ABSTRACT
Objective To study the effect and toxicity ofgefitinib combined with selected radiotherapy in the treatment of patients with advanced non-small-cell lung cancer (NSCLC). Methods From March 2006 to February 2009,10 of 13 advanced NSCLC patients who got benefit from gefitinib were enrolled to treatment group (gefitinib concurrent selected radiotherapy) and control group (gefitinib only), with 5 cases in each group. The response was evaluated as progression free survival (PFS) and overall survival (OS).Results No patient got complete remission (CR). Ten of 13 patients got partial remission (PR) and stable disease (SD). The 1 year and 2 years survival rate was 53.8%(7/13) and 46.2%(6/13) respectively. The median PFS in treatment group and control group was 24 months and 8 months respectively(P= 0.0019). The median OS was 32 months and 10 months respectively (P= 0.0062). The main toxicities were reversible skin rash and diarrhea,and 3 patients developed asymptomatic radiation pulmonary fibrosis. Conclusions Gefitinib combining with selected radiotherapy is effective and tolerated in patients with advanced NSCLC. It may prolong PFS and OS. It may be a rational choice for the standard and individualized treatment of NSCLC.
ABSTRACT
Corticotropin-releasing factor (CRF)is a neuroendoerine peptide that stimulates the synthesis and release of adrenecortieotropic hormone from the pituitary. CRF widely distributed in the body has been implicated in the regulation of endocrine, neural, behavioral responses and has relevance in the the physio- logical effects and pathophysiology of gut. The delayed gastric emptying, inhibited small intestinal transit and stimulated colonic transit are the most common responses evoked by CRF. CRF delay gastric emptying by ac- tivating CRF2 receptor while the stimulation of colonic motility is mediated by the activation of CRF1 recep- tor. Development of antagonists of CRF receptor may treat a new therapeutic strategy for treatment of stress- related gastrointestinal disease.
ABSTRACT
Objective To investigate the feasibility and safety of laparoscopic radical resection for rectal carcinoma.Methods A total of 80 patients with rectal carcinoma received laparoscopic radical resection in our hospital from March 2004 to January 2008.During the operation,adequate proximal and distal bowel segments,and mesentery and lymph nodes surrounding the tumor were resected completely.And then lower anterior resection(Dixon)and sigmoid colostomy for abdominal perineal resection(Miles)were implemented.Results Among the 80 patients,4 were converted to open surgery during the operation,and the other 76 patients were treated by laparoscopy successfully.Dixon surgery was performed on 44 cases with a mean operation time of(178?38)minutes,intraoperative blood loss of(61?17)ml,excised lymph nodes number of(11.3?2.9),and postoperative hospital stay of(7.1?3.2)days.Miles were carried out on 32 patients,in which the mean operation time was(231?49)minutes and intraoperative blood loss was(210?178)ml;a mean of(12.9?3.7)lymph nodes were resected,the postoperative hospital stay was(9.3?4.1)days.No residual cancer was found in the patients.After the treatment,1 patient developed stoma stenosis,5 showed perineal wound infection,1 had anastomotic leak,and 6 complained of urinary retention immediately after the surgery.No patient had postoperative hemorrhage or died after the procedure.Follow-up was achieved in 70 cases for 9 to 48 months,during which 5 patients had recurrence,2 died of multiple organ failure induced by multiple metastasis,and 5 patients developed ileus.Conclusion Laparoscopic resection for rectal carcinoma is safe and feasible for selected patients,when the surgeons are skilled with experience on both open colectomy and laparoscopic surgery.