Background and Objective:Although there are many randomized clinical trials of late course accelerated hyperfractionated radiotherapy (LCAHFR) combined with FP chemotherapy for esophageal cancer, the efficacy and toxi...Background and Objective:Although there are many randomized clinical trials of late course accelerated hyperfractionated radiotherapy (LCAHFR) combined with FP chemotherapy for esophageal cancer, the efficacy and toxicity are controversial. This study was to evaluate the efficacy and toxicity of LCAHFR combined with FP chemotherapy in treating esophageal cancer. Methods: Reports of randomized clinical trials on LCAHFR combined with FP chemotherapy for esophageal cancer published between January 1999 and January 2009 were researched through Wanfang, CNKI, and PubMed databases. RevMan4.2 software was used for Meta-analysis. Results: Twenty-one reports, including 2030 patients, were included in the meta-analysis. Of the 2030 patients, 1006 underwent LCAHFR (LCAHFR group), and 1024 underwent LCAHFR combined with FP chemotherapy (combination group). Compared with those of the LCAHFR group, the 1-, 2-, 3-, 5-years survival rates and 1-, 2-, 3-year local control rates of the combination group were significant increased, and the acute toxicity was also increased, but chronic toxicity showed no significant difference. C onclusions: LCAHFR combined with FP chemotherapy can improve the survival rate and the local control rate of the patients with esophageal cancer. The increased acute toxicity need to be concerned, whereas the chronic toxicity needs a long-term observation.展开更多
Prof. Dr. Manfred Held will give a 7-day intro-ductive short course in Yellow Mountain of Anhui Province to the following topics: Shaped Charge Threat, KE Performance,
The aim of this mini-review is to compare and contrast the pros and cons of short-course and long-course neoadjuvant chemoradiation therapy regimens for stageⅡ&Ⅲrectal adenocarcinoma.Multiple trials have demonst...The aim of this mini-review is to compare and contrast the pros and cons of short-course and long-course neoadjuvant chemoradiation therapy regimens for stageⅡ&Ⅲrectal adenocarcinoma.Multiple trials have demonstrated the equal efficacy and safety of short-course and long-course radiation therapy as a part of neoadjuvant regimens.Published data also shows that total neoadjuvant therapy could be more successful than neoadjuvant chemoradiation followed by adjuvant chemotherapy.This review points out future research directions for patients with locally advanced rectal adenocarcinoma such as comparing total neoadjuvant therapy that contains a short-course of radiation therapy to the standard of care,and evaluating how the sequence of short-course radiation therapy and chemotherapy in the total neoadjuvant therapy impacts the pathological complete response(pCR)rate,local control,and survival outcomes.展开更多
Objective To investigate variation in levels of transforming growth factor beta 1(TGF-β1)before and after radiotherapy in patients with esophageal cancer in order to evaluate the predictive value of TGF-β1 for the e...Objective To investigate variation in levels of transforming growth factor beta 1(TGF-β1)before and after radiotherapy in patients with esophageal cancer in order to evaluate the predictive value of TGF-β1 for the effects of radiotherapy Methods A total of 140 patients with esophageal squamous carcinoma undergoing radical radiation therapy in the Department of Oncology from March 2015 to December 2017 were enrolled.The patients were divided into the effective(115 cases)and ineffective(25 cases)groups according to World Health Organization(WHO)criteria for the evaluation of solid tumors(2009 RECIST standard).TGF-β1 levels were measured in all patients by using enzyme-linked immunosorbent assay(ELISA).Multiple-factor analysis of the predictive value of the treatment efficacy was performed by Cox regression analysis.Results After