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Objective:To evaluate the impact of sarcopenia on survival and treatment-related toxicity in postoperative recurrent esophageal squamous cell carcinoma (ESCC) patients treated with chemoradiotherapy.Methods:Clinical data of 147 patients with postoperative locoregional recurrent ESCC receiving chemoradiotherapy in Huai'an First People's Hospital from 2016 to 2017 were retrospectively analyzed. Pectoralis muscle area (PMA) was determined using routine pre-radiotherapy CT simulation scan above the aortic arch level. Sarcopenia was defined as a cut-off value of pectoralis muscle index (PMI) (PMA/height 2) <11.55 cm 2/m 2 for males and <8.69 cm 2/m 2 for females. The incidence of toxicity, 1- and 3-year overall survival (OS) rates were statistically compared between patients with and without sarcopenia. Results:Sarcopenia was detected in 49 of 147 (33.3%) patients. The incidence of grade 3-4 toxicities in sarcopenic patients was significantly higher compared to that in their counterparts without sarcopenia (40.8% vs. 18.4%, P=0.005). In addition, patients with sarcopenia had significantly worse 1-year (61.2% vs. 82.7%) and 3-year OS rates (10.2% vs. 28.6%) than those without sarcopenia (both , P<0.001). Multivariate analysis showed that sarcopenia was an independent prognostic factor for poor OS ( P<0.001). Conclusion:PMI based on CT simulation scan has prognostic value in postoperative locoregional recurrent ESCC patients treated with chemoradiotherapy, which probably serves as a novel diagnostic tool for sarcopenia.
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Objective Retrospectively analyzed the predictive value of imaging evaluation in stage Ⅱ/Ⅲ esophageal carcinoma patients treated with preoperative chemoradiotherapy.Methods A total of 145 stage Ⅱ/Ⅲ esophageal carcinoma pantients were enrolled.We analyzed the overall survival rates of the patients with pathological complete response (pCR) and those without (NpCR),X-film complete response (xCR) and those without (NxCR),RECIST complete response (rCR) and those without (NrCR).And we used Cox model for multivariate analysis.Results The rates of pCR,xCR and rCR were 33.8％,42.8％ and 38.6％ for all patients,respectively.The 1-,3-5-year overall survival rates were 87.8％,79.6％,61.2％ for pCR patients and 75％,40.6％,24.0％ for NpCR patients (x2 =20.215,P ＜0.05),respectively;The 1-,3-5-year overall survival rates were 80.6％,66.1％,51.6％ for xCR patients and 75％,44.6％,25.3％ for NxCR patients(x2 =8.895,P ＜0.05),respectively;The 1-,3-5-year overall survival rates were 83.9％,69.6％,53.6％ for rCR patients and 76.4％,46.1％,25.8％ for NxCR patients(x2 =10.862,P ＜ 0.05),respectively.Multivariate survival analysis using Cox regression model showed that pCR was a positive independent prognostic factor (HR =0.333,95％ CI:0.200-0.554,P ＜ 0.05).Conclusions Short-term imaging evaluation could effectively predict the prognosis of stage Ⅱ/Ⅲ esophageal carcinoma patients treated with preoperative chemoradiotherapy.And pCR was a positive independent prognostic factor.
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Objective To compare the efficacy of the therapeutic alliance of radiotherapy and Semustine (CCNU)chemotherapy with radiotherapy alone after partial resection of high-grade sliomas.Methods Forty-nine cases with partial resection of brain gliomas were randomly divided into two groups.In the control group(sole radiotherapy n=19),patients were only treated with local radiotherapy,with the dose of 40Gy/20f/4W,and then added the amount to 61～64Gy/27～28f/5～6W with low fractionation radiotherapy.In the observation group(therapeutic alliance n=23),patients underwent the above mentioned radiotherapy plus six Courses of adjuvant CCNU chemotherapy.Meanwhile,enhanced GD-MRI was performed to evaluate the changes of glioma volume,the nerve function status was evaluated with Karnofsky scale,and record the survival time.Results Twenty-four weeks after radiotherapy,improvements in glioma size and nerve function status of the observation group were superior than that in the control group(all P＜0.05),meanwhile,the long-term survival rate of observation group war also significantly better than that of the control group(P＜0.05).Conclusion Radiotherapy combined with CCNU could increase the glioma remission rate after partial resection,improve the life quality of patients.and extend their survival time.