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Objective@#To investigate oral health related life quality and associated factors of senior primary school students in Bengbu City, so as to provide scientific basis for targeted oral health education for children.@*Methods@#A stratified cluster random sampling method was adopted to select 1 760 senior students (grade 5 to 6) from 12 primary schools in 4 districts of Bengbu City from September to November 2022. A cross sectional survey was conducted on the oral health of students through questionnaires related to oral health. The effect of oral problems on quality of life was assessed by the Child Daily Life Oral Influence Scale (Child-OIDP). Chi square test, non parametric test and binary Logistic regression model were used to analyze the influencing factors of oral health related quality of life in senior primary school students.@*Results@#The prevalence of oral problems affecting the quality of daily life was 70.00%, and the severe impact rate was 15.06%. Oral feeding was the most affected (57.95%). The Child-OIDP score was (7.49±8.57). Binary Logistic regression analysis showed that mother s education level, self rated teeth and oral conditions, bruised tooth, toothache in the past year, and gingival bleeding in the past 2 weeks were significantly associated with the incidence of Child-OIDP ( OR=1.86-5.00, P <0.05).@*Conclusion@#It is common that oral problems affect the quality of daily life of senior primary school students in Bengbu. Families and schools should strengthen oral health knowledge education and behavior guidance, so as to reduce the impact of oral problems on daily life among senior primary school students.
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Objective:To investigate the radiation dose and fractionation regimens for limited stage small cell lung cancer (LS-SCLC) in Chinese radiation oncologists.Methods:Over 500 radiation oncologists were surveyed through questionnaire for radiation dose and fractionation regimens for LS-SCLC and 216 valid samples were collected for further analysis. All data were collected by online questionnaire designed by WJX software. Data collection and statistical analysis were performed by SPSS 25.0 statistical software. The differences in categorical variables among different groups were analyzed by Chi-square test and Fisher's exact test. Results:Among 216 participants, 94.9% preferred early concurrent chemoradiotherapy, 69.4% recommended conventional fractionation, 70.8% preferred a total dose of 60 Gy when delivering conventional radiotherapy and 78.7% recommended 45 Gy when administering hyperfractionated radiotherapy.Conclusions:Despite differences in LS-SCLC treatment plans, most of Chinese radiation oncologists prefer to choose 60 Gy conventional fractionated radiotherapy as the main treatment strategy for LS-SCLC patients. Chinese Society of Clinical Oncology (CSCO), National Comprehensive Cancer Network (NCCN) and Chinese Medical Association guidelines or expert consensus play a critical role in guiding treatment decision-making.
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Objective:To investigate the effects of enteral nutrition on the incidence of treatment complications, results from nutritional indexes and proportions of immune cell subsets in elderly patients with esophageal carcinoma during concurrent chemoradiotherapy.Methods:From January 1, 2020 to December 31, 2020, 108 elderly patients(≥60 years)undergone concurrent chemoradiotherapy for esophageal carcinoma at Quanzhou First Hospital and eligible for inclusion were enrolled in the case-control study.They were randomly divided into the study group(enteral nutrition group)and the control group(normal diet group), with 54 cases in each group.The incidence of complications, results from nutritional indexes and immune cell subsets of the two groups were analyzed according to data type.Results:The incidence of bone marrow suppression(Grade Ⅰ-Ⅱ)in the study group(37.0%)was significantly lower than that in the control group(63.0%)( χ2=7.259, P<0.01). The incidence of bone marrow suppression(Grade Ⅲ-Ⅳ)in the study group(11.1%)was significantly lower than that in the control group(27.8%)( χ2=4.788, P<0.05). The levels of hemoglobin, total serum protein and albumin were(121.36±11.63)g/L, (73.78±7.79)g/L and(40.95±3.52)g/L in the study group and(106.45±10.85)g/L, (63.12±8.35)g/L and(35.54±4.12)g/L in the control group, respectively, after 4 weeks of radiotherapy and chemotherapy( P<0.05). The proportions of CD3+ and CD4+ were(64.15±5.84)% and(48.64±4.28)% in the study group and(59.25±6.27)% and(45.27±4.52)% in the control group, respectively, after 4 weeks of radiotherapy and chemotherapy( P<0.05). The proportion of CD8+ was(26.93±3.63)% in the study group and(30.35±3.36)% in the control group after 4 weeks of radiotherapy and chemotherapy( P<0.05). Conclusions:During concurrent chemoradiotherapy for elderly patients with esophageal carcinoma, enteral nutrition with adjustment based on patient's food intake can reduce patients' nutritional risk and modulate the proportion of immune cell subsets, thus reducing the occurrence of bone marrow suppression.
