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Objective To investigate the clinical efficacy of aprepitant in the treatment of cisplatin based chemotherapy in-duced nausea and vomiting.Methods The tumor patients treated with cisplatin(80 mg/m2)chemotherapeutic regimen in Affiliated Shantou Hospital of Sun Yat-Sen University from December 1,2014 to December 1,2016 were selected,61 cases still had vomiting after using granisetron and dexamethasone for routinely stopping vomiting,the patients with aprepitant and dexamethasone for fur-ther stopping vomiting served as the aprepitant group,while the patients with granisetron and dexamethasone as the granisetron group.Then the complete response(CR)rates within 24,24-72,>72-144 h were observed in the two groups.Results The CR rates within 24 h in the aprepitant group and granisetron group were 66.67% and 51.61% respectively,the difference was not sta-tistically significant(P=0.232),which at 24-72 h were 80.00% and 54.84% respectively,the aprepitant group was significantly better than the granisetron group(P=0.036),which at >72-144 h were 86.67% and 64.52% respectively,the aprepitant group was better than the granisetron group(P=0.045).The comparison of adverse reactions between the two antiemetic drugs found that constipation,diarrhea,urticaria,fatigue and anxiety had no significant difference(P>0.05),the occurrence rate of total adverse reactions in the aprepitant group was 23.33%,which in the granisetron group was 25.81%,the difference between the two groups was not statistically significant(P>0.05).Conclusion Aprepitant combined with dexamethasone has better effect for treating hy-peremetic chemotherapy drug cisplatin chemotherapy caused nausea and vomiting with good tolerance.
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Objective To compare of clinical effect between radiotherapy and chemoradiotherapy and investigate the prognostic factors in elderly patients with esophageal squamous cell cancer.Methods 229 elderly patients with esophageal squamous cell cancer who received radiotherapy and chemoradiotherapy from January 2009 to December 2013 were retrospective analyzed.The Local control rate and survival rate were calculated by Kaplan-Meier method,and the short effect and long term effect between radiotherapy and chemoradiotherapy were compared.Cox regression model was used for invariant analysis and multivariate analysis.Results The follow up time was 15.3months.The short effect of radiotherapy group was not better than that of chemoradiotherapy group,with CR 35.6％ vs 45.8％,RR 61.0％ vs 53.0％,SD 2.7％ vs 0 and PD 0.7％ vs 1.2％ (P=0.211).The 1-,2-,3-year local control rates of radiotherapy group were significantly poorer than that of chemoradiotherapy group,with 82.8 ％,60.5 ％ and 52.7％ vs 89.5％,85.4％ vs 80.9％,respectively (P=0.009).However,there were no significance difference between the 1-,2-,3-year survival rates of radiotherapy group and chemoradiotherapy group,with 66.4％,29.5％,17.1％ vs.65.9％,40.3 ％,30.8 ％,respectively (P =0.071).In invariant analysis,T stage,N stage,clinical stage and radiotherapy dose (＜ 60 Gy,60 ～66 Gy,＞66 Gy) were related with the prognosis of esophageal carcinoma.The COX regression model showed that T stage,N stage and radiotherapy dose were independent prognostic factors that effected survival rate.Conclusion In elderly patients with esophageal squamous cell cancer,chemoradiotherapy can improve the local control rates,but not benefit the survival rate.T stage,N stage and radiotherapy dose were independent prognostic factors that effected survival rate,which could provided evidence for prognosis judgement and clinical practice.
