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Objective To evaluated the efficacy of biomarker?guided concurrent chemoradiotherapy in unrescetable esophageal squamous cell carcinoma patients. Methods 54 cases of unrescetable esophageal squamous cell carcinoma were enrolled in the prospective non?randomized clinical study and divided into study group and control group. All cases were treated with concurrent chemoraditherapy. Intensity?modulated radiation therapy was used with a dose of 60?66 Gy. Chemotherapy was perfromed on day 1 and d29. In the study group the selection of the chemotherapy drug was based on the excision repair cross?complementation 1 ( ERCC1) ,thymidylate synthetase ( TYMS) ,ribonucleotide reductase M1( RRM1) ,and theβ?tubulin isotypeⅢ( TUBB3) mRNA expression levels. In the control group,the regiment for chemotherapy was Cisplatin plus Fluorouracil. The objective response rate and overall survival ( OS ) were calculated using Kaplan?meier method and log?rank test was used for between?group comparison. The survival rate was calculated using Kaplan?Meier method and analyzed using log?rank method, other comparison was performed by χ2 test. Results The follow?up rate was 100% in the study group and 96% in the controll group. The objective response rate of the study group and the control group were 85% and 86 ( P=0. 483 ) , respectively. The median survival time ( MST) in the study group was 35. 5 months and that in the control group was 25. 8 months. The 1?,2?,and 3?year OS rates of the study group and the control group were 84%,68%,46% and 71%,59%,28% respectively (P=0. 047).No significant differences were observed in the incidence of side?effects in the two groups. Conclusions Selecting the chemotherapy drug according to biomarker,combined with radiation therapy,could improve survival.in unrescetable esophageal squamous cell carcinoma. The value needs further investigation.
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Objective:To assess the role of EGFR mutations on pemetrexed response in patients with advanced lung adenocarcino-ma. Method: Forty pulmonary adenocarcinoma patients with evaluable lesions were retrospectively screened .They had been treated with pemetrexed-included chemotherapy and had EGFR gene test results. The evaluation endpoints were overall response rate,disease control rate and progression free survival. Result:No significant statistical difference was seen in overall response rate(ORR) (44.4%VS 31.8%, respectively) and disease control rate(DCR) (88.9%VS 81.8%, respectively ) between EGFR wild group and EGFR muta-tion group, but patients in EGFR wild group had longer progression free survival(PFS) ( 8.9 months VS 5.3 months;P=0.046). Conclu-sion:EGFR mutation status can influence the efficacy of pemetrexed.
ABSTRACT
With the rapid development of the computer technology and the constant updating of the radiotherapy equipment, a huge improvement has been manifested by the new generation of the Gamma Knife radiotherapy system. Not only its functions are being improved, but also the treatment indications are expanding. These advances have been widely recognized by the clinical medical experts, breaking off the forbbiden zone of surgical operations, saving a lot of tumor patients with both malignant and benign lesions, who are not suitable for surgical operations due to local anatomical limitations. However, there are still a lot of clinicians being not clear about the funcitons and generations of Gamma Knife radiotherapy system. Moreover, variant guidances by different manufacturerers have given rise to confusions, especially on the equipment purchasing. Therefore, in this report we summarize the features of Gamma radiotherapy systems produced by different manufacturers in recent years, to supply reference data for the organization and expert buyers.
Subject(s)
Equipment and Supplies , Purchasing, Hospital , Methods , RadiotherapyABSTRACT
This paper reports 32 patients with primary esophageal small cell undifferentiated carcinoma confirmed by histologic examination from April 1972 to January 1989 in our hospital. The 1-, and 3-, 5-year survival rates were 53.1%, 18.8% and 6.3%. 93.7% patients died of local un-control, recurrence or metastasis. The age, sex, tumor size, stenosis, position and the type in X-films did not influence the treatment results. Patients with primary esophageal small cell undifferentiated carcinoma should receive a multimodal treatment instead of surgery alone.