AIM: To evaluate results of pre-operative radiochemotherapy followed by surgery for 15 patients with locally advanced un-resectable rectal cancer.METHODS: 15 patients with advanced non-resectable rectal cancer were tr...AIM: To evaluate results of pre-operative radiochemotherapy followed by surgery for 15 patients with locally advanced un-resectable rectal cancer.METHODS: 15 patients with advanced non-resectable rectal cancer were treated with pre-operative irriadiation of 40-46 Gy plus concomitant chemotherapy (5-FU+LV and 5′-DFuR) (RCS group). For comparison, 27 similar patients,treated by preoperative radiotherapy (40-50 Gy) plus surgery were served as control (RS group).RESULTS: No radiochemotherapy or radiotherapy was interrupted and then was delayed because of toxicities in both groups. The radical resectability rate was 73.3% in the RCS group and 37.0% (P=0.024) in RS group. Sphincter preservation rates were 26.6% and 3.7% respectively (P=0.028). Sphincter preservation rates of lower rectal cancer were 27.3 % and 0.0 % respectively (P=0.014). Response rates of RCS and RS groups were 46.7 % and 18.5 %(P=0.053). The tumor downstage rates were 8 (53.3%)and 9 (33.3%) in these groups (P=0.206). The 3-year overall survival rates were 66.7 % and 55.6% (P=0.485), and the disease free survival rates were 40.1% and 33.2%(P=0.663). The 3-year local recurrent rates were 26.7%and 48.1% (P=0.174). No obvious late effects were found in either groups.CONCLUSION: High resectability is possible following preoperative radiochemotherapy and can have more sphincters preserved. It is important to improve the quality of the patients′ life even without increasing the survival or local control rates. Preoperative radiotherapy with concomitant full course chemotherapy (5-Fu+LV and 5′-DFuR) is effective and safe.展开更多
AIM： To evaluate the utility of local tumor therapy combined with percutaneous transhepatic bilian/drainage （PTBD） for malignant obstructive bilian/disease. METHODS： A total of 233 patients with malignant billan/o...AIM： To evaluate the utility of local tumor therapy combined with percutaneous transhepatic bilian/drainage （PTBD） for malignant obstructive bilian/disease. METHODS： A total of 233 patients with malignant billan/obstruction were treated in our hospital with PTBD by placement of metallic stents and/or plastic tubes. After PTBD, 49 patients accepted brachytherapy or extraradiation therapy or arterial infusion chemotherapy. The patients were followed up with clinical and radiographic evaluation. The survival and stent patency rate were calculated by Kaplan-Meier survival analysis. RESULTS： Twenty-two patients underwent chemotherapy （11 cases of hepatic carcinoma, 7 cases of pancreatic carcinoma, 4 cases of metastatic lymphadenopathy）, and 14 patients received radiotherapy （10 cases of cholangiocardnoma, 4 cases of pancreatic carcinoma）, and 13 patients accepted brachytherapy （7 cases of cholangiocarcinoma, 3 cases of pancreatic carcinoma, 4 cases of metastatic lymphadenopathy）. The survival rate of the local tumor treatment group at 1, 3, 6, and 12 months was 97.96%, 95.92%, 89.80%, and 32.59% respectively, longer than that of the non treatment group. The patency rate at 1, 3, 6, and 12 months was 97.96%, 93.86%, 80.93%, and 56.52% respectively. The difference of patency rate was not significant between treatment group and non treatment group. CONCLUSION： Our results suggest that local tumor therapy could prolong the survival time of patients with malignant biliary obstruction, and may improve stent patency.展开更多
The relationship between dopamine D2 receptors and brain perfusion in hemi-parkinsonism rats was studied. Hemi-parkinsonism rats were made by stereotaxic 6-hydroxy dopamine (6-OH-DA) lesions in substantia nigra(SN) an...The relationship between dopamine D2 receptors and brain perfusion in hemi-parkinsonism rats was studied. Hemi-parkinsonism rats were made by stereotaxic 6-hydroxy dopamine (6-OH-DA) lesions in substantia nigra(SN) and ventral tegmental area(VTA), apomorphine (Apo) which could induced the successful model rat rotates toward the intact side was used to select the rats, 125I-IBZM ex-vivo autoradiography analysis and 99mTc-HM-PAO regional cerebral biodistribution were used to evaluate D2 receptors and cerebral blood flow. The HPLC-ECD were used to measure striatum DA and its metabolites content. The lesioned side striatum DA and its metabolites HVA DOPAC reduced significantly than that of the intact side and seudo-operated group, striatum/cerebellum 125I-IBZM uptake ratio was 8.04+-0.71 in lesioned side of hemi-parkinsonism rats, significantly increased compared with the intact side and the seudo-operated group(p <0.05), 30.11+-4.53% enhancement as compared to the intact side, and also show good correlation with 30 min Apo induced rotation numbers (r=0.98), the regional cerebral blood flow study didn’t show significant difference between bilateral brain cortex area(p >0.05). These results indicated that in the 6- OH-DA lesioned side DA content decreased significantly and an up-regulation of striatum D2 receptor binding sites was induced in hemi-parkinsonism rats, which showed good correlation with rotation behavior induced by Apo. Comparing with cerebral blood flow, D2 receptor reflected by IBZM seems to be more specific and earlier to detect the cerebral functional impairment in experimental bend-parkinsonism.展开更多
