More Cycles of Intravenous Chemotherapy are Associated with Reduced Growth in Children with Retinoblastoma

Background Chemotherapy can have a negative impact on the growth of children with different cancers.However,few studies have examined whether intravenous chemotherapy(IVC)affects the growth of children with retinoblastoma(RB).The present study evaluated the height differences(actual height compared to the age standardized value)and survival of pediatric RB patients treated with IVC.Methods This was an observational cohort study.A total of 87 pediatric RB patients were included.The study population was stratified into two groups based on the number of chemotherapy cycles administered(≤4 versus>4).The height at baseline(before IVC),height after IVC and overall survival were compared between the two groups.Results Before IVC,no height differences were observed between the two groups(P=0.585).After IVC,all of the patients had a reduced height compared to the age standardized height(P=0.035).Patients who underwent more cycles of chemotherapy had a greater height difference compared to those who received fewer cycles(P=0.008).For those who had reduced height,the difference was positively associated with the number of chemotherapy cycles(r=0.279,P=0.043).Among the patients who exhibited a greater height difference,those who underwent more than four cycles of chemotherapy had a decreased overall survival(P=0.042).Conclusions Pediatric RB patients who underwent more cycles of chemotherapy were more likely to have a reduced height.Further studies are needed to determine the optimal treatment strategy to prevent the reduced growth while maintaining the benefits of chemotherapy.

Efficacy of continuous gastric artery infusion chemotherapy in relieving digestive obstruction in advanced gastric cancer

BACKGROUND Obstruction or fullness after feeding is common in gastric cancer(GC)patients,affecting their nutritional status and quality of life.Patients with digestive obstruction are generally in a more advanced stage.Existing methods,including palliative gastrectomy,gastrojejunostomy,endoluminal stent,jejunal nutrition tube and intravenous chemotherapy,have limitations in treating these symptoms.AIM To analyze the efficacy of continuous gastric artery infusion chemotherapy(cGAIC)in relieving digestive obstruction in patients with advanced GC.METHODS This study was a retrospective study.Twenty-nine patients with digestive obstruction of advanced GC who underwent at least one cycle of treatment were reviewed at The Second Affiliated Hospital of Zhejiang University School of Medicine.The oxaliplatin-based intra-arterial infusion regimen was applied in all patients.Mild systemic chemotherapy was used in combination with local treatment.The clinical response was evaluated by contrast-enhanced computed tomography using Response Evaluation Criteria In Solid Tumors(RECIST)criteria.Digestive tract symptoms and toxic effects were analyzed regularly.A comparison of the Karnofsky Performance Status(KPS)score and Stooler’s Dysphagia Score before and after therapy was made.Univariate survival analysis and multivariate survival analysis were also performed to explore the key factors affecting patient survival.RESULTS All patients finished cGAIC successfully without microcatheter displacement,as confirmed by arteriography.The median follow-up time was 24 mo(95%CI:20.24-27.76 mo).The overall response rate was 89.7%after cGAIC according to the RECIST criteria.The postoperative Stooler’s Dysphagia Score was significantly improved.Twentytwo(75.9%)of the 29 patients experienced relief of digestive obstruction after the first two cycles,and 13(44.8%)initially unresectable patients were then considered radically resectable.The median overall survival time(mOS)was 16 mo(95%CI:9.32-22.68 mo).Patients who received radical surgery had a significantly longer mOS than other patients(P value<0.001).Multivariate Cox regression analysis indicated that radical resection after cGAIC,intravenous chemotherapy after cGAIC,and immunotherapy after cGAIC were independent predictors of mOS.None of the patients stopped treatment because of adverse events.CONCLUSION cGAIC was effective and safe in relieving digestive obstruction in advanced GC,and it could improve surgical conversion possibility and survival time.

Comparison of regional arterial chemotherapy and systemic intravenous chemotherapy for advanced pancreatic cancer:a systematic review and meta-analysis

Chemotherapy is the mainstay of treatment for advanced pancreatic cancer(stageⅢ/Ⅳ).However,conventional systemic intravenous chemotherapy(SIC)has been unsatisfactory for pancreatic cancer.In recent years,regional arterial infusion chemotherapy(RAIC)has been clinically used as a new chemotherapy regimen for the treatment of advanced pancreatic cancer,but its efficacy is controversial.The purpose of this study was to evaluate the clinical efficacy and safety of RAIC.We searched literatures in databases such as PubMed,EMBASE,Cochrane Library,Web of Science,and CNKI.After screening,this meta-analysis finally included 9 randomized controlled trials(RCTs)with 444 patients(230 RAIC and 214 SIC).We used the Cochrane Risk of Bias 2.0 tool to assess risk of bias for included RCTs.Outcomes were overall survival(OS),overall response rate(ORR),adverse events rate(AER),and pain remission rate.Outcome indicators used relative risk(RR)and its 95%confidence interval(CI)as effect analysis statistics.The results showed that RAIC had some advantages over SIC in terms of ORR,OS,incidence of leukopenia,and pain remission.In conclusion,compared with SIC,RAIC has better clinical efficacy and lower toxicity in the treatment of advanced pancreatic cancer.

Retrospective analysis of 56 patients with advanced gastric cancer treated with combination of intravenous and intra-arterial intensified neoadjuvant chemotherapy

Background Pre-operative chemotherapy has gained widespread interest while treating advanced gastric cancer in eastern countries. However, there is currently no established standard regimen for gastric cancer. The aim of this research was to explore the value of preoperative chemotherapy with a combination of intravenous and intra-arterial intensified chemotherapy in advanced .qastric cancer.