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ABSTRACT Objective: To investigate the accuracy of aortic dimensions measured by Revolution™ computed tomography (CT) in infants with complex coarctation of the aorta (CoA) and to further analyze the utility of the degree of CoA in predicting the risk of prolonged postoperative cardiac intensive care unit stay. Methods: A total of 30 infants with complex CoA who underwent surgical correction from January 2020 to July 2022 were retrospectively enrolled. General demographic data, preoperative imaging, and perioperative outcomes were collected. Univariate and multivariate analyses were performed to investigate predictors of prolonged postoperative cardiac intensive care unit stay, and the reliability of the CT measurements was assessed by the intraclass correlation coefficient. Results: All infants were divided into a mild or severe CoA group. The duration of mechanical ventilation and cardiac intensive care unit stay in the mild CoA group were significantly lower than those in the severe CoA group. After multivariate analysis, we found that the degree of CoA and age at surgery were significant predictors of prolonged postoperative cardiac intensive care unit stay. The intraclass correlation coefficient between CT measurements and intraoperative measurements was between 0.937 and 0.975, and the measurement results had good reliability. Conclusion: CT angiography can provide a comprehensive and accurate preoperative evaluation of aortic dimensions measured in infants with complex CoA. The degree of CoA is an independent risk factor for prolonged postoperative cardiac intensive care unit stay in infants with complex CoA.
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Objective: To evaluate the efficacy and survival outcomes of dose-dense (biweekly) carboplatin plus paclitaxel (PC) as neoadjuvant chemotherapy (NAC) in triple-negative breast cancer (TNBC), and to explore an optimal neoadjuvant chemotherapy regimen for TNBC. Methods: Patients diagnosed as TNBC(cT1-4N0-3M0) in Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Between January 2008 and September 2018 who received dose-dense PC and standard 3-weekly PC as NAC were 1∶1 matched using propensity score matching (PSM) to compare the efficacy, safety and survival outcomes. Results: One hundred of TNBC patients were enrolled (50 patients were divided in dose-dense group, 50 patients in standard group). The objective response rate (ORR) of dose-dense group and standard group were both 90.0% (45/50). The grade 3-4 neutropenia in dose-dense group was less than that of standard group (32.7% vs. 68.0%, P=0.001), while the rate of ALT/AST elevation in dose-dense group was higher than that of standard group (57.1% vs. 32.0%, P=0.012). The pathological complete response (pCR) rates were 34.0% (17/50) in dose-dense group and 38.0% (19/50) in standard group, without statistically significance (P=0.677). The median follow-up time was 55 months (3-150 months). The 5-year recurrence-free survival (RFS) in dose-dense group and standard group were 83.5% and 75.2%, respectively the 5-year overall survival (OS) in dose-dense and standard group were 87.9% and 84.5% the difference were not statistically significant (P=0.322 and 0.647, respectively). Patients with residual disease (tumor size≥1 cm or lymph node positive) had poor prognosis, the 5-year RFS and OS were 59.3% and 68.5%, respectively. Conclusions: Dose-dense PC has similar efficacy with standard 3-weekly PC and has a good safety profile. Since dose-dense regimen can shorten the duration of therapy, it can be an alternative in TNBC.
