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Objective:To investigate the feasibility, efficacy, and safety of CT- and bronchoscopy-guided 125I seed implantation in the treatment of central lung cancer complicated with atelectasis. Methods:Retrospective analysis was conducted on twenty-nine patients who were treated from May 2016 to Oct 2019 in the Second Hospital of Tianjin Medical University for central non-small-cell lung carcinoma complicated with pulmonary atelectasis that was inoperable due to medical reasons. 125I seeds were implanted into the trachea under the guidance of bronchoscopy first.The 125I seeds were then implanted into the hilum of the lungs by percutaneous puncture under the guidance of the CT and template.The seed activity was 18.5-29.6 MBq, and the prescription dose was 120 Gy.TPS planning and quality verification were performed before and after the operations.The rate of atelectasis recanalization, the satisfactory rate of dose verification, the improvement of dyspnea index, the survival time, and the adverse events during and after operation were observed. Results:All 29 patients with lung cancer complicated with atelectasis successfully completed the seed implantation, and the satisfactory rate of quality verification was 93.1%.The rate of atelectasis recanalization at 2, 6, 12, 18, and 24 months was 93.1%, 89.7%, 78.6%, 76.2%, and 60%, respectively.Their dyspnea and anoxia symptoms were significantly relieved in 5-28 months after treatment.The results showed that the patients′ dyspnea index was 2.8-0.8 before treatment and 1.4-0.9 after treatment.The median follow-up period was 20 months and median survival was 21 months.Adverse events associated with the radiation therapy included pneumothorax, hemoptysis, cough, fever, and particle displacement.No level-3 or more serious adverse events occurred.Conclusions:The CT- and bronchoscopy-guided 125I seed implantation is a safe and effective therapy option for the treatment of central non-small-cell lung carcinoma associated with atelectasis.It contributes to a high rate of local recanalization, and can rapidly improve clinical conditions and quality of life of the patients with few adverse reactions.
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Objective:To analyze the efficacy and the adverse reactions of conventional treatment-failed advanced refractory ovarian cancer cases after treatment with apatinib.Methods:Six patients enrolled in the Second Hospital of Tianjin Medical University from June 2015 to October 2015 received treatment with apatinib. Treatment efficacy was evaluated by imaging and analysis of tumor markers,including CA125,CEA,and NSE.Results:The age range of the six patients was 48-71 years(median:55 years).Their histopath-ological subtypes included poorly differentiated serous cystadenocarcinoma(4/6),borderline papillary adenoma(1/6),and clear cell carcinoma(1/6).Clinical evaluation of patients revealed no cases with complete remission,two cases with partial response,one case with stable disease,and three cases with progressive disease.The objective response rate was 33%(2/6)and the disease control rate was 50%(3/6).In all patients,the main side effects were hypertension and hand-foot syndrome,which were controlled.Conclusions:The treatment of conventional treatment-failed advanced refractory ovarian cancer with apatinib has better exact effects,and medical toxicity can be controlled.In the future,to seek more effective treatment strategies,the mechanism of apatinib in the treatment of ad-vanced ovarian cancer should be further explored.
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Objective To explore the safety,effectivity and dosimetric continence of 3D-printing coplanar template(3D-PCT)combined with CT-guided 125I seed implantation in the treatment of non-small cell lung cancer(NSCLC).Methods From May 2014 to November 2016,a total of 20 NSCLC patients who were suitable for 125I seed implantation were recruited in this study.Of all the patients,10 received 125I seed implantation treatment by CT-guided combined with 3D-PCT (3D group),and the rest,by freehand puncture combined with CT-guided 125I seed implantation (free-hand group).During two days before the surgery,the patients received the CT scan.Then the digital imaging and communications in medicine (DICOM) was collected to input to the Brachytherapy Treatment Planning System (BTPS).The dose parameters including D90,D100,V100,V150,conformal index(CI),external index(EI),and homogneneity index(HI) were compared between pre-operation and post-operation.Pair t-test and single sample t-test were performed.Results V150 in 3D group between preoperation and postoperation showed statistically significant difference (t =-2.916,P ＜ 0.05),and there was no significant difference in the rest parameters(P ＞ 0.05).However,the number of seeds,V100,EI,HI in free-hand group between preoperation and postoperation showed statistically significant difference (t =-2.516,2.492,4.725,7.258,P ＜0.05),and there was no significant difference in the rest parameters(P ＞0.05).Comparison of indicuted that there was significant difference in V100,V150,CI,EI,HI and dose error rate between the 3D group and the free-hand group with single sample t test,the result showed V100,CI,EI,HI between two groups(t =2.598,2.278,4.637,4.616,-4.785,P ＜0.05),and there was no significant difference in V150 (P ＞ 0.05).Conclusions CT-guided 125I seed implantation brachytherapy combined with 3D-PCT for treatment of NSCLC safe is feasible,and dose controllable,and there is a certain advantage in the spatial distribution of seed compared with free-hand puncture.
