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Objective To analyse the effectiveness of the preoperative 3-dimensional conformal radiotherapy for large nephroblastoma up to 10 centimeters in diameter,and to investigate more effective preoperative therapies for intermediate and advanced nephroblastoma.Methods 32 cases of nephroblastoma were treated with preoperative radiotherapy with a dose fractionation as follows:150-200 cGy/fraction,5 fraction/week,the total dose of 1 000-2 000cGy,the mean dose of 1 600 cGy.During the radiotherapy,the B ultrasonic examination and CT were performed weekly to measure the variation of tumor volumes.The time of operation were determined based on the overall health status of patients,the shrinkage of tumor,and adhesions between tumor and adjacent vital organs.Radiontherapy was terminated one week before operation.4 patients who were found tumor adhered to normal tissues around kidney during operation were placed silver clip,and were given postoperative radiotherapy with additional dose of 1 000-2 000 cGy and the mean dose of 1 200 cGy.Results The median tumor reduction rate was 37 ％.The effective rate of preoperative radiotherapy was 100 ％.The complete resection rate was 87.5 ％.2-years tumor-free survival rates was 84.4 ％ and 5-years was 78.1％.There was no surgery-related death.Conclusion Preoperative 3-dimensional conformal radiotherapy reduces tumor volume,and raises resection and survival rate.
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Objective To investigate the long-term curative effect of the radiotherapy combined uterine arterial interventional chemoembolization for cervical cancer.Methods Records of 632 patients with cervical cancer stage Ⅱ-Ⅳa proved by pathology in Lanzhou Command General Hospital from January 1st,1999 to August 31st.2009 were retrospective analysed.One hundrand and twenty-six cases of them were treated with radical radiothempy combined uterine arterial interventional chemoembolization(arterial chemoembolization+radiotherapy group).506 cases of them were treated with radical radiotherapy only (radiotherapy group);the evaluation of the late radiation injury was done,according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer(RTOG/EORTC)advanced radiation injury criteria.Prognosis and complications were compared between two groups,relative risk factors of radiothempy complications were identified by method of logistic regression.Results (1)Survival:the total survival mtes of 1-year,2-year,5-year and 8-year were 94.4%,82.3%,48.8%,29.1%,respectively.The survival rates of arterial chemoembolization+radiotherapy group were 96.0%.82.1%,37.2%,25.7%,while the survival rates of radiotherapy group were 94.1%,80.8%,51.1%,31.5%,in which there were significant differences between two groups (x2 = 0.009, P= 0.993; x2 =0. 158, P =0.691;X2 =11. 197,P=0. 001;x2 =9. 649,P =0.002). During the follow-up period, the rate of recurrence and metastasis in arterial chemoembolization + radiotherapy group were 77. 0% (97/126), while 73. 3% (371/ 506) in radiotherapy group ( x2 = 0. 705,P = 0. 401). (2) Radiotherapy complications and relative risk factors; the total incidence of tardive bladder injury higher than RTOG/EORTC stage II was 5.5% (35/632), while it was 11. l%(14/126)in arterial chemoembolization + radiotherapy group, 4.2% (21/506) in the radiotherapy group(x2 =9.344,P =0.002). The results of logistic regression showed that the uterine arterial interventional chemoembolization was relative risk factors of the tardive bladder injury ( x2 =6. 440, OR = 2. 869,P=0. 011). Conclusions Compared with the simple radiotherapy, there are a similar short-term survival rate and significant poor 5-year, 8-year survival rate in the patients treated with the uterine arterial interventional chemoembolization combined with radiotherapy, which also may be strong dangerous factor for the occurrence of tardive bladder injury. The results shown that the uterine arterial interventional chemoem bolization do not recommend to be routine adjuvant therapy for the radical radiotherapy of cervical cancer.
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Objective To evaluate the effects of induction chemotherapy plus radiotherapy (ICRT) and concurrent chemotherapy plus radiotherapy (CCRT) for Stage Ⅱ -Ⅲ non-small cell lung carcinoma (NSCLC) . Methods From July 19% to July 1999, 64 patients with Stage Ⅱ -Ⅲ NSCLC were randomized into two groups: ICRT group (32 patients) induction chemotherapy with DDP( 100mg/m2,dl) and VP-16 (100mg/m2,dl-d3) per week, one cycle per 4 weeks was given. Radiation was given after 2-3 cycles. CCRT group (32 patients) received radiotherapy plus concurrent chemotherapy with DDP(20 mg/m2,dl-d5) and VP-16 (50 mg/m2,dl-d5) per week for 8 weeks. In either group, radiation was given with a total dose of 60-70 Gy/6-7 weeks. Results One patient was excluded from ICRT group for development of distant metastasis, and 3 from CCRT group for their acute complications or other diseases. The overall response rates ( CR + PR) of ICRT and CCRT groups were 81.3% and 84.4%, respectively . NR + PD rates of both groups were 18.7% and 15.6% . The median survival periods were 13.4 months in ICRT group and 21.6 months in CCRT group (t = 2.58, P