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Humans , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carboplatin/therapeutic use , Neoadjuvant Therapy/adverse effects , Paclitaxel/therapeutic use , Treatment Outcome , Triple Negative Breast Neoplasms/pathologyABSTRACT
Objective: To investigate the feasibility, efficacy and safety of transbrachial access for interventional therapy on prosthetic paravalvular leak (PVL) post surgical valve replacement. Methods: This is a retrospective study. Patients with PVL after surgical valve replacement who underwent interventional therapy via the brachial artery approach in Structural heart disease center of Fuwai hospital between August 2017 and October 2019, were included. All patients underwent puncture of the brachial artery under local anesthesia, angiography and transcatheter closure procedure were performed. The procedure was performed under transthoracic echocardiography (TTE) guidance. Baseline data, operation data and pre-and post-operative TTE examination results were collected and analyzed. Postoperative complications were recorded and operational adverse events were obtained during follow up in the outpatient department after discharge. The operation success rate was calculated, which was defined as the degree of perivalvular regurgitation decrease by 1 grade and above according to TTE without interfering the valve movement and coronary artery blood flow within 30 days after occluder placement. Results: A total of 10 patients were enrolled in this study, the mean age was (57.5±14.6) years, and 6 patients were males. There were 7 cases with aortic PVL, and 3 cases with mitral PVL. Except for one patient who was converted to the femoral vein-transseptal approach, the other 9 patients were successfully implanted with the devices via the brachial artery approach. The operation time was (103.3±34.0) minutes, and there was no need for rigorous bed rest after the operation. The median hospital stay was 7.5 (3.0, 9.8) days. The operation success rate was 9/10 via the brachial artery approach. The differences in the degree of perivalvular regurgitation, New York Heart Association (NYHA) classification, left ventricular end diastolic diameter and left atrial diameter before and after operation were statistically significant (all P<0.05). One case developed new hemolysis with renal insufficiency on the second day after procedure and discharged after successful dialysis. Another case experienced complication of brachial artery pseudoaneurysm after procedure and discharged after successful treatment with thrombin injection. The mean follow-up time was (14.3±7.9) months. During the follow-up, NYHA classification remained as Ⅰ/Ⅱ in 9 patients, no operational adverse events were observed. Conclusions: Transbrachial access for interventional therapy on PVL post surgical valve replacement is a feasible, effective, and safe procedure. It has the advantages of simplifying the operation process and reducing postoperative bed rest time.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Aortic Valve/surgery , Cardiac Catheterization , Feasibility Studies , Heart Valve Prosthesis , Heart Valve Prosthesis Implantation/adverse effects , Retrospective Studies , Surgical Instruments , Treatment OutcomeABSTRACT
Objective:To preliminarily interpret the compatibility of Ginseng Radix et Rhizoma Rubra and Rhodiolae Crenulate Radix et Rhizoma in chemical and pharmacodynamic levels，and provide theoretical basis for its clinical application.Method:Rapid resolution liquid chromatography coupled with quadrupole-time-of-flight tandem mass spectrometry（RRLC-Q-TOF-MS） was applied to identify and analyze the changes in chemical components of the Ginseng Radix et Rhizoma Rubra and Rhodiolae Crenulate Radix et Rhizoma before and after compatibility. The anti-fatigue activity before and after compatibility of Ginseng Radix et Rhizoma Rubra and Rhodiolae Crenulate Radix et Rhizoma was detected by weight-loading swimming experiment and determination of levels of serum urea，blood lactic acid and hepatic glycogen.Result:A total of 51 compounds were identified in mixture decoction of Ginseng Radix et Rhizoma Rubra and Rhodiolae Crenulate Radix et Rhizoma. Malonyl ginsenoside mRg1，mRb1，mRb2，mRb3 and mRd contents were significantly decreased，while ginsenoside Rb1，Rb2，Rb3，Rd，F2 and Rg3 contents were significantly increased in the compatibility mixture. According to pharmacodynamics study，as compared with those in the blank control group，swimming time of mice was significantly prolonged in all other groups （P<0.01），serum urea nitrogen（P<0.05，P<0.01） and lactic acid（P<0.05，P<0.001） levels of mice in the combined decoction and the single decoction groups were significantly lowered，while liver glycogen levels were significantly elevated（P<0.05，P<0.01）. The anti-fatigue ability of the combined decoction of Ginseng Radix et Rhizoma Rubra and Rhodiolae Crenulate Radix et Rhizoma was higher than that of the single decoctions.Conclusion:In this article, the effect enhancing mechanism of compatibility of Ginseng Radix et Rhizoma Rubra with Rhodiolae Crenulate Radix et Rhizoma was revealed based on the chemical changes, providing theoretical reference for the clinical application and development of products.
