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Purpose@#The purpose of this study was to compare the survival and toxicities in cervical esophageal squamous cell carcinoma (CESCC) treated by concurrent chemoradiothrapy with either three-dimensional conformal radiotherapy (3D-CRT) or intensity-modulated radiotherapy (IMRT) techniques. @*Materials and Methods@#A total of 112 consecutive CESCC patients were retrospectively reviewed. 3D-CRT and IMRT groups had been analyzed by propensity score matching method, with sex, age, Karnofsky performance status, induction chemotherapy, and tumor stage well matched. The Kaplan-Meier method and Cox proportional hazards model were used for overall survival (OS) and progression-free survival (PFS). Toxicities were compared between two groups by Fisher exact test. @*Results@#With a median follow-up time of 34.9 months, the 3-year OS (p=0.927) and PFS (p=0.859) rate was 49.6% and 45.8% in 3D-CRT group, compared with 54.4% and 42.8% in IMRT group. The rates of grade ≥ 3 esophagitis, grade ≥ 2 pneumonitis, esophageal stricture, and hemorrhage were comparable between two groups, while the rate of tracheostomy dependence was much higher in IMRT group than 3D-CRT group (14.3% vs.1.8%, p=0.032). Radiotherapy technique (hazard ratio [HR], 0.09; 95% confidence interval [CI], 0.01 to 0.79) and pretreatment hoarseness (HR, 0.12; 95% CI 0.02 to 0.70) were independently prognostic of tracheostomy dependence. @*Conclusion@#No survival benefits had been observed while comparing IMRT versus 3D-CRT in CESCC patients. IMRT with fraction dose escalation and pretreatment hoarseness were considered to be associated with a higher risk for tracheostomy dependence. Radiation dose escalation beyond 60 Gy should be taken into account carefully when using IMRT with hypofractionated regimen.
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Objective@#The present study aimed to explore the rationality of peeling process of Pruni semen through the determination of amygdalin.@*Methods@#The content of amarogentin in seed coat, seed kernel and total seed of Pruni semen, respectively, were determined by HPLC according to the methods of content determination under Pruni semen in Chinese Pharmacopeia (2015). The chromatographic column was Inertsil ODS-SP C18 (4.6 mm×150 mm, 5 μm). The gradient elution with acetonitrile-water as mobile phase was performed. The flow velocity was 0.6 ml/min, the column temperature was 40 ℃, and the wavelength was 210 nm.@*Results@#The average recovery rate (n=6) was 98.26%. The sample was stable within 24 h, and the RSD (n=6) was 1.12%. The quality of control products was good in the range of 0.02-0.40 μg. The analysis indicated that there is no significant differences (P>0.05) in the contents of amygdalin in seed coat, seed kernel and total seed of Pruni semen.@*Conclusions@#With the content of amygdalin as the index of evaluation, the Pruni semen had better not be peeled.
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Objective The present study aimed to explore the rationality of peeling process of Pruni semen through the determination of amygdalin. Methods The content of amarogentin in seed coat, seed kernel and total seed of Pruni semen, respectively, were determined by HPLC according to the methods of content determination under Pruni semen in Chinese Pharmaсopeia (2015). The chromatographic column was Inertsil ODS-SP C18 (4.6 mm×150 mm, 5 μm). The gradient elution with acetonitrile-water as mobile phase was performed. The flow velocity was 0.6 ml/min, the column temperature was 40 , and the wavelength was ℃210 nm. Results The average recovery rate (n=6) was 98.26%. The sample was stable within 24 h, and the RSD (n=6) was 1.12%. The quality of control products was good in the range of 0.02-0.40 μg. The analysis indicated that there is no significant differences (P>0.05) in the contents of amygdalin in seed coat, seed kernel and total seed of Pruni semen. Conclusions With the content of amygdalin as the index of evaluation, the Pruni semen had better not be peeled.
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To establish a new quantitative method for simultaneous determination of multi-components in Scrophularia root by using high performance liquid chromatography (HPLC) and validate its feasibilities．Meanwhile,using catalpol as one chemical reference substance to establish the relative correct factors and relative retention values of aucubin,harpagide,acteoside,angoroside C,harpagoside and cinnamic acid．Then using the quantitative analysis of multi-components by single-marker (QAMS)model,the six analytes can be quantitatively determined in Scrophularia root．The method was evaluated by comparison of the quantitative results to external standard method．No significant differences were observed between the quantitative results of the two methods．The obtained RCFs were credible．It is feasible and suitable to evaluate the quality of Scrophularia root.
