ABSTRACT
Objective To investigate the clinical effects and safety of bevacizumab combined with S-1 as the second-line treatment of recurrent and/or metastatic esophageal cancer after chemoradiation. Methods Patients with recurrent or metastatic esophageal cancer after chemoradiation were treated with bevacizumab and S-1. Bevacizumab was used by intravenous infusion, 7.5mg/kg body weight on day 1; S-1 was used by oral at 80mg/m·d on day 1-14, 21 days as a cycle of treatment and repeated until either pro- gressive disease or intolerable toxicity occurred. Chest CT were performed and RECIST 1.1 was used for response evaluation. Kaplan-Meier method was used for survival analysis. Side effects were recorded and analyzed. Results Totally 78 patients were enrolled in the study, including 67 squamous cell carcinoma and 11 adenocarcinoma histologically. The overall response (CR+PR) rate was 22.4% (17/76) and disease control (CR+PR+SD) rate was 61.8% (47/76) respectively. The median follow-up time was 20 months (range from 9 to 44 months). The median progression-free survival (PFS) was 4.9 months (95% CI 4.4-5.5) and the median overall survival (OS) was 8.1 months (95% CI 7.6-9.2). The median PFS and OS of patients with metastasis diseases were 6.2 months (95% CI 3.3 to 6.3) and 8.5 months (95% CI 5.8 to 11.2), where PFS was longer than that of patients with local regional recurrence (median 5.0 months, 95% CI 3.0 to 5.5, P=0.017) and OS was longer than that of patients with regional disease and metastasis (median 8.0 months, 95% CI 4.6 to 9.5, P=0.010). The common adverse effects were mild to moderate neutropenia (84.2%), grade I-II hand and foot syndrome (51.3%), grade I-II nausea (48.7%), mild epistaxis (30.1%) and mild vomiting (14.5%). Esophageal bleeding occurred in 7.9% of patients. One patient (1.3%) died from massive bleeding which was caused by esophageal perforation. Conclusion Bevacizumab combined with S-1 was effective and safe for esophageal cancer patients who had recurrent or metastatic diseases after chemoradiation.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Bevacizumab , Drug Combinations , Esophageal Neoplasms , Drug Therapy