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Objective::To analyze and identify the metabolites of major components of Shaoyao Gancaotang in urine and feces of normal and polycystic ovary syndrome (PCOS) rats, and to explore the effect of PCOS on the metabolism of Shaoyao Gancaotang. Method::Female SD rats were randomly divided into normal group and PCOS group. PCOS rat model was prepared by administration of letrozole solution for 21 days, and the estrous cycle of rats was observed. UHPLC-QTRAP-MS/MS technique and LightSight 2.3 software were used to analyze and identify the metabolites of major components of Shaoyao Gancaotang in urine and feces of normal and PCOS rats. The mobile phase was water-methanol for gradient elution, the flow rate was 0.3 mL·min-1, electrospray ion source was employed under negative ion mode. Result::Phase Ⅰ and phase Ⅱ reactions mainly occurred in drug metabolism. A total of 27 metabolites were detected in urine of normal rats, and 34 metabolites were detected in urine of PCOS rats. A total of 29 metabolites were detected in feces of normal rats, and 27 metabolites were detected in feces of PCOS rats. Conclusion::The metabolites in the urine of PCOS rats are more diverse than those of normal rats, and the disease status of PCOS may affect the in vivo metabolic pathway of active ingredients in Shaoyao Gancaotang.
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Objective To evaluate the safety of Propofol combined with Fentanyl in intravenous anesthesia for endoscopic retrograde cholangiopancreatography(ERCP)in elderly patients.Methods The clinical data of 63 elderly patients aged ≥80 years with common bile duct stones who underwent ERCP in digestive endoscopy center of our hospital were retrospectively analyzed.All the patients were divided into Propofol combined with Fentanyl anesthesia group(group A,n =41)and midazolam combined with Fentanyl anesthesia group(group B,n=22).The changes of blood pressure,heart rate and blood oxygen saturation(SpO2),and postoperative complications were compared between the two groups.Results The incidence of hypotension was higher in Propofol combined with Fentanyl anesthesia group than in midazolam combined with Fentanyl anesthesia group(24.4 ％ vs.0.0％,x2=4.683,P =0.030),but the incidence of SpO2 ＜ 90 ％ in midazolam combined with fentanyl anesthesia group was significantly increased(22.7％ vs.0.0％,x2 =7.250,P =0.007).There was no statistically significant difference in the incidence of anesthesia-related complications (39.0％ vs.36.4％,x2 =0.043,P =0.836) and postoperative complications (4.9 ％ vs.4.5 ％,x2 =0.003,P =0.953) between the two groups.Conclusions For elderly patients with common bile duct stones,intravenous anesthesia with Propofol and Fentanyl during ERCP is safe,and blood pressure changes need to be closely monitored.
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Objective To analyze the difference of teaching modes of course of digital signal processing for the undergraduates and postgraduates.Methods The teaching modes were compared from the aspects of educational objective,teaching content, teaching method,examination mode and etc.Results Differentiated teaching modes contributed to the satisfactory education of the undergraduates and postgraduates. Conclusion The differentiated teaching modes for the undergraduates and postgraduates provide references for the high-level education in universities and colleges of science and technology. [Chinese Medical Equipment Journal,2018,39(5):87-89,102]
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Objective To propose a method for accurately controlling the resistivity of 3D printing materials to facilitate to establish a human-head volume conductor model.Methods Two kinds of ABS/CB composite conductive printing materials covering the resistivity ranges of parenchymal and skull were selected through resistivity measurement and analysis. The correlation between the proportions and resistivities of the two kinds of ABS/CB materials and the empirical formula on the correlation between the resistivity and proportion was obtained through exponential function fitting. Results The selected ABS/CB composite material behaved well in frequency stability and time stability,and the obtained empirical formula had high-correlation coefficient.Conclusion Accurate control of 3D printing model resistivity is realized,and it's facilitated to gain 3D printing material with the same resistivity as those of skull and parenchymal.