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Objective To evaluate the clinical effectiveness and safety of stents loaded with 125I seeds compared to conventional stents.Methods Literatures were searched in PubMed,EMbase,Cochrane Library,CBM,CNKI,Wanfang Data and other electronic databases from inception to November 2016.Two reviewers independently screened the literature according to the inclusion and exclusion criteria,extracted data and assessed quality of the included studies independently.Meta-analyses were performed using RevMan 5.3.Results A total of five RCTs and 14 CCTs involving 1 211 patients were included.The mean survival time of the 125I stent group was significantly higher than that of the control group [mean difference =4.11,95％ CI (2.16-6.07)P ＜0.001].The incidence of restenosis after 3:The available data showed that the incidence of re-staging of 125I stent in the treatment group was lower than that of the normal stent group [RR =0.23,95％ CI(0.12-0.62),P =0.002].Postoperative bleeding [RR =0.80,95％CI (0.52-1.23),P=0.30];Postoperative pain[RR=1.06,95％CI(90.88-1.27),P=0.55];postoperative stent shift [RR =0.53,95％ CI(0.27-1.05),P =0.07].The difference of incidence of complications was not statistically significant.There was no difference in the incidence of complications between the two groups.Conclusions The available data suggest that 125I stent is superior to common stent in the treatment of advanced esophageal cancer.There are no differences found in the incidence of complications between 125I stent and conventional stent.However,due to the limited quality of the included studies,more high-quality and multicenter-based studies are needed to verify the above conclusion.
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Objective To systematically evaluate the efficacy and safety of 125I seed implantation for treatment of advanced pancreatic cancer.Methods An electronic literatuire search was performed about randomized controlled trials(RCTs) of 125I implantation for treamtent of advanced pancreatic cancer in CNKI,Wanfang Data,CBM,Cochrane Library,PubMed and Embase (from the date of building the database to November 2016).Two investigators independently screened literature,extracted data and assessed the risk bias of included studies,and the Meta-analysis was performed by using Revman 5.3software.Results There were 12 RCTs (n =689) included.Meta-analysis showed that the objective respond rate(ORR) (OR =3.24,95％CI2.33-4.52,P＜0.001),the 6-month survival rate(OR =3.61,95％ CI 1.53-8.52,P =0.003),the 12-month survival rate(OR =4.80,95％ CI 2.40-9.57,P ＜ 0.001) and the relief rate of pain were higher than those in the control group.However,there were no significant differences between both groups in the 2-year survival rate and the adverse reaction rate,which were (OR=2.36,95％ CI 0.47-11.74,P =0.29) and (OR =4.94,95％ CI 1.05-23.23,P =0.04),respectively.Conclusions The limited current evidence showed that 125I implantation for treatment of advanced pancreatic cancer is effective and safety.125I implantation can improve the ORR,short-time survival rate and pain relief rate.In addition,there was no significant increase in the incidence of related adverse events except for seed malposition.Although the quality and quantity of evidences is limited,it merits further study to provide high quality evidences.
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Objective To study the relationship between the expression level of PLK1 in castration-resistant prostate cancer (CRPC) tissues, and its relationship with pathological features. Methods Forty-four CRPC specimens including 28 samples from patients with prostate adenocarcinoma, 14 samples from patients with neuroendocrine prostate cancer (NEPC) and 2 samples from patients with other types of prostate cancer, and 10 normal prostatic hyperplasia specimens were collected from January 2010 to September 2016 in the Second Hospital of Tianjin Medical University. The expression levels of PLK1 in these tissues were detected by S-P immunohistochemistry. The relationship between PLK1 expression and pathologic factors was discussed. Results The positive expression of PLK1 was located in cytoplasm of carcinoma cells, and no express of PLK1 was found in benign prostatic hyperplasia tissues. The expression levels of PLK1 showed no significantly differences between different groups of age, local tumor invasion and regional nodal status, and the level of prostate-specific antigen (PSA, P>0.05). The expression level of PLK1 in patients with Gleason score>8 was higher than that in patients with Gleason score≤8. The PLK1 expression level was positively correlated with Gleason score (rs=0.441,P<0.05). Conclusion PLK1 protein is over-expressed in CRPC tissues, which can reflect the proliferation and differentiation of cancer cells and may be a potential marker of CRPC.
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Objective To evaluate the efficacy and toxicity of pemetrexed and nedaplatin in the treatment of patients with locally advanced or metastatic urothelial cell carcinoma who failed a first-line GC regimen.Methods A total of 11 patients with locally advanced or metastatic urothelial carcinoma failed with first-line treatment of GC regimen were included in the present study.There were 6 males and 5 females,aged 56-80 years old,median age was 65 years old.Six patients' primary tumors were in bladder,4 in the renal pelvis,1 ureter.There were 7 cases with ECOG score 0 point,3 cases 1 point,1 case 2 points.Patients received pemetrexed 500 mg/m2 intravenously on the 1st day,and nedaplatin 25mg/m2 from the 1st to 3th day every 21 days.The evaluation of efficacy and adverse reactions were carried out after 2 to 3 cycles.Results Eleven patients received 1 to 6 cycles (mean 3.3 cycles) treatments.There were 2 cases (18.2％) complete remission,5 cases (45.5％) partial remission,2 cases (18.2％) no change and 2 cases (18.2％) progressed.The total effective rate was 63.6％.The main adverse events were anemia (6 cases),leukopenia (5 cases),nausea and vomiting (6 cases) and rash (5 cases),all of which were mild to moderate.No treatment-related death occurred.Conclusions Pemetrexed and nedaplatin regimen could be effective in the treatment of advanced urothelial carcinoma after first-line chemotherapy failed.The side effect is mild.