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Objective To investigate the long-term efficacy and prognosis of concurrent chemoradiotherapy alone and concurrent chemoradiotherapy after neoadjuvant chemotherapy for stage ⅡB-ⅢB cervical squamous cell carcinoma. Methods A retrospective analysis was performed among 171 patients with stage ⅡB-ⅢBcervical squamous cell carcinoma who were admitted to our hospital and had complete follow-up data from February 1,2005 to October 31,2011. Results The median follow-up time was 66 months. There were no significant differences in the 3-or 5-year overall survival rates between the concurrent group and the neoadjuvant group(81.4% vs.75.9%,74.3% vs.67.2%,P=0.469).According to the subgroup analysis,there was no correlation between lymph node metastasis and survival curve(P=0.310,P=0.151).The univariate and Cox multivariate analyses showed that tumor size,lymph node metastasis,and concurrent chemotherapy method were independent prognostic factors for cervical cancer(P<0.05).For the patients with lymph node metastasis, the neoadjuvant group had a significantly higher pelvic local recurrence rate than the concurrent group (P=0.047),while there were no significant differences in mortality,distant metastasis,or long-term adverse reactions between the two groups(all P>0.05).For the patients without lymph node metastasis,the neoadjuvant group had a significantly higher incidence of grade 3-4 bone marrow suppression than the concurrent group (P=0.016), while there were no significant differences in mortality,local recurrence,distant metastasis,or long-term adverse reactions between the two groups (all P>0.05). Conclusions Concurrent chemoradiotherapy alone and concurrent chemoradiotherapy after neoadjuvant chemotherapy achieve similar treatment outcomes in patients with stage ⅡB-ⅢBcervical squamous cell carcinoma,no matter whether they have lymph node metastasis or not. Tumor size,lymph node metastasis,and concurrent chemotherapy method are independent prognostic factors.Neoadjuvant chemotherapy increases the risk of grade 3-4 marrow suppression during concurrent chemoradiotherapy,prolongs irradiation time,and increases the risk of local recurrence.
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Objective To investigate the correlation between the biomarkers related to radio-sensitivity and preoperative radiotherapy in rectal cancer patients, and to establish a logistic regression model to predict the effect of the preoperative radiotherapy through detecting the expression levels of the molecular markers. Methods 33 patients with rectal cancer who received preoperative radiotherapy from January 2010 to January 2015 were retrospectively analyzed. Patients' information was also collected including the serum level of carcino-embryonic antigen (CEA), the immune-histochemical expression levels of vascular endothelial growth factor (VEGF), epidermal growth factor receptor (EGFR), thymidylate synthase (TS) and Ki-67, and image data (CT or magnetic resonance imaging) before radiotherapy, preoperative clinical staging and the postoperative pathologic staging. According to the postoperative pathological remission, the treatment effects of preoperative radiotherapy included effective (CR+PR) and ineffective (PD+SD) were evaluated. The relationship between these molecular markers and the curative effect of preoperative radiotherapy was analyzed by logistic regression analysis using SPSS v17.0 software, and a logistic curative effect prediction model was established. Results As a result of single factor and multiple factors logistic binary regression analysis, CEA, VEGF and Ki-67 were recognized as the interested factors for the radio-sensitivity predicting in patients with rectal cancer who received preoperative radiotherapy. A molecular markers predictive model for radio-sensitivity in preoperative radiotherapy in rectal cancer is as follow: log P=1.700-0.276×CEA-0.238×VEGF-0.135 ×EGFR+1.377 ×TS+0.080 ×Ki-67. Serum CEA level and the expression of VEGF might associate with radio-resistant, and the expression of Ki-67 might associate with better reaction to preoperative radiotherapy. Conclusion The levels of serum CEA, VEGF and Ki-67 may be the predictors of radio-sensitivity in rectal cancer patients who received preoperative radiotherapy.
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Objective To observe and evaluate acute toxicities in a series of human immunodeficiency virus (HIV)-positive cancer patients receiving radiation therapy.Methods The study retrospectively reviewed the acute radiation reaction of radiation therapy of 14 HIV seropositive patients diagnosed with carcinoma between Feb 2008 and Dec 2013 at the Yunnan Tumor Hospital during the radiotherapy period and 1 month following treatment.Acute adverse effects were classified according to the site of radiation therapy and analyzed using the Common Terminology Criteria for Adverse Events (CTCAE) version 3.0.Results Seven patients experienced interruptions or delays in treatment,and 2 stopped treatment entirely.The most common acute adverse effects were skin reactions and mucous membrane reactions,including dermatitis,stomatitis or diarrhea.Eight patients had grade 3 acute adverse effects,including 6 patients with grade 3 skin reactions and 2 patients with grade 3 mucosa reactions.Conclusions Radiotherapy is an effective treatment for HIV positive patients with tumors,however it frequently induced severe acute radiation responses.