radiotherapy,36,79,and 25 cases experienced complete response(CR),partial response(PR),and no response(NR),respectively,with a total effective rate of 82.14%.The TGF-β1 level was significantly lower in the effective group than that in the ineffective group(P<0.05)and covariance analysis revealed significantly reduced TGF-β1 level in esophageal cancer patients following radiotherapy.The multi-factor Cox regression model revealed that the predictive value of TGF-β1 for the effect of radiotherapy was largest,with a hazard ratio[HR]of 1.955(P=0.002),followed by exposure dose,with(HR=1.367;P=0.035).Conclusion Serum TGF-β1 level can serve as a predictor for the short-term effects of radiotherapy in patients with esophageal cancer.展开更多
BACKGROUND Radiotherapy or chemoradiotherapy is widely used for the treatment of rectal cancer preoperatively.Although the combination of radiotherapy and chemotherapy as an established preoperative neoadjuvant therap...BACKGROUND Radiotherapy or chemoradiotherapy is widely used for the treatment of rectal cancer preoperatively.Although the combination of radiotherapy and chemotherapy as an established preoperative neoadjuvant therapy shows high efficacy in the treatment of rectal cancer,some patients experience a response of poor tolerance and outcomes due to the long duration radiotherapy.The study compared short duration radiotherapy plus chemotherapy vs long duration radiotherapy plus chemotherapy for rectal cancer to determine whether short duration radiation treatment should be considered to diminish complications,reduce risk of recurrence and improve survival in patients with rectal cancer.AIM To evaluate the efficacy and safety of short duration radiotherapy combined with chemotherapy for the treatment of advanced rectal cancer.METHODS One hundred patients with stage IIIB or higher severe rectal cancer were selected as the study subjects at The First Affiliated Hospital of Hebei North University between December 2018 and December 2019.The patients were assigned to different groups based on the treatment regimens.Fifty patients who received preoperative short durations of radiotherapy plus chemotherapy were enrolled in an observation group and fifty patients who received conventional radiotherapy and chemotherapy were enrolled in a control group.Colonoscopic biopsy was performed for all patients with pathological diagnosis of rectal cancer.The expression of tumor-related factors such as RUNX3 and Ki-67 was quantitatively analyzed using immunohistochemistry in the tissues of the patients before and after treatment.Moreover,the duration of procedure,the amount of bleeding during the operation,the anus-conserving rate,the incidence of postoperative complications(wound infection,anastomotic leakage,postoperative intestinal obstruction,etc.)and postoperative pathology were compared between the two groups.The overall survival rate,recurrence rate and distant metastasis rate were also compared through postoperative reexamination and regular follow-up.RESULTS There was no significant difference in the positive expression rate of RUNX3 and Ki-67 between the two groups before the treatment(P>0.05).Compared with the pretreatment value,the positive rate of RUNX3 was increased and the positive rate of Ki-67 was decreased in both groups after the treatment(all P<0.05).The incidence of leukopenia,thrombocytopenia,neutropenia and diarrhea were higher in the observation group than in the control group(all P<0.05).There was no significant difference in the incidence of anemia,fatigue,neurotoxicity and nausea and vomiting between the two groups(all P>0.05).No significant difference was observed in the duration of procedure,intraoperative bleeding,the anus-conserving rate and the incidence of postoperative complications between the two groups(P>0.05).After 1 year of follow-up,the 1-yr survival rate was 80.0%in the observation group and 68.0%in the control group,the recurrence rate was 8.0%in the observation group and 10.0%in the control group,the distant metastasis rate was 6.0%in the observation group and 8.0%in the control group difference(all P<0.05).CONCLUSION Short duration radiotherapy combined with chemotherapy can improve the cure rate,prolong the survival time and reduce the incidence of complications in patients with advanced rectal cancer.展开更多
