Exploration on the function and clinical significance of meridians and collaterals in tumor metastasis based on Quepen (ST 12) / 中国针灸

The relationship among Quepen (ST 12), meridians that run through Quepen(ST 12) and primary lesion of tumor that metastasized to supraclavicular lymph node [the location of Quepen (ST 12)] are analyzed on the basis of the meridians-collaterals theory, investigation on literature and clinical practice and the clinical feature that varies primary tumor are always bound to supraclavicular lymph node metastasis. Integrated with clinical practice, the function and clinical significance of meridians and collaterals in treating cancer are preliminarily put for ward. The tumor and it's metastasis that locate in the regions where the meridians run through are taken into consideration in acknowledging and treating disease.

A systematic review and meta-analysis of randomized controlled trails : adjuvant interferon therapy for hepatocellular carcinoma / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of adjuvant interferon (IFN) therapy for viral hepatitis related hepatocellular carcinoma(HCC) after the treatment of resection, ablation or TACE.</p><p><b>METHODS</b>PUBMED, EMBASE, Cochrane Library, CNKI, CBM, Wan fang Data were searched, plus some manual search and searching on the internet for grey literature. The studies that according to the standards were included, then Meta-analysis were done.</p><p><b>RESULTS</b>Eight studies (n=857, 442 treated with IFN) were eligible for this study, pooled data showed benefit of IFN for the prevention of HCC recurrence, 1-year [RR=0.71, 95% CI (0.51, 0.99)], 3-year [RR=0.86, 95% CI (0.76-0.98)], 4-year [RR=0.79, 95% CI (0.68-0.91)]. IFN showed benefit for improving 1-year and 2-year survival, 1-year [RR=1.09, 95% CI (1.01-1.18)], 2-year [RR=1.25, 95% CI (1.04-1.50)]. The difference on 2-year, 5-year recurrence rate are without statistical significance, the same to 3-year, 4-year, 5-year survival rate.</p><p><b>CONCLUSION</b>IFN therapy after the treatment of resection, ablation or TACE can probably reduce HCC recurrence rate and improve survival with acceptable toxicities.</p>

Clinical observation of transarterial chemoembolization combined with sorafenib for advanced hepatocellular carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To observe the efficacy and side effects of transarterial chemoembolization (TACE) combined with sorafenib for advanced hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>Forty patients with HCC were treated with sorafenib (400 mg bid) after TACE. The efficacy was evaluated according to RECIST 1.1 criteria, and side effects were assessed by NCI CTC 3.0 criteria.</p><p><b>RESULTS</b>Among the forty cases, one case achieved complete remission (CR), seven cases achieved partial remission (PR), nineteen cases achieved stable disease (SD) and thirteen cases had progressive disease (PD). The disease control rate (DCR) was 67.5%. The overall survival time was 1 - 18 months, and 1-year survival rate was 54.0%. The major adverse events were hand-foot skin reaction, diarrhea and thrombocytopenia.</p><p><b>CONCLUSION</b>The combined therapy of TACE and sorafenib is effective and well tolerated for advanced HCC.</p>

Evaluation of the results of fine-needle aspiration liver biopsies and the complications in 2528 cases / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the value of fine-needle aspiration biopsy (FNAB) in diagnosing primary liver cancer (PLC) and its major complications.</p><p><b>METHODS</b>From June 1, 1985 to May 31, 2005, 2528 patients who were presented with suspected PLC underwent ultrasound-guided FNAB in the Cancer Hospital of Fudan University. The results were retrospectively reviewed.</p><p><b>RESULTS</b>Of those 2528 cases, there was malignancy in 2061 patients (81.53%), of which 1704 were diagnosed as primary liver neoplasms; 41 were diagnosed as metastatic carcinoma, and 316 were not further classified as primary or metastatic. No malignancy was found in 431 cases (17.05%). In 36 cases (1.42%), suspicious malignancy or anaplasia was suggested. Follow-up results showed that all the 2061 positive cases were verified to be malignant and there were no false positive cases. 163 of the 431 negative cases were verified to be malignant in the follow-ups, of which 136 cases were PLC; 28 of the 36 suspicious malignancy or anaplasia were proven to be malignant (all were PLC). The sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of our FNAB for diagnosing liver malignancy were 91.52%, 100.00%, 100.00%, 59.10% and 92.44%, respectively, and 81.01% cases were diagnosed by FNAB in all the 2096 cases with PLC. Cytological examinations of the smears obtained by FNAB correctly distinguished primary and secondary malignancy in 77.49% of the patients. After FNAB, 11 patients (0.44%) had intraperitoneal hemorrhages and 5 cases (0.20%) had needle tract implantation metastases.</p><p><b>CONCLUSIONS</b>FNAB is important and effective for determining the malignancy potential of liver tumors, especially for PLC. Complications related to FNA were rather rare, therefore, this technique may be easily applied to clinical practice.</p>

