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Objective To investigate the recurrence and metastasis patterns of gastric cancer after curative resection and to guide target definition of prophylactic radiotherapy.Methods In the past 8 years,130 gastric cancer patients with treatment failure after radical resection were retrospectively analyzed.The failure sites were confirmed by B ultrasonography, CT or MRI imaging.Ten of 28 patients with ascites were found to have adenocarcinoma cells in the ascites.All superficial node and abdominal wall metastases were diagnosed pathologically by biopsy.And 27 patients with gastric remnant and/or anastomotic recurrence were diagnosed pathologically by biopsy.Results Of 130 patients, 53 were presented with multiple recurrences or metastases, 27 with gastric remnant and/or anastomostic recurrence, 28 with peritoneal metastases, 22 with liver metastases, 9 with pancreatic metastases, 60 with abdominal lymph node (LN) metastases, 8 with abdominal wall metastases, 5 with pelvic implantations, 6 with lung metastases, 5 with brain metastases, 5 with bone metastases, 8 with cervical lymph node metastases, 9 with mediastinal lymph node metastases and 8 with other metastases.Of 60 patients with abdominal LN metastases, 35, 16 and 9 had peri-gastric LNs,peri-pancreatic LNs and para-aortic LNs metastases.Abdominal LN metastases were found in 33 from 77 patients with primary gastric fundus or cardiac carcinoma, 20 from 40 patients with gastric body carcinoma,and 7 from 13 patients with pyloric carcinoma, respectively.Conclusions The failure sites of gastric cancer after radical resection are mainly the gastric stump/stoma, peritoneum, liver and abdominal LN.The perigastric, peri-pancreatic and/or para-aortic LN metastases are the most common failure of LNs.Thus, the peri-gastric, peri-pancreatic and para-aortic LN regions and gastric stump/stoma should be included in postoperative radiotherapy, and current chemotherapy is recommended.
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Objective To investigate whether the single nucleotide polymorphisms (SNP) in DNA repair gene XRCC1(X-ray repair cross-complementing 1) were associated with the survival of cisplatin based combination concurrent chemoradiotherapy in esophagus cancer. Methods Overall 286 esophagus cancer patients receiving cisplatinum based chemotherapy were investigated. 5' nuclease allelic discrimination assay (TaqMan) and real-time PCR were taken to assess XRCC1 genotypes. Efficacies and adverse-effects were analyzed individually according to their genotype. Results Short-time effects showed the RR rate in patients with Arg/Arg and Arg/GIn genotypes(A group) was 93.56 %, significantly higher than 69.81% (P<0.05) in patients with GIn/GIn genotype (B group). The 1-year and 3-year survival rates were 82.8 %, 41.2 % in A group, significantly (P<0.05) different from 58.5 %, 26.4 % in B group, respectively. No statistically differences were found on adverse effects. Conclusion Significant relationships are found between single nucleotide polymorphisms in XRCC1 and outcome in esophagus cancer receiving cisplatin based concurrent chemoradiotherapy.
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Objective To investigate the treatment effects of chrono-chemotherapy (CC) with radiotherapy on advanced esophageal carcinoma. Methods Eighty patients with advanced esophageal carcinoma were randomly divided into two groups: a radiotherapy group (R) and a chrono-chemotherapy plus radiotherapy group (CC+R). 40 patients received radical radiotherapy alone and the radiation dose was 64-70 Gy for 6-7 weeks (R). 40 patients were treated by chrono--chemotherapy plus radiotherapy. Patients were chrono-introvein infusion with cisplatin and 5-fluorouraeil. Patients were given cisplatin 20 mg/m2 infusion on 10-hour-22-hour and 5-fluorouracil 500 mg/m2 by infusion from 22:00 to 10:00 next day. The period of treatment was 5 days. Treatment was repeated on the 29th day. The radiation dose was 50-60 Gy, for 5-6 weeks (CC+R). The treatment effects and X images of all patients were observed and followed up for 6 to 20 months. Results The improvements of clinical symptoms were 92.5% (37/40) in CC+R group and 75.0% (30/40) in R group, with an obvious difference between the two groups (P <0.05). The 1-, 2-year survival rates were 75.0% (30/40) and 52.5% (21/40), 47.5% (19/40) and 30.0% (12/40) in two groups, with significant difference in 1-year survival rate between the two groups (P <0.05). Conclusion Radiotherapy combined with chrono-chemotherapy was an effective method for advanced esophageal carcinoma.
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Objective To study the hemoprotective effects of a rotary magnetic field (RMF) to radiation-injured mice. Methods 132 male BALB/c mice were randomly divided into four groups: a normal group (N), a magnetic treatment group (M), an irradiation group(R) and an irradiation combining magnetic treatment group (R + M). Mice in the N group received no treatment. Mice in the R and R + M groups received total body irradiation with 6.0 Gy 60Co γ/rays. Mice in the M and R + M groups were treated with a RMF for one and half an hour at a time, twice a day, totally for 30 days. The survival rate was observed for 30 days. On days 0, 5, 9, 15, 21, 30, the subjects' peripheral blood cells were counted. On day 9, 23 and 30, the number of bone marrow nucleated cells (BMNCs), colony forming unit-spleen (CFU-S), spleen-body ratio, the cell cycle and apoptosis of bone marrow cells were measured. The pathological sectioning of the femur was performed and the expression level of bone morphogenetic proteins (BMP2/4) in the bone marrow was evaluated. Results ①No mice died in the N and M group. The RMF treatment increased the survival rate and survival days among the irradiated mice (P < 0.01). ②The RMF treatment increased the number of blood cells in their peripheral blood of the R + M group. ③The number of BMNCs, CFU-S and the proportation of G2 + M stage in the R + M were markedly higher than that of the R group, but the proportation of the apoptosis was lower than that of the R group on the 9th day (P < 0.05). Furthermore, the spleen index in the R + M group was also higher than that of the R group on the 23rd day (P < 0.05). ④RMF could improve the expression level of BMP2/4 in the radiation-injued mice. Conclusion The RMF treatment had an obvious protective effect against the effects of irradiation and it accelerated the recovery of hematopeiesis and the hematopoietic microenvironment in mouse bone marrow.
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Objective The efficacies of nedaplatin-combined chemotherapy were compared with those of cisplatin-combined chemotherapy in patients with advanced malignant tumors. Methods Two hundred and sixty-two patients were divided into two groups randomly, the nedaplatin(NDP) group (M94, F36, median age 58y) and the eisplatin(Cis) group (M95, F37, median age 57y). Cycles were repeated every 4 weeks. Effects were assessed after 2 cycles. First-line schedules were chosen, and nedaplatin and cisplatin were used respectively. Results The results showed that the remission rate (50.8 %) in NDP group was significantly higher than that (40.2 %) in Cis group (P<0.05). The NDP had better efficacy than Cis especially in treating ovary cancer and esophageal cancer. The toxicity of NDP was milder for gastro-intestinal tract but more serious for bone marrow than that of Cis(P<0.01). Conclusion As a new broad-spectrum anti-tumor agent, NDP could be a better choice than cisplatin in the treatment of malignant tumors. It is especially of better efficacy in treating ovary cancer and esophageal cancer, and could be recommended as the first-line drugs.