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Objective To establish a human-head phantom with realistic skull anatomy and resistivity distribution in order to provide an accurate experimental platform for brain electrical impedance tomography(EIT).Methods Firstly a skull model with 3-layer structure was constructed with double-nozzle 3D printer,and every layer had its specific resistivity verified on the accuracy. Then brain parenchyma with its resistivity was modelled using 3D printer and cerebrospinal fluid and scalp were mimicked using NaCl solution;after the whole phantom was assembled,imaging test using EIT was performed.Results The skull model was similar to the realistic one in terms of anatomy and resistivity distribution;the EIT experiment on the new phantom showed similar results to simulation.Conclusion The proposed phantom has realistic skull anatomy,resistivity distribution and multi-layer anatomical structure, which reflects the features of skull resistivity and thus is suitable for experiments on brain EIT.
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Objective To evaluate the effect of damped least-square algorithm on the identification of focal bidirectional electrical impedance perturbation in the intracranial area, and to analyze the influence of this kind of perturbation on the reconstruction quality of electrical impedance tomography. Methods Focal bidirectional electrical impedance perturbation was built based on the three-dimensional model and damped least-square algorithm was introduced into imaging. The position error and resolution were used to evaluate the imaging performance.Results When the focal electrical impedance perturbation existed,the target whose conductivity varied greatly or volume was large was more likely to be identified in the images while the target with smaller volume or variable conductivity presented in the reconstruction image was not obvious. It's pointed out that it may cause reconstruction images in some cases could not truly reflect the location and change information of the object of primary cerebral hemorrhage.At the same time,it affected the reconstruction precision,causing the position error and resolution with large fluctuation. Conclusion In reconstruction algorithm linearity correct matrix introduced for bidirectional electrical impedance perturbation contributes to enhancing the recognition of bidirectional perturbation, so that the characterization of the electrical impedance imaging can be augmented for clinical intracerebral hemorrhage.
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Objective To observe the effects of percutaneous endoscopic gastrostomy (PEG)on mortality and complications in patients with persistent dysphagia after stroke using a points scoring system for selecting PEG indication.Methods A total of 75 patients were divided into low score group without PEG,high score group without PEG and low score group with PEG (n=25 each).The follow-up period was 18 months,and the differences in complications,mortalities and survival periods among groups were compared.Results The number of times of aspiration pneumonia was (1.36± 1.44) in low score group,(1.96±2.28) in high score group,(0.36±0.64) in low score group with PEG,with statistically significant differences among three groups (H=7.148,P=0.028).No difference in the morbidity of aspiration pneumonia was found between low score group and high score group (P=0.189).The number of times of aspiration pneumonia was decreased in low score groups after PEG versus in low score group without PEG (P=0.030) and in high score group (P＜0.01).The numberof times of gastrointestinal hemorrhage was (0.48± 0.77)in low score group,(0.64± 0.91) in high score group,(0.12±0.33) in low score group with PEG,with statistically significant differences among three groups (H=5.532,P =0.063).No statistically significant difference in gastrointestinal hemorrhage was found between low score groups and low score group after PEG (P=0.430),as well as between low score group and low score group with PEG (P=0.079).The morbidity of gastrointestinal hemorrhage was lower in low score group than in high score group (P=0.012).The survival rate at the observation end was 88.0％ (22/25),52.0％ (13/25) and 92.0％ (23/25) in low score group,high score group and low score group with PEG,respectively,with statistically significant difference among the three groups (x2 =7.906,P =0.001).Kaplan-Meier survival curve showed that the survival period were longer in the low score group with or without PEG than in high score group (P＜0.01),but no statistically significant difference was found between low score groups with or without PEG (P=0.626).Conclusions The reasonable evaluation using a points-scoring system before PEG might predict the prognosis of such patients:the higher score would indicate higher mortality.PEG operation for low score group with better condition could decrease the aspiration pneumonia and decrease gastrointestinal hemorrhage significantly,but could not prolong general survival time and decrease general mortality.
