AIM:To evaluate the role of endoscopic stenting with or without concurrent 3-dimensional conformal chemoradiotherapy (3D-CRT) in patients with inoperable esophageal cancer.METHODS:Advanced esophageal cancer patients i...AIM:To evaluate the role of endoscopic stenting with or without concurrent 3-dimensional conformal chemoradiotherapy (3D-CRT) in patients with inoperable esophageal cancer.METHODS:Advanced esophageal cancer patients indicated for esophagectomy received esophageal stents.A part of patients completed 3D-CRT after stenting.Efficacy was assessed by endoscopy and computed tomographic scan before and 4 wk after completion of the treatment.The median survival,3D-CRT toxicity and complications were compared between 3D-CRT and control groups.RESULTS:From 1999 to 2008,99 consecutive patients with T3/T4 disease and unsuitable for esophagectomy were placed with esophageal stents.Sixty-seven patients received 3D-CRT,while 36 patients treated withendoscopic stents alone were recruited as controls.After 3D-CRT treatment,the median tumor volume of 3D-CRT patients were reduced significantly from 43.7 ± 10.2 cm 3 to 28.8 ± 8.5 cm 3 (P < 0.05).The complete and partial response rate was 85.1%,and no response was 14.9%.After 3D-CRT,the incidence rate of T2 and T3 disease evident on CT scan increased to 78.4% while T4 decreased from 66.7% to 21.6% (P < 0.05).3DCRT Karnofsky Performance Status improved in 3D-CRT patients compared with the control group (P=0.031).3D-CRT patients had a longer survival than the control group (251.7 d vs 91.1 d,P < 0.05).And the median half-year survival rate in 3D-CRT group (91%) was higher than in the control group (50%,P < 0.05).The most common toxicity was leukocytopenia in the 3D-CRT group (46.7% vs 18.8%,P=0.008).The control group had a higher rate of restenosis than the 3D-CRT group (81.3% vs 9.0%,P < 0.05).The rate of nephrotoxicity was increased in 3D-CRT as compared with the control group (31.3% vs 15.6%,P < 0.05).CONCLUSION:3D-CRT can improve dysphagia in patients with inoperable esophageal carcinoma.3D-CRT combined with stenting results in better survival as compared with endoscopic stents used alone.展开更多
Objective： The aim of this study was to study the short-term curative effects and adverse reactions of docetaxel （DOC） in concurrent chemoradiotherapy compared to DDP plus 5-Fu （DF） combined with concurrent radio...Objective： The aim of this study was to study the short-term curative effects and adverse reactions of docetaxel （DOC） in concurrent chemoradiotherapy compared to DDP plus 5-Fu （DF） combined with concurrent radiotherapy in patients with advanced nasopharyngeal carcinoma. Methods： Thirty-three patients in the experimental group （DOC group） were given DOC 25 mg/m2 ivgtt, dl, 7 times, concurrent radiotherapy was performed from dl. Thirty-three patients in the control group （DF group） were given cisplatin 25 mg/@ivgtt dl-3 and 5-Fu 550 mg/m2iv, dl-5, 3 weeks a cycle, 2 cycles, and concurrent radiotherapy was performed from dl. Six MV X-ray and 9 MeV electronic line for external irradiation were adopted in concur- rent radiotherapy. Results： The response rates of DOC group and DF group were 90.9% and 93.9%, the rates of neutropenia were 45.45% and 67.74%, and the rates of oral mucositis were 60.61% and 90.32%. Conclusion： The difference of short- term curative effects between DOC group and DF group was not statistically significant in patients with advanced nasopha- ryngeal carcinoma. The rates of adverse reactions were lower in DOC group. DOC combined with concurrent radiotherapy could be a new choice for patients with advanced nasopharyngeal carcinoma.展开更多
Background The data on the prognostic values of high sensitivity C-reactive protein （hsCRP） levels in patients with advanced symp-tomatic heart failure （HF） receiving cardiac resynchronization therapy （CRT） are ...Background The data on the prognostic values of high sensitivity C-reactive protein （hsCRP） levels in patients with advanced symp-tomatic heart failure （HF） receiving cardiac resynchronization therapy （CRT） are scarce. The aim of present study was to investigate the association of serum hsCRP levels with left ventricle reverse remodeling after six months of CRT as well as long-term outcome. Methods A total of 232 CRT patients were included. The assessment of hsCRP values, clinical status and echocardiographic data were performed at baseline and