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PURPOSE: Previous studies reported an association between an increased risk of tongue cancer and radiation treatment for nasopharyngeal carcinoma (NPC). This study compared the clinicopathologic characteristics and outcomes of tongue squamous cell carcinoma (TSCC) in patients with and without a history of radiotherapy for NPC. MATERIALS AND METHODS: From 1965 to 2009, a total of 73 patients were diagnosed with TSCC with a history of radiotherapy for NPC. The patients were matched in a 1:3 ratio with patients with sporadic TSCC according to age, sex, and year of the TSCC diagnosis. The primary endpoint was the overall survival. RESULTS: The median interval from NPC to TSCC was 82 months. The NPC survivors were more likely to be diagnosed with a more advanced T classification, less likely to have lymph node involvement, and more likely to have the tumor located in the dorsum of the tongue than sporadic TSCC. Regarding the histologic characteristics, the NPC survivors were more likely to have a weak lymphocytic host response, low tumor budding, and low risk of a worse pattern of invasion. The sporadic TSCC patients had a better overall survival (hazard ratio, 0.690; p=0.033) than the NPC survivors. In competing risks analysis, the cumulative incidence functions for the competing event (documented non-tongue cancer death) were significantly higher in the NPC survivors (Gray's test, p=0.001). CONCLUSION: TSCC patients with a history of radiotherapy for NPC appear to have particular clinicopathologic features, a poorer survival, and are more likely to die from non-tongue cancer causes than those with sporadic TSCC.
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Humans , Carcinoma, Squamous Cell , Case-Control Studies , Classification , Diagnosis , Epithelial Cells , Incidence , Lymph Nodes , Neoplasms, Second Primary , Prognosis , Radiotherapy , Survivors , Tongue Neoplasms , TongueABSTRACT
BACKGROUND: MRI T1ρ and T2 mapping have been applied to study lumbar intervertebral disc degeneration in human and rhesus monkey, showing that they can be used for evaluating the early degeneration, but their application in New Zealand rabbit lumbar intervertebral disc degeneration is never reported.OBJECTIVE: To compare the relaxation time values of T1ρ and T2 mapping at different time points in a New Zealand rabbit model of ischemic lumbar intervertebral disc degeneration, and to compare the sensitivity for degeneration.METHODS: Fifteen New Zealand rabbits were randomly divided into three groups, and one of intervertebral discs at L4-5,L5-6 and L6-7 was designed for ischemic lumbar intervertebral disc degenerative model and the other two discs for controls. All the rabbits underwent T1ρ and T2 mapping preoperatively, 1, 3 or 6 months postoperatively to analyze the changes in the relaxation time at different time points.RESULTS AND CONCLUSION: (1) In the modeling group, the T2 mapping relaxation time of nucleus pulposus was (118.53±20.51) ms and (85.42±11.65) ms at 3 and 6 months after modeling, respectively, which showed significant difference when compared with preoperatively (146.21±16.93) ms (P < 0.05); but the time showed no significant difference compared with 1 month after modeling (P > 0.05). (2)T1ρ relaxation time of nucleus pulposus was (64.75±14.63) ms at 6 months after modeling, which showed significant difference when compared with preoperatively (87.88±8.87) ms (P < 0.05); but the time showed no significant difference compared with 1 and 3 months after modeling (P > 0.05). (3) In the control group, there was no significant difference in the T1ρ or T2 mapping relaxation time of nucleus pulposus before operation with 1, 3 or 6 months after operation (P > 0.05). The Pfirrmann grade of lumbar intervertebral disc was changed to Pfirrmann grades II-III at 6 months after modeling. (4) These results suggest that MR T1ρ and T2 mapping both are quantitative tools for evaluating the progress of ischemic lumbar intervertebral disc degeneration in New Zealand rabbits, especially the T2 mapping MRI may be more sensitive to early degenerative changes.
