Intra-arterial chrono-chemotherapy for liver metastasis arised from colorectal cancer

Objective To evaluate the toxic effects and efficacy of the intra-arterial chrono-chemotherapy on patients with liver metastasis arised from colorectal cancer. Methods Chemotherapy of 42 patients were randomly divided into group A (n = 20) with continuously constant arterial infusion, and group B (n = 22) with arterial chrono-modulated infusion. And the toxic effects and efficacy of two groups were compared. Results A significant difference was found in the toxic effects of digestive system between the two groups. The treatment response was similar in the two groups. Conclusions Intra-arterial chrono-chemotherapy may decrease the toxic effects and improve the life quality of these patients. (J Intervent Radiol, 2006, 15: 487-490)

Shenqi Fuzheng injection combined with GP chemotherapy in the treatment of advanced non-small cell lung cancer： a meta-analysis

Objective： To evaluate the clinical efficacy of Shenqi Fuzheng injection combined with gemcitabine plus cisplatin（GP） in the treatment of advanced non-small cell lung cancer （NSCLC）. Methods： we performed a systematicsearch in the electronic databases such as Cochrane Library, Pubmed, Embase, Chinese Journal Full-text Database,Chinese Biomedical Literature Database, Chinese Science and Technology Periodical Full-text Database andWanfang Database up to 30 January 2017. Randomized controlled trials （RCT） of Shenqi Fuzheng Injectioncombined with GP chemotherapy in the treatment of advanced NSCLC were searched, and all the RCTs wereconducted on methodological quality assessment. Data extraction and data analysis were according to standards ofCochrane systematic review. Results： Eight trials were included including a total of 701 patients. Meta-analysisresults： Shenqi Fuzheng injection combined with GP chemotherapy could significantly improve the functionalstatus of patients with NSCLC （OR = 3.44, 95% CI [2.26, 5.25], P 〈 0.0001） and clinical treatment efficacy （OR =（OR = 0.31, 95%CI [0.20, 0.47], P 〈 0.0001. The rate of leukopenia （OR = .31, 95%CI [0.20,0.47], P 〈 0.0001）,thrombocytopenia （OR = 0.58, 95%CI [0.37, 0.91], P = 0.020）, hemoglobin decline （（OR = 0.31, 95%CI [0.16,0.59], P = 0.0004） and incidence of gastrointestinal reactions （OR = 0.58,P 〈 0.05） could be reduced. Conclusion：Shenqi Fuzheng injection combined with GP chemotherapy in the treatment of advanced NSCLC obtainedsignificantly clinical efficacy. The quality of the literature incorporated is low, the conclusion requires high-qualityresearch to further prove.

Impact of duration of adjuvant chemotherapy in radically resected patients with T4bN1-3M0/TxN3bM0 gastric cancer

AIM To provide evidence regarding the postoperative treatment of patients with T4 b N1-3 M0/Tx N3 b M0 gastric cancer, for which guidelines have not been established. METHODS Patients who had undergone curative resection between 1996 and 2014 with a pathological stage of T4 b N1-3 M0/Tx N3 b M0 for gastric cancer were retrospectively analyzed; staging was based on the 7 th edition of the American Joint Committee on Cancer staging system. The clinicopathological characteristics, administration of adjuvant chemotherapy, and patterns of recurrence were studied. Univariate and multivariate analyses of prognostic factors were conducted. The chemotherapeutic agents mainly included fluorouropyrimidine, platinum and taxanes, used as monotherapy, doublet, or triplet regimens. Patterns of first recurrence were categorized as locoregional recurrence, peritoneal dissemination, or distant metastasis.RESULTS The 5-year overall survival(OS) of the whole group(n = 176) was 16.8%, and the median OS was 25.7 mo(95%CI: 20.9-30.5). Lymphovascular invasion and a node positive rate(NPR) ≥ 0.8 were associated with a poor prognosis(P = 0.01 and P = 0.048, respectively). One hundred forty-seven(83.5%) of the 176 patients eventually experienced recurrence; the most common pattern of the first recurrence was distant metastasis. The prognosis was best for patients with locoregional recurrence and worst for those with peritoneal dissemination. Twelve(6.8%) of the 176 patients did not receive adjuvant chemotherapy, while 164(93.2%) patients received adjuvant chemotherapy. Combined chemotherapy, including doublet and triplet regimens, was associated with a better prognosis than monotherapy, with no significant difference in 5-year OS(17.5% vs 0%, P = 0.613). The triplet regimen showed no significant survival benefit compared with the doublet regimen for 5-year OS(18.5% vs 17.4%, P = 0.661). Thirty-nine(22.1%) patients received adjuvant chemotherapy for longer than six months; the median OS in patients who received adjuvant chemotherapy for longer than six months was 40.2 mo(95%CI: 30.6-48.2), significantly longer than the 21.6 mo(95%CI: 19.1-24.0) in patients who received adjuvant chemotherapy for less than six months(P = 0.001).CONCLUSION Patients with T4 b N1-3 M0/Tx N3 b M0 gastric cancer showed a poor prognosis and a high risk of distant metastasis. Adjuvant chemotherapy for longer than six months improved outcomes for them.