after six months of CRT. Long-term follow-up included all-cause mortality and hospitalizations for HF. Results During the mean follow-up periods of 31.3 ± 31.5 months, elevated hsCRP （〉3 mg/L） prior to CRT was associated with a significant 2.39-fold increase （P=0.006） in the risk of death or HF hospitalizations. At 6-month follow-up, patients who responded to CRT showed significant reductions or maintained low in hsCRP levels （–0.5 ± 4.1 mg/L reduction） compared with non-responders （1.7 ± 6.1 mg/L increase, P=0.018）. Com-pared with patients in whom 6-month hsCRP levels were reduced or remained low, patients in whom 6-month hsCRP levels were increased or maintained high experienced a significantly higher risk of subsequent death or HF hospitalizations （Log-rank P〈0.001）. The echocardio-graphic improvement was also better among patients in whom 6-month hsCRP levels were reduced or remained low compared to those in whom 6-month hsCRP levels were raised or maintained high. Conclusions Our findings demonstrated that measurement of baseline and follow-up hsCRP levels may be useful as prognostic markers for timely potential risk stratification and subsequent appropriate treatment strategies in patients with advanced HF undergoing CRT.展开更多
Objective:The purpose of this study was to evaluate the efficacy and safety of concurrent chemoradiotherapy (CCRT) in patients with locally advanced non-small cell lung cancer (LANSCLC). Methods:83 cases of patients w...Objective:The purpose of this study was to evaluate the efficacy and safety of concurrent chemoradiotherapy (CCRT) in patients with locally advanced non-small cell lung cancer (LANSCLC). Methods:83 cases of patients who have been diagnosed for locally advanced NSCLC by determined cytology or pathology were divided into two groups randomly, 42 patients in NP group and 41 patients in EP group. All patients accepted thoracic three-dimensional conformal radiotherapy (3D-CRT) and concurrent either NP chemotherapy in NP group or EP chemotherapy in EP group. 3D-CRT were started on day 1 in the first cycle of chemotherapy. Chemotherapy were carried out for 4 cycles, every cycle was 21 days. Thoracic radiotherapy adopted conventional fractionated irradiation with 15 MeV-X ray, a total dose of 60 Gy. Results: In 83 patients were evaluable, there were 5 cases complete regression to be observed, 29 cases had partial regression (PR), 7 cases with stable disease (SD) and 1 case with progression disease (PD) in NP group. CR 3 cases, PR 27 cases, SD 9 cases and PD 2 cases in EP group. The overall response rate (RR) both NP group and EP group were 80.9%, 73.2%, respectively (P = 0.785).1-, 2-, 3-year survival rate were 90.5%, 69.0%, 28.6% and 82.9%, 51.2%, 21.9%, respectively (P = 0.393). The incidence of leukopenia and thrombocytopenia in NP group was higher than that in the EP group (P < 0.05). Conclusion:CCRT in patients with locally advanced non-small cell lung cancer, 3D-CRT with concurrent NP or EP chemotherapy. 1-, 2-, 3-year overall survival (OS) and average survival time (AST) were not statistically differences, a higher incidence of toxicities were observed in NP group but can be tolerable.展开更多
Objective： The aim of our study was to investigate the early outcome of the taxotere and cisplatin chemora- diotherapy to the advanced cervical cancer. Methods： Fifty-six cases with cervical cancer （FIGO lib to IVa...Objective： The aim of our study was to investigate the early outcome of the taxotere and cisplatin chemora- diotherapy to the advanced cervical cancer. Methods： Fifty-six cases with cervical cancer （FIGO lib to IVa） were divided randomly into two groups in the oncology hospital of Jingzhou from September 2009 to October 2010, radiotherapy alone （28 cases） and radiation plus chemotherapy （TP） group. There was no difference of radiotherapy between the two groups, the RT ＋ C cases who accepted TP regimen during the radiation, and DDP once weekly injection of vain, according to 20 mg/m2 and taxotere once weekly i.v. according to 35 mg/m2. These regimen were given for 4-5 weeks, and some medicine for vomit- ing was given to the RT ＋ C cases. Two groups were received an oral medicine MA 160 mg every day during the treatment. Results： The early outcome： the complete remission rate was 64.3% and partial remission rate was 35.7% in RT ＋ C. The complete remission rate was 32.1% and partial remission rate was 39.3% in RT. The total response rate and complete remis- sion of RT ＋ C group was higher than that of the RT group. There was significant difference between the two groups. In RT ＋ C group, 1-year survive rate was 100.00% （28/28）; in RT group, 1-year survive rate was 85.71% （24/28）. There was significant difference between the two groups （X2 = 4.31 〉 3.84, P 〈 0.05）. Conclusion： The taxotere and cisplatin chemoradiotherapy can improve the early outcome of the advanced cervical cancer, and the adverse effect are raised, but that can be endured.展开更多