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Aim To evaluate the correlation between in vitro release and in vivo absorption of azithromycin cat-ionic micron niosomes (ACMNS)by Wagner-Nelson method and deconvolution method. Methods The in vitro release behavior of ACMNS was studied by dy-namic membrane dialysis. After a single dose of intra-gastric administration with ACMNS and AM in rats,the AM concentrations in plasma were determined by high performance liquid chromatography(HPLC). Wagner-Nelson and deconvolution method were used to reveal the in vitro / in vivo correlation. Results X used as cu-mulative in vitro release and Fa as the absorption per-centage,the regression equation was established:F a =3. 0524X - 5. 7709,r = 0. 8976,and X used as cumu-lative in vitro release and R as input function,the re-gression equation was established:R = 2. 3413X -58. 687,r = 0. 5217. r < r( 2,0. 05) = 0. 9500 (P <0. 05). Conclusion There is no correlation between in vitro release and in vivo absorption of ACMNS.
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Objective To improve the skills of pharmacists in pharmaceutical care and to provide patients with better individualized pharmaceutical care.Methods A total of 785 traditional Chinese medicine (TCM) counseling outpatient cases, consultation modes, objectives, consulting drugs, consulting problems were analyzed.Results Office counseling was the dominant method for TCM counseling (85.10%), followed by telephone counseling (14.90%). Of all the counselings, patients and their relatives accounted for 80.63%, where females was 60.25% and males 39.75%; and patients over 40 years of age accounted for 81.91%. Of all the pharmacy counseling, heart system disorder were the major (14.79%), followed by drugs for Qi, blood and body fluid disorder (12.61%); the contents of counseling were diversity, which included dosage and administration amounts (29.04%), experience for drug use (14.14%), drug interactions (10.39%) and adverse reactions (9.55%). Conclusion TCM counseling could offer an effective platform of communication between pharmacists and patients, improve patients' medication compliance, and ensure patients' safe, rational, economical and effective.
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OBJECTIVE:To virtually screen lignanoid compounds with inhibitory effect of histone deacetylase(HDAC)by vir-tual screening method. METHODS:Using“lignanoid”as keyword,requiring CNKI,VIP,PubMed and other database,lignanoid compounds were collected as ligand to establish ligand base, histone deacetylase receptor HDAC2 (PDB code:4LXZ) and HDAC8 (PDB code:1T69) were selected from PDB database,and then ligands and 3D active site of receptors were docked by SYBYL-X 2.0 software. The affinity of receptors to ligand was reflected by total score. RESULTS:345 lignanoid compounds, 4LXZ and 1T69 primary ligand were used to establish ligand base which included 347 ligands. Ligands No.275,271,110,200, 056,258,181,129,037,270,187 were demonstrated good affinity with receptors HDAC2 and HDAC8. Ligands and receptors residue were docked via hydrogen bond. CONCLUSIONS:Lignanoid compounds have inhibitory effect on HDAC;virtual screen-ing method is effective in natural product activity prediction,which can provide quick access to and theoretical guidance for new pharmacological studies of lignanoid compounds.
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<p><b>INTRODUCTION</b>It is important to decrease the radiation exposure of normal tissue in intensity-modulated radiation therapy (IMRT). Minimizing planning target volume (PTV) margins with more precise target localization techniques can achieve this goal. This study aimed to quantify the extent to which organs at risk (OARs) are spared when using reduced margins in the treatment of nasopharyngeal carcinoma (NPC).</p><p><b>METHODS</b>Two IMRT plans were regenerated for 40 patients with NPC based on two PTV margins, which were reduced or unchanged following cone beam computed tomography online correction. The reduced-margin plan was optimized based on maximal dose reduction to OARs without compromising target coverage. Dosimetric comparisons were evaluated in terms of target coverage and OAR sparing.</p><p><b>RESULTS</b>Improvements in target coverage occurred with margin reduction, and significant improvements in dosimetric parameters were observed for all OARs (P < 0.05) except for the right optic nerve, chiasm, and lens. Doses to OARs decreased at a rate of 1.5% to 7.7%. Sparing of the left parotid and right parotid, where the mean dose (Dmean) decreased at a rate of 7.1% and 7.7%, respectively, was greater than the sparing of other OARs.</p><p><b>CONCLUSIONS</b>Significant improvements in OAR sparing were observed with margin reduction, in addition to improvement in target coverage. The parotids benefited most from the online imaging-guided approach.</p>