Neutrophil-to-lymphocyte ratio and carbohydrate antigen 19-9 as prognostic markers for advanced pancreatic cancer patients receiving first-line chemotherapy

BACKGROUND A decline in serum carbohydrate antigen 19-9(CA19-9)levels during systemic chemotherapy is considered as a prognostic marker for patients with advanced pancreatic cancer.Neutrophil-to-lymphocyte ratio(NLR)has been extensively studied as a simple and useful indicator of prognosis in various cancers including pancreatic cancer.AIM To assess the prognostic significance of NLR and CA19-9 in patients with advanced pancreatic adenocarcinoma received first-line chemotherapy according to CA19-9 positivity.METHODS We retrospectively analyzed patients diagnosed with advanced pancreatic cancer who received first-line chemotherapy between January 2010 and July 2017 at the Catholic University of Seoul St.Mary’s Hospital.Patients were divided according to CA19-9 positivity(CA19-9-positive vs-negative groups)and pre-and posttreatment NLR levels.To determine cut-off value of NLR and CA19-9 reduction,time-dependent receiver operating characteristic curve was applied.We evaluated overall survival(OS)and progression-free survival(PFS)for each group using Kaplan-Meier method,and we performed multivariate analyses on the entire cohort.RESULTS We included 271 patients in this study.Cut-off value of NLR and CA19-9 reduction was determined as 2.62 and 18%.Multivariate analysis showed that post-treatment NLR<2.62 and reduction of≥18%of baseline CA19-9 were significantly associated with OS and PFS.Post-treatment NLR≥2.62 showed hazard ratio(HR)of 2.47[95%confidence interval(CI):1.84-3.32,P<0.001]and CA19-9 decline(≥18%)showed HR of 0.51(95%CI:0.39-0.67,P<0.001)for OS.When CA19-9-positive patients were divided into groups according to CA19-9 response(responder vs non-responder)and post-treatment NLR(<2.62 vs≥2.62),CA19-9 responder and post-treatment NLR<2.62 group showed better survival than CA19-9 non-responder and post-treatment NLR≥2.62 group(OS 11.0 mo vs 3.9 mo,P<0.001;PFS 6.3 mo vs 2.0 mo,P<0.001).The combination of CA19-9 decline and post-treatment NLR showed a significant correlation with clinical response in CA 19-9 positive group.Within the CA19-9-negative group,the posttreatment NLR<2.62 group showed better survival than the post-treatment NLR≥2.62 group(OS 12.7 mo vs 7.7 mo,P<0.001;PFS 6.7 mo vs 2.1 mo,P<0.001),and post-treatment NLR showed correlation with clinical response.CONCLUSION In advanced pancreatic cancer patients positive for CA19-9 and treated with systemic chemotherapy,the combination of post-treatment NLR<2.62 and 18%decline of CA19-9 at the first response evaluation is a good prognostic marker.Post-treatment NLR<2.62 alone could be used as a prognostic marker and an adjunctive tool for response evaluation in CA19-9-negative patients.

