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Objective:To analyze the fail mode of neoadjuvant therapy combined with surgery for locally advanced esophageal squamous cell carcinoma (ESCC) after long-term follow-up.Methods:Clinical data of consecutive 238 patients with locally advanced resectable ESCC who underwent neoadjuvant therapy combined with surgery in Zhejiang Cancer Hospital from September 2012 to October 2019 were retrospectively analyzed. The failure mode in the whole cohort was analyzed after long-term follow-up. The overall survival (OS) and disease free survival (DFS) rates were analyzed by Kaplan-Meier method. Survival differences were determined by log-rank test.Results:The pathological complete response (pCR) rate was 42.0% in 238 patients. After a median follow-up of 46.1 months, tumor progression occurred in 96 patients (40.3%), including 25 patients (10.5%) with local recurrence, 61 patients (25.6%) with distant metastases, and 10 patients (4.2%) with simultaneous local recurrence and distant metastases. The median OS and DFS were 64.7 months and 49.9 months. And the 3-, 5-, and 7-year OS and DFS rates were 70.0%, 52.8%, 36.4% and 63.5%, 42.5%, and 30.0%, respectively. The 3-, 5-, and 7-year locoregional recurrence-free survival rates and distant metastasis-free survival rates were 86.0%, 71.4%, 61.2% and 70.6%, 55.9%, 43.0%. Compared with non-pCR patients, the overall progression rate and distant metastasis rate of pCR patients were lower (26.0% vs. 50.7%, 16.0% vs. 32.6%, both P<0.05). And the 3-, 5-, and 7-year OS (83.0% vs. 60.2%, 69.7% vs. 41.7%, 50.4% vs. 27.7%, all P<0.001) and DFS rates (80.4% vs. 51.4%, 63.9% vs. 31.2%, 45.9% vs. 20.3%, all P<0.001) were significantly better in pCR patients. Conclusions:Distant metastasis is the main failure mode of patients with locally advanced ESCC after neoadjuvant therapy. Patients with postoperative pCR can achieve better long-term survival.
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Objective To investigate the level and relationships of posttraumatic growth (PTG) and psychological distress among patients with prostate cancer. Method Totally 116 patients with prostate cancer involved in the investigation by a self-designed demographic questionnaire, posttraumatic growth inventory (PTGI) and distress thermometer (DT). Results The total score of PTGI was (53.12 ± 13.51), at a low level, and the score of DT was (4.32 ± 2.59), at a medium level. The score of DT was negatively correlated to the scores of PTG and its dimensions (all P<0.05). Conclusions Patients with prostate cancer show a low level of PTG and a medium level of psychological distress and they are negatively related . Therefore , nurses should take measures to reduce the patients psychological distress and then improve their PTG level.
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Objective To explore a reasonable therapeutic plan for treating HIV/AIDS with traditional Chinese medicine plus western medicine. Methods Twenty-nine patients with HIV/AIDS were selected and recruited into a HIV group and a AIDS group according to the clinical diagnosis. Each group was further divided into comparison stage and treatment stage. In HIV group, observations and statistics of observation indexes were performed during the comparison stage; while TCM treatment was applied in the treatment stage. In AIDS group, HAART was applied in the comparison stage, and HAART combined with TCM therapy were used in the treatment stage. Both comparison stage and the treatment stage lasted 12 months. Results In HIV group, self control results showed that immune and virus indexes did not have significant changes, but also with no side or toxic effects, In the AIDS group, contrasting between the comparison stage and the treatment stage showed that there were significant improvement of symptoms (χ2=4.9231, 2.5000, P<0.05) , anti-toxic effects (χ2=9.333、 16.4091、10.2273, P<0.01) and immune indexed(t=3.1990,P<0.01) after treated additionally with traditional Chinese medicine. Conclusion Traditional Chinese medicine could improve the immunity function and clinical symptoms, reduce side effect of HAART medicine and stabilize CD4+ T cells of patient with HIV/AIDS.
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Objective To investigate the effect of blocking VEGF expression on the radiation sensitivity of esophageal cancer cell line TE-1 in vivo. Methods 32 male Balb/c/nu nude mice were randomly divided into four groups, including control group, radiation group, anti-VEGF group, and anti-VEGF + radiation group. The anti-VEGFcDNA cells were subcutaneously injected into the paw pats of mice (2 × 106/100 μl). The subcutaneous tumors were irradiated with 18 Gy of 60Co y-rays when the diameter of tumors varied from 0. 8 to 1.0 cm. The volume of the tumors was measured before and after irradiation, respectively. The expression level of VEGF mRNA and protein were examined by RT-PCR and Western blotting, respectively. Apoptotic cells were detected by electron micrographs. Results Latent period of the tumor formation of anti-VEGF group was lengthened compared with other groups(t = 13. 898,P ＜0.01 ). The volumes of tumor in anti-VEGF group [ ( 1207. 50 ± 97.07 ) mm3 ] and anti-VEGF +radiation group [ ( 1057. 5 ± 91.50 ) mm3 ] were not statistically different post-irradiation ( t = 1. 124, P ＞0.05 ) , but smaller than those in control group [ ( 5442. 50 ± 185.08 ) mm3 ] and radiation group [ (2922. 50 ± 152. 773)mm3 ] with statistical differences( t = 9. 475-21. 238, P ＜ 0. 01 ). The expression level of endogenous VEGFmRNA and protein in anti-VEGF group and anti-VEGF + radiation group were statistically different from control group and radiation group (F = 387.394, 13.519, P ＜ 0.01 ).Conclusions Antisense VEGF could inhibit the proliferation of esophageal cancer cell in the nude mice.Effect of blocking VEGF expression before irradiation on esophageal cancer xenografts might be limited.
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Objective To observe the preventive and therapeutic effect of Yangyin Shengxue Mixture (Herbal decoction for nourishing yin and blood) on radiation-induced oral mucosal injury.Methods Sixty nasopharyngeal carcinoma patients were randomized into two groups: treatment group (30 cases) receiving Yangyin Shengxue Mixture three days before till one week after radiotherapy, and control group (30 patients) using conventional Tinidazole Gargle for prevention of oral-mucositis. Before and after treatment, the body weight, hemoglobin and state of infection of patients were examined. The time of occurrence of symptoms, degree of acute radiation mucositis and degree of pain were observed to evaluate the damage of oral mucosa according to RTOG standard for radiation injury of oral mucosa and Numeric Rating Scales (NRS). Results There were different degrees of radiation mucositis in both groups during radiotherapy, but the time of occurrence in the treatment group was significantly later than that of the control group (P