the identification of malignancy. Conclusions Patients with cancer of the lung, ovarian, breast, pancreas, and liver are more likely to be complicated with pulmonary embolism than those with other types of solid tumors. Patients with distant metastasis are at a higher risk of pulmonary embolism. Pulmonary embolism without concurrent deep venous thrombosis is more frequently observed than concurrence of both disorders in the clinical setting.展开更多
Background Hepatic arterial infusion chemotherapy for liver metastases is under evaluation because of the high target dose and low general toxicity. To investigate the efficacy and safety of a Folfox4 regimen administ...Background Hepatic arterial infusion chemotherapy for liver metastases is under evaluation because of the high target dose and low general toxicity. To investigate the efficacy and safety of a Folfox4 regimen administered through a combined hepatic arterial and systemic infusion for the first-line treatment of colorectal cancer （CRC） with unresectable liver metastases. Methods Twenty-seven CRC patients with unresectable hepatic metastases and no prior chemotherapy were enrolled into the study. They received a Folfox4 regimen; 1st day： HAl of oxaliplatin 85 mg/m2 and L-folinic acid 200 mg/m2, followed by a bolus hepatic arterial injection of 5-fluorouracil 400 mg/m2, then continuous HAl of 5-FU 600 mg/m2; 2nd day： infusion of L-folinic acid 200 mg/m2 i.v. followed by an intravenous bolus injection of 5-Fluorouraci1400 mg/m2, then continuous infusion of 5-fluorouracil 600 mg/m2 i.v. The patients received HAl during the odd cycles, and the intravenous administration of the same Folfox4 regimen during the even cycles. Results A total of 236 treatment cycles were given with a median of 10 cycles. The therapy generated the following results after six treatment cycles： complete response （CR） 1/27 （3.7%）, partial response （PR） 17/27 （63.0%）, stable disease （SD） 6/27 （22.2%）, and progress disease （PD） 3/27 （11.1%）. Five patients had hepatectomy. The serum levels of both carcinoembryonic antigen （CEA） and CA19-9 were significantly reduced （P〈0.05）. A median time to progression of 11 months and a median overall survival of 24 months were documented. The major adverse events included grade 1/2 nausea/vomiting, upper abdominal pain, peripheral neuropathy, and neutropenia/thrombocytopenia. Conclusions The Folfox4 regimen administered through combined hepatic arterial and systemic infusions is efficacious and safe for the treatment of CRC with unresectable liver metastases, and it facilitates the control of local lesions.展开更多
文摘Background Pulmonary embolism, a potentially fatal event, occurs more frequently in cancer patients than in the general population. To offer an accurate diagnosis and effective treatment to such patients in China, we analyzed the incidence rate and clinical features of pulmonary embolism in patients with solid tumor hospitalized in the Peking Union Medical College （PUMC） Hospital. Methods A retrospective analysis was made of the hospitalized patients with solid malignancies complicated with pulmonary embolism who had been admitted into the PUMC Hospital from January 2002 to December 2008. Results The incidence of pulmonary embolism in hospitalized patients with solid malignancies was 0.27% （120/43 967） The median age at diagnosis was 57.5 years. The male to female ratio was 1.0：1.4 （49：71）. Patients with non-small-cell lung cancer （NSCLC） constituted the largest proportion of the 120 patients （37.5%）, followed by patients with breast （9.2%）, ovarian （8.3%）, pancreatic （6.7%）, and liver cancer （6.7%）. Eighty patients （66.7%） had stage ]V cancer. Bone was the most common site of distant metastasis （46.3%）. D-dimer level was elevated in 90.9% of the 66 tested patients. The incidence of bleeding due to anti-coagulation therapy was 3.6%. Thirty-six （30.0%） of the 120 patients had concurrent deep venous thrombosis in the lower extremities. Seventeen patients developed acute pulmonary embolism within 2 weeks after surgery, 3 of whom died suddenly. Four patients presented with deep venous thrombosis and 1 with pulmonary embolism prior to the identification of malignancy. Conclusions Patients with cancer of the lung, ovarian, breast, pancreas, and liver are more likely to be complicated with pulmonary embolism than those with other types of solid tumors. Patients with distant metastasis are at a higher risk of pulmonary embolism. Pulmonary embolism without concurrent deep venous thrombosis is more frequently observed than concurrence of both disorders in the clinical setting.
文摘Background Hepatic arterial infusion chemotherapy for liver metastases is under evaluation because of the high target dose and low general toxicity. To investigate the efficacy and safety of a Folfox4 regimen administered through a combined hepatic arterial and systemic infusion for the first-line treatment of colorectal cancer （CRC） with unresectable liver metastases. Methods Twenty-seven CRC patients with unresectable hepatic metastases and no prior chemotherapy were enrolled into the study. They received a Folfox4 regimen; 1st day： HAl of oxaliplatin 85 mg/m2 and L-folinic acid 200 mg/m2, followed by a bolus hepatic arterial injection of 5-fluorouracil 400 mg/m2, then continuous HAl of 5-FU 600 mg/m2; 2nd day： infusion of L-folinic acid 200 mg/m2 i.v. followed by an intravenous bolus injection of 5-Fluorouraci1400 mg/m2, then continuous infusion of 5-fluorouracil 600 mg/m2 i.v. The patients received HAl during the odd cycles, and the intravenous administration of the same Folfox4 regimen during the even cycles. Results A total of 236 treatment cycles were given with a median of 10 cycles. The therapy generated the following results after six treatment cycles： complete response （CR） 1/27 （3.7%）, partial response （PR） 17/27 （63.0%）, stable disease （SD） 6/27 （22.2%）, and progress disease （PD） 3/27 （11.1%）. Five patients had hepatectomy. The serum levels of both carcinoembryonic antigen （CEA） and CA19-9 were significantly reduced （P〈0.05）. A median time to progression of 11 months and a median overall survival of 24 months were documented. The major adverse events included grade 1/2 nausea/vomiting, upper abdominal pain, peripheral neuropathy, and neutropenia/thrombocytopenia. Conclusions The Folfox4 regimen administered through combined hepatic arterial and systemic infusions is efficacious and safe for the treatment of CRC with unresectable liver metastases, and it facilitates the control of local lesions.