Time-dependent study of combined chemotherapy of Cyclophophamide,Cisplatin and Adriamycin

Objective This paper was aimed to investigate the time-dependence of toxicity and pharmacodynamic action in Cyclophosphamide-Cisplatin-Adriamycin(CAP)combined chemotherapy and to find theoptimal administrating time to provide the better dosage regimen for the clinical cancer treatment.Methods S180 tumor bearing mice were firstly divided into six groups,and then were injected(ip.)with CTX(20 mg·kg-1),DDP(1 mg·kg-1),ADM(1 mg·kg-1)at different time(10:00 h,14:00 h,18:00 h,22:00 h,02:00 h and 06:00 h),respectively.In all groups ADM(1 mg·kg-1)were administed every three days.Finally the various related data was collected to assess the time-dependence of toxicity and pharmacodynamic action in CAP combined chemotherapy.Results The tumors could be inhibited by CAP combined chemotherapy in all the tested groups at different time,the group administed at 02:00 h showed the best action.The results of tumor cell cycle analysis showed that DNA synthesis decreased after the chemotherapy,most significantly at 22:00 h.The levels of tumor cell apoptosis-related proteins p53 and Bcl-2 increased after combination chemotherapy,whereas the level of Bax declined.And p53 changed most remarkably from 18:00 to 22:00 h,and for Bcl-2 and Bax that was from 02:00 to 10:00 h.The distribution of bone marrow cells cycle appeared sub-G1 peak,which is the phenomenon of apoptosis,at 02:00 h and 10:00 h was the most significant.At the same time the proportion of G1 and S-phase decreced,which indicates DNA synthesis of bone marrow cell declined.A time-dependent 19 KD activated fragments of Caspase-3 appeared by western blotting determination,at 02:00 h and 10:00 h.Conclusions The CAP combined chemotherapy had the best pharmacodynamic action during 22:00-02:00 h and the worst during the 10:00-14:00 h.As refer to toxicity,the most toxic time was during 06:00-14:00 h.

CYFRA 21-1 as an early predictor of first line chemotherapy response in advanced non small cell lung cancer

Objective： In an era of ever evolving, promising new therapies for advanced non small cell lung cancer （NSCLC）, early predictors of response to therapy, are needed. We evaluated early variations in CYFRA 21-1 serum levels of patients with advanced NSCLC receiving first line chemotherapy and correlated the results with objective tumor response. Methods： 29 consecutive, previously untreated, patients of advanced non small cell lung cancer, with measurable disease on CT scan were evaluated. All patients were treated with conventional systemic chemotherapy, although the choice of chemotherapy was left to the discretion of the treating physicians. Serum samples were obtained immediately before the start of 1st and 2nd cycles of chemotherapy. CYFRA 21-1 was measured with an electrochemiluminescense immunoassay on an automatic analyzer （Elecsys 2000; Roche Diagnostics）. Response was evaluated using Response evaluation criteria in solid tumors （RECIST） criteria. Results： 10 patients had partial response, 9 patients had stable disease and 9 had progressive disease. None of the patients had complete response. 21/29 （72%） patients had an elevated baseline value of CYFRA 21-1.62% patients （18/29） had a decrease in CYFRA 21-1 after 1 cycle of chemotherapy. The average reduction in the 2nd reading was irrespective of whether baseline value was normal or not. The average reduction was statistically significant （P = 0.002; 95% CI, from 0.8369 to 3.49464; t test）. 8 out of 10 （80%） patients with partial response had a reduction in their 2nd reading of. CYFRA （P = 0.019; 95% CI, from 0.81965 to 7.20035; t test） which was significant. We also observed that 6/9 （66%） patients whose disease remains stable also had a decrease in their subsequent reading （P = 0.0106; 95% CI, from -0.44942 to 3.82720; t test）, though it was not significant statistically. Although 5 out of 9 （55%） patients, who had an increase in their CYFRA 21-1 level, had progressive disease, but it was not statistically significant （P = 0.537; 95% CI, from -1.20021 to 2.13354; ttest）. 14 out of 19 （73%） who either had partial response or had stable disease, had a reduction in their 2nd value of CYFRA 21-1 and was significant statistically （P = 0.004; 95% CI, from 0.74792 to 3.50208; t test）. We also observed that except for 1 patient, all patients who had a decrease of 42% or more in their subsequent CYFRA 21-1 level, were those who had either responded to chemotherapy or had stable disease （P = 0.001）, which was statistically significant. Conclusion： We can conclude that monitoring of serum marker CYFRA 21-1, early dudng first-line chemotherapy may be a useful prognostic tool for evaluation of early tumor response in patients with advanced NSCLC.