OBJECTIVE To evaluate the clinical efficacy and toxicities of simultaneous modulated accelerated radiotherapy （SMART） and concurrent chemotherapy for locally advanced nasopharyngeal carcinoma. METHODS Eightyseven pa...OBJECTIVE To evaluate the clinical efficacy and toxicities of simultaneous modulated accelerated radiotherapy （SMART） and concurrent chemotherapy for locally advanced nasopharyngeal carcinoma. METHODS Eightyseven patients with nasopharyngeal carcinoma received SMART from April 2002 to September 2006. According to the UICC staging system, 30 patients were diagnosed as stage IIb, 42 patients stage III, 13 patients stage IVa and 2 patients stage IVb. The intensitymodulated radiotherapy was delivered with the ＂step and shoot＂ SMART technique with the prescribed dose of 66-76 Gy （2.2-2.4 Gy/day） to the gross tumor volume （GTV） and positive neck lymph nodes （GTVLN）, with 60 Gy （2.0 Gy/day） to the highrisk clinical target volume （CTV1）, encompassing the area around the nasopharynx and the upper neck, and with 54 Gy （1.8 Gy/day） to the lowrisk clinical target volume （CTV2）, including the lower neck and supraclavicular area. Among all the patients, 31 received 2 cycles of SMART concurrently with 5 fluorouracil （5-Fu） and cisplatin （the FP group） and 56 received 2 cycles of concurrent cisplatin. All the patients received 3 to 4 cycles of adjuvant combination chemotherapy of cisplatin and 5fluorouracil starting from the 1st month after completion of SMART. RESULTS With a median follow up of 59 months （ranging from 19 to 85 months）, the 1, 2 and 3year overall survival rates were 100%, 94.6% and 91.3% respectively. Acute mucositis and pharyngitis were more frequently observed in the FP group than in the cisplatin group. CONCLUSION SMART technique provides an excellent opportunity to spare normal tissue and is probably more biologically effective. Combination of single cisplatin was more tolerable.展开更多
文摘AIM:To evaluate the role of endoscopic stenting with or without concurrent 3-dimensional conformal chemoradiotherapy (3D-CRT) in patients with inoperable esophageal cancer.METHODS:Advanced esophageal cancer patients indicated for esophagectomy received esophageal stents.A part of patients completed 3D-CRT after stenting.Efficacy was assessed by endoscopy and computed tomographic scan before and 4 wk after completion of the treatment.The median survival,3D-CRT toxicity and complications were compared between 3D-CRT and control groups.RESULTS:From 1999 to 2008,99 consecutive patients with T3/T4 disease and unsuitable for esophagectomy were placed with esophageal stents.Sixty-seven patients received 3D-CRT,while 36 patients treated withendoscopic stents alone were recruited as controls.After 3D-CRT treatment,the median tumor volume of 3D-CRT patients were reduced significantly from 43.7 ± 10.2 cm 3 to 28.8 ± 8.5 cm 3 (P < 0.05).The complete and partial response rate was 85.1%,and no response was 14.9%.After 3D-CRT,the incidence rate of T2 and T3 disease evident on CT scan increased to 78.4% while T4 decreased from 66.7% to 21.6% (P < 0.05).3DCRT Karnofsky Performance Status improved in 3D-CRT patients compared with the control group (P=0.031).3D-CRT patients had a longer survival than the control group (251.7 d vs 91.1 d,P < 0.05).And the median half-year survival rate in 3D-CRT group (91%) was higher than in the control group (50%,P < 0.05).The most common toxicity was leukocytopenia in the 3D-CRT group (46.7% vs 18.8%,P=0.008).The control group had a higher rate of restenosis than the 3D-CRT group (81.3% vs 9.0%,P < 0.05).The rate of nephrotoxicity was increased in 3D-CRT as compared with the control group (31.3% vs 15.6%,P < 0.05).CONCLUSION:3D-CRT can improve dysphagia in patients with inoperable esophageal carcinoma.3D-CRT combined with stenting results in better survival as compared with endoscopic stents used alone.