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Objective:To investigate whether microRNA-338-3p (miR-338-3p) affects the proliferation and apoptosis of choroidal microvascular endothelial cells by regulating the expression of T cell factor 4 (TCF4).Methods:Human choroidal microvascular endothelial cells were cultured in vitro, and they were divided into vascular endothelial growth factor (VEGF) group and Normal control group.The Cultured cells in the VEGF group were divided into four subgroups, and were transfected with miR-NC, miR-338-3p mimics, miR-338-3p mimics + pcDNA, miR-338-3p mimics + pcDNA-TCF4 before VEGF treatment, respectively.Quantitative real-time PCR (qRT-PCR) was used to detect the expression of miR-338-3p and TCF4.MTT assay was used to detect cell proliferation.Flow cytometry was used to detect the apoptosis rate.The double luciferase report experiment verified the targeting relationship of miR-338-3p and TCF4.Western blot was used to detect the expression of Ki-67, PCNA, bax, and bcl-2. Results:After VEGF treatment, the expression level of miR-338-3p was significantly reduced, the expression level of TCF4 mRNA was significantly increased, the cell viability was significantly increased, and the apoptosis rate was significantly decreased, the levels of Ki-67, PCNA, bcl-2 protein were increased significantly, and the level of bax protein was decreased significantly (all at P<0.05). After miR-338-3p overexpression, the cell viability was significantly reduced, the apoptosis rate was significantly increased, and the levels of Ki-67, PCNA, and bcl-2 proteins were significantly reduced, the level of bax protein was increased significantly (all at P<0.05). Double luciferase reporting experiments confirmed that miR-338-3p targeted TCF4.Compared with the VEGF + miR-338-3p + pcDNA group, the cell viability of the VEGF + miR-338-3p + pcDNA-TCF4 group was significantly increased ([56.48±13.20]% vs. [96.24±16.24]%), and the apoptosis rate was significantly reduced ([30.59±3.57]% vs.[12.36±1.29]%), the levels of Ki-67, PCNA and bcl-2 protein were significantly increased (0.41±0.11 vs. 0.96±0.19; 0.44±0.10 vs. 0.97±0.20; 0.55±0.12 vs. 0.98±0.15), and the levels of bax protein were significantly decreased (0.87±0.13 vs. 0.42±0.11) ( t=5.700, 14.408, 7.516, 7.111, 6.715, 7.927; all at P<0.01). Conclusions:Overexpression of miR-338-3p can negatively regulate TCF4 expression, thereby inhibite choroidal microvascular endothelial cell proliferation and induce apoptosis.
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Accurate detection of low frequency mutations from plasma cell-free DNA in blood using targeted next generation sequencing technology has shown promising benefits in clinical settings. Duplex sequencing technology is the most commonly used approach in liquid biopsies. Unique molecular identifiers are attached to each double-stranded DNA template, followed by production of low-error consensus sequences to detect low frequency variants. However, high sequencing costs have hindered application of this approach in clinical practice. Here, we have developed an improved duplex sequencing approach called SinoDuplex, which utilizes a pool of adapters containing pre-defined barcode sequences to generate far fewer barcode combinations than with random sequences, and implemented a novel computational analysis algorithm to generate duplex consensus sequences more precisely. SinoDuplex increased the output of duplex sequencing technology, making it more cost-effective. We evaluated our approach using reference standard samples and cell-free DNA samples from lung cancer patients. Our results showed that SinoDuplex has high sensitivity and specificity in detecting very low allele frequency mutations. The source code for SinoDuplex is freely available at https://github.com/SinOncology/sinoduplex.