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Objective To improve the non?surgical N staging system for esophageal carcinoma ( EC) . Methods A retrospective analysis was performed in 501 patients newly diagnosed with esophageal squamous cell carcinoma who received radiotherapy in our hospital from 2009 to 2013. The impacts of the supraclavicular lymph nodes and mediastinal lymph nodes on the overall survival ( OS) rate were analyzed. The original non?surgical N staging system was improved and the proposed N staging system was evaluated. The OS rates were calculated using the Kaplan?Meier method and analyzed using the log?rank test. The univariate and multivariate analyses were performed using the log?rank test and Cox regression model, respectively. Results The 3?and 5?year sample sizes were 404 and 205, respectively. In all patients, the 1?, 3?, and 5?year OS rates were 64?9%, 26?5%, and 18?3%, respectively;the 1?, 3?, and 5?year distant metastasis?free ( DMF) rates were 86?2%, 68?9%, and 67?3%, respectively;the 1?, 3?, and 5?year local control rates were 72?7%, 53?1%, and 43?6%, respectively. The univariate analysis showed that the incidence, 3?year OS rate, and 3?year DMF rate of supraclavicular lymph node metastases in patients with cervical and upper?thoracic EC were significantly higher than those in patients with middle?thoracic and lower?thoracic EC ( 25?7% vs. 14?2%, P=0?034;24?2% vs. 11?5%, P=0?016;84?8% vs. 69?2%, P=0?007) . The multivariate analysis also showed that the number of metastatic lymph nodes was an independent prognostic factor for the OS and DMF rates in patients ( P= 0?000;P= 0?007 ) . Conclusions It is reasonable to classify upper?thoracic EC with supraclavicular lymph node metastasis into stage N1 diseases. The proposed N staging system with the factor of the number of metastatic lymph nodes is more scientific and objective than the original N staging system.
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Objective To evaluate the therapeutic effects of platinum alone chemotherapy combined with radiotherapy for esophageal carcinoma without operation.Methods Form April 2008 to February 2010,47 initial treatment patients with esophageal carcinoma were treated by platinum alone chemotherapy (cisplatin or nedaplatin 20 mg/m2,one times per weeks) and conventional fractionated radiation therapy (200 cGy per fraction,2 times per day,5 days per week,to a total dose of 6 000-7 000 cGy).Results 1-,2-,3-,4-year overall survival rates were 63.83 ％ (30/47),40.43 ％ (19/47),38.30 ％ (18/47),30.77 ％ (4/13).4-year survival rate of 13 cases with lymph node metastasis was 0,it was lower than that of cases without lymph node metastasis (40 ％,4/10),the difference was statistically significant (x2 =6.295,P =0.012).The 3-year survival rates in cisplatin or nedaplatin combined with radiotherapy group were 31.25 ％ (5/16) and 41.94 ％ (13/31),the difference was not statistically significant (x2 =0.510,P =0.475).Conclusion Low doses of platinum alone chemotherapy combined with radiotherapy for the treatment of esophageal cancer are safe,but long-term efficacy needs to be confirmed in larger clinical trials.
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Objective To evaluate the efficacy and safety of induction chemotherapy and three-dimensional conformal radiation (3D-CRT) combined with endostar in the treatment of locally advanced non-small cell lung cancer (NSCLC).Methods Thirty patients with locally advanced NSCLC were enrolled and divided into observation group (15 cases) and control group (15 cases).In the observation group,the patients received induction chemotherapy and 3D-CRT combined with endostar.Chemotherapy:Vinorelbine 25mg/m2 on day 1 and 8,DDP 30mg/m2 on day 2 to 4.Endostar 7.5mg/m2 on day 1 to 14,which was used again after 7 days for 2 to 4 cycles.In the control group,the patients received induction chemotherapy and 3D-CRT at the same dosage.All patients were treated with 3D-CRT and the prescription dose was 60 ～ 68Gy per fraction.The responses were evaluated according to WHO criteria.The shortterm efficacy between the 2 groups was compared.Results The overall effective rate of the two groups were 66.7％ and 60.0％,respectively (P ＞ 0.05).The median progression-free survival time was 12 months in the observation group and 10 months in the control group.The median survival time was 20 months in the observation group and 18 months in the control group.The 1 year overall survival rate was 80.0％ in the observation group and 73.3％ in the control group(P ＞ 0.05).The main toxicities in the two groups were marrow suppression,gastrointestinal symptoms,acute radiation pneumonitis and acute radiation esophagitis.There was no significant difference between the two groups (P ＞ 0.05).Conclusions The combination of endostar with induction chemotherapy and 3D-CRT can improve the short-term efficacy rate of locally advanced NSCLC,the adverse events of which are tolerable,but the improvement is not significant in both groups.The result pending further randomized multi-center phase Ⅲ clinical study.