Clinical observation on electric stimulation of Yongquan (KI 1) for prevention of nausea and vomiting induced by Cisplatin / 中国针灸

<p><b>OBJECTIVE</b>To search for an effective method for controlling nausea and vomiting induced by chemotherapy.</p><p><b>METHODS</b>Eighty-eight cases of hepatic cancer with interventional therapy of Cisplatin were randomly divided into a treatment group and a control group, 44 cases in each group. The treatment group were treated with an antiemetic and electroacupuncture at Yongquan (KI 1), and the control group only with the antiementic. The controlling rates for nausea and vomiting were compared between the two groups.</p><p><b>RESULTS</b>The controlling rates for acute nausea, vomiting and delayed vomiting in the treatment group were better than those in the control group (P < 0.05).</p><p><b>CONCLUSION</b>Electroacupuncture at Yongquan (KI 1) can better prevent and improve the symptoms of nausea and vomiting in the patient with chemotherapy of Cisplatin.</p>

Three-dimensional conformal radiotherapy combined with transcatheter arterial chemoembolization for hepatocellular carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the response and tolerance in hepatocellular carcinoma (HCC) patients treated by three-dimensional conformal radiotherapy (3DCRT) combined with. transcatheter arterial chemoembolization (TACE).</p><p><b>METHODS</b>Fourty-six HCC patients confirmed by cytology or histology were studied. All patients underwent TACE 1 to 3 courses. Then they received 3DCRT after an interval of about one month. 3DCRT was given with the field covering the tumor with a generous margin. 6 MV X-ray was used. The total dose was 30 - 54 Gy, in daily 2 Gy fractions. Immediate response was recorded according to the WHO criteria carried out by serial CT scan one month after 3DCRT. Irradiation toxicities were scored by the RTOG criteria. Acute liver toxicity was graded according to the common toxicity criteria (CTC) of National Cancer Institute. Late toxicity was focused on radiation-induced liver disease (RILD).</p><p><b>RESULTS</b>Partial response was observed in 8 (17.4%) patients. Stable disease and progressive disease was observed in 35 (76.1%) patients and 3 (6.5%) patients, respectively. No complete response was observed at the time of the response evaluation. The overall survival rate at 1-, 2- and 3-year was 60.9%, 39.1% and 28.3%, respectively, with a median survival period of 16 months. The 1-, 2- and 3-year local progression-free rate was 73.9%, 56.5% and 39.1%, respectively. The 1-, 2- and 3-year distant metastasis rate was 15.2%, 21.7% and 34.8%. Univariate analysis showed that favorable prognostic predictors for survival were: T3 stage, CACA 2001 stage I, absence of portal thrombosis, Child-Pugh grade A and irradiation dose of >45 Gy. Irradiation dose and liver cirrhosis were identified by Cox-regression analysis as independent predictors for survival. Two patients experienced CTC grade 1 acute hepatic toxicity and three patients experienced grade 3 acute hepatic toxicity. Two patients developed RILD. Three patients experienced RTOG grade 1 acute gastrointestinal complication and one patient experienced acute gastrointestinal bleeding. Five patients experienced RTOG grade 1 leucopenia, and five patients experienced grade 2 leucopenia.</p><p><b>CONCLUSION</b>3DCRT combined with TACE is safe and effective for HCC. It is worthy of a further dose escalation study.</p>