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Various chromatographic techniques, including silica gel column chromatography, Sephadex LH-20, preparative thin-layer chromatography, and preparative HPLC, were employed to isolate the chemical constituents from callus cultures of Dysosma versipellis. Structures of the compounds were elucidated based on UV, IR, MS and NMR spectroscopic data analysis. Totally, seven flavonoid glycosides were isolated from the 95% ethanol extract of the callus cultures and identified as kaempferol-3-O-[6″-(3″'-methoxy)-malonyl]-β-D-glucopyranoside(1), kaempferol-3-O-(6″-O-acetyl)-β-D-glucopyranoside(2), kaempferide-3-O-β-D-glucopyranoside(3), kaempferol-3-O-β-D-glucopyranoside(4), isoquercitrin(5), quercetin-4'-O-β-D-glucopyranoside(6) and kaempferol-3-(6″-malonyl)-β-D-glucopyranoside(7), respectively.All these compounds were isolated from callus cultures of D. versipellis for the first time.Compounds 1, 2, 3, 6 and 7 were firstly obtained from plant materials of D. versipellis, and compound 1 was a new compound.
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<p><b>OBJECTIVE</b>To analyze the composition and control status of chronic diseases among rural residents in a Beijing suburb district.</p><p><b>METHODS</b>Rural residents aged 35 years or older were investigated by stratified random sampling in Pinggu District, Beijing. Each participant received questionnaire-based survey,physical examination,and laboratory tests including routine blood test,urine albumin creatinine ratio (ACR), liver and renal function,serum lipid, fasting blood glucose, and glycosylated hemoglobin.</p><p><b>RESULTS</b>A total of 10 385 residents completed all items. Cerebrovascular disease was leading cause of hospitalization (accounting for 14.4%) and its incidence in the population was 9.6%. The incidences of hypertension,hyperlipidemia,diabetes mellitus,and gout/hyperuricemia,which were the main compositions related with metabolic diseases,were up to 64.4%,42.5%,24.4%, and 9.0%, respectively. The disease onset was significantly related with the age. The incidence of hypertension was gradually elevated with the increasing of age,while the peak age was 55-64 years for diabetes and 35-44 years for gout/hyperuricemia. The awareness rate of hypertension,diabetes,and chronic kidney disease was 60.2%, 55.1%,and 6.0%,respectively. The control rate of chronic disease was 19.2% and 28.8% in hypertensive and diabetic patients, respectively.</p><p><b>CONCLUSIONS</b>Cerebrovascular diseases and metabolic-associated diseases are the main chronic diseases affecting rural residents in Pinggu district, Beijing. The awareness rate and control rate of chronic diseases needs to be further enhanced by strengthening health education and improving the community medical service.</p>
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Adult , Humans , Middle Aged , Beijing , Chronic Disease , Diabetes Mellitus , Hypertension , Hyperuricemia , Prevalence , Rural Population , Surveys and QuestionnairesABSTRACT
Objective To study the efficacy and safety of polyethylene glycol electrolytes powder (Ⅱ)on bowel preparation in elderly people.Methods A total of 120 elderly patients were divided into two groups,polyethylene glycol electrolytes powder(Ⅱ)group (the experimental group,n =60)and oral colonic salt group (the control group,n =60).The bowel preparation scores,gastrointestinal compliance,patient compliance,and safety of patients were evaluated.Results Bowel preparation scores of the experimental group (7.42 ±1.05)was much better than that of the control group(5.87 ±1.05)(t =8.10,P =0.00). The efficiency rate of bowel preparation of the experimental group was significantly higher than that of the control group(95% VS 65%,χ2 =16.88,P =0.00).Compliance of bowel preparation of the experimental group was much better than that of the control group (χ2 =7.67,P =0.01).There was no significant differ-ence in gastrointestinal compliance between the two groups(χ2 =3.08,P =0.08).No serious adverse events occurred.Conclusion The effect of bowel preparation of elderly patients with polyethylene glycol electro-lytes powder(Ⅱ)is significantly advantageous in drug intestinal tolerance,taste,and safety,which can re-place the traditional method for bowel preparation.