文摘Objective： The aim of this study was to study the short-term curative effects and adverse reactions of docetaxel （DOC） in concurrent chemoradiotherapy compared to DDP plus 5-Fu （DF） combined with concurrent radiotherapy in patients with advanced nasopharyngeal carcinoma. Methods： Thirty-three patients in the experimental group （DOC group） were given DOC 25 mg/m2 ivgtt, dl, 7 times, concurrent radiotherapy was performed from dl. Thirty-three patients in the control group （DF group） were given cisplatin 25 mg/@ivgtt dl-3 and 5-Fu 550 mg/m2iv, dl-5, 3 weeks a cycle, 2 cycles, and concurrent radiotherapy was performed from dl. Six MV X-ray and 9 MeV electronic line for external irradiation were adopted in concur- rent radiotherapy. Results： The response rates of DOC group and DF group were 90.9% and 93.9%, the rates of neutropenia were 45.45% and 67.74%, and the rates of oral mucositis were 60.61% and 90.32%. Conclusion： The difference of short- term curative effects between DOC group and DF group was not statistically significant in patients with advanced nasopha- ryngeal carcinoma. The rates of adverse reactions were lower in DOC group. DOC combined with concurrent radiotherapy could be a new choice for patients with advanced nasopharyngeal carcinoma.
文摘Background The data on the prognostic values of high sensitivity C-reactive protein （hsCRP） levels in patients with advanced symp-tomatic heart failure （HF） receiving cardiac resynchronization therapy （CRT） are scarce. The aim of present study was to investigate the association of serum hsCRP levels with left ventricle reverse remodeling after six months of CRT as well as long-term outcome. Methods A total of 232 CRT patients were included. The assessment of hsCRP values, clinical status and echocardiographic data were performed at baseline and after six months of CRT. Long-term follow-up included all-cause mortality and hospitalizations for HF. Results During the mean follow-up periods of 31.3 ± 31.5 months, elevated hsCRP （〉3 mg/L） prior to CRT was associated with a significant 2.39-fold increase （P=0.006） in the risk of death or HF hospitalizations. At 6-month follow-up, patients who responded to CRT showed significant reductions or maintained low in hsCRP levels （–0.5 ± 4.1 mg/L reduction） compared with non-responders （1.7 ± 6.1 mg/L increase, P=0.018）. Com-pared with patients in whom 6-month hsCRP levels were reduced or remained low, patients in whom 6-month hsCRP levels were increased or maintained high experienced a significantly higher risk of subsequent death or HF hospitalizations （Log-rank P〈0.001）. The echocardio-graphic improvement was also better among patients in whom 6-month hsCRP levels were reduced or remained low compared to those in whom 6-month hsCRP levels were raised or maintained high. Conclusions Our findings demonstrated that measurement of baseline and follow-up hsCRP levels may be useful as prognostic markers for timely potential risk stratification and subsequent appropriate treatment strategies in patients with advanced HF undergoing CRT.