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OBJECTIVE@#To evaluate the effect of using free double- leaf perforator flap posterolateral calf peroneal artery in anatomical reconstruction of the oropharyngeal structure after ablation of advanced oropharyngeal carcinoma.@*METHODS@#Twenty-six patients with oropharyngeal defects after ablation of oropharyngeal malignancies were recruited, including 12 with carcinoma in the tongue base, 5 in the latenral pharyngeal wall and 9 in the soft palate. Between July, 2016 and July, 2018, the patients underwent surgeries for reconstruction of the oropharyngeal defects using flaps. The areas of tissue defects repaired by double-leaf perforator flaps ranged from 40.5 to 72.5 cm. Reconstruction was performed for oropharyngeal defects in the soft palate, pterygopalate, parapharyngeal, pterygo- mandibular, and tongue base tissues. The patients' outcomes including mouth opening, functions of deglutition, linguistic function, restoration of palatopharyngeal anatomical structure and postoperative survival were evaluated, and their quality of life was assessed using FACT-H&N scale (Chinese Edition).@*RESULTS@#All the 26 patients with transplantation of the free flaps survived. Six months after the operation, the oropharyngeal function and anatomical structure of the patients were basically restored. The questionnaire survey showed that the patients' physical, social/family, emotional and functional conditions, the total score of the core scale, items scores for the head and neck, and the total score of the scale all improved significantly after the operation compared with those before the operation ( < 0.05).@*CONCLUSIONS@#The free peroneal artery bilobate perforator flap in the posterolateral crus, which seldom has anatomical variations of the blood vessels, allows flexible design and contains rich tissue volume to facilitate defect repair with different approaches and ranges. The application of this flap, which is an ideal perforator flap for reconstruction of the oropharyngeal structure and function, can improve the quality of life of patients following operations for advanced oropharyngeal cancer.
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Humans , Arteries , Free Tissue Flaps , Oropharyngeal Neoplasms , Perforator Flap , Quality of Life , Plastic Surgery Procedures , Skin Transplantation , Soft Tissue InjuriesABSTRACT
Objective To evaluate the effect of double-leaf perforator free flap pedicled with posterolateral calf peroneal artery on repairing facial through-and-through defect after oral cancer oblation.Methods Nine patients with facial through-and-through defects after oblation of oral and maxillofacial malignancies,including 4 cases of buccal mucosa carcinoma,2 cases of maxilla osteosarcoma,1 case of carcinoma of the maxillary sinus and 2 cases of parotid duct carcinoma,were recruited from May,2016 to May,2018.The flap was used to repair the facial defect of recruited patients.The area of the bigger leaf of bilobed perforator flap was 7.0 cm×8.0 cm-6.0 cm×7.0 cm and the small leaf was 4.5 cm×4.5 cm-4.0 cm×4.0 cm,respectively.The intraoral and facial defects needed to be reconstructed contained the oral mucosal of the upper palate,the skin,subcutaneous tissue and mucosa of the cheek.The radiotherapy was performed 1.0-1.5 months after the operation.The prognosis including appearance,mouth opening,and the functions of deglutition,and language were assessed.Results Through 3-18 months outpatient followed-up,all 9 cases of transplanted flaps survived well and the incisions of the donor and recipient areas healed by first intention.The patients were satisfied with the facial appearance,mouth opening,and the functions of deglutition and language at the 6 months follow-up.The radiotherapy had no damage on the survival of the bilobed perforator flap.There was no recurrence or metastasis in follow-up.Conclusion The double-leaf perforator free flap pedicled with posterolateral calf peroneal artery is an ideal free tissue for repairing the facial perforating defect after oral cancer oblation because of its constant blood vessel,abundant tissues,flexible design and operating methods.