Evaluating the benefit of adjuvant chemotherapy in patients with ypT0-1 rectal cancer treated with preoperative chemoradiotherapy

BACKGROUND Adjuvant chemotherapy(ACTx)is recommended in rectal cancer patients after preoperative chemoradiotherapy(PCRT),but its efficacy in patients in the early post-surgical stage who have a favorable prognosis is controversial.AIM To evaluate the long-term survival benefit of ACTx in patients with ypT0–1 rectal cancer after PCRT and surgical resection.METHODS We identified rectal cancer patients who underwent PCRT followed by surgical resection at the Asan Medical Center from 2005 to 2014.Patients with ypT0–1 disease and those who received ACTx were included.The 5-year overall survival(OS)and 5-year recurrence-free survival(RFS)were analyzed according to the status of the ACTx.RESULTS Of 520 included patients,413 received ACTx(ACTx group)and 107 did not(no ACTx group).No significant difference was observed in 5-year RFS(ACTx group,87.9%vs no ACTx group,91.4%,P=0.457)and 5-year OS(ACTx group,90.5%vs no ACTx group,86.2%,P=0.304)between the groups.cT stage was associated with RFS and OS in multivariate analysis[hazard ratio(HR):2.57,95%confidence interval(CI):1.07–6.16,P=0.04 and HR:2.27,95%CI:1.09–4.74,P=0.03,respectively].Furthermore,ypN stage was associated with RFS and OS(HR:4.74,95%CI:2.39–9.42,P<0.00 and HR:4.33,95%CI:2.20–8.53,P<0.00,respectively),but only in the radical resection group.CONCLUSION Oncological outcomes of patients with ypT0–1 rectal cancer who received ACTx after PCRT showed no improvement,regardless of the radicality of resection.Further trials are needed to evaluate the efficacy of ACTx in these group of patients.

Is CA19-9 effective in predicting chemotherapeutic response in patients with synchronous liver metastases with colorectal cancer?

Evaluation of response to chemotherapy in colorectal cancer patients with synchronous liver metastases is important in terms of treatment management.In this Letter to the Editor,several issues in the article are discussed.For the comparison of carbohydrate antigen 19-9(CA19-9)values referenced in the study,the patient group was not matched for cancer stage.Therefore,it may be more appropriate to select and compare CA19-9 values in patients with same-stage cancer.

Effect of TCM Combined with Chemotherapy on Immune Function and Quality of Life of Patients with Non-small Cell Lung Cancer inStage Ⅲ-Ⅳ

Objective: To observe and compare the effect of traditional Chinese medicine (TCM) combined with chemotherapy (CT) on immune function and quality of life (QOL)of patients with non-small cell lung cancer (NSCLC) in stage Ⅲ-Ⅳ. Methods: One hundred cases with stage Ⅲ-Ⅳ NSCLC were randomly divided into two groups. The treated group (n=50) received CT combined with TCM, and the control group received CT alone. The percentage of T lymphocyte subset in peripheral blood and the change of natural killer (NK) cell count were observed after treatment. The QOL and tolerance of CT were also compared between the two groups after treatment. Results: In the treated group, CD3 cell count, CD4 cell count, CD4/ CDg ratio and NK cell activity were higher than those in control group, while CD8 cell count in the treated group was lower than that in the control group (P<0.05), and QOL and tolerance of CT in the treated group were also better (P<0.05). Conclusion: TCM combined with CT could raise the patients' ability in tolerating CT in stage Ⅲ-ⅣNSCLC.