AIM To investigate second primary malignancy(SPM) risk after radiotherapy in rectal cancer survivors METHODS We used Taiwan's National Health Insurance Research Database to identify rectal cancer patients between ...AIM To investigate second primary malignancy(SPM) risk after radiotherapy in rectal cancer survivors METHODS We used Taiwan's National Health Insurance Research Database to identify rectal cancer patients between 1996 and 2011. Surgery-alone, preoperative short course, preoperative long course, and post-operative radiotherapy groups were defined. The overall and sitespecific SPM incidence rates were compared among the radiotherapy groups by multivariate Cox regression, taking chemotherapy and comorbidities into account. Sensitivity tests were performed for attained-year adjustment and long-term survivors analysis. RESULTS A total of 28220 patients were analyzed. The 10-year cumulative SPM incidence was 7.8% [95% confidence interval(CI): 7.2%-8.2%] using a competing risk model. The most common sites of SPM were the lung, liver, and prostate. Radiotherapy was not associated with increased SPM risk in multi-variate Cox model(hazard ratio = 1.05, 95%CI: 0.91-1.21, P = 0.494). The SPM hazard remained unchanged in 10-yearsurvivors. In addition, no SPM risk difference was found between the preoperative radiotherapy and postoperative radiotherapy groups.CONCLUSION In this large population-based cohort study, we demonstrated that radiotherapy had no increase in SPM.展开更多
【目的】探讨纯中医规范化综合治疗短病程突发性聋(简称突聋)的临床疗效及其影响因素。【方法】对516例采用纯中医规范化综合治疗的短病程突聋住院患者(中医组)的临床资料进行回顾性分析,并与《中国突发性聋分型治疗的多中心临床研究》...【目的】探讨纯中医规范化综合治疗短病程突发性聋(简称突聋)的临床疗效及其影响因素。【方法】对516例采用纯中医规范化综合治疗的短病程突聋住院患者(中医组)的临床资料进行回顾性分析,并与《中国突发性聋分型治疗的多中心临床研究》的1024例患者(西医组)的疗效进行对照,分析患者性别、耳别、年龄、耳聋程度、听力曲线类型、伴随症状(耳鸣、眩晕、耳闷)及中医证型对疗效的影响。【结果】(1)基线资料比较:与西医组相比,中医组低频下降型占比较低,全聋型占比较高,治疗难度相对较大,而疗程缩短近2/3(12.60 d vs 30.00 d)。(2)疗效分析:中医组516例患者中,痊愈175例,显效121例,有效90例,无效130例,总有效率为74.80%,与西医组1024例相比,无论总体疗效还是按听力曲线分类统计疗效,差异均无统计学意义(P>0.05)。(3)疗效影响因素分析:听力曲线类型与突聋疗效关系密切(P<0.001),低频下降型疗效最好,全聋型疗效最差;耳聋程度越轻,痊愈可能性越大(P<0.001);无眩晕者疗效优于伴眩晕者(P<0.001);青少年患者疗效较中老年好(P<0.05);中医证型与疗效无关(P>0.05)。【结论】纯中医规范化综合治疗短病程突聋疗效较好,与西医常规治疗相比可能具有一定的优势;听力曲线类型、耳聋程度、是否伴随眩晕及年龄是影响疗效的相关因素。展开更多
文摘Background and Objective:Although there are many randomized clinical trials of late course accelerated hyperfractionated radiotherapy (LCAHFR) combined with FP chemotherapy for esophageal cancer, the efficacy and toxicity are controversial. This study was to evaluate the efficacy and toxicity of LCAHFR combined with FP chemotherapy in treating esophageal cancer. Methods: Reports of randomized clinical trials on LCAHFR combined with FP chemotherapy for esophageal cancer published between January 1999 and January 2009 were researched through Wanfang, CNKI, and PubMed databases. RevMan4.2 software was used for Meta-analysis. Results: Twenty-one reports, including 2030 patients, were included in the meta-analysis. Of the 2030 patients, 1006 underwent LCAHFR (LCAHFR group), and 1024 underwent LCAHFR combined with FP chemotherapy (combination group). Compared with those of the LCAHFR group, the 1-, 2-, 3-, 5-years survival rates and 1-, 2-, 3-year local control rates of the combination group were significant increased, and the acute toxicity was also increased, but chronic toxicity showed no significant difference. C onclusions: LCAHFR combined with FP chemotherapy can improve the survival rate and the local control rate of the patients with esophageal cancer. The increased acute toxicity need to be concerned, whereas the chronic toxicity needs a long-term observation.
