AIM： To evaluate the efficacy of thalidomide in com- bination with other therapies to treat patients with ad- vanced hepatocellular carcinoma （HCC）. METHODS： We performed a retrospective analysis of all patients w...AIM： To evaluate the efficacy of thalidomide in com- bination with other therapies to treat patients with ad- vanced hepatocellular carcinoma （HCC）. METHODS： We performed a retrospective analysis of all patients with HCC who were treated with thalido- mide for at least two months. The medical records of patients with HCC who were treated at our institution between April 2003 and March 2008 were reviewed. Image studies performed before and after treatment, tumor response, overall survival, and the decrease in o-fetoprotein （AFP） levels were evaluated. RESULTS： A total of 53 patients with HCC received either 100 or 200 mg/d of thalidomide. The patient population consisted of 9 women and 44 men with a median age of 61 years. Thirty patients （56.6%） were classified as Child-Pugh A, and 12 patients （22.6%） were classified as Child-Pugh B. Twenty-six patients had portal vein thrombosis （49.1%）, and 25 patients had extrahepatic metastasis （47.1%）. The median duration of thalidomide treatment was 6.0 mo. Six of the 53 patients achieved a confirmed response （11.3%）, one achieved a complete response （1.9%） and 5 achieved a partial response （9.4%）. The disease control rate （CR ＋ PR ＋ SD） was 28.3% （95% CI： 17.8-42.4）, and the median overall survival rate was 10.5 too. The 1- and 2-year survival rates were 45% and 20%, respectively. Only one complete response patient showed an im- proved overall survival rate of 66.8 mo. Sixteen patients （30.2%） showed more than a 50% decrease in their serum AFP levels from baseline, indicating a better re- sponse rate （31.3%）, disease control rate （43.8%）, and overall survival time （20.7 mo）. The therapy was well tolerated, and no significant toxicities were observed. CONCLUSION： Thalidomide was found to be safe for advanced HCC patients, demonstrating anti-tumor ac- tivity including response, survival, and AFP decreases of greater than 50% from baseline.展开更多
Two cases of gastroendoscopy-associated Acinetobacter baumannii (A. baumannii ) bacteremia were discovered at the study hospital. The first case was a 66-year-old woman who underwent endoscopic retrograde cholangiopan...Two cases of gastroendoscopy-associated Acinetobacter baumannii (A. baumannii ) bacteremia were discovered at the study hospital. The first case was a 66-year-old woman who underwent endoscopic retrograde cholangiopancreatography and endoscopic retrograde papillotomy, and then A. baumannii bacteremia occurred. The second case was a 70-year-old female who underwent endoscopic retrograde biliary drainage due to obstruction of intra-hepatic ducts, and bacteremia occurred due to polymicrobes (Escherichia coli , viridans streptococcus , and A. baumannii ). After a literature review, we suggest that correct gastroendoscopy technique and skill in drainage procedures, as well as antibiotic prophylaxis, are of paramount importance in minimizing the risk of gastroendoscopy-associated bacteremia.展开更多
文摘AIM： To evaluate the efficacy of thalidomide in com- bination with other therapies to treat patients with ad- vanced hepatocellular carcinoma （HCC）. METHODS： We performed a retrospective analysis of all patients with HCC who were treated with thalido- mide for at least two months. The medical records of patients with HCC who were treated at our institution between April 2003 and March 2008 were reviewed. Image studies performed before and after treatment, tumor response, overall survival, and the decrease in o-fetoprotein （AFP） levels were evaluated. RESULTS： A total of 53 patients with HCC received either 100 or 200 mg/d of thalidomide. The patient population consisted of 9 women and 44 men with a median age of 61 years. Thirty patients （56.6%） were classified as Child-Pugh A, and 12 patients （22.6%） were classified as Child-Pugh B. Twenty-six patients had portal vein thrombosis （49.1%）, and 25 patients had extrahepatic metastasis （47.1%）. The median duration of thalidomide treatment was 6.0 mo. Six of the 53 patients achieved a confirmed response （11.3%）, one achieved a complete response （1.9%） and 5 achieved a partial response （9.4%）. The disease control rate （CR ＋ PR ＋ SD） was 28.3% （95% CI： 17.8-42.4）, and the median overall survival rate was 10.5 too. The 1- and 2-year survival rates were 45% and 20%, respectively. Only one complete response patient showed an im- proved overall survival rate of 66.8 mo. Sixteen patients （30.2%） showed more than a 50% decrease in their serum AFP levels from baseline, indicating a better re- sponse rate （31.3%）, disease control rate （43.8%）, and overall survival time （20.7 mo）. The therapy was well tolerated, and no significant toxicities were observed. CONCLUSION： Thalidomide was found to be safe for advanced HCC patients, demonstrating anti-tumor ac- tivity including response, survival, and AFP decreases of greater than 50% from baseline.
基金Supported by A Grant from the Changhua Christian Hospital,partially
文摘Two cases of gastroendoscopy-associated Acinetobacter baumannii (A. baumannii ) bacteremia were discovered at the study hospital. The first case was a 66-year-old woman who underwent endoscopic retrograde cholangiopancreatography and endoscopic retrograde papillotomy, and then A. baumannii bacteremia occurred. The second case was a 70-year-old female who underwent endoscopic retrograde biliary drainage due to obstruction of intra-hepatic ducts, and bacteremia occurred due to polymicrobes (Escherichia coli , viridans streptococcus , and A. baumannii ). After a literature review, we suggest that correct gastroendoscopy technique and skill in drainage procedures, as well as antibiotic prophylaxis, are of paramount importance in minimizing the risk of gastroendoscopy-associated bacteremia.