奥沙利铂联合5-氟脲嘧啶、甲酰四氢叶酸时辰治疗晚期胃肠道癌的临床研究

目的评价奥沙利铂(L-OHP)联合5-氟脲嘧啶(5-Fu)、甲酰四氢叶酸(CF)方案以时辰化疗法治疗晚期胃肠道癌的疗效和毒副反应。方法44例晚期胃肠道癌患者,使用FFL方案时辰化疗法治疗:L-OHP 25 mg/(m2.d),每天给药时间为10∶00-22∶00,持续输注12 h,给药高峰16∶00;5-Fu 600 mg/(m2.d),CF 300 mg/(m2.d),每天给药时间为22∶00-次日10∶00,不同输液通道持续输注12 h,给药高峰4∶00,使用多通道程控时辰输液泵连续给药4 d,14-21 d为1个周期,至少使用2个周期。结果44例患者共完成151个周期化疗,每例患者化疗平均周期数为3.4个周期。33例晚期胃癌患者中,部分缓解(PR)17例,稳定(SD)10例,进展(PD)6例;11例晚期结直肠癌患者中,部分缓解(PR)4例,稳定(SD)4例,进展(PD)3例。所有患者的总有效率为47.7%(21/44)。中位肿瘤进展时间为5个月,中位生存期为8个月。最常见的毒副反应为骨髓抑制、恶心和呕吐、外周神经毒性、黏膜炎、腹泻,但以Ⅰ-II度为主。中位肿瘤进展时间为5个月,中位生存期为8个月。结论FFL方案时辰化疗疗效满意,毒副反应轻,是治疗晚期胃肠道癌安全有效的化疗方案。

CPT-11在鼻咽癌裸鼠组织中时辰给药疗效观察及细胞周期分布变化的初步研究

目的:观察CPT-11(艾力)时辰给药对鼻咽癌裸鼠的疗效、毒副反应以及细胞周期分布的变化,为CPT-11时辰化疗提供实验基础和临床应用参考。方法:统一光照条件下(光照时间7:00～19:00),黑暗时间(19:00～7:00)饲养3周、50只鼻咽癌移植瘤裸鼠模型分为给药组和对照组。给药组荷瘤小鼠在3、9、15、21HALO(Hours After Light Onset设光后小时)腹腔注射CPT-11 66mg/kg;15天后处死所有小鼠,检测各组小鼠的WBC、HB、PLT,然后剥离肿瘤计算各组抑瘤率,制成单个细胞悬液,固定,染色后流式细胞仪测DNA细胞周期含量;并取盲肠组织光镜下观察肠粘膜组织结构。结果:CPT-11对鼻咽癌移植瘤裸鼠有显著性疗效(P<0.01),其中15HALO,抑瘤率最大(P<0.05);而21HALO抑瘤率最小(P<0.05)。15HALO给药组WBC、HB、PLT数均高于其他各组(P<0.05),体重增加明显(P<0.05),光镜下粘膜损伤分级显著降低(P<0.05),21HALO给药组血象、体重增加最少,粘膜损伤分级较高(P<0.05)。9HALO要优于3HALO(P<0.05)。21HALO,3HALO细胞主要分布在G_2期(54.1100±17.3374053.0300±20.79316)。其中15HALO与21HALO差异最明显(P<0.01)。结论:CPT-11对鼻咽癌移植瘤裸鼠有明显的抑制作用且疗效及毒副作用呈现时辰节律变化(15HALO最优,21HALO最差),为CPT-11时辰化疗的临床应用提供了参考。

Different strategies of treatment for uterine cervical carcinoma stage ⅠB2-ⅡB

Uterine cervical cancer is the second most common gynecological malignancy. It is estimated that over 35% of tumors are diagnosed at locally advanced disease, stage ⅠB2-ⅡB with an estimated 5-year overall survival of 60%. During the last decades, the initial treatment for these women has been debated and largely varies through different countries. Thus, radical concurrent chemoradiation is the standard of care in United Sated and Canada, and neoadjuvant chemotherapy followed by radical surgery is the first line of treatment in some institutions of Europe, Asia and Latin America. Until today, there is no evidence of which strategy is better over the other. This article describe the evidence as well as the advantages and disadvantages of the main strategies of treatment for women affected by uterine cervical cancer stage ⅠB2-ⅡB.

