Clinical efficacy of thoracoscopic surgery combined with chemoradiotherapy in patients with N2 stage ⅢA non-small cell lung cancer / 实用医学杂志

Objective To evaluate the clinical efficacy of thoracoscopic surgery combined with chemorad-iotherapy in patients with N2 stage ⅢA non-small cell lung cancer (NSCLC). Methods 40 patients (study group) received thoracoscopic surgery and another 40 patients (control group) received traditional thoracotomy. Combination therapy with navelbine and cisplatin were postoperatively administered for four cycles and one cycle lasted for 3 weeks. 7 to 14 days after chemotherapy , sequential conformal radiotherapy were delivered. The one-year survival and two-year survival rates , duration of tatal treatment , and adverse reactions were compared between the two groups. Results In the study group, duration of total treatment time and time to postoperative chemotherapy were significantly shorter (χ2=9.45,P=0.002 andχ2=41.324, P=0.000), and the KPS score was significantly higher (χ2 = 15.118,P = 0.002). No significant differences were found between the two groups in bone marrow suppression,gastrointestinal reactions,and one- or two-year survival rate. Conclusions As compared with conventional surgery,post-thoracoscopic surgery sequential chemoradiotherapy for patients with N2 stage ⅢA NSCLC could achieve a better efficacy with less surgical trauma , shorter hospital stay , faster recovery , and shorter time to postoperative chemotherapy and total treatment duration;it is worth further researching and popularizing.

Comparison of two regimens of postoperative concurrent chemoradiotherapy in adult patients with grade III-IV cerebral gliomas / 南方医科大学学报

<p><b>OBJECTIVE</b>To compare the therapeutic efficacy of two regimens of postoperative radiotherapy with concurrent chemotherapy using temozolomide (TMZ) and teniposide (VM-26) plus semustine (Me-CCNU) in adult patients with grade III-IV cerebral gliomas.</p><p><b>METHODS</b>Ninety-six adult postoperative patients with grade III-IV cerebral gliomas were randomized into two groups (n=48) to receive 60 Gy radiotherapy with concurrent TMZ treatment (TMZ-RT group) and radiotherapy with VM-26 plus Me-CCNU treatments (VM-RT group). The adverse effects of marrow depression, gastrointestinal toxicity and acute radiation-induced brain injury were observed. The immediate effect and survival outcome of the patients were compared between the two groups.</p><p><b>RESULTS</b>No adverse effects beyond grade III were observed in the two groups. TMZ-RT group showed a significantly lower incidence of grade I-II adverse effects than VM-RT group (P<0.05). The median survival time and 1-, 2-, and 3-year survival rates of the patients in TMZ-RT group were 28 months, 72.9%, 54.2% and 31.3%, respectively, showing significant differences from those in VM-RT group (16 months, 62.5%, 33.3% and 16.7%, respectively, P<0.05).</p><p><b>CONCLUSION</b>Radiotherapy with concurrent TMZ chemotherapy is an effective regimen with mild toxicities for treatment of adult malignant cerebral glioma.</p>

A randomized multicentre study of chemoradiotherapy in patients with locally advanced (inoperable) rectal cancer / 中华放射肿瘤学杂志

Objective To evaluate the feasibility and efficacy of chemoradiotherapy for locally advanced (inoperable) rectal cancer. Methods Seventy-six patients with locally advanced (T_4) or recurrent rectal cancer were randomized into two groups of concurrent chemoradiotherapy with either oxaliplatin plus 5-FU (oxaliplatin 130 mg/m~2, day 1,5-FU 350 mg/m~2, day 1 -5 ,LV 200 mg/m~2, day 1 -5, 4 weeks per cycle) or capecitabine (1650 mg/m~2, day 1 -14, 3 weeks per cycle) alone. All patients received pelvic three-dimensional conforrnal radiotherapy (3 DCRT) of 46 -50 Gy in 23 -25 fractions, with a boost of 14 -18 Gy in 7 -9 fractions. Results The median follow-up time was 19 months. The overall response rate was 64% in the oxaliplatin/5-FU group comparing with 58% in the capecitabine group (χ~2 = 0. 08 ,P =0. 772), with the median survival time of 22 months and 18 months (u = 17.71, P = 0. 077), respectively. The overall survival in the two groups was 68% and 63% at 1 year, and 21% and 19% at 2 years, respectively (χ~2 = 0. 97, P = 0. 326). There were no treatment-related deaths or grade 4 toxicities. Neutrocytopenia (39. 5% vs 77.7%, z = -3.97,P =0. 0001), diarrhea (47.4% vs 88.9%, z = -4. 78, P = 0. 0001), nausea and vomiting (68.4% vs 97.2%, z = -3. 17, P = 0. 0001), and neurotoxicity (5.3% vs 66.7%, z= -6.56, P= 0.0001) were more common in the oxaliplatin/5-FU group. Conclusions Concurrent chemoradiotherapy is well-tolerated and effective in patients with locally advanced (inoperable) rectal cancer.