ABSTRACT
OBJECTIVE@#To improve the diagnostic and therapeutic efficiency for secondary laryngeal tuberculosis through an analysis on the clinical features of patients with this disease.@*METHOD@#A retrospective study was made among 49 cases with laryngeal tuberculosis treated in Tibetan General Hospital of Chinese PLA, and the clinical data were carefully analyzed to summarize the clinical experience of this disease.@*RESULT@#Of 49 patients, 24 cases had 1 year history, 11 cases had 1 to 3 years, 9 cases had 3 to 5 years, 5 cases had 5 years or more. Thirty-eight patients had the history of tuberculosis and 11 had none. Thirty-four patients had taken anti-tuberculosis drugs but none had standard therapy as demanded. All cases had mild general symptoms (mild fever, night sweats, weight loss, et al) and atypical local symptoms (hoarseness, sore throat). Therefore, 42 cases were misdiagnosed as non-specific chronic laryngitis, of which 15 cases got worse after oral administration or inhaling of steroid hormones. Seven persons were misdiagnosed as laryngeal cancer. All patients were confirmed pulmonary tuberculosis by X ray exam or CT scanning. Twelve cases had strong positive PPD tests and 2 cases were detected positive by sputum smear. All patients was treated by standard systematic and local chemical therapy against tuberculosis (inhaling of antituberculosis drugs for 1 to 2 months). All were cured but one died in a road accident, and none had recurrence after 1- to 9- year follow-up.@*CONCLUSION@#All of those the patients with long period hoarseness and sore throat should take chest CT scan or X-ray exam for the highest incidence of pulmonary tuberculosis at high altitudes. CT scanning is the prefer for its high resolution. Pathological biopsy and diagnostic therapy should be taken to make accurate diagnosis. Usually steroid hormones should not be recommended.
Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Altitude , Retrospective Studies , Tibet , Tuberculosis, Laryngeal , Diagnosis , Drug TherapyABSTRACT
Objective To observe and cpmpare the efficacy and complications of hyperfractional integrated intraeavitary brachtherapy in middle-advanced squamous-cell carcinoma with the traditionsl brachytherapy.Methods In the observed group,328 patients with cervical cancer received hypeffractional integrated intracavitary after loading therapy between Jan 2004 and Jan 2005 were selected.The dose of point A was 2.5 Gy-3.0 Gy/fraction,2 fractions per week,and the total dose of reference point A was 49.8 Gy in stage Ⅱ b,52.6 Gy in stage in Ⅲb.In the control group,331 cases treated with traditional aflerloading brachytherapy between Jan 2002 and Dec 2003 were selected.The dose of point A was 5.0～7.0 Gy/fraction,1 fraction per week,and the total dose of point A was 50.1 Gy in stage Ⅱb,53.5 Gy in stage Ⅲb.In vitro irradiation began at the same time with the intracavitary brachytherapy.The whole pelvic was irradiated with 15 MV X-rays.Results In the observed group,the recent control rate of stage Ⅱb was 97.2%(104/107),94.1%(208/221)for stage Ⅲb.The 3-year survival rate was 80.5%(264/328).and the 5-year survival rate was 68.6%(225/328).The complication rate was 5.2%(17/328)for cystitis, 14.6%(48/328) for proctitis.Out of 331 cases in control group,the recent control rate of stage Ⅱb was 95.4%(103/108),92.8%(207/223)for stage Ⅲb.The 3-year survival rate was 75.2%(249/331),the 5-vear survival rate was 62.5%(207/331).The complication rate was 13.3%(44/331)for cystitis,and 32.3%(107/331)for proctitis.Conclusions Compared with combination of traditional brachytherapy and external radiotherapy,combination of hyperfraetional integrated brachtherapy therapy and external radiotherapy has no significant improvement for recent control rate and long-term survival rate,but could reduce the complication rates of cystitis and proctitis.
ABSTRACT
Objective To explore the clinicopathological characteristics of hereditary ovarian cancer syndrome(HOCS). Methods From Jan. 2000 to Jan. 2007, among 580 cases of primary ovarian cancer, 42 cases(herediatary group),who had a positive family history of ovarian cancer and met the diagnostic criteria of HOCS, were analyzed retrospectively. One hundred cases without a family history of ovarian cancer were enrolled randomizely as control group (sporadic group). Results The incidence of HOCS was 7.2% (42/580). Forty-two cases associated tumors affected at least 2 successive generations in 31 families and affected 1 generation in 8 families. Eighty-seven percent (27/31)was from maternal lineage, while 13% (4/31)from paternal lineage. Earlier age of onset was significantly difference between two groups[(49±10) years vs. (55±10) years, P<0.05]. There were 90% belong to serous adenocarcinoma in the herediatary group, while 84% in the sporadic group. There was statistical difference in the proportion of mucinous adenocarcinoma (0 vs. 11%, P<0.05). The most common clinical manifestations were abdominal distention and anorexia (64% vs. 70%, P>0.05), International Federational of Gynecology Obstetrics(FIGO)stage Ⅲ (62% vs. 63%, P>0.05) between two groups. Fourteen cases (33%,14/42) were previously untreated in the herediatary group, while 40 cases (40%, 40/100) in the sporadic group. There were 15 cases (36%, 15/42) underwent secondary surgery and 15 cases (36%, 15/42) underwent third surgery or more in berediatary group, while 50 cases (50%, 50/100) and 27 cases(27%, 27/100) in the sporadic group. The mean number of ehemotberapy cycles received in two groups was 13.3 and 11.8 (P>0.05). The 3-year and 5-year survival rate in herediatary group were 73.6% and 54.9% respectively, compared with 47.4% and 21.2% (P<0.05) in sporadic group. Conclusion Hereditary ovarian cancer mostly from maternal lineage are featuring in early age of onset, serous adenocarcinoma, advanced stage (stage Ⅲ), and better prognosis after the comprehensive treated by cytoreductive surgery plus with chemotherapy.