文摘Objective:The purpose of this study was to evaluate the efficacy and safety of concurrent chemoradiotherapy (CCRT) in patients with locally advanced non-small cell lung cancer (LANSCLC). Methods:83 cases of patients who have been diagnosed for locally advanced NSCLC by determined cytology or pathology were divided into two groups randomly, 42 patients in NP group and 41 patients in EP group. All patients accepted thoracic three-dimensional conformal radiotherapy (3D-CRT) and concurrent either NP chemotherapy in NP group or EP chemotherapy in EP group. 3D-CRT were started on day 1 in the first cycle of chemotherapy. Chemotherapy were carried out for 4 cycles, every cycle was 21 days. Thoracic radiotherapy adopted conventional fractionated irradiation with 15 MeV-X ray, a total dose of 60 Gy. Results: In 83 patients were evaluable, there were 5 cases complete regression to be observed, 29 cases had partial regression (PR), 7 cases with stable disease (SD) and 1 case with progression disease (PD) in NP group. CR 3 cases, PR 27 cases, SD 9 cases and PD 2 cases in EP group. The overall response rate (RR) both NP group and EP group were 80.9%, 73.2%, respectively (P = 0.785).1-, 2-, 3-year survival rate were 90.5%, 69.0%, 28.6% and 82.9%, 51.2%, 21.9%, respectively (P = 0.393). The incidence of leukopenia and thrombocytopenia in NP group was higher than that in the EP group (P < 0.05). Conclusion:CCRT in patients with locally advanced non-small cell lung cancer, 3D-CRT with concurrent NP or EP chemotherapy. 1-, 2-, 3-year overall survival (OS) and average survival time (AST) were not statistically differences, a higher incidence of toxicities were observed in NP group but can be tolerable.
文摘Objective： The aim of our study was to investigate the early outcome of the taxotere and cisplatin chemora- diotherapy to the advanced cervical cancer. Methods： Fifty-six cases with cervical cancer （FIGO lib to IVa） were divided randomly into two groups in the oncology hospital of Jingzhou from September 2009 to October 2010, radiotherapy alone （28 cases） and radiation plus chemotherapy （TP） group. There was no difference of radiotherapy between the two groups, the RT ＋ C cases who accepted TP regimen during the radiation, and DDP once weekly injection of vain, according to 20 mg/m2 and taxotere once weekly i.v. according to 35 mg/m2. These regimen were given for 4-5 weeks, and some medicine for vomit- ing was given to the RT ＋ C cases. Two groups were received an oral medicine MA 160 mg every day during the treatment. Results： The early outcome： the complete remission rate was 64.3% and partial remission rate was 35.7% in RT ＋ C. The complete remission rate was 32.1% and partial remission rate was 39.3% in RT. The total response rate and complete remis- sion of RT ＋ C group was higher than that of the RT group. There was significant difference between the two groups. In RT ＋ C group, 1-year survive rate was 100.00% （28/28）; in RT group, 1-year survive rate was 85.71% （24/28）. There was significant difference between the two groups （X2 = 4.31 〉 3.84, P 〈 0.05）. Conclusion： The taxotere and cisplatin chemoradiotherapy can improve the early outcome of the advanced cervical cancer, and the adverse effect are raised, but that can be endured.
文摘OBJECTIVE To evaluate the clinical efficacy and toxicities of simultaneous modulated accelerated radiotherapy （SMART） and concurrent chemotherapy for locally advanced nasopharyngeal carcinoma. METHODS Eightyseven patients with nasopharyngeal carcinoma received SMART from April 2002 to September 2006. According to the UICC staging system, 30 patients were diagnosed as stage IIb, 42 patients stage III, 13 patients stage IVa and 2 patients stage IVb. The intensitymodulated radiotherapy was delivered with the ＂step and shoot＂ SMART technique with the prescribed dose of 66-76 Gy （2.2-2.4 Gy/day） to the gross tumor volume （GTV） and positive neck lymph nodes （GTVLN）, with 60 Gy （2.0 Gy/day） to the highrisk clinical target volume （CTV1）, encompassing the area around the nasopharynx and the upper neck, and with 54 Gy （1.8 Gy/day） to the lowrisk clinical target volume （CTV2）, including the lower neck and supraclavicular area. Among all the patients, 31 received 2 cycles of SMART concurrently with 5 fluorouracil （5-Fu） and cisplatin （the FP group） and 56 received 2 cycles of concurrent cisplatin. All the patients received 3 to 4 cycles of adjuvant combination chemotherapy of cisplatin and 5fluorouracil starting from the 1st month after completion of SMART. RESULTS With a median follow up of 59 months （ranging from 19 to 85 months）, the 1, 2 and 3year overall survival rates were 100%, 94.6% and 91.3% respectively. Acute mucositis and pharyngitis were more frequently observed in the FP group than in the cisplatin group. CONCLUSION SMART technique provides an excellent opportunity to spare normal tissue and is probably more biologically effective. Combination of single cisplatin was more tolerable.