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Seven meroterpenoids and five small-molecular precursors were isolated from Penicillium sp., an endophytic fungus from Dysosma versipellis. The structures of new compounds, 11beta-acetoxyisoaustinone (1) and isoberkedienolactone (2) were elucidated based on analysis of the spectral data, and the absolute configuration of 2 was established by TDDFT ECD calculation with satisfactory match to its experimental ECD data. Meroterpenoids originated tetraketide and pentaketide precursors, resepectively, were found to be simultaneously produced in specific fungus of Penicillium species. These compounds showed weak cytotoxicity in vitro against HCT-116, HepG2, BGC-823, NCI-H1650, and A2780 cell lines with IC 50 > 10 micromol x L(-1).
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Humans , Berberidaceae , Microbiology , Cell Line , Cell Line, Tumor , Lactones , Pharmacology , Monoterpenes , Pharmacology , Penicillium , ChemistryABSTRACT
OBJECTIVE: To study the lignans constituents from callus culture of Dysosma versipellis (Hance) M. cheng ex Ying.
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<p><b>OBJECTIVE</b>To evaluate the clinical characteristics and prognosis of adrenal metastasis from breast cancer, and to explore methods to improve prognosis.</p><p><b>METHODS</b>Thirty-four breast cancer patients with adrenal metastasis were diagnosed and treated in our hospital from Jan. 1999 to Dec. 2010. SPSS 17.0 was used for survival analysis.</p><p><b>RESULTS</b>During the Jan. 1999 to Dec. 2010 period, 13 595 patients with breast cancer were treated in our hospital. Among them, 34 cases had adrenal metastasis from breast cancer, with an incidence of 0.25%. The median time to progression (TTP) and overall survival of the 34 patients was 6.2 months (95%CI 3.1-9.3 months) and 21.4 months (95%CI 0-44.0 months), respectively. Eleven patients (34.4%) achieved partial response among 32 patients who received chemotherapy, and 10 (31.2%) achieved stable disease. Patients who achieved best response of PR or SD were superior in TTP and OS than patients with disease progression after chemotherapy (TTP: 18.1 months vs. 2.3 months, P < 0.001; OS: 35.2 months vs. 10.3 months, P = 0.003). Patients who received 1st or 2nd line chemotherapy were superior in TTP than patients who received over 2nd line chemotherapy (TTP: 15.7 months vs. 4.2 months, P = 0.005).</p><p><b>CONCLUSIONS</b>The incidence of adrenal metastasis from breast cancer is low. Chemotherapy-based systemic therapy should be recommended to improve the prognosis for these patients.</p>
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Adult , Aged , Female , Humans , Middle Aged , Adrenal Gland Neoplasms , Drug Therapy , General Surgery , Adrenalectomy , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Breast Neoplasms , Drug Therapy , Pathology , Carcinoma, Ductal, Breast , Drug Therapy , Pathology , General Surgery , Disease Progression , Remission Induction , Retrospective Studies , Survival RateABSTRACT
Anthracycline-Taxane chemotherapy is widely used in neoadjuvant treatment for breast cancers. However, there is limited data reported in patients with triple negative breast cancer (TNBC). Here, we evaluated the pathologic responses and survival of neoadjuvant epirubicin and taxanes chemotherapy in patients with locally advanced TNBC to provide some useful information for clinical practice. A total of 43 patients with locally advanced TNBC were enrolled in this study. Patients were administered with epirubicin 75 mg/m(2) plus paclitaxel 175 mg/m(2) or docetaxel 75 mg/m(2) every 3 weeks for at least 2 cycles. The primary endpoint was pathologic complete response (pCR), which was defined as no residual invasive cancer, or only carcinoma in situ in both the excised breast and axillary lymph node, while relapse-free survival (RFS) and overall survival (OS) were secondary endpoints. Thirty-nine (90.7%) patients were at clinical stages IIB-IIIC. Thirty-seven (86%) completed 4-6 cycles of preoperative chemotherapy, and objective response rate (ORR) was 81.4% (35/43). Forty-two patients underwent radical surgery subsequently. The pCR rate was 14.3% (6/42). The most common adverse events in neoadjuvant chemotherapy were nausea/vomiting (88.4%, 38/43) and neutropenia (88.4%). After a median follow-up period of 34.0 months, 3-year RFS and OS rate was 53.6% and 80.1%, respectively. All events of recurrence and death occurred in non-pCR patients, in whom the 3-year RFS and OS rates were 44.3% and 76.6%, respectively. This study suggest that neoadjuvant chemotherapy with epirubicin plus taxanes has a relatively low pCR rate and high early recurrence risk in locally advanced TNBC, which indicates the necessity for more efficacious treatment. Further study is needed to validate these results.