Patients with locally advanced esophageal cancer have a dismal prognosis when treated exclu- sively by surgery. This fact prompted many investigators to apply neoadjuvant treatment strategies in an e?ort to improve su...Patients with locally advanced esophageal cancer have a dismal prognosis when treated exclu- sively by surgery. This fact prompted many investigators to apply neoadjuvant treatment strategies in an e?ort to improve survival. Results from phase III randomized trials are encouraging however, they revealed 五笔字型计算机汉字输入技术 that only patients with major histopathological response will bene?t from treatment. Therefore, predic- tive molecular markers indicating response or non-response to neoadjuvant treatment would be extremely helpful in selecting patients for current and future treatment protocols. In this paper we review the role of the molecular markers ERCC1 (excision repair cross-complementing 1 gene) and c-erbB-2 (synonym: HER2/neu) in predicting response to radiochemotherapy and outcome for patients with locally advanced resectable esophageal cancers (cT2-4, Nx, M0). The results are promising and it appears that we might expect to unequivocally identify with ERCC1 and c-erbB-2 respectively, approximately up to one third of patients who ful?l the criteria for neoadjuvant treatment for locally advanced esophageal cancer but will not bene?t from our treatment protocol. Integration of such markers in the clinical setting might prevent a substantial number of patients from expensive, non-e?ective and potentially harmful therapies, and could lead to a more individualized type of combined multimodality treatment in the near future.展开更多
AIM： To evaluate late effects of chemoradiation on gastrointestinal mucosa with an endoscopic scoring system and compare it to a clinical scoring system. METHODS： Twenty-four patients going to receive chemoradiation...AIM： To evaluate late effects of chemoradiation on gastrointestinal mucosa with an endoscopic scoring system and compare it to a clinical scoring system. METHODS： Twenty-four patients going to receive chemoradiation after gastric surgery underwent endoscopy four wk after surgery and one year after the chemoradiation finished. Upper gastrointestinal findings were recorded according to a system proposed by World Organisation for Digestive Endoscopy （OMED） and clinical scoring was done with RTOG-EORTC radiation morbidity scoring systems. RESULTS： There was no significant endoscopic difference in gastric and intestinal mucosa after chemoradiation （P 〉 0.05） and there was no association between endoscopic scores and clinical scores. Endoscopic changes were minimal. CONCLUSION： Late effects after chemoradiation in operated patients with gastric cancers can be evaluated with an endoscopic scoring system objectively and this system is superior to clinical scoring systems.展开更多
文摘AIM: To evaluate results of pre-operative radiochemotherapy followed by surgery for 15 patients with locally advanced un-resectable rectal cancer.METHODS: 15 patients with advanced non-resectable rectal cancer were treated with pre-operative irriadiation of 40-46 Gy plus concomitant chemotherapy (5-FU+LV and 5′-DFuR) (RCS group). For comparison, 27 similar patients,treated by preoperative radiotherapy (40-50 Gy) plus surgery were served as control (RS group).RESULTS: No radiochemotherapy or radiotherapy was interrupted and then was delayed because of toxicities in both groups. The radical resectability rate was 73.3% in the RCS group and 37.0% (P=0.024) in RS group. Sphincter preservation rates were 26.6% and 3.7% respectively (P=0.028). Sphincter preservation rates of lower rectal cancer were 27.3 % and 0.0 % respectively (P=0.014). Response rates of RCS and RS groups were 46.7 % and 18.5 %(P=0.053). The tumor downstage rates were 8 (53.3%)and 9 (33.3%) in these groups (P=0.206). The 3-year overall survival rates were 66.7 % and 55.6% (P=0.485), and the disease free survival rates were 40.1% and 33.2%(P=0.663). The 3-year local recurrent rates were 26.7%and 48.1% (P=0.174). No obvious late effects were found in either groups.CONCLUSION: High resectability is possible following preoperative radiochemotherapy and can have more sphincters preserved. It is important to improve the quality of the patients′ life even without increasing the survival or local control rates. Preoperative radiotherapy with concomitant full course chemotherapy (5-Fu+LV and 5′-DFuR) is effective and safe.