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To evaluate the clinical effect of application of free peroneal artery perforator flap in repairing postoperative tissue defect after resection of oral maxillary malignant tumor. Methods From January, 2016 to June, 2018, 14 patients with maxillary malignant tumor were treated with tumor excision. Then the free per-oneal artery perforator flap was used to reconstruct tissue defect caused by tumorectomy. There were 6 cases of squa-mous-cell carcinoma of palatine, 2 cases of adenoid cystic carcinoma of palatine, and 6 cases of maxillagingiva squa-mous cell carcinoma. The incised area of flap was 4.0 cm×5.0 cm to 7.0 cm×8.0 cm. There were 5 cases of hard palate soft tissue defect repair and 9 cases of simultaneous repair of soft and hard palate. Followed-up by outpatient service in 3-12 months after operation, postoperative maxillamorphology, phonetic function, swallow function, opening degree and prognosis of the patients were evaluated. Results All 14 implanted flaps were alive.One flap had vas-cular crisis, and rescued by surgical exploration and timely rescue.Three flaps were prolonged healing.All donor sites were sutured directly.All surgical incisions healed primarily.Half a year after the operation, the appearance of maxilla was formed gradually. The phonetic function, swallowing function, opening degree and movement of lower leg were all recovered normal. One year after the operation, epithelization was done in 6 cases. And there was no tumor recur-rence.Conclusion The peroneal artery perforator flap has long vascular pedicle, larg diameter, high survival rate after vascular anastomosis and relatively concealed donor area. It can be used to repair and reconstruct the tissue defect in maxillary malignant tumor resection and achieved good result.
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Objective To investigate the characteristics of target motion in esophageal cancer during normal breathing with four-dimensional computed tomography(4DCT). Methods Twenty patients with primary esophageal cancer received respiratory gated 4DCT to obtain the target motion during normal breathing and delineate the gross tumor volume (GTV). The center coordinate and volume of each GTV were measured and recorded to calculate the displacement of the GTV center and the change in volume in different respiratory phases. Results The displacement of the GTV center in each esophageal segment in superior-inferior direction (0.521±0.319 cm) was significantly greater than that in right-left direction (0.169± 0.083 cm) and that in anterior-posterior direction (0.167±0.095 cm)(all P<0.05). The maximum displacement of the GTV center in each direction was significantly different in different esophageal segments(all P<0.05).The displacement of the GTV center in each direction was not entirely consistent in different respiratory phases. The displacement of the GTV center in each direction in T50phase was greatest when T0phase was the reference phase. The volume of GTV had no significant changes at the end of the expiratory phase and the inspiratory phase (P=0.313). Conclusions The displacement of GTV center in each esophageal segment in superior-inferior direction is significantly greater than that in right-left direction and that in anterior-posterior direction and the displacement of GTV center in each direction is significantly different in different esophageal segments. Therefore, all the factors should be considered to develop a reasonable target for precise radiotherapy. For esophageal cancer in cervical and upper chest esophageal segment,it is reasonable to delineate ITV based on the fusion image of the images at the end of inspiratory phase and expiratory phase. The deformation of target volume of the esophageal cancer in the cervical and upper chest esophageal segment is not significant in the respiratory cycle.
