OBJECTIVE To evaluate how arterial infusion chemotherapy after radical surgery influences long-term surviva if patients with pathologic T3 （pT3） esophageal squamous carcinoma. METHODS We divided 190 patients with pa...OBJECTIVE To evaluate how arterial infusion chemotherapy after radical surgery influences long-term surviva if patients with pathologic T3 （pT3） esophageal squamous carcinoma. METHODS We divided 190 patients with pathologic PT3 esophageal squamous carcinoma, confirmed by consecutive radical surgery, into an experimental group （surgery ＋ intra-arterial infusion, 56 T3N0M0 and 52 T3N1M0 cases）, and the remaining patients into a control group （surgery alone, 48 T3N0M0 and 34 T3N1M0 cases）. The experimental group was sub-grouped into 56 cases （26 T3N0M0 and 30 T3N1M0 cases） receiving 1 or 2 periods of chemotherapy, while 52 cases （30 T3N0M0 and 22 T3N0M0 cases） underwent 3 or more than 3 periods of chemotherapy. We used one to seven courses of selected arterial infusion chemotherapy of cisplatin （80 mg/m2 of body-surface area） and fluorouracil （800 mg/m2） with or without epirubicin at 3-4 weeks post operation. The interval between each period was 3-4 weeks. All cases were followed-up for more than 5 years. Survival rates were calculated by the Kaplan-Meier methods and survival differences between patients with and without selected arterial infusion chemotherapy were compared with the Log-rank test. Prognostic variables were entered into a Cox regression analysis model controlling for age, site, lymph node status, and treatment received. RESULTS The overall survival rates were not significantly different between the experimental group and the control group, but there was better survival for patients who received 3 or more than 3 courses of chemotherapy. Lymph node status （N） was an important factor in the prognosis. CONCLUSION Trans-catheter arterial infusion chemotherapy is a safe and effective method of therapy. Postoperative selective arterial infusion chemotherapy can improve the survival rate in patients with esophageal squamous carcinoma who were previously treated by radical surgery. However, this modality of therapy needs further investigation.展开更多
OBJECTIVE To observe and evaluate the value of utilizing selective internal iliac artery infusion and selective internal iliac artery embolization for the treatment of unremitting gross hematuria of stage T4 bladder c...OBJECTIVE To observe and evaluate the value of utilizing selective internal iliac artery infusion and selective internal iliac artery embolization for the treatment of unremitting gross hematuria of stage T4 bladder carcinoma. METHODS Fifty-eight stage T4 bladder carcinoma patients were selected. The patients were grouped to the TAI group and the TAE group. The main symptom of hemorrhage was gross hematuria. None of the patients in our study could receive trunk embolization. The infusion plan was oxaliplatin （100 mg/m2） and epirubicin （EPI 50mg/m2）. Embolization was done with coils or strips of gelatin sponge. The duration of gross hematuria was observed. Routine urinalysis and routine blood examination were performed. EORTC QLQ-C30 was used to evaluate the quality of life before and after treatment. RESULTS Gross hematuria and hematuria by light microscope in all patients were reviewed. Resolution time of gross hematuria in the TAI group was 6.7 ± 1.8 days and that in the TAE group was 3.5 ± 0.7 days. The changes in routine urianlysis, routine blood examination and EORTC QLQ-C30 are shown in Figs.l-3. Gross hematuria disappeared in both groups within 7 days after treatment, but the time for the gross hematuria to resolve in the TAE group was much less than that in TAI group （t = 2.51, P 〈 0.01）, and there were no significant differences in the 7th and 21st day between the 2 groups. On the 90th day, the number of erythrocytes in the urine was near 30, close to gross hematuria. The EORTC QLQ-C30 scores decreased after interventional therapy in both groups, which means that quality of life was increased, but there were no significant differences between the 2 groups. CONCLUSION Selective internal iliac artery infusion and selective internal iliac artery embolization are safe, and, in our study, therapeutic efficacy was satisfactory in treating unremitting gross hematuria of stage T4 bladder carcinoma in patients who could not receive trunk embolization. TAE can stop gross hematuria in the short term, but it can be used just once and the long-term therapeutic effect is not satisfactory. TAI had a therapeutic effect similar to TAE, but for a shorter duration, and TAI can be performed multiple times. TAI is one of the facultative treatments for treating gross hematuria of stage T4 bladder carcinoma.展开更多