文摘Prof. Dr. Manfred Held will give a 7-day intro-ductive short course in Yellow Mountain of Anhui Province to the following topics: Shaped Charge Threat, KE Performance,
文摘The aim of this mini-review is to compare and contrast the pros and cons of short-course and long-course neoadjuvant chemoradiation therapy regimens for stageⅡ&Ⅲrectal adenocarcinoma.Multiple trials have demonstrated the equal efficacy and safety of short-course and long-course radiation therapy as a part of neoadjuvant regimens.Published data also shows that total neoadjuvant therapy could be more successful than neoadjuvant chemoradiation followed by adjuvant chemotherapy.This review points out future research directions for patients with locally advanced rectal adenocarcinoma such as comparing total neoadjuvant therapy that contains a short-course of radiation therapy to the standard of care,and evaluating how the sequence of short-course radiation therapy and chemotherapy in the total neoadjuvant therapy impacts the pathological complete response(pCR)rate,local control,and survival outcomes.
文摘Objective To investigate variation in levels of transforming growth factor beta 1(TGF-β1)before and after radiotherapy in patients with esophageal cancer in order to evaluate the predictive value of TGF-β1 for the effects of radiotherapy Methods A total of 140 patients with esophageal squamous carcinoma undergoing radical radiation therapy in the Department of Oncology from March 2015 to December 2017 were enrolled.The patients were divided into the effective(115 cases)and ineffective(25 cases)groups according to World Health Organization(WHO)criteria for the evaluation of solid tumors(2009 RECIST standard).TGF-β1 levels were measured in all patients by using enzyme-linked immunosorbent assay(ELISA).Multiple-factor analysis of the predictive value of the treatment efficacy was performed by Cox regression analysis.Results After radiotherapy,36,79,and 25 cases experienced complete response(CR),partial response(PR),and no response(NR),respectively,with a total effective rate of 82.14%.The TGF-β1 level was significantly lower in the effective group than that in the ineffective group(P<0.05)and covariance analysis revealed significantly reduced TGF-β1 level in esophageal cancer patients following radiotherapy.The multi-factor Cox regression model revealed that the predictive value of TGF-β1 for the effect of radiotherapy was largest,with a hazard ratio[HR]of 1.955(P=0.002),followed by exposure dose,with(HR=1.367;P=0.035).Conclusion Serum TGF-β1 level can serve as a predictor for the short-term effects of radiotherapy in patients with esophageal cancer.
基金The Key Science and Technology Program of Zhangjiakou,No.1921132H.
文摘BACKGROUND Radiotherapy or chemoradiotherapy is widely used for the treatment of rectal cancer preoperatively.Although the combination of radiotherapy and chemotherapy as an established preoperative neoadjuvant therapy shows high efficacy in the treatment of rectal cancer,some patients experience a response of poor tolerance and outcomes due to the long duration radiotherapy.The study compared short duration radiotherapy plus chemotherapy vs long duration radiotherapy plus chemotherapy for rectal cancer to determine whether short duration radiation treatment should be considered to diminish complications,reduce risk of recurrence and improve survival in patients with rectal cancer.AIM To evaluate the efficacy and safety of short duration radiotherapy combined with chemotherapy for the treatment of advanced rectal cancer.METHODS One hundred patients with stage IIIB or higher severe rectal cancer were selected as the study subjects at The First Affiliated Hospital of Hebei North University between December 2018 and December 2019.The patients were assigned to different groups based on the treatment regimens.Fifty patients who received preoperative short durations of radiotherapy plus chemotherapy were enrolled in an observation group and fifty