BACKGROUND Primary small cell of esophageal carcinoma is an aggressive tumor with no established treatment guidelines.A treatment strategy was adopted based on small cell carcinoma of the lung because of many similar ...BACKGROUND Primary small cell of esophageal carcinoma is an aggressive tumor with no established treatment guidelines.A treatment strategy was adopted based on small cell carcinoma of the lung because of many similar clinicopathological features.Here,we report one of the largest case series in a western population.AIM To review the practice of treating small cell oesophageal cancer(SCOC)with different treatment modalities treated at our institution between 2001 and 2014.METHODS A total of 28 cases of SCOC have been identified.All cases were identified with a ten-digit code known as the CHI number.Data was collected using a combination of an electronic database,case notes and the chemotherapy electronic prescribing system(chemocare).We collected information on age,gender,performance status,staging of the disease(limited stage vs extensive stage).RESULTS The results showed 17 patients(61%)were diagnosed with limited stage small cell oesophageal cancer(LS-SCOC),while 11 patients(39%)were diagnosed with extensive stage small cell oesophageal cancer(ES-SCOC).The median age at diagnosis of SCOC was 72 years(range 52-86).The median survival for patients with ES-SCOC was 7 mo(95%CI:1-12)vs LS-SCOC[median 23 mo(95%CI:14-40)],P<0.0001.Subgroup analysis of those who received treatment showed the median survival for patients who received palliative chemotherapy was 7 mo(95%CI:1.5-12),concurrent chemoradiation 45 mo(95%CI:38-)and sequential chemoradiation 20 mo(95%CI:17-25),P<0.0001.CONCLUSION Our data strongly support the use of concurrent chemoradiation in the treatment of LS-SCOC in patients who are fit with no significant comorbidity.展开更多
There is a global unmet need for rapid and cost-effective prognostic and diagnostic tools that can be used at the bedside or in the doctor’s office to reduce the impact of serious disease.Many cancers are diagnosed l...There is a global unmet need for rapid and cost-effective prognostic and diagnostic tools that can be used at the bedside or in the doctor’s office to reduce the impact of serious disease.Many cancers are diagnosed late,leading to costly treatment and reduced life expectancy.With prostate cancer,the absence of a reliable test has inhibited the adoption of screening programs.We report a microelectronic point-of-care metabolite biomarker measurement platform and use it for prostate cancer detection.The platform,using an array of photodetectors configured to operate with targeted,multiplexed,colorimetric assays confined in monolithically integrated passive microfluidic channels,completes a combined assay of 4 metabolites in a drop of human plasma in under 2 min.A preliminary clinical study using L-amino acids,glutamate,choline,and sarcosine was used to train a cross-validated random forest algorithm.The system demonstrated sensitivity to prostate cancer of 94%with a specificity of 70%and an area under the curve of 0.78.The technology can implement many similar assay panels and hence has the potential to revolutionize low-cost,rapid,point-of-care testing.展开更多
文摘BACKGROUND Primary small cell of esophageal carcinoma is an aggressive tumor with no established treatment guidelines.A treatment strategy was adopted based on small cell carcinoma of the lung because of many similar clinicopathological features.Here,we report one of the largest case series in a western population.AIM To review the practice of treating small cell oesophageal cancer(SCOC)with different treatment modalities treated at our institution between 2001 and 2014.METHODS A total of 28 cases of SCOC have been identified.All cases were identified with a ten-digit code known as the CHI number.Data was collected using a combination of an electronic database,case notes and the chemotherapy electronic prescribing system(chemocare).We collected information on age,gender,performance status,staging of the disease(limited stage vs extensive stage).RESULTS The results showed 17 patients(61%)were diagnosed with limited stage small cell oesophageal cancer(LS-SCOC),while 11 patients(39%)were diagnosed with extensive stage small cell oesophageal cancer(ES-SCOC).The median age at diagnosis of SCOC was 72 years(range 52-86).The median survival for patients with ES-SCOC was 7 mo(95%CI:1-12)vs LS-SCOC[median 23 mo(95%CI:14-40)],P<0.0001.Subgroup analysis of those who received treatment showed the median survival for patients who received palliative chemotherapy was 7 mo(95%CI:1.5-12),concurrent chemoradiation 45 mo(95%CI:38-)and sequential chemoradiation 20 mo(95%CI:17-25),P<0.0001.CONCLUSION Our data strongly support the use of concurrent chemoradiation in the treatment of LS-SCOC in patients who are fit with no significant comorbidity.
基金This work was supported by EPSRC grants EP/K021966/1 and EP/L023652/1.S.B.P.is now at the Department of Electronic Engineering&York Biomedical Research Institute,University of York,York,YO105DD UK.M.P.B.is part of the Wellcome Centre for Integrative Parasitology funded by a Wellcome Trust core grant(104111/Z/14/Z).
文摘There is a global unmet need for rapid and cost-effective prognostic and diagnostic tools that can be used at the bedside or in the doctor’s office to reduce the impact of serious disease.Many cancers are diagnosed late,leading to costly treatment and reduced life expectancy.With prostate cancer,the absence of a reliable test has inhibited the adoption of screening programs.We report a microelectronic point-of-care metabolite biomarker measurement platform and use it for prostate cancer detection.The platform,using an array of photodetectors configured to operate with targeted,multiplexed,colorimetric assays confined in monolithically integrated passive microfluidic channels,completes a combined assay of 4 metabolites in a drop of human plasma in under 2 min.A preliminary clinical study using L-amino acids,glutamate,choline,and sarcosine was used to train a cross-validated random forest algorithm.The system demonstrated sensitivity to prostate cancer of 94%with a specificity of 70%and an area under the curve of 0.78.The technology can implement many similar assay panels and hence has the potential to revolutionize low-cost,rapid,point-of-care testing.