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Objective To evaluate the clinical features of nasopharyngeal carcinoma with different sur英文摘要>=rival time and to analyze the factors associated with prognosis improvement.Methods Three hundred and fifty three patients with nasopharyngeal carcinoma treated in our hospital from January 2000 to April 2002 were analyzed retrospectively.They were divided into three groups based on their survival time.One hundred and forty five patients were divided into A groups whose overall survival time were less than five years.Sixteen patients were included in B group whose overall survival time were greater than or equal to five years and less than ten years,and the other one hundred and ninety two patients were divided into C groups whose overall survival time were greater than or equal to ten years.The clinical features were compared and factors associated with survival were identified.Results The 5 and 10 years overall survival rates of the 353 nasopharyngeal carcinoma patients underwent radiotherapy were 58.924％ and 54.391％ respectively.Curative effect of early nasopharyngeal carcinoma was better.Cox regression analysis identified age,N stage,combined with chemotherapy or not and complete remission rate of nasopharynx and neck lymph were independent prognostic factors.Conclusion For nasopharyngeal carcinoma patients,early detection,early treatment,rational comprehensive treatment and complete remission after treatment and complications prevention are important.
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Objective To evaluate the clinical effectiveness and the major toxic effect of radiotherapy combined with docetaxol and cisplatin respectively in the treatment of locally advanced non-small cell lung cancer (NSCLC).Methods 98 patients with locally advanced NSCLC were randomly divided into two groups.All of the patients were treated with 3D-CRT.One group was treated combined with docetaxel,20mg/m2,every week,totally 6 times.The other group was treated combined with cisplatin,30mg/m2,every week,totally 6 times.The total dose was 60 ～66Gy,2Gy/F,5 times each week for 5 ～7 weeks.The clinical effect and the major toxic effect between two groups were compared.Results The median survival time in group that treated with docetaxol was 17.2 months,median progression-free survival time was 13.5 months,and the 1,2 and 3-year survival rates of the patients were 78.6％,35.7％ and 19.5％ respectively.The median survival time in group that treated with cisplatin was 16 months,median progression-free survival time was 16.5 months,and the 1,2 and 3-year survival rates of the patients were 74％,34％ and 20％ respectively.The differences between two group were not stetisticelly significant( P ＞0.05 ).However,the side effect of the stomach and intestine and late radiation complication in group treated with docetaxol were slighter than those in group treated with cisplatin.Conclusion The clinical effect of radiotherapy combined with docetaxol in the treatment of locally advanced NSCLC was equal to radiotherapy combined with cisplatin.But radiotherapy combined with docetaxol has a slighter and acceptable toxic effect,which was worth the clinical application.
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Objective To evaluate the clinical efficacy of platinum-based chemotherapy combined radiotherapy for cervical cancer.Methods From October 2008 to June 2010,61 patients with cervical cancer were treated by radiotherapy( conventional external radiation and after-loading brachytherapy,to a total dose of 8000- 8500 cGy)combined platinum-based chemotherapy (cisplatin or nedaplatin 20 mg/m2,one times per weeks) in our department.The clinical efficacy and side effects were evaluated.Results Among 61 patients,the short-term effective rate was 100％ ( 61/61 ) and 1-year survival rate was 85.2％ ( 52/61 ).There was no significant difference between cisplatin group and nedaplatin in 1-year survival rate ( 84.6％ vs.85.7％,x2 =0.014,P=0.095).Arrest of bone marrow at Ⅰ,Ⅱ,Ⅲ and Ⅳlevel occurred 5,24,5 and 1 patients in the cisplatin group,and 6,12,3 and 3 patients in the nedaplatin group.There was also no significant difference between these two groups in great mass side effects induced by chemoradiotherapy (x2 =6.402,P =0.171 ).Conclusion It is worth practising of platinum-based chemotherapy combined radiotherapy for cervical carcinoma.The side effects induced by chemoradiotherapy is low.
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Objective To evaluate the effects and toxic side-effects of radiotherapy combined with xeloda or carboplatin respectively for locally advanced esophagus carcinoma.Methods 74 cases with locally advanced esophagus carcinoma were randomly allocated into two groups.One group received radiotherapy combined with Xeloda,500mg at a time,twice a day,taken orally from the beginning of radiotherapy till end of treatment.The second group received radiotherapy combined with Carboplatin by intravenous drip at 100mg a day,for 5 days,from the first week of radiotherapy.Results The overall response rate in the radiotherapy combined with Xeloda group was 91.4％ and 89.7％ in the radiotherapy combined with Carboplatin group.The difference between the two groups was not statistically significant(P ＞0.05 ).Kaplan-Meier survival analysis showed no statistically significant differences in survival between the two groups.The toxic side-effects of gastrointestinal tract,reaction myelosuppression and late radiation reaction were notably alleviated in the Xeloda group compared with the Carboplatin group.Conclusion Compared with Carboplatin,Xeloda combined with radiotherapy had less toxic side-effects for treatment of advanced esophagus carcinoma,with an equal local control rate,which worthy of clinical application.