Preoperative serum carbohydrate antigen 19-9 levels predict early recurrence after the resection of early-stage pancreatic ductal adenocarcinoma

BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is a serious disease with a poor prognosis.Only a minority of patients undergo surgery due to the advanced stage of the disease,and patients with early-stage disease,who are expected to have a better prognosis,often experience recurrence.Thus,it is important to identify the risk factors for early recurrence and to develop an adequate treatment plan.AIM To evaluate the predictive factors associated with the early recurrence of earlystage PDAC.METHODS This study enrolled 407 patients with stage I PDAC undergoing upfront surgical resection between January 2000 and April 2016.Early recurrence was defined as a diagnosis of recurrence within 6 mo of surgery.The optimal cutoff values were determined by receiver operating characteristic(ROC)analyses.Univariate and multivariate analyses were performed to identify the risk factors for early recurrence.RESULTS Of the 407 patients,98 patients(24.1%)experienced early disease recurrence:26(26.5%)local and 72(73.5%)distant sites.In total,253(62.2%)patients received adjuvant chemotherapy.On ROC curve analysis,the optimal cutoff values for early recurrence were 70 U/mL and 2.85 cm for carbohydrate antigen 19-9(CA 19-9)levels and tumor size,respectively.Of the 181 patients with CA 19-9 level>70 U/mL,59(32.6%)had early recurrence,compared to 39(17.4%)of 226 patients with CA 19-9 level≤70 U/mL(P<0.001).Multivariate analysis revealed that CA 19-9 level>70 U/mL(P=0.006),tumor size>2.85 cm(P=0.004),poor differentiation(P=0.008),and non-adjuvant chemotherapy(P=0.025)were significant risk factors for early recurrence in early-stage PDAC.CONCLUSION Elevated CA 19-9 level(cutoff value>70 U/mL)can be a reliable predictive factor for early recurrence in early-stage PDAC.As adjuvant chemotherapy can prevent early recurrence,it should be recommended for patients susceptible to early recurrence.

Second-line therapy for gemcitabine-pretreated advanced or metastatic pancreatic cancer

AIM： To investigate second-line chemotherapy in gemcitabine-pretreated patients with advanced or metastat- ic pancreatic cancer [（frequency, response, outcome, course of carbohydrate antigen 19-9 （CA 19-9）].METHODS： This retrospective study included all patients with advanced or metastatic pancreatic cancer （adenocarcinoma or carcinoma） treated with secondline chemotherapy in our center between 2000 and 2008. All patients received first-line chemotherapy with gemcitabine, and prior surgery or radiotherapy was permitted. We analyzed each chemotherapy protocol for second-line treatment, the number of cycles and the type of combination used. The primary endpoint was overall survival. Secondary endpoints included progression-free survival, response rate, grade 3-4 toxicity, dosage modifications and CA 19-9 course.a second-line therapy among 206 patients who had initially received first-line treatment with a gemcitabi- ne-based regimen. Median number of cycles was 4 （range： 1-12） and the median duration of treatment was 2.6 mo （range： 0.3-7.4）. The overall disease control rate was 40.0%. The median overall survival and progression-free survival from the start of second-line therapy were 5.8 （95% CI： 4.1-6.6） and 3.4 mo （95% CI： 2.4-4.2）, respectively. Toxicity was generally acceptable. Median overall survival of patients with a CA 19-9 level declining by more than 20% was 10.3 mo （95% CI： 4.5-11.6） vs 5.2 mo （95% CI： 4.0-6.4） for others （P = 0.008）.CONCLUSION： A large proportion of patients could benefit from second-line therapy, and CA 19-9 allows efficient treatment monitoring both in first and secondline chemotherapy.

COVID-19 vaccine related hypermetabolic lymph nodes on PET/CT:Implications of inflammatory findings in cancer imaging

