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Objective:To collect the clinical materials of primary liver cancer patients treated by gamma knife and analyze the treatment methods as well as short-term efficacy,and to provide a reference for the clinical treatment of primary liver cancer patients.Methods:A total of 633 patients with inoperable primary liver cancer were treated by body gamma knife.According to the TNM staging method of Union for International Cancer Control(UICC), there were 351 cases with clear TNM staging.Among them, there were 251 cases (71.5%) at T3 stage and 57 cases(16.2%) at T4 stage.The prescription dose of 200-600 cGy each time to the 40%-85% dose line covering the planned target volume(PTV), this program was performed 5 times per week, and the number of treatment ranged from 2 to 13.The biochemical and imaging changes were observed 2-3 months after treatment to evaluate the short-term efficacy.Results:During the treatment, 229(36.2%)patients had adverse reactions,100 (15.8%) patients appeared the reduced white blood cells, and 137 (21.6%) patients appeared the reduced platelets.On discharge from the hospital, 601 patients were improved, 22 patients had no obvious change, 5 cases were worse, and 5 cases died.The proportion of improved patients who received the cumulative dose between 3 000 cGy to 4 000 cGy was higher than those who received the cumulative dose less than 3 000 cGy(P0.05).Conclusion:The proportion of adverse reactions in the primary liver cancer patients treated with body gamma knife is relatively low and the short-term efficacy is ideal.Body gamma knife treatment is a safe and effective treatment method for the primary liver cancer patients.
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Objective To evaluate the clinical efficacy and safety of stereotactic radiotherapy (SRT) combined with bevacizumab for brain metastases in patients with lung adenocarcinoma.MethodsThe clinical data of 95 patients with brain metastases of lung adenocarcinoma were retrospectively analyzed, including 36 patients treated with SRT and bevacizumab (bevacizumab group) and 59 patients treated with SRT, corticosteroids, and mannitol (traditional drug group).The tumor response rate, peritumoral edema control rate, improvement in Karnofsky Performance Scale (KPS) score, and adverse reactions were analyzed.Results Compared with the traditional drug group, the bevacizumab group had significantly higher tumor response rate (P=0.033) and peritumoral edema control rate (P=0.000) at 1-4 weeks after treatment, as well as an obvious improvement in KPS score and reduced doses of corticosteroids and mannitol.In addition, the adverse reactions in the bevacizumab group were mild and controllable.Conclusions SRT combined with bevacizumab for brain metastases in patients with lung adenocarcinoma can achieve higher short-term tumor response rate and peritumoral edema control rate and improve patients' quality of life.
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<p><b>OBJECTIVE</b>To investigate the changes of blood glucose in pancreatic cancer patients associated with diabetes mellitus (DM) after radiotherapy and analyze the related factors.</p><p><b>METHODS</b>Clinical data of 69 cases of stage I to III pancreatic carcinoma associated with DM were retrospectively analyzed. All patients were divided into four groups according to the history of DM, and the clinical characteristics and blood glucose changes after stereotactic radiotherapy were analyzed. The correlation between blood glucose and serum tumor markers was analyzed.</p><p><b>RESULTS</b>No significant differences were found in clinical characteristics of the four groups. The history of DM <12 months accounted for 39.1% of the pancreatic cancer patients, much more higher than that of patients with a longer disease course. After radiotherapy, the blood glucose changes were not significantly different between the two groups with DM history <12 months and 12-24 months (P = 0.519), but there were significant differences between the patients with DM history <12 months and those with DM history 25-36 months and >36 months (P < 0.05 for both). After radiotherapy, CA199/CEA was reduced and blood glucose was also improved in the patients with DM history <12 months and 12-24 months, and the reduction of CA199/CEA showed a significant positive correlation with the improvement of blood glucose (r = 0.834 and r = 0.660, P < 0.01 for both), however, no significant correlation was found between the two parameters in patients with DM history 25-36 months and >36 months (r = 0.319 and r = 0.439, P > 0.05 for both).</p><p><b>CONCLUSIONS</b>Hyperglycemia in diabetic patients with a disease course <24 months might be a clinical manifestation secondarily developed in pancreatic cancer patients. Therefore, patients with new onset diabetes should be closely followed-up for early detection of pancreatic cancer.</p>
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Aged , Humans , Male , Middle Aged , Biomarkers, Tumor , Blood , Blood Glucose , Diabetes Mellitus , Blood , Pancreatic Neoplasms , Blood , Retrospective Studies , Time FactorsABSTRACT
