Background: We used transcatheter arterial infusion chemotherapy (TAI) for patients with T1G3 and greater than T2 bladder cancer, which was diagnosed after extensive and deep transurethral resection of bladder tumor (...Background: We used transcatheter arterial infusion chemotherapy (TAI) for patients with T1G3 and greater than T2 bladder cancer, which was diagnosed after extensive and deep transurethral resection of bladder tumor (TUR-BT), and we investigated the utility of serum cytokeratin 19 fragment (CYFRA) as a predictive factor of the response to therapy. Material and Methods: From November 2001 to November 2010, 56 patients (46 males and 10 females) with pathologically confirmed T1 G3 or greater than T2 bladder cancer after TUR-BT underwent two courses of TAI of cisplatin, methotrexate and doxorubicin as neoadjuvant setting. Then, patients underwent evaluation TUR-BT. Thereafter, the bladder was preserved in patients with superficial or undetectable tumors on TUR-BT. Advanced cases and residual bladder tumor cases were treated with total cystectomy or systemic chemotherapy. CYFRA levels were measured before and after performing TAI. Results: With this therapy, the 5-year survival rate was 85.7% in pT1G3, 82.3% in pT2, and 66.6% in greater than pT3 cases. Bladder preservation with no recurrence was observed in 58.7% of the patients. Grade III adverse events included leucopenia (6/56 patients: 10.7%). Serum CYFRA levels significantly decreased with treatment (in 4/6 patients with elevated CYFRA levels). Conclusion: These results suggest that although total cystictomy is usually indicated for T1G3 bladder cancers, bladder preservation and control of micrometastases can be achieved by performing TAI after extensive and deep TUR-BT. Our results also suggest the utility of monitoring serum CYFRA to assess the response to therapy.展开更多
Background Patients with esophageal squamous cell carcinoma （ESCC） undergoing definitive chemoradiotherapy （CRT） seem to have a disparity in therapeutic response. The identification of CRT sensitivity-related clin...Background Patients with esophageal squamous cell carcinoma （ESCC） undergoing definitive chemoradiotherapy （CRT） seem to have a disparity in therapeutic response. The identification of CRT sensitivity-related clinicopathological factors would be helpful for selecting patients most likely to benefit from CRT. Cytokeratin 19 fragment antigen 21-1 （CYFRA21-1） and carcinoembryonic antigen （CEA） have been reported as useful tumor markers for esophageal cancer. The aim of this study was to examine the predictive value of CYFRA21-1 in comparison with CEA and other clinicopathological factors in patients with ESCC treated with definitive CRT. Methods Pretreatment serum CYFRA21-1 and CEA levels were measured by immunoradiometric assays. The relationships between pretreatment clinicopathological factors and the efficacy of CRT were analyzed. Overall survival （OS） was estimated by univariate and multivariate analysis. Results The results from a univariate analysis indicated that the efficacy of CRT was significantly associated with the serum levels of CYFRA21-1 and CEA before treatment （P=0.001 and P=0.023, respectively）. It also indicated that the efficacy of CRT was significantly associated with the pretreatment tumor location （P=-0.041）. By Logistic regression analysis, the independent predictive factor associated with efficacy of CRT was CYFRA21-1 （P=0.002）. The OS of the patients with high CYFRA 21-1 levels was worse than that of those with low CYFRA21-1 levels （P=0.001）. In multivariate analysis, a low level of CYFRA21-1 was the most significant independent predictor of good OS （P=0.007）. Conclusions CEA and tumor location may be useful in predicting the sensitivity of ESCC to CRT. CYFRA21-1 may be an independent predictor for definitive CRT sensitivity in ESCC.展开更多
文摘Background: We used transcatheter arterial infusion chemotherapy (TAI) for patients with T1G3 and greater than T2 bladder cancer, which was diagnosed after extensive and deep transurethral resection of bladder tumor (TUR-BT), and we investigated the utility of serum cytokeratin 19 fragment (CYFRA) as a predictive factor of the response to therapy. Material and Methods: From November 2001 to November 2010, 56 patients (46 males and 10 females) with pathologically confirmed T1 G3 or greater than T2 bladder cancer after TUR-BT underwent two courses of TAI of cisplatin, methotrexate and doxorubicin as neoadjuvant setting. Then, patients underwent evaluation TUR-BT. Thereafter, the bladder was preserved in patients with superficial or undetectable tumors on TUR-BT. Advanced cases and residual bladder tumor cases were treated with total cystectomy or systemic chemotherapy. CYFRA levels were measured before and after performing TAI. Results: With this therapy, the 5-year survival rate was 85.7% in pT1G3, 82.3% in pT2, and 66.6% in greater than pT3 cases. Bladder preservation with no recurrence was observed in 58.7% of the patients. Grade III adverse events included leucopenia (6/56 patients: 10.7%). Serum CYFRA levels significantly decreased with treatment (in 4/6 patients with elevated CYFRA levels). Conclusion: These results suggest that although total cystictomy is usually indicated for T1G3 bladder cancers, bladder preservation and control of micrometastases can be achieved by performing TAI after extensive and deep TUR-BT. Our results also suggest the utility of monitoring serum CYFRA to assess the response to therapy.
文摘Background Patients with esophageal squamous cell carcinoma （ESCC） undergoing definitive chemoradiotherapy （CRT） seem to have a disparity in therapeutic response. The identification of CRT sensitivity-related clinicopathological factors would be helpful for selecting patients most likely to benefit from CRT. Cytokeratin 19 fragment antigen 21-1 （CYFRA21-1） and carcinoembryonic antigen （CEA） have been reported as useful tumor markers for esophageal cancer. The aim of this study was to examine the predictive value of CYFRA21-1 in comparison with CEA and other clinicopathological factors in patients with ESCC treated with definitive CRT. Methods Pretreatment serum CYFRA21-1 and CEA levels were measured by immunoradiometric assays. The relationships between pretreatment clinicopathological factors and the efficacy of CRT were analyzed. Overall survival （OS） was estimated by univariate and multivariate analysis. Results The results from a univariate analysis indicated that the efficacy of CRT was significantly associated with the serum levels of CYFRA21-1 and CEA before treatment （P=0.001 and P=0.023, respectively）. It also indicated that the efficacy of CRT was significantly associated with the pretreatment tumor location （P=-0.041）. By Logistic regression analysis, the independent predictive factor associated with efficacy of CRT was CYFRA21-1 （P=0.002）. The OS of the patients with high CYFRA 21-1 levels was worse than that of those with low CYFRA21-1 levels （P=0.001）. In multivariate analysis, a low level of CYFRA21-1 was the most significant independent predictor of good OS （P=0.007）. Conclusions CEA and tumor location may be useful in predicting the sensitivity of ESCC to CRT. CYFRA21-1 may be an independent predictor for definitive CRT sensitivity in ESCC.
