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Objective To compare the therapeutic effect of preoperative chemoradiotherapy or postoperative adjutant chemoradiotherapy for locally advanced rectal cancer.Methods The clinical data of 76 patients with locally advanced rectal cancer from 2011 to 2016 in Guizhou Provincial People's Hospital were retrospectively analysed.A total of 30 cases received preoperative chemoradiotherapy (group A),5 of them received concurrent chemoradiotherapy combined with bevacizumab target treatment.The other 46 cases (group B) were given post-operative adjutant chemoradiotherapy.Both group A and group B were treated with intensity-modulated radiation therapy (IMRT).The chemoradiotherapy regime was as follows:the median of target volume dose was 50.4 Gy (45.0-55.8 Gy);the median of chemotherapy sessions was 26 times (24-28 times).Capecitabine tablets (825 mg/m2,twice a day) were also given on the date of chemotherapy.The clinical data and follow-up results of all patients were compared between the two groups.Results The five-year disease free survival rates of group A and group B were 66.7％ and 57.7％,respectively;and the five-year overall survival rates of group A and group B were 81.8％ and 73.0％,respectively,no statistically significant difference was found between the two groups (P=0.599,0.489).The anus-preserving rates of patients with tumor below peritoneal reflection in group A and group B were 56.52％ and 25.00％,there was statistically significant difference (P=0.045).In the group A,86.6 ％ patients resulted in down-staging,including 3 cases with complete pathologic response.Conclusion Preoperative chemotherapy could down tumor stage and improve rates of anal preservation and local control without increasing possibility of postoperative complications.Preoperative chemotherapy in combination with bevacizumab target treatment may be more effective in lowering tumor stage.
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Objective To explore the clinical application value of the expression levels of serum hypoxia induced factor-1α(HIF-1α),vascular endothelial growth factor(VEGF),carcino-embryonic antigen(CEA)and CA125 in predicting the recurrence or metastasis of colon cancer after radical resection.Methods Totally 123 cases of colon cancer after radical surgery in our hospital from July 2009 to December 2013 were performed the retrospective analysis.The correlation between the serum markers levels with the recurrence or metastasis was dynamically analyzed.Results (1)The HIF-1αand CEA levels after operation in 123 cases of co-lon cancer were decreased significantly compared with before operation;(2)The HIF-1α,CEA and CA125 levels in 39 cases of re-currence or metastasis were significantly increased compared with those in 84 cases of non-recurrence or non-metastasis (P <0.05);(3)in 39 cases of recurrence or metastasis,the HIF-1α and CEA levels in recurrence or metastasis were increased signifi-cantly compared with those after the end of chemotherapy (P <0.05);(4)HIF-1αwas positively correlated to VEGF(P <0.05). Conclusion The serum levels of HIF-1αand CEA in the patients with colon cancer are positively correlated with recurrence or me-tastasis,the dynamically combined detection of serum markers has an important significance for predicting and early find recurrence or metastasis after radical operation in colon cancer.
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Objective To investigatethe the clinical efifcacy and immunomodulatory effect of paclitaxel and cisplatin in treatment of advanced ovarian carcinoma by different administration ways. Methods 94 patients with advanced ovarian carcinoma were randomly divided into observation group and control group. Patients in observation group (47 cases) were treats with paclitaxel plus cisplation by intraperitoneal infusion chemotherapy, the other patients (47 cases) who are in control group were treats with paclitaxel plus cisplation by intravenous chemotherapy. Two groups used the same medicinal dose, and 3 weeks as a course. After two courses, therapeutic effect and drug toxicity side effects were evaluated by measuring positive rate changes of peripheral blood immune cells (CD 4+CD 25+cell), the CD 4+/CD 8+ratio changes, progression-free survival and 3-year survival rate. Results The efifcacy of patients in two groups were evaluated objectively. Observation group of RR and DC were respectively 78.7%and 91.5%, signiifcantly higher than that of control group. To the end of follow-up period, two groups of progression-free surial compared with a signiifcant difference. After two courses of chemotherapy, positive rate of immune cells (CD 4+CD 25+cell) declined had signiifcant difference compared with before treatment. After two courses of chemotherapy, two groups of CD 4+/CD 8+ratio were increased, compared with before treatment, which is a signiifcant difference. The main adverse reactions of the two groups were myelosuppression and neurotoxicity, but there were no termination of tolerance for adverse reactions. Conclusion The programs with paclitaxel plus cisplatin peritoneal perfusion chemotherapy for advanced ovarian cancer which is effective, small toxic and safe, is worthy of clinical application.