ABSTRACT
Numerous studies revealed that radiation can promote the immunogenic cell death, enhance the immune response of tu-mor-antigen-specific T cells, and induce systematic antitumor immunity, which may result in abscopal effect. Abscopal effect refers to the regression of non-irradiated metastatic lesions distant from the primary tumor site that is directly subjected to irradiation. Despite that abscopal effect has been clinically reported and that many preclinical studies have confirmed its biological basis, abscopal effect remains a subclinical phenomenon, in which objective efficacy is difficult to obtain. Currently, the anti-PD-1/PD-L1 therapy in clinical applications shows a clear and definite curative effect, thereby making local radiotherapy combined with immunotherapy a new treat-ment pattern. However, the clinical practice of this new mode should be based on appropriate dose and fraction and the most suitable temporal combination to achieve the synergic antitumor immune response.
ABSTRACT
Objective To investigate the clinical characteristics of polymyositis/dermatomyositis (PM/DM) complicated with venous thromboembolism (VTE).Methods Medical records of patients with PM/DM at Peking Union Medical College Hospital from Jan 2000 to Oct 2014 were reviewed to identify VTE.The comparisons of various categorical clinical manifestations between groups were evaluated using t-test and x2 test.Results Twenty-three PM/DM patients developed VTE,which accounted for 1.86％ of the 1 235 PM/DM patients hospitalized during the same period.Among these 23 patients (18 female and 5 male),5 patients had PM and 18 patients had DM.With respect to the occurrence of VTE,no significant difference was found between DM and PM or between male and female.Their age was (57±7) years (range:47-71 years old),significantly older than patients without thrombosis [(47±13) years,t=-3.191,P=0.001].Twenty-one patients (75％,21/28) developed VTE in the first year after the diagnosis of PM/DM.The incidence rate ratios (IRR) for DVT in PM/DM were 1.46％ (18/1 235) and for PTE was 0.73％ (9/1 235),in which 4 cases complicated with lower extremity DVT.Most patients exhibited active disease and high levels of D-Dimer during the emergence of VTE.Conclusion Patients with PM/DM have an increased risk of VTE,especially in older patients and at the early stage after the diagnosis of PM/DM,indicating that more attention should be paid to these patients in the clinic.