Subject(s)
Humans , Carcinoma , Nasopharyngeal Neoplasms , Organs at Risk , Parotid Gland , Radiation Exposure , Radiometry , Radiotherapy Dosage , Radiotherapy Planning, Computer-Assisted , Radiotherapy, Intensity-ModulatedABSTRACT
<p><b>BACKGROUND</b>Insulin-like growth factor-binding protein-3 (IGFBP-3) is suggested to predict the radiosensitivity and/or prognosis of patients with esophageal squamous cell carcinoma (ESCC). The present study was designed to investigate the clinical and prognostic effects of IGFBP-3 on ESCC.</p><p><b>METHODS</b>IGFBP-3 was detected by immunohistochemistry in paraffin-embedded tissues from 70 ESCC patients treated with radiotherapy alone and further examined by western blotting analysis in 10 pairs of fresh ESCC tissues and adjacent non-malignant esophageal specimens. Receiver operating characteristic (ROC) analysis was used to determine cut-off scores for tumor positivity and to evaluate patient survival status. The χ(2) test was performed to analyze the association of IGFBP-3 expression with clinical characteristics and radiotherapy response. Associations between prognostic outcomes and IGFBP-3 expression were investigated using Kaplan-Meier analysis and the Cox proportional hazards model.</p><p><b>RESULTS</b>The threshold for IGFBP-3 positivity was set to greater than 65% [area under the ROC curve (AUC)=0.690, P<0.019]. Of the 70 ESCC patient tissues tested, 32 (45.7%) were defined as having high IGFBP-3 expression. The levels of IGFBP-3 protein expression were decreased in 70.0% (7 of 10) of ESCC tissues compared with adjacent non-malignant esophageal tissue. In addition, IGFBP-3 expression was associated with pathologic classification (P<0.05 for T, N, and M categories and clinical stage). Patients with elevated protein level of IGFBP-3 in the tumor had an improved radiotherapy response and prolonged overall survival (P<0.001).</p><p><b>CONCLUSIONS</b>High level of IGFBP-3 expression in ESCC associates with early clinical stages and are predictive for favorable survival of the patients treated with radiotherapy.</p>
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Humans , Blotting, Western , Carcinoma, Squamous Cell , Esophageal Neoplasms , Immunohistochemistry , Insulin-Like Growth Factor Binding Protein 3 , Kaplan-Meier Estimate , Prognosis , Proportional Hazards Models , ROC Curve , Radiation-Sensitizing AgentsABSTRACT
Objective In order to investigate the situation application of compound Danshen injection (CDI) in the treatment and to provide reference for clinical rational use.Methods Adverse drug reactions (ADR) report literatures through WANFANG DATA, VIP DATA and CNKI from 1989 to 2013 with (CDI) were retrieved the data including patient age, gender, medical history, dosage, medication time and ADR type were got and analyzed.Results One hundred and twenty-one literatures with one hundred and forty-eight ADR report cases wore retrieved. The ADR of (CDI) rate of male was higher than female. The original disease causes were cardiovascular and cerebrovascular diseases. The age, a rather elderly bunch, was not associated with the disease. The frequent onest time of adverse reaction was in 5-20 min after medication, and allergic reaction was the main adverse reaction.Conclusion The ADR of CDI should not be ignored. Patients constitution, gender, medication time and the combined application should be pay more attention to reduce the incidence of ADR and ensure the drug safety.
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Objective To study the role of azithromycin niosomes (AM-NS) in promoting the intestinal absorption of AM in rats. Methods Six healthy male rates were randomly divided into two groups. Single-pass intestinal perfusion was employed to investigate the intestinal absorption of the duodenum, jejunum, ileum and colon when the perfusion rate was 0. 2 mL/min and period was 1 h. The concentrations of the drugs were determined by HPLC; the drug absorption rate constant (Ka) and the intestinal apparent permeation coefficients (Peff) were calculated. Results The absorption Ka of AM-NS in the duodenum, jejunum, ileum and colon were 2. 41, 2. 35, 2. 54 and 2. 95 folds that of the free AM, and the Peff were 2. 34, 1. 47, 2. 20, and 1. 40 folds that of the free AM, respectively, with significant differences found between the two groups for both Ka and Peff (P<0. 05). Conclusion AM-NS can significantly improve the absorption of azithromycin in the intestine of rats.