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Anthracycline-Taxane chemotherapy is widely used in neoadjuvant treatment for breast cancers. However, there is limited data reported in patients with triple negative breast cancer (TNBC). Here, we evaluated the pathologic responses and survival of neoadjuvant epirubicin and taxanes chemotherapy in patients with locally advanced TNBC to provide some useful information for clinical practice. A total of 43 patients with locally advanced TNBC were enrolled in this study. Patients were administered with epirubicin 75 mg/m(2) plus paclitaxel 175 mg/m(2) or docetaxel 75 mg/m(2) every 3 weeks for at least 2 cycles. The primary endpoint was pathologic complete response (pCR), which was defined as no residual invasive cancer, or only carcinoma in situ in both the excised breast and axillary lymph node, while relapse-free survival (RFS) and overall survival (OS) were secondary endpoints. Thirty-nine (90.7%) patients were at clinical stages IIB-IIIC. Thirty-seven (86%) completed 4-6 cycles of preoperative chemotherapy, and objective response rate (ORR) was 81.4% (35/43). Forty-two patients underwent radical surgery subsequently. The pCR rate was 14.3% (6/42). The most common adverse events in neoadjuvant chemotherapy were nausea/vomiting (88.4%, 38/43) and neutropenia (88.4%). After a median follow-up period of 34.0 months, 3-year RFS and OS rate was 53.6% and 80.1%, respectively. All events of recurrence and death occurred in non-pCR patients, in whom the 3-year RFS and OS rates were 44.3% and 76.6%, respectively. This study suggest that neoadjuvant chemotherapy with epirubicin plus taxanes has a relatively low pCR rate and high early recurrence risk in locally advanced TNBC, which indicates the necessity for more efficacious treatment. Further study is needed to validate these results.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Antineoplastic Combined Chemotherapy Protocols , Chemoradiotherapy, Adjuvant , Methods , Disease-Free Survival , Epirubicin , Neoadjuvant Therapy , Methods , Neoplasm Recurrence, Local , Pathology , Neoplasm, Residual , Pathology , Paclitaxel , Taxoids , Treatment Failure , Treatment Outcome , Triple Negative Breast Neoplasms , Drug Therapy , PathologyABSTRACT
<p><b>OBJECTIVE</b>Endobronchial metastases (EBM) secondary to extrapulmonary solid malignant tumors are rare but may occur. The most common extrathoracic malignancies associated with EBM are colorectal, renal and breast cancer. This study aimed to evaluate the clinicopathological aspects of EBM from breast cancer and the prognosis of the patients.</p><p><b>METHODS</b>Clinicopathological data of 11 cases diagnosed as EBM from breast cancer treated in our hospital from 2003 to 2010 were re-evaluated. Their symptoms, recurrence interval, radiological features, histopathological properties, and prognosis were assessed.</p><p><b>RESULTS</b>Eleven cases were diagnosed by bronchoscopic bronchial biopsy. The median interval from diagnosis of breast cancer was 57 months (range: 11 - 189 mo). All patients had other proven metastases when the EBM was diagnosed. The most frequently observed symptoms were cough (8 cases). Interestingly, two patients were asymptomatic. Hilar mass (5 cases) was a common radiological finding. No disaccordance between the hormone receptor status in the primary and metastatic lesions in these patients was found. The median survival after EBM diagnosis was 21 months (range: 6 - 36) with four patients still alive and one of these four patients was surviving more than 7 years.</p><p><b>CONCLUSIONS</b>On average, EBM is diagnosed about 5 years after the diagnosis of breast cancer, which is a relatively long lead time, but the median survival time is short, as 21 months in our group. The treatment plan must be individualized, because in some cases, long-term survival can be expected.</p>