基金Supported by the Natural Science Foundation of Beijing, No.7982035
文摘AIM： To evaluate the utility of local tumor therapy combined with percutaneous transhepatic bilian/drainage （PTBD） for malignant obstructive bilian/disease. METHODS： A total of 233 patients with malignant billan/obstruction were treated in our hospital with PTBD by placement of metallic stents and/or plastic tubes. After PTBD, 49 patients accepted brachytherapy or extraradiation therapy or arterial infusion chemotherapy. The patients were followed up with clinical and radiographic evaluation. The survival and stent patency rate were calculated by Kaplan-Meier survival analysis. RESULTS： Twenty-two patients underwent chemotherapy （11 cases of hepatic carcinoma, 7 cases of pancreatic carcinoma, 4 cases of metastatic lymphadenopathy）, and 14 patients received radiotherapy （10 cases of cholangiocardnoma, 4 cases of pancreatic carcinoma）, and 13 patients accepted brachytherapy （7 cases of cholangiocarcinoma, 3 cases of pancreatic carcinoma, 4 cases of metastatic lymphadenopathy）. The survival rate of the local tumor treatment group at 1, 3, 6, and 12 months was 97.96%, 95.92%, 89.80%, and 32.59% respectively, longer than that of the non treatment group. The patency rate at 1, 3, 6, and 12 months was 97.96%, 93.86%, 80.93%, and 56.52% respectively. The difference of patency rate was not significant between treatment group and non treatment group. CONCLUSION： Our results suggest that local tumor therapy could prolong the survival time of patients with malignant biliary obstruction, and may improve stent patency.
文摘The relationship between dopamine D2 receptors and brain perfusion in hemi-parkinsonism rats was studied. Hemi-parkinsonism rats were made by stereotaxic 6-hydroxy dopamine (6-OH-DA) lesions in substantia nigra(SN) and ventral tegmental area(VTA), apomorphine (Apo) which could induced the successful model rat rotates toward the intact side was used to select the rats, 125I-IBZM ex-vivo autoradiography analysis and 99mTc-HM-PAO regional cerebral biodistribution were used to evaluate D2 receptors and cerebral blood flow. The HPLC-ECD were used to measure striatum DA and its metabolites content. The lesioned side striatum DA and its metabolites HVA DOPAC reduced significantly than that of the intact side and seudo-operated group, striatum/cerebellum 125I-IBZM uptake ratio was 8.04+-0.71 in lesioned side of hemi-parkinsonism rats, significantly increased compared with the intact side and the seudo-operated group(p <0.05), 30.11+-4.53% enhancement as compared to the intact side, and also show good correlation with 30 min Apo induced rotation numbers (r=0.98), the regional cerebral blood flow study didn’t show significant difference between bilateral brain cortex area(p >0.05). These results indicated that in the 6- OH-DA lesioned side DA content decreased significantly and an up-regulation of striatum D2 receptor binding sites was induced in hemi-parkinsonism rats, which showed good correlation with rotation behavior induced by Apo. Comparing with cerebral blood flow, D2 receptor reflected by IBZM seems to be more specific and earlier to detect the cerebral functional impairment in experimental bend-parkinsonism.
文摘Patients with locally advanced esophageal cancer have a dismal prognosis when treated exclu- sively by surgery. This fact prompted many investigators to apply neoadjuvant treatment strategies in an e?ort to improve survival. Results from phase III randomized trials are encouraging however, they revealed 五笔字型计算机汉字输入技术 that only patients with major histopathological response will bene?t from treatment. Therefore, predic- tive molecular markers indicating response or non-response to neoadjuvant treatment would be extremely helpful in selecting patients for current and future treatment protocols. In this paper we review the role of the molecular markers ERCC1 (excision repair cross-complementing 1 gene) and c-erbB-2 (synonym: HER2/neu) in predicting response to radiochemotherapy and outcome for patients with locally advanced resectable esophageal cancers (cT2-4, Nx, M0). The results are promising and it appears that we might expect to unequivocally identify with ERCC1 and c-erbB-2 respectively, approximately up to one third of patients who ful?l the criteria for neoadjuvant treatment for locally advanced esophageal cancer but will not bene?t from our treatment protocol. Integration of such markers in the clinical setting might prevent a substantial number of patients from expensive, non-e?ective and potentially harmful therapies, and could lead to a more individualized type of combined multimodality treatment in the near future.
文摘AIM： To evaluate late effects of chemoradiation on gastrointestinal mucosa with an endoscopic scoring system and compare it to a clinical scoring system. METHODS： Twenty-four patients going to receive chemoradiation after gastric surgery underwent endoscopy four wk after surgery and one year after the chemoradiation finished. Upper gastrointestinal findings were recorded according to a system proposed by World Organisation for Digestive Endoscopy （OMED） and clinical scoring was done with RTOG-EORTC radiation morbidity scoring systems. RESULTS： There was no significant endoscopic difference in gastric and intestinal mucosa after chemoradiation （P 〉 0.05） and there was no association between endoscopic scores and clinical scores. Endoscopic changes were minimal. CONCLUSION： Late effects after chemoradiation in operated patients with gastric cancers can be evaluated with an endoscopic scoring system objectively and this system is superior to clinical scoring systems.