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<p><b>OBJECTIVE</b>To study the influence of preoperative chemoradiotherapy (CRT) on pulmonary function and postoperative pulmonary complications in esophageal cancer patients.</p><p><b>METHODS</b>Pulmonary function and postoperative pulmonary complications of 63 esophageal cancer patients undergoing preoperative CRT and operation in Cancer Center of Sun Yat-sen University between 2002 and 2013 were collected retrospectively. The influence of preoperative CRT on pulmonary functional indexes and postoperative pulmonary complications were analyzed.</p><p><b>RESULTS</b>After preoperative CRT, DLco% decreased significantly (83.7±17.7 vs. 96.4±17.8, P<0.01), while no obvious changes in other indexes were found. Postoperative pulmonary complication rate was 34.9% (22/63), including 19 cases of pneumonia and 3 cases of acute pulmonary injury/acute respiratory distress syndrome. Differences in postoperative pulmonary complication rates were not statistically significant between patients with DLco% <80 and those with DLco% ≥80 patients (29.7% vs. 41.7%, P>0.05), and between patients with DLco% decline ≥15% and those with DLco% decline <15% patients (31.6% vs. 37.8%, P>0.05).</p><p><b>CONCLUSION</b>Preoperative CRT can damage the diffusion function but not ventilation function of esophageal cancer patients, and does not increase the postoperative pulmonary complication rate.</p>
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Female , Humans , Male , Middle Aged , Chemoradiotherapy , Esophageal Neoplasms , Drug Therapy , Radiotherapy , Lung , Perioperative Care , Postoperative Complications , Retrospective StudiesABSTRACT
<p><b>OBJECTIVE</b>The purpose of this study was to investigate the value of postoperative chemotherapy for locally advanced rectal cancer patients who reached pathological ypT1-4N0 after neo-adjuvant chemoradiotherapy.</p><p><b>METHODS</b>We performed a retrospective study of 104 patients treated with preoperative chemoradiotherapy followed by radical resection, who achieved pathological ypT1-4N0, between Mar 2003 and Dec 2010. There were 73 patients who received postoperative adjuvant chemotherapy, and the other 31 patients did not. The distribution of final pathologic stages for these patients was ypT1-2N0 in 39 cases and ypT3-4N0 in 65 cases.</p><p><b>RESULTS</b>The median follow-up was 41 months. The 3-year overall survival rate (OS) and recurrence-free survival rate (RFS) for the whole group (ypT1-4N0) were 93.4% and 85.3%, respectively. The 3-year OS and RFS in the adjuvant chemotherapy group and non-adjuvant chemotherapy group were 95.5%, 88.6% and 88.6%, 77.2%, respectively. There were no significant differences in 3-year RFS (P = 0.108) and OS (P = 0.106) between the two groups. The 3-year local recurrence and distant metastasis rates in the adjuvant chemotherapy group were 4.1% (3/73) and 5.5% (4/73), while for the non-adjuvant chemotherapy group, the 3-year local recurrence rate and distant metastasis rate were 3.2% (1/31) and 16.1% (5/31), respectively. Significant difference was found in distant metastasis rates (P = 0.030) between the two groups, but not in local recurrence rates (P = 0.676).Further subgroup analysis indicated that for the ypT1-2N0 patients, there were no significant differences in 3-year OS (P = 0.296) and RFS (P = 0.939) between the adjuvant and non-adjuvant chemotherapy groups, while negative results displayed in 3-year local recurrence rates (P = 0.676) and distant metastasis rates (P = 0.414). However, for patients with ypT3-4N0, significant differences were showed in both the 3-year OS (P = 0.034) and RFS (P = 0.025), and further analysis revealed that the 3-year distant metastasis rate was significantly higher in the non-adjuvant chemotherapy group than in the adjuvant chemotherapy group (P = 0.010) , but with non-significant difference in the 3-year local recurrence (P = 0.548).</p><p><b>CONCLUSIONS</b>Adjuvant chemotherapy may not improve survival for ypT1-2N0 patients. However, it may be clinically meaningful for ypT3-4N0 patients by decreasing distant metastasis rate. Further randomized controlled clinical trials are needed to confirm our results.</p>
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Adenocarcinoma , Drug Therapy , Pathology , Radiotherapy , General Surgery , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Chemoradiotherapy, Adjuvant , Chemotherapy, Adjuvant , Deoxycytidine , Therapeutic Uses , Fluorouracil , Therapeutic Uses , Follow-Up Studies , Leucovorin , Therapeutic Uses , Neoadjuvant Therapy , Neoplasm Metastasis , Neoplasm Recurrence, Local , Neoplasm Staging , Organoplatinum Compounds , Therapeutic Uses , Postoperative Period , Radiotherapy, Conformal , Rectal Neoplasms , Drug Therapy , Pathology , Radiotherapy , General Surgery , Retrospective Studies , Survival RateABSTRACT