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Objective To investigate the outcome of free posterolateral leg perforator flap in the reconstruction of soft tissue defects of oral and maxillofacial area.Methods From February,2014 to August,2016,16 patients were performed defect reconstruction following oral cancer ablation with free posterolateral leg perforator flap including 3 cases of sequamous cell carcinoma of the tongue,6 cases of carcinoma of the buccal mucosa,7 cases of sequamouse cell carcinoma of the floor of mouth.The flap ranged from 5.0 cm×3.0 cm to 13.0 cm ×9.0 cm in size,and were adjected to the soft tissue defects of oral and maxillofacial area.The outcome of reconstruction was evaluated by considering the facial appearance,the swallowing and the speach function,the ranges of mouth opening and patient prognosis.Results All 15 transplanted flaps survived well and only 1 survived after disposing in time,because of vascular crisis.The donor sites were closed directly without donor-site morbidity.All patients were satisfactory with their facial appearance,the ranges of mouth opening and swallowing and speech function.Conclusion The free posterolateral leg perforator was an ideal free tissue for repairing functionally oral and maxillofacial defects,sinceit including some beneficial characteristic such as constant blood vessel,flexible and divese design,abundant and position-latent donor site tissues,small operation loss,flexible preparation and loss of major vascular nerves.
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Objective To observe the clinical effects of unilateral cleft lip repairmen via improved Millard technique. Methods 64 cases of patients with unilateral cleft lip were collected from July 2014 to June 2015. The traditional Millard technique was improved by moving traditional fixed point of columella nasi to close with the lateral nasal columella roots,and the moving range was adjusted according to the nasal columella deformity and nostril size. Meanwhile ,the nasal floor and the alar basal incisions were not designed. Instead ,fully free of affected side orbicularis oris muscles were applied to making apposition suture with the healthy side. Results It showed that anatomic form of the upper lip and the philtral column of patients ,whose unilateral cleft lips were repaired by the improved Millard technique,were normal,and both sides of the lip peak were basically symmetrical after 1 ~ 12 month(s)follow-up. Conclusions Compared with the traditional Millard technique,the improved technique could bring a better effect on appearance of the patients. And it will be one of the ideal repairing techniques for unilateral cleft lip.
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Objective To investigate the forearm flap personalized design method and the curative effect in repairing maxillofacial defects.Methods From March,2011 to September,2015,16 cases with oral maxillofacial tumor and facial tissue defect were treated.There were 8 males and 8 females with an age range of 41-70 years (mean,54 years).According to the shape and size of the defect after tumor resection in each patient,the forearm flap was designed to repair the defect.The effectiveness was evaluated after operation by observing the survival of the forearm flap transplantation,the patient's facial appearance,the functions of speech,swallowing.Results The incision healed by first intention in this group,16 cases of forearm flap survived.All cases were followed-up 8-36 months without tumor recurrence.The functions of speech,swallowing were basically normal.The facial appearance was satisfactory.The patients were satisfied with their appearance and functional recovery after operation.Conclusion Take personal way of forearm flap design according to maxillofacial soft tissue defect,can restore the maximum facial appearance and function of patients,improve the quality of life of patients after surgery to repair,can obtain satisfactory results.
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Objective To investigate the method of the separation gel vacuum tube combined with matrix‐assisted laser desorp‐tion/ionization time of flight mass spectrometry system (VITEK‐MS) for fasting identifying positive blood culture bacteria .Methods Fifty cases of positive blood culture by the BacT/ALERT3D blood culture system and Gram‐negative bacteria by direct staining in the First Affiliated Hospital of Guangzhou University from March to October 2015 were collected .The bacteria were directly ex‐tracted from the blood culture bottle by the separation gel tube and performed the fast identification by adopting the VITEK‐MS system .At the same time the bacteria were performed the subcultivation and identification .then the coincidence of this method was compared .Results Among 50 cases of Gram‐negative bacteria by positive blood culture ,21 cases of bacteria were not identified ,29 cases of bacteria were identified ,the positive rate was 58 .0% .the coincidence rate with the conventional identification results was 96 .6% ;the method of separation gel combined with VITEK‐MS was nearly 24 h in advance compared with the traditional method . Conclusion Adopting the separation gel vacuum tube combined with VITEK‐MS for identifying bacteria has the higher coincidence rate of positive blood culture Gram negative bacteria ,can greatly shorten the identification time ,this method is rapid and simple .