We observed several patients presenting 2-[^(18)F]FDG uptake in the reactive axillary lymph node at PET/CT imaging,ipsilateral to the site of the COVID-19 vaccine injection.Analog finding was documented at[^(18)F]Choline PET/CT.The aim of our study was to describe this source of false positive cases.All patients examined by PET/CT were included in the study.Data concerning patient anamnesis,laterality,and time interval from recent COVID-19 vaccination were recorded.SUVmax was measured in all lymph nodes expressing tracer uptake after vaccination.Among 712 PET/CT scans with 2-[^(18)F]FDG,104 were submitted to vaccination;89/104 patients(85%)presented axillary and/or deltoid tracer uptake,related to recent COVID-19 vaccine administration(median from injection:11 days).The mean SUVmax of these findings was 2.1(range 1.6–3.3).Among 89 patients with false positive axillary uptake,36 subjects had received chemotherapy due to lymph node metastases from somatic cancer or lymphomas,prior to the scan:6/36 patients with lymph node metastases showed no response to therapy or progression disease.The mean SUVmax value of lymph nodal localizations of somatic cancers/lymphomas after chemotherapy was 7.8.Only 1/31 prostate cancer patients examined by[^(18)F]Choline PET/CT showed post-vaccine axillary lymph node uptake.These findings were not recorded at PET/CT scans with[^(18)F]-6-FDOPA,[^(68)Ga]Ga-DOTATOC,and[^(18)F]-fluoride.Following COVID-19 mass vaccination,a significant percentage of patients examined by 2-[^(18)F]FDG PET/CT presents axillary,reactive lymph node uptake.Anamnesis,low-dose CT,and ultrasonography facilitated correct diagnosis.Semi-quantitative assessment supported the visual analysis of PET/CT data;SUVmax values of metastatic lymph nodes were considerably higher than post-vaccine lymph nodes.[^(18)F]Choline uptake in reactive lymph node after vaccination was confirmed.After the COVID-19 pandemic,nuclear physicians need to take these potential false positive cases into account in daily clinical practice.

Effects of concurrent chemoradiotherapy on immune function and tumor markers SCC-Ag and CYFRA21-1 in patients with esophageal carcinoma

Objective: To investigate the effects of concurrent chemoradiotherapy and radiotherapy alone on immune function and tumor markers SCC-Ag and CYFRA21-1 in patients with esophageal carcinoma. Method: A total of 84 patients with esophageal cancer treated in our hospital from June 2015 to April 2017 were selected and randomly divided into the observation group and the control group with 42 cases each. The control group received radiotherapy only and irradiated by medical electron linear accelerator, radiotherapy for 6 weeks. The observation group was given radiotherapy and chemotherapy concurrently, 3 weeks for 1 courses, 2 cycles of chemotherapy. The fasting venous blood of patients in two groups were collected in the morning when patients were hospitalized and after chemotherapy, using flow cytometry to detect the immune function indexes of two groups of patients with esophageal cancer before and after treatment, including natural killer cells (NK), T suppressor cells (Ts), T helper cells (Th), Th/Ts and T lymphocytes (T total). The levels of serum SCC-Ag and CYFRA21-1 were detected by electrochemiluminescence assay. Results: There were no significant differences in the indexes of immune function between the two groups before treatment. Total T, the proportion of Th and Th/Ts in the two groups both increased significantly;the proportion of Ts decreased significantly;the difference was statistically significant. NK was higher than treatment before but not significantly. After treatment, the levels of T total, Th, Th/Ts in the observation group were significantly higher than the control group;the levels of NK and Ts were not significantly different. Before treatment, there was no significant difference in serum SCC-Ag and CYFRA21-1 between the two groups. After treatment, the serum SCC-Ag and CYFRA21-1 levels of the two groups were both significantly decreased;the serum levels of SCC-Ag and CYFRA21-1 in the observation group were significantly lower than the control group. Conclusion: Radiotherapy combined with chemotherapy of cisplatin and paclitaxel can improve the immune function and reduce serum SCC-Ag and CYFRA21-1 levels of esophageal cancer patients. This therapeutic schemes can be beneficial to increase the survival rate of patients with esophageal cancer.

时辰化疗治疗初治远处转移鼻咽癌的临床研究

目的:研究TPF(多西他赛+顺铂+5-氟脲嘧啶)方案时辰化疗较常规化疗治疗初治远处转移鼻咽癌在减轻毒性、降低免疫功能损害方面是否具有优势。方法:选取贵州省肿瘤医院2012年12月至2014年10月46例初治远处转移(UICC 2010分期Ⅳc期)鼻咽癌患者入组。随机分为时辰组23例及常规组23例。均采用TPF方案诱导化疗2个周期,21~28 d/周期。时辰组:DTX 75 mg/m2静滴3~4 h d1(DDP前使用);DDP 75 mg/m2持续静脉泵入d1~5,10 am^10 pm;5-FU 750 mg/(m2·d)持续静脉泵入d1~5,10 pm^10 am。常规组:DTX 75 mg/m2静滴3~4 h d1(DDP前使用);DDP 75 mg/m2静滴d1;5-FU 750 mg/(m2·d)持续静滴d1~5,共120 h。化疗后评价有效者行三维适形调强放疗(IMRT),同期行顺铂单药增敏化疗(100 mg/m2静滴d1~2,21 d/周期,共2个周期。放化疗结束1个月后行辅助化疗:方案及方法同诱导化疗,共2个周期。不良反应按CTCAE v3.0评价系统分级,临床疗效参照2000年实体瘤疗效评价标准(RECIST)评价,有效率为CR+PR。结果:2级以上呕吐发生率常规组高于时辰组,差异有统计学意义(P<0.05)。化疗后时辰组CD4/CD8升高,常规组CD4/CD8降低(P<0.05)。结论:时辰化疗能够降低严重呕吐的发生率,在减少严重骨髓抑制方面可能存在优势,可能改善了患者的免疫功能。