Objective To evaluate the preliminary clinical efficacy of bevacizumab for cerebral radiation necrosis (CRN). Methods Nineteen patients with CRN for whom the treatment with steroids and mannitol failed were retrospectively analyzed with a total of 22 lesions. Except for 5 lesions confirmed by pathological evidence, all lesions were confirmed by the following imaging evidence:1. computed tomography (CT)?or magnetic resonance imaging (MRI)?enhanced lesions showed loss of tension and were accompanied by substantial edema;2. CT?or MRI?enhanced lesions had a low perfusion pressure;3. magnetic resonance spectroscopy indicated that the enhanced areas had a decreased choline peak; 4. positron emission tomography showed that the fluorodeoxyglucose uptake was substantially reduced in the enhanced areas. All patients were given 5 mg/ kg bevacizumab at an interval of 14 days for 2?6 cycles. MRI examination was performed in each cycle before treatment, and the enhanced lesions on T1?weighted images ( T1 WI) and edema on T2?weighted images (T2 WI) were compared before and after treatment. The clinical symptoms, Karnofsky Performance Status ( KPS), and adverse reactions in all patients were evaluated. Comparison before and after treatment was performed by paired t test. Results All 19 patients completed the treatment successfully and there were no severe adverse reactions. The clinical symptoms of patients were substantially improved after the second cycle of treatment, and the KPS score increased by 26?? 8 on average. The visible volume of enhanced lesions on MRI T1 WI was significantly reduced by 54?? 8% after treatment (P= 0?? 000), while the visible volume of edema on MRI T2 WI was reduced by 80?? 7% after treatment (P= 0?? 000). The follow?up time ranged from 3 to 12 months with a mean value of 5?? 6 months. Eleven patients kept clinical improvement in CRN, four patients had recurrence, and four patients died from tumor progression. Conclusions Bevacizumab is preliminarily confirmed to substantially improve the clinical symptoms and quality of life in patients with CRN.
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PET and PET/CT are the methods of displaying the functional and metabolic changes in tissues. With its high sensitivity and specificity, it can be used as a noninvasive systemic functional examination. There are significant values in its diagnosing, staging, treatment directing and prognosis assessing in the malignant lymphoma.
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OBJECTIVE@#To explore the significance of 8F-FDG PET-CT in the diagnosis of the recurrence and metastasis of head-and-neck tumor after definitive treatment.@*METHOD@#Forty-two patients having received definitive treatment for head-and-neck tumor of whom the tumor could not be identified clinically underwent 18F-FDG PET-CT examination. Follow-up data could be obtained for all foci identified on PET-CT images. PET-CT and CT accuracy was compared on the basis of follow-up and histopathologic findings.@*RESULT@#A total of 103 foci were noted on PET-CT images. Identified by follow-up data, the sensitivity, specificity and accuracy were 92.55%, 42.11% and 84.07% respectively for CT examination, and 100.00%, 52.63%, and 92.04% for PET-CT respectively. The sensitivity and accuracy of PET-CT were significantly higher than those of CT (P 0.05).@*CONCLUSION@#The major benefits of FDG PET were that it differentiates scar and relapse, as well as detects LN and distant metastasis. Detailed clinical information and inclusion of results of morphological diagnostics are prerequisites for PET-CT final image interpretation, while scans should not be performed less than 6 weeks after definitive treatment.
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Adult , Aged , Female , Humans , Male , Middle Aged , Carcinoma, Squamous Cell , Diagnostic Imaging , Pathology , Head and Neck Neoplasms , Diagnostic Imaging , Lymphatic Metastasis , Neoplasm Recurrence, Local , Positron-Emission Tomography , MethodsABSTRACT
Objective To discuss the CT features of primary retroperitoneal tumor(PRT) ,so that to improve the knowledge of these diseases.Methods 24 cases with PRT confirmed by surgery and pathology were assessed retrospectively,and their CT manifestations were analyzed in comparison with pathology. Results All cases included:8 cases of liposarcoma with predominant fat components, 2 cases of fibrosarcoma with evident involvement of adjacent tissues,2 cases of leiomyosarcoma with multiple centers fused, 4 cases of schwannoma localized at paraspine and cystic generation commonly,1 case of ganglioma with hypodense parenchyma,1 case of neuroblastoma with large calcification, 1 case of paraganglioma and 2 cases of chemodectoma and enhanced obviously,1 case of pheochromocytoma enhanced evidently with cystic generation ,1 case of neuroendocrinoma without specific characteristic and 1 case of teratoma with 3 layers of embryo tissues. Conclusion CT acan is able to localize the primary retroperitoneal tumors accurately,but specific CT features only see in some cases.