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Objective The purpose of this article was to investigate the diagnostic value of CT and MRI in preoperative local staging for rectal cancer patients. Methods Forty rectal cancer patients were enrolled,and their preoperative CT and MRI staging and pathological staging in T and N were compared. Results The total diagnostic accordance rate of CT staging in T was 57.5%(31/40),among which the accordance rate of T1-2,T3 and T4 was 87.5%(35/40),83.25%(33/40) and 70%(28/40),respectively. The total diagnostic accordance rate of MRI staging in T was 77.5%(31/40), among which the accordance rate of T1-2, T3 and T4 was 92.5%(37/40), 77.5%(31/40) and 85%(34/40),respectively. The differences were tested by Chi-square test,and there were no significant differences between the two groups in T staging. The sensitivity of T staging by CT was 77.78%(7/9) for T1-2, 75% (12/16) for T3 and 93.33% (14/15) for T4. Compared with CT, the sensitivity of MRI was 66.67%(6/9) for T1-2, 81.25%(13/16) for T3 and 80%(12/15) for T4, and there were no significant differences between the two groups. The specificity of T staging by CT was 90.32% (28/31) for T1-2, 45.83%(11/24) for T3 and 96%(24/25) for T4. Compared with CT, the specificity of MRI was 100% (31/31) for T1-2, 75% (18/24) for T3 and 88%(22/25) for T4, and there was a significant difference in T3 specificity ( <0.05) . The total diagnostic accordance rate of CT staging in N was 82.5% (33/40),among which the rate of N- and N+was 82.5%(33/40) and 82.5%(33/40), respectively. The total diagnostic accordance rate of MRI staging in N was 62.5%(25/40),among which the rate of N- and N+was 62.5% (25/40) and 62.5%(25/40), respectively. There were significant differences between the two groups in pelvic N staging ( < 0.05) . The sensitivity of N staging by CT was 75.00%for N- (18/24) and 81.25%(13/16) for N+. Compared with CT,the sensitivity of MRI was 75.00%(18/24) for N- and 43.75%(7/16) for N+,and there were significant differences between the two groups ( <0.05) . The specificity of N staging by CT was 81.25% (13/16) for N- and 83.33%(20/24) for N+. Compared with CT, the specificity of MRI was 43.75% (7/16) for N- and 75.00%(18/24) for N+, and there were significant differences between the two groups ( <0.05) . Conclusion MRI has a high reliability in diagnosing rectal cancer with penetrating through the muscularis propria into the placenta percreta or not, but CT is superior in diagnosing the lymphonodus metastasis.
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OBJECTIVE@#To detect the expression of EGFR and NF-kappaB and the relationship between the two factors and radiosensitivity in human nasopharyngeal carcinoma.@*METHOD@#The expression of EGFR and NF-kappaB were detected with immunohistochemical staining SP methods in forty-one patients. The radiotherapy effect was assessed by follow up visit and clinical judgement. All of the forty-one patients were divided into three groups: the complete response group, the partial response (or the stable disease) group and the progressive disease group.@*RESULT@#The expression of EGFR and NF-kappaB were detected in human nasopharyngeal carcinoma tissues, which were not in normal ones. EGFR and NF-kappaB were significant difference of the radiosensitivity in nasopharyngeal carcinoma tissues (P0.05). The two factors' expression had negative correlation with radiosensitivity.@*CONCLUSION@#EGFR and NF-kappaB, as important targets, could predict the radiosensitivity of NPC, which could be helpful for targeting treatment and promote the effect of radiotherapy of NPC.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , ErbB Receptors , Metabolism , NF-kappa B , Metabolism , Nasopharyngeal Neoplasms , Metabolism , Pathology , Radiotherapy , Radiation ToleranceABSTRACT
Objective:To detect the expression of EGFR and NF-ΚB and the relationship between the two fac-tors and radiosensitivity in human nasopharyngeal carcinoma. Methods The expression of EGFR and NF-ΚB were detected with immunohistochemical staining SP methods in forty-one patients. The radiotherapy effect was assessed by follow up visit and clinical judgement. All of the forty-one patients were divided into three groups: the complete response group,the partial response(or the stable disease)group and the progressive disease group. Result:The ex-pression of EGFR and NF-ΚB were detected in human nasophaTyngeal carcinoma tissues, which were not in normal ones. EGFR and NF-ΚB were significant difference of the radiosensitivity in nasopharyngeal carcinoma tissues (P0. 05). The two factors'expression had negative correlation with radiosensitivity. Conclusion: EGFR and NF-ΚB, as important tar-gets, could predict the radiosensitivity of NPC, which could be helpful for targeting treatment and promote the effect of radiotherapy of NPC.