一种晚期复发鼻咽癌(NPC)的时辰化疗方案疗效观察

目的：对比观察DDP联合5－FU的时辰化疗与常规化疗在同时期化放疗应用过程中对晚期复发转移的NPC(鼻咽癌：NasopharyngealCarcinoma)的疗效。方法：50例局部晚期复发转移的NPC患者，随机分为时辰化疗组（CC组：chrono－chemotherapy）27例，常规化疗组（RC组：routine－chemotherapy）23例。均采用同时期化放疗措施。结果：CC组为27例，其CR率、有效率（CR＋PR）分别为18．5％、66．7％，中位生存期12个月（3～20个月）。RC组为23例，其CR率、有效率（CR＋PR）分别为8．7％、39．1％，中位生存期10个月（2．8～17个月）。两组CR率及有效率（CR＋PR）有显著性差异(P＜0．05)，中位生存期无显著性差异（P＞0．05）。毒副反应比较结果：RC组相对于CC组口腔炎、恶心、呕吐、脱发更多见（P＜0．05），骨髓毒性反应亦有显著性差异（P＜0．05）。结论：DDP联合5－FU的时辰化疗对晚期复发转移的NPC治疗效果较好，毒副反应较低，因此，同时期放疗与DDP联合5－FU的时辰化疗为晚期复发转移NPC较为有效的治疗方案。

口腔癌时辰化疗

目的:分析比较卡铂(CBP)联合5-氟脲嘧啶(5-Fu)对口腔鳞癌患者行时辰化疗与常规化疗的疗效和毒副作用.方法:2002-03～2004-04收治的以卡铂联合5-Fu行化疗的T3、T4口腔鳞癌患者73 例,随机分为时辰化疗组37 例和常规化疗组36 例,比较化疗2 个疗程后2 组的疗效和毒副作用.结果:时辰化疗组的疗效显著高于常规化疗组,其有效率分别为75.68﹪、52.78﹪(P<0.05);时辰化疗组的毒副作用发生率显著低于常规化疗组,毒副作用发生率分别为24.32﹪、58.33﹪(P<0.05).结论:卡铂联合5-Fu化疗方案对口腔鳞癌患者行时辰化疗能达到减毒增效的目的,且方法简单易行,适合临床推广应用.

健脾扶正汤择时用药联合时辰化疗对晚期胃癌患者生活质量及免疫功能的影响

目的观察健脾扶正汤择时用药联合FOLFOX方案时辰化疗对晚期胃癌患者生活质量及免疫功能的影响。方法 80例患者随机分成两组,两组均采用FOLFOX方案时辰化疗,21 d为1个周期,2个周期评价疗效。治疗组加用健脾扶正汤择时用药治疗,对照组加用健脾扶正汤非择时用药治疗。14 d为1个疗程,2个疗程评价疗效。观察临床证候变化、生活质量、免疫功能及毒副反应变化。结果两组生活质量情况比较,食量增加:治疗组与对照组分别为75.0%和55.0%(P<0.05);睡眠改善:治疗组与对照组分别为80.0%和57.0%(P<0.05)。免疫功能变化比较,治疗组治疗后CD3+、CD4+/CD8+比值明显高于治疗前(P<0.01),而对照组治疗后CD3+、CD4+/CD8+比值明显低于治疗前(P<0.05)。结论健脾扶正汤择时用药联合FOLFOX方案时辰化疗治疗晚期胃癌能提高患者机体免疫功能及生活质量,延长生存期。