Objective To understand the situation of depression and its related influencing factors among medical staff in Hunan province.Methods Data were collected through random sampling with multi-stage stratified cluster.Wilcoxon rank sum test,Kruskal-Wallis H test and Ordinal regression analysis were used for data analysis by SPSS 17.0 software.Results This survey was including 16 000 medical personnel with 14 988 valid questionnaires and the effective rate was 93.68％.Results from the single factor analysis showed that factors as:level of the hospital grading,gender,education background,age,occupation,title,departments,the number of continue education,income,working overtime every week,the frequency of night work,the number of patients treated in the emergency room etc.,had statistical significances (P＜0.05).Data from ordinal regression showed that the probabilities related to depression that clinicians and nurses suffering from were 1.58 times more than the pharmacists (OR=1.58,95％ CI:1.30-1.92).The probability among those whose income was less than 2000 Yuan/month was 2.19 times of the ones whose earned more than 3000 Yuan/month (OR=2.19,95％CI:2.05-2.35).The higher the numbers of days with working overtime every week,the frequencies of night work,and the numbers of patients being treated at the emergency room,with more probabilities of the people with depression seen in our study.Conclusion Depression seemed to be common among doctors and nurses.We suggested that the government need to increase the monthly income and to reduce the workload and intensity,lessen the overworking time,etc.
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<p><b>OBJECTIVE</b>To study the clinical characteristics, pathological features, diagnosis, therapy and prognosis of primary small cell carcinoma of the larynx (PSCCL).</p><p><b>METHODS</b>Six cases of PSCCL collected from 1990 to 2009 was retrospectively analyzed. The diagnosis was confirmed by pathological examination. Among six patients, one case belonged to stage III, and the others were in stage IVA. One case abandoned treatment; one case received chemotherapy; one case underwent supraglottic hemilaryngectomy and adjuvant chemoradiotherapy; one case underwent induction chemotherapy, radiotherapy and consolidation chemotherapy. Two cases received induction chemotherapy, concurrent chemoradiation and consolidation chemotherapy. The drug regimens included bleomycin, fluorouracil, cisplatin, etoposide and taxel for 3-6 cycles. The radiotherapy technique included conventional radiotherapy, CT-Sim and three dimensional conformal radiation therapy with (60)Co or 4 MV X-ray for 60 - 66 Gy during 6 - 7 weeks.</p><p><b>RESULTS</b>The time of follow-up was 3 - 24 months and the median was 13 months. Two patients applied with concurrent chemoradiation were alive without tumor. The patient abandoning therapy died of respiratory failure, and the others died of lung or liver metastasis after 8 - 12 months.</p><p><b>CONCLUSIONS</b>PSCCL is a disseminated disease, so the pretreatment evaluation is necessary. Concurrent chemoradiation is an ideal treatment model for this disease.</p>
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Adult , Humans , Male , Middle Aged , Young Adult , Carcinoma, Small Cell , Diagnosis , Therapeutics , Combined Modality Therapy , Laryngeal Neoplasms , Diagnosis , Therapeutics , Prognosis , Retrospective StudiesABSTRACT
<p><b>BACKGROUND AND OBJECTIVE</b>Extraskeletal Ewing's sarcoma (EES) is a rare, rapidly growing, round-cell, malignant tumor that can develop in the soft tissues at any location. This study was to analyze the clinical features, diagnosis and treatment of EES.</p><p><b>METHODS</b>Clinical data of 18 patients with EES, treated at between Cancer Center of Sun Yat-sen University between 1995 and 2007, were analyzed.</p><p><b>RESULTS</b>Of the 18 patients, 13 were male and 8 were female, aged from 8 months to 60 years. Twelve (66.7%) patients were between 5-25 years of age. Eight (44.4%) patients had tumors originated from low extremities.Sixteen patients had masses at their first visit. Sixteen patients were treated by the combined modality therapy, and 2 patients were treated by the single modality therapy. The 1-, 3- and 5- year actuarial survival rates were 82.4%, 64.2% and 32.1%, respectively. The presence of metastatic disease at the time of diagnosis and the mode of treatment were prognostic factors.</p><p><b>CONCLUSIONS</b>EES is common in adolescent. It often manifests as a localized mass. The combined modality therapy is recommended for this disease. The presence of metastatic disease at the time of diagnosis and the mode of treatment are prognostic factors.</p>