文摘OBJECTIVE To evaluate how arterial infusion chemotherapy after radical surgery influences long-term surviva if patients with pathologic T3 （pT3） esophageal squamous carcinoma. METHODS We divided 190 patients with pathologic PT3 esophageal squamous carcinoma, confirmed by consecutive radical surgery, into an experimental group （surgery ＋ intra-arterial infusion, 56 T3N0M0 and 52 T3N1M0 cases）, and the remaining patients into a control group （surgery alone, 48 T3N0M0 and 34 T3N1M0 cases）. The experimental group was sub-grouped into 56 cases （26 T3N0M0 and 30 T3N1M0 cases） receiving 1 or 2 periods of chemotherapy, while 52 cases （30 T3N0M0 and 22 T3N0M0 cases） underwent 3 or more than 3 periods of chemotherapy. We used one to seven courses of selected arterial infusion chemotherapy of cisplatin （80 mg/m2 of body-surface area） and fluorouracil （800 mg/m2） with or without epirubicin at 3-4 weeks post operation. The interval between each period was 3-4 weeks. All cases were followed-up for more than 5 years. Survival rates were calculated by the Kaplan-Meier methods and survival differences between patients with and without selected arterial infusion chemotherapy were compared with the Log-rank test. Prognostic variables were entered into a Cox regression analysis model controlling for age, site, lymph node status, and treatment received. RESULTS The overall survival rates were not significantly different between the experimental group and the control group, but there was better survival for patients who received 3 or more than 3 courses of chemotherapy. Lymph node status （N） was an important factor in the prognosis. CONCLUSION Trans-catheter arterial infusion chemotherapy is a safe and effective method of therapy. Postoperative selective arterial infusion chemotherapy can improve the survival rate in patients with esophageal squamous carcinoma who were previously treated by radical surgery. However, this modality of therapy needs further investigation.
文摘OBJECTIVE To observe and evaluate the value of utilizing selective internal iliac artery infusion and selective internal iliac artery embolization for the treatment of unremitting gross hematuria of stage T4 bladder carcinoma. METHODS Fifty-eight stage T4 bladder carcinoma patients were selected. The patients were grouped to the TAI group and the TAE group. The main symptom of hemorrhage was gross hematuria. None of the patients in our study could receive trunk embolization. The infusion plan was oxaliplatin （100 mg/m2） and epirubicin （EPI 50mg/m2）. Embolization was done with coils or strips of gelatin sponge. The duration of gross hematuria was observed. Routine urinalysis and routine blood examination were performed. EORTC QLQ-C30 was used to evaluate the quality of life before and after treatment. RESULTS Gross hematuria and hematuria by light microscope in all patients were reviewed. Resolution time of gross hematuria in the TAI group was 6.7 ± 1.8 days and that in the TAE group was 3.5 ± 0.7 days. The changes in routine urianlysis, routine blood examination and EORTC QLQ-C30 are shown in Figs.l-3. Gross hematuria disappeared in both groups within 7 days after treatment, but the time for the gross hematuria to resolve in the TAE group was much less than that in TAI group （t = 2.51, P 〈 0.01）, and there were no significant differences in the 7th and 21st day between the 2 groups. On the 90th day, the number of erythrocytes in the urine was near 30, close to gross hematuria. The EORTC QLQ-C30 scores decreased after interventional therapy in both groups, which means that quality of life was increased, but there were no significant differences between the 2 groups. CONCLUSION Selective internal iliac artery infusion and selective internal iliac artery embolization are safe, and, in our study, therapeutic efficacy was satisfactory in treating unremitting gross hematuria of stage T4 bladder carcinoma in patients who could not receive trunk embolization. TAE can stop gross hematuria in the short term, but it can be used just once and the long-term therapeutic effect is not satisfactory. TAI had a therapeutic effect similar to TAE, but for a shorter duration, and TAI can be performed multiple times. TAI is one of the facultative treatments for treating gross hematuria of stage T4 bladder carcinoma.