patients who received conventional radiotherapy and chemotherapy were enrolled in a control group.Colonoscopic biopsy was performed for all patients with pathological diagnosis of rectal cancer.The expression of tumor-related factors such as RUNX3 and Ki-67 was quantitatively analyzed using immunohistochemistry in the tissues of the patients before and after treatment.Moreover,the duration of procedure,the amount of bleeding during the operation,the anus-conserving rate,the incidence of postoperative complications(wound infection,anastomotic leakage,postoperative intestinal obstruction,etc.)and postoperative pathology were compared between the two groups.The overall survival rate,recurrence rate and distant metastasis rate were also compared through postoperative reexamination and regular follow-up.RESULTS There was no significant difference in the positive expression rate of RUNX3 and Ki-67 between the two groups before the treatment(P>0.05).Compared with the pretreatment value,the positive rate of RUNX3 was increased and the positive rate of Ki-67 was decreased in both groups after the treatment(all P<0.05).The incidence of leukopenia,thrombocytopenia,neutropenia and diarrhea were higher in the observation group than in the control group(all P<0.05).There was no significant difference in the incidence of anemia,fatigue,neurotoxicity and nausea and vomiting between the two groups(all P>0.05).No significant difference was observed in the duration of procedure,intraoperative bleeding,the anus-conserving rate and the incidence of postoperative complications between the two groups(P>0.05).After 1 year of follow-up,the 1-yr survival rate was 80.0%in the observation group and 68.0%in the control group,the recurrence rate was 8.0%in the observation group and 10.0%in the control group,the distant metastasis rate was 6.0%in the observation group and 8.0%in the control group difference(all P<0.05).CONCLUSION Short duration radiotherapy combined with chemotherapy can improve the cure rate,prolong the survival time and reduce the incidence of complications in patients with advanced rectal cancer.
文摘AIM To investigate second primary malignancy(SPM) risk after radiotherapy in rectal cancer survivors METHODS We used Taiwan's National Health Insurance Research Database to identify rectal cancer patients between 1996 and 2011. Surgery-alone, preoperative short course, preoperative long course, and post-operative radiotherapy groups were defined. The overall and sitespecific SPM incidence rates were compared among the radiotherapy groups by multivariate Cox regression, taking chemotherapy and comorbidities into account. Sensitivity tests were performed for attained-year adjustment and long-term survivors analysis. RESULTS A total of 28220 patients were analyzed. The 10-year cumulative SPM incidence was 7.8% [95% confidence interval(CI): 7.2%-8.2%] using a competing risk model. The most common sites of SPM were the lung, liver, and prostate. Radiotherapy was not associated with increased SPM risk in multi-variate Cox model(hazard ratio = 1.05, 95%CI: 0.91-1.21, P = 0.494). The SPM hazard remained unchanged in 10-yearsurvivors. In addition, no SPM risk difference was found between the preoperative radiotherapy and postoperative radiotherapy groups.CONCLUSION In this large population-based cohort study, we demonstrated that radiotherapy had no increase in SPM.
文摘【目的】探讨纯中医规范化综合治疗短病程突发性聋(简称突聋)的临床疗效及其影响因素。【方法】对516例采用纯中医规范化综合治疗的短病程突聋住院患者(中医组)的临床资料进行回顾性分析,并与《中国突发性聋分型治疗的多中心临床研究》的1024例患者(西医组)的疗效进行对照,分析患者性别、耳别、年龄、耳聋程度、听力曲线类型、伴随症状(耳鸣、眩晕、耳闷)及中医证型对疗效的影响。【结果】(1)基线资料比较:与西医组相比,中医组低频下降型占比较低,全聋型占比较高,治疗难度相对较大,而疗程缩短近2/3(12.60 d vs 30.00 d)。(2)疗效分析:中医组516例患者中,痊愈175例,显效121例,有效90例,无效130例,总有效率为74.80%,与西医组1024例相比,无论总体疗效还是按听力曲线分类统计疗效,差异均无统计学意义(P>0.05)。(3)疗效影响因素分析:听力曲线类型与突聋疗效关系密切(P<0.001),低频下降型疗效最好,全聋型疗效最差;耳聋程度越轻,痊愈可能性越大(P<0.001);无眩晕者疗效优于伴眩晕者(P<0.001);青少年患者疗效较中老年好(P<0.05);中医证型与疗效无关(P>0.05)。【结论】纯中医规范化综合治疗短病程突聋疗效较好,与西医常规治疗相比可能具有一定的优势;听力曲线类型、耳聋程度、是否伴随眩晕及年龄是影响疗效的相关因素。