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Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , 12E7 Antigen , Antigens, CD , Metabolism , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Bone Neoplasms , Cell Adhesion Molecules , Metabolism , Combined Modality Therapy , Lower Extremity , Lung Neoplasms , Neoplasm Recurrence, Local , Neoplasm, Residual , Radiotherapy, High-Energy , Sarcoma, Ewing , Diagnosis , Metabolism , Pathology , General Surgery , Therapeutics , Soft Tissue Neoplasms , Diagnosis , Metabolism , Pathology , General Surgery , Therapeutics , Survival Rate , Vimentin , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To evaluate the long-term effect of sodium glycididazole (CMNa) as a hypoxic radiosensitizer on the radiotherapy for nasopharyngeal carcinoma.</p><p><b>METHODS</b>Between May 1999 and May 2002, 211 patients with pathologically confirmed nasopharyngeal carcinoma were randomized into group-A treated by radiotherapy plus CMNa or group-B by radiotherapy alone. The staging was determined according to 92' Fuzhou staging systerm. The type, procession and dosage of radiotherapy were identical in both groups. The early adverse effect grade was assessed based on the CTC2.0 criteria and the late adverse effects were evaluated according to the RTOG/EORTC criteria. The median follow-up time was 52 months. All the data was analyzed by the SPSS 13.0 software. Characteristics and adverse events of these patients were compared between the two groups using t-test and the Wilcoxin rank sum test. Time-to-event curves were estimated using the Kaplan-Meier method. The prognostic parameters were analyzed using univariate analysis and the Cox multivariate regression analysis.</p><p><b>RESULTS</b>The clinical data of the two groups were comparable. The 3-year survival was 88.4% in group-A, while 75.2% in group-B, with a statistically significant difference between two groups (P = 0.010). Univariate analysis showed that the 3-year survival was statistically correlated with N-staging ((N0-1, 86.9%, N2-3 73.8%, P < 0.001), T-staging (T1-2 85.6%, T3-4 79.3%, P = 0.014), TNM staging (P = 0.039), and whether using CMNa or not during rediotherapy (Group-A 88.4%, Group-B 75.2%, P = 0.010). The 5-year recurrence-free survival, 5-year metastasis-free survival and 5-year overall survival were 75.8%, 74.9% and 77.7% in Group-A, while 63.0%, 63.0% and 62.4% in Group-B with a statistically significant difference between two groups (0.013, 0.022 and 0.010, respectively). If stratified in the subgroups, the overall survival of stage III - IV patients was statistically different between group A and B (P = 0.009), however, not of stage I - II patients (P = 0.502). Cox multivariate regression analysis showed that the independent prognostic parameters for survival were N-stage (RR = 3.288) , T-stage (RR = 2.147) and use of CMNa during rediotherapy (RR = 0.407). However, there was no statistically significant difference between two groups in acute or late adverse effects on nervous system or heart, which suggested that use of CMNa during radiotherapy would not aggravate the toxicity caused by radiotherapy.</p><p><b>CONCLUSION</b>Sodium glycididazole is well tolerable effective as a hypoxic radiosensitizer, which can improve the efficacy of radiotherapy and the long-term result of nasopharyngeal carcinom a patients, especially for the stage III - IV patients.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Follow-Up Studies , Kaplan-Meier Estimate , Metronidazole , Therapeutic Uses , Multivariate Analysis , Nasopharyngeal Neoplasms , Pathology , Radiotherapy , Neoplasm Staging , Prognosis , Proportional Hazards Models , Radiation-Sensitizing Agents , Therapeutic Uses , Time Factors , Treatment Outcome , VomitingABSTRACT
Objective To study the affection of cultivating regions to the quality of Radix Angelicae Sinensis and the scientific basis of authenticity of Radix Angelicae Sinensis.Methods The amounts of ferulic acid,ligustilide and total polysaccharide in Radix Angelicae Sinensis cultivated in Gansu,Yunnan, Sichuan,Shanxi provinces were determined by HPLC and UV spectrophotometry.Results Radix Angelicae Sinensis cultivated in Gansu province possesses the highest contents of ferulic acid,ligustilide and total polysaccharide among that from four regions.Conclusion The quality of Radix Angelicae Sinensis cultivated in Gansu province is better than that from other regions.It is reasonable to regard Radix Angelicae Sinensis cultivated in Gansu province as authentic medical herbs.