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Objective To analyze the regions of abdominal lymph node metastasis in recurrent thoracic esophageal squamous cell carcinoma ( TE-SCC) after radical surgery, and to guide the design of target volume in postoperative adjuvant radiotherapy. Methods Patients with TE-SCC who were admitted to our hospital from February 2005 to April 2013 were enrolled as subjects. All patients were diagnosed with abdominal lymph node metastasis by imaging after R0 radical surgery. The exact regions of abdominal lymph node metastasis were classified according to the 7th edition of American Joint Committee on Cancer ( AJCC) TNM staging system for gastric cancer, and then retrospectively analyzed. The difference of two group was analyzed by χ2 test. Results Among the 1593 eligible patients, 148( 9. 3%) were diagnosed with abdominal lymph node metastasis after surgery. In the 148 patients, the abdominal lymph node metastasis rates in the upper, middle, and lower thoracic esophagus were 2. 3%, 7. 8%, and 26. 6%, respectively ( P=0. 000);the incidence rates of pathological stages T1/2 and T3/4 were 8. 7% and 9. 5%, respectively ( P=0. 601);the incidence rates of 0-2 and ≥3 metastatic lymph nodes in postoperative pathological examination were 4. 8%and 20. 1%, respectively (P=0. 000). The abdominal lymph node metastasis rate was the highest in the para-aortic lymph node ( 16a2) , followed by para-aortic lymph node ( 16a1) and the lymph nodes around the celiac trunk, posterior area of the pancreatic head, and common hepatic artery ( 64. 9%, 41. 2%, 37. 8%, 32. 4%, and 20. 9%) , yielding an overall metastasis rate of 91. 9%. Conclusions The major regions of abdominal lymph node metastasis in esophageal carcinoma after radical surgery include para-aortic lymph nodes ( 16a2 and 16a1) and the lymph nodes around the celiac trunk, posterior area of the pancreatic head, and common hepatic artery. These regions are the abdominal target volumes of postoperative adjuvant radiotherapy.
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Objective To investigate the effect of small interfering RNA (siRNA) interference in the expression of epidermal growth factor receptor (EGFR) on the radiosensitivity of esophageal squamous carcinoma (Eca-109) and esophageal adenocarcinoma (OE-19) cell lines.Methods Human Eca-109 and OE-19 cell lines were selected as study subjects.Various EGFR-siRNA and negative siRNA were synthesized chemically through lipofection.Reverse transcription-polymerase chain reaction and Western blot were applied to measure the expression of EGFR before and after transfection,and the CCK8 assay was applied to analyze the influence of transfection on cell proliferation.Blank control groups of Eca-109 and OE-19 cells (O1 and O2 groups),simple irradiation groups (R1 and R2 groups),and EGFR-siRNA irradiation groups (E-R1 and E-R2 groups) were set,and the doses for single irradiation were 0,2,4,6,and 8 Gy.The colony-forming assay was applied to calculate survival fraction (SF) and sensitization enhancement ratio (SERD0 ratio),and flow cytometry was applied to evaluate the influence of EGFR-siRNA combined with radiotherapy on cell cycle distribution and apoptosis rate,and the dose for single irradiation was 6 Gy.Results The expression of EGFR in both cell lines was significantly down-regulated by EGFR-siRNA,and the inhibition rate of cell proliferation by transfection was＜5％ (4.9％ and 4.5％,respectively).The results of colony-forming assay showed that the cells in the E-R1 and E-R2 groups had a lower SF than those in the O1 and O2 groups,with an SERD0ratio of 1.40 and 1.01,respectively.The results from flow cytometry showed that compared with the E-R2 group,the E-R1 group had a higher proportion of cells in G2/M phase and a lower proportion of cells in S phase after irradiation (P=0.016 and 0.028),as well as a higher apoptosis rate (P=0.007).Conclusions Compared with the cell line OE-19,the cell line Eca-109 has a significantly increased radiosensitivity when treated with siRNA interference in EGFR expression.
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Objective To investigate the impact of clinical factors on survival in patients receiving concurrent chemotherapy and three?dimensional radiotherapy ( 3DRT) for stage IV non?small cell lung cancer ( NSCLC) . Methods A total of 203 patients were enrolled in a prospective clincial study from 2008 to 2012, and among these patients, 178 patients were eligible for analysis of clinical factors. All patients were treated with platinum?based doublets chemotherapy, with a median number of chemotherapy cycles of 4( 2?6 cycles) and a median dose of 3DRT of 60?3 Gy (36?0?76?5 Gy).The Kaplan?Meier method was used to calculate overall survival ( OS) rates, the log?rank test was used to compare survival rates between groups, and the Cox regression model were used for multivariate analysis. Results The 1?, 2?, and 3?year overall survival rates were 56%, 16%, and 10%, respectively, and the median survival time was 13 months (95% CI=11?500?14?500). The univariate analysis showed that platelet count ≤221×109/L, neutrophil count ≤5.2×109/L, white blood cell count<7×109/L, and improvement in Karnofsky Performance Scale ( KPS) after treatment significantly prolonged OS ( P=0?000,0?022,0?003, and 0?029) , and metastasis to a single organ and hemoglobin≥120 g/L tended to prolong OS (P=0?058 and 0?075). The multivariate analysis showed that white blood cell count<7×109/L, platelet count ≤221×109/L, and improvement in KPS after treatment were beneficial to OS ( all P<0?05) . Conclusions White blood cell count and platelet count before treatment and KPS after treatment are prognostic factors for patients with stage IV NSCLC receiving concurrent chemotherapy and 3DRT. Clinical Trial Registry ClinicalTrials. gov, registration number:ChiCTRTNC10001026.
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Objective To retrospectively analyze the prognostic factors of advanced esophageal carcinoma (EPC) with concurrent chemoradiotherapy.Methods A total of 200 advanced EPC patients between January 2008 and December 2011 were reviewed,and all of them received concurrent chemoradiotherapy,either IMRT or CRT.Among them,there were 92 and 108 patients in the IMRT and CRT group,respectively.The chemotherapy scheme was paclitaxel combined with different platinum drugs (cisplatin,nedaplatin,oxaliplatin or lobaplatin).The number of chemotherapy cycles was 2-4.Results Patients who received IMRT had a significant higher 3-year overall survival (OS) than that who received CRT (63.6 ％ vs 38.9 ％,x2 =12.102,P =0.001).Three-year OS differed no significantly between different chemotherapy regimens.There were 44.6 ％,57.5 ％,52.5 ％ and 52.5 ％ for those who received cisplatin,nedaplatin,oxaliplatin and lobaplatin,respectively (x2 =2.756,P =0.431).Patients received different cycles of chemotherapy had comparable treatment outcome,and the overall survival were 44.1％,51.6 ％ and 57.4 ％ for those who underwent 2,3 and 4 chemotherapy cycles at 3 years,without any statistical significance (x2 =2.497,P =0.287).Univariate analysis indicated that lesion length on X-ray,M stage,6th edition UICC staging and radiotherapy methods were the potential predictive factors.Multivariate analysis shown that gender,lesion length on X-ray and radiotherapy methods were the significant prognostic factors.Conclusion The significant prognostic factors for advanced EPC with concurrent chemoradiotherapy are mainly lesion length on X-ray and radiotherapy methods.
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According to the 2012 estimates,esophageal cancer(EC)was the fifth commonly diagnosed cancer and the forth leading cause of cancer -related death .The incidence and mortality rates of EC have been increasing in China .Combined -modality therapy for EC is well accepted , and molecular targeted therapy be-comes a research area.Nowadays,multiple agents have been developed and studied in phase Ⅱ/Ⅲtrials,mainly including cetuximab,erlotinib,trastuzumab,bevacizumab.In this review,we focus on the development of molecular targeted therapy for EC .
