ABSTRACT
De novo malignancy after liver transplantation is an important factor that affecting the long-term survival of recipient. The main risk factors for de novo malignancy include immunosuppression and many factors of recipients, such as age, gender, race, primary disease, preoperative tumor history and precancerous lesion, carcinogenic virus infection, smoking and drinking, etc. Currently, there is no standardized monitoring scheme after liver transplantation, but planned monitoring is required for high-risk recipients, thus to achieve early diagnosis and improve the survival rate. This article summarized the incidence, prognosis and related risk factors of de novo malignancy after liver transplantation, which provided reference for improving long-term survival rate of recipients after liver transplantation.
ABSTRACT
Objective To evaluate the clinical efficacy and toxicity of paclitaxel liposome combined with cisplatin chemotherapy in NSCLC with brain metastasis. Methods Twenty-eight patients were newly diag-nosed NSCLC with brain metastasis(confirmed by pathology or cytology). The patients were treated with pacli-taxel liposome(135 mg/ m2 )on day 1 intravenous drip for 3 hours,cisplatin,25 mg/ m2 on day 1-3. The course of treatment was 21 days. The patients accepted the anti-allergy treatment before chemotherapy. Results Twenty-eight patients could be evaluated,and 101 treatment cycles were completed( 3. 6 cycles per patient). General lesion assessment presented that no patient got complete remission( CR),13 patients (46. 43% )got a partial response(PR),11(39. 28% )had a stable disease(SD)and 4(14. 29% )had a progressive disease( PD). The objective response rate( RR)was 46. 43% ,and the disease control rate (DCR) was 85. 71% . Local cerebral response assessment showed that no patient got CR,6 patients (21. 43% )got a PR,15(53. 58% )had a SD and 4(14. 29% )had a PD. The RR was 21. 43% ,and the DCR was 85. 71% . There was a significant difference in the RR(χ2 = 3. 90,P = 0. 03)but not in the DCR (χ2 = 0. 15,P = 0. 3)between the local cerebral disease and the general lesion. The median time to disease progression(TTP)for general lesion and local cerebral were 7. 2 months and 6. 2 months,respectively(χ2 =6. 43,P < 0. 05). The adverse reactions included bone marrow suppression,gastrointestinal reactions,elevated transaminases,alopecia,neurotoxicity,etc. All of these could be well controlled. Conclusion Paclitaxel liposome combined with cisplatin regimen demonstrates a higher efficacy and well tolerable against main metas-tasis of NSCLC,and the adverse effects are minor.