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Objective To evaluate the clinical features of local advanced glottic laryngeal cancer patients with beyond five years survival and to provide help for the treatment of advanced glottic laryngeal cancer patients.Methods The data of 129 cases of patients with local advanced glottic laryngeal cancer treated in our hospital from January 1999 to August 2005 were analyzed retrospectively.They were divided into two groups based on their survival time.Forty six patients with beyond five years survival were included in the first group and the other eighty three patients were in the second group.The clinical features were compared and factors associated with survival were identified.Results Compared with the group with under five years survival,the lymph node metastatic rate before treatment was lower,patients treated concurrently with operation were more,and complete remission rate after treatment were higher in the group with beyond five years survival.The differences between two groups had statistical significant.Cox regression analysis identified only operation and complete remission rate were independent prognostic factors.Conclusion For local advanced glottic laryngeal cancer,rational comprehensive treatment and complete remission after treatment and complications prevention are important.But they need to be validated by the large-scale clinical trials.
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Objective To evaluate the efficacy of zoledronic acid combined with radiotherapy for bone meta-static cancer. Methods 71 cases with bone metastatic cancer were randomly divided into observation group (40 ca-ses) and control group (31 cases). The observation group was treated with zoledronic acid, 4 mg intravenously and local radiotherapy. The control group was treatd by radiotherapy alone. Results Pain relief was noted in 90% pa-tients in the observation group and 83.9% in the control group, respectively. The statistical difference was not signif-icant(P > 0.05). After the treatment had finished 3 months pain alleviation situation:Pain relief was noted in 87.5% patients in the observation group and 67.7% in the control group, respectively. The difference between the two groups was significant(χ2 =4.09, P =0.043). No serious radiotherapy and serious adverse drug reactions was found. Conclusion Zoledronic acid combined with radiotherapy was superior to radiotherapy alone for metastatic cancer bone pain relief, analgesic effect maintain a longer time.
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Objective To evaluate the therapeutic effects of whole course hyperfractionation radiotherapy for esophageal carcinoma. Methods Form January 2000 to December 2001,126 patients with esophageal carcinoma were treated by whole course hyperfractionation radiotherapy(120～140 cGy per fraction, 2 times per day, to a total dose of 6400～7400 cGy) in our department. Results The short-term effective rate was 99.21%. The 1, 2 and 5 year survival rate was 61.11%, 41.27%, 23.02% and the median survival time was 1.29 years. The 1, 2 and 5 year disease-free survival rates was 57.94%, 38.10%, 19.84% and the median disease-free survival time was 1.16 years. Conclusion It is promising of whole course hyperfractionation radiotherapy for esophageal carcinoma. But it must be validated by the large-scale clinical trials.
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Objective To approach the therapeutic effects and complication of combined induction chemo-therapy and hyperfraetionated radiotherapy for nasopharyngeal carcinoma.Methods Form January 2000 to November 2002,101 patients with nasopharyngeal carcinoma were treated by combined induction chemotherapy and hyperfrac-tionated radiotherapy.For hyperfraetionated radiotherapy,y-ray from 60 Co were performed and two daily fractions of 1.2Gy were given,with an interval of≥6 hours,5 days per week to a median dose of 7255cGy for nasopharynx and 7201cGy for neck.For induction chemotherapy,carboplatin and 5-fluorouraeil were transfused.Results The inci-denee rate of greater than or equal to the third grade acute mucositis was 24.8%.The complete remission rate after treatment was 83.2%.The 1,2 and 5 year survival rate was 90.1%,82.2%-and 57.4%.Conclusion With this treatment schedule,patient's tolerance and therapeutic effect is good.It provids a treatment means for nasopharyngeal carcinoma.But it must be validated by the large-scale clinical trials.