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Objective To investigate the efficacy and safety of three?dimensional radiotherapy (3DRT) with concurrent chemotherapy for stage IV non?small?cell lung cancer ( NSCLC). Methods A total of 198 eligible patients from 2008 to 2012 were enrolled as subjects. With an age ranging between 18 and 80 years and a Karnofsky Performance Status ( KPS) score of 70 or more, those patients had no contraindication for radiotherapy and chemotherapy, and were newly diagnosed with stage IV NSCLC confirmed by histology or cytology, as well as limited metastatic disease (≤3 organs). Survival rates and acute toxicities in those patients were evaluated. Results The 3?year follow?up rate was 98?? 5% and the 3?year sample size was 165. The median overall survival (OS) and progression?free survival (PFS) were 13?? 0 months (95% CI,11?? 7 ?14?? 3 months) and 9?? 0 months (95% CI,7?? 7 ?10?? 3 months), respectively, while the 1?, 2?, and 3?year OS rates were 53?? 5%, 15?? 8%, and 9?? 2%, respectively. Multivariate analysis showed that a primary tumor volume smaller than 134 cm3 , a stable or increased KPS score after treatment, and a radiation dose of 63 Gy or more were independent prognostic factors for longer survival time ( P=0?? 008;P= 0?? 010;P= 0?? 014). The incidence rates of grade 3?4 neutropenia, thrombocytopenia, anemia, grade 3 radiation esophagitis, and grade 3 radiation pneumonitis were 37?? 9%, 10?? 1%, 6?? 9%, 2?? 5%, and 6?? 6%, respectively. The main cause of death was distant metastasis, and only 10% of the patients died of recurrence alone. Conclusions 3DRT with concurrent chemotherapy achieves satisfactory treatment outcomes with tolerable toxicities for stage IV NSCLC. Primary tumor volume, change in the KPS score after treatment, and radiation dose are independent prognostic factors for OS.Clinical Trial Registry Chinese Clinical Reistry,registration number:ChiCTRC10001026.
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<p><b>OBJECTIVE</b>To retrospectively compare the efficacy of postoperative radiotherapy (RT) alone with that of postoperative radiotherapy with concurrent chemotherapy (CRT) for thoracic esophageal squamous cell carcinoma (EPC) with positive lymph nodes, and to evaluate the clinical value of RT + CRT.</p><p><b>METHODS</b>304 EPC patients underwent esophagectomy with three-field lymph node dissection had pathological lymph node metastases, but no hematogenous distant metastasis. Among them, 140 cases underwent postoperative RT alone, and 164 cases underwent postoperative CRT. The dose of irradiation was 50 Gy, and the chemotherapy regimen was taxol and cis-platinum, and a cycle was 21 days.</p><p><b>RESULTS</b>The 1-, 3- and 5-year total survival rates of the whole group were 90.1%, 56.6% and 43.3%, respectively, with a median survival time of 49.7 months. The 5-year overall survival rates of the CRT and RT groups were 47.4% and 38.6%, respectively (P = 0.030), with a median survival time of 53.5 and 41.7 months, respectively (P = 0.030). The overall survival rates of the patients who underwent 1, 2, 3, 4 cycles of chemotherapy were 24.4%, 53.0%, 58.1% and 43.3%, respectively (P = 0.007). Among them, the 5-year total survival rate of patients with 2-4 cycles of chemotherapy was significantly better than that of patients who underwent one cycle of chemotherapy (P = 0.001). Univariate analysis showed that number of metastatic lymph nodes, pT stage, therapeutic regimen and number of chemotherapy cycles were significantly correlated with the prognosis of the patients (P < 0.05 for all). Multivariate analysis showed that number of metastatic lymph nodes, pT stage, and number of chemotherapy cycles were independent prognostic factors of the patients (P < 0.05 for all). Early toxic effects including neutropenia, radiation esophagitis, and gastrointestinal effects were significantly more severe in the CRT group than that in the RT group (P < 0.05), however, there were no significant differences of late toxic effects between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>Postoperative CRT for thoracic EPC with positive lymph nodes can improve the survival rate, with tolerable adverse effects.</p>