ABSTRACT
Rectal cancer is one of the common cancers which poses a threat to the health of mankind. In recent years. Multi-modality treatment strategies for locally advanced rectal cancer improve the treatment efficiency. Accurate prediction of the treatment response after the neoadjuvant chemoradiotherapy (CRT) can guide more suitable treatment strategy. MERCURY study proved the prognostic value of post-CRT standard morphologic MRI(T2-weighted) assessment of tumor regression grade(TRG), and MRI assessment of circumferential resection margin can guide the definitive surgery. Compared with standard morphologic MRI (T2-weighted), functional MRI, including diffusion weighted imaging (DWI) and dynamic contrast enhanced (DCE) MRI, has shown more promising results for the prediction of therapeutic response in rectal cancer. The addition of diffusion-weighted images to T2-weighted images improves the accuracy of restaging examinations for determination of complete pathologic responders. DCE can reflect the tumor micro-vascular environment, and the change of perfusion in response to treatment. These images have the potential to improve the accuracy of therapeutic response in rectal cancer.
Subject(s)
Humans , Chemoradiotherapy , Contrast Media , Diffusion Magnetic Resonance Imaging , Magnetic Resonance Imaging , Methods , Margins of Excision , Neoadjuvant Therapy , Neoplasm Staging , Methods , Prognosis , Rectal Neoplasms , Diagnostic Imaging , PathologyABSTRACT
Objective To investigate the clinical effect of posterior pedicle screw fixation combined with anterior decompression and fusion for the treatment of thoracolumbar burst fractures.Methods The clinical data of 53 patients underwent posterior pedicle screw fixation and anterior decompression and fusion were retrospectively analyzed.The vertebral height,Cobb angle,vertebral tube volume,the Frankel gradient and Fugl -Meyer score were recorded and compared before and after treatment.Results 49 patients were followed up.At the last time of follow -up,the vertebral height,Cobb angle,vertebral tube volume all significantly improved (t =24.047,P <0.001;t =21.815,P <0.001;t =31.699,P <0.001).The Frankel gradient before treatment was:A 6 cases,B 18 cases,C 15 cases,D 10 cases,E 4 cases.After treatment,it came to 3 cases,8 cases,11 cases,17 cases,10 cases,respectively.There was significant difference before and after treatment (Z =2.997,P =0.003).There was significant difference in Fugl -Meyer score before and after treatment[(74.65 ±8.42)points,(90.26 ±9.17)points,respectively,P <0.001 ].Conclusion There is excellent effect on posterior pedicle screw fixation followed by anterior decompression and fusion for the treatment of thoracolumbar burst fractures.It is good for the recovery of motion and spinal function.
ABSTRACT
etabolic response to radiotherapy may predict the prognosis of paitents with locally advanced NPC. The prognosis is poor for patients with high FDG uptake before and after radiotherapy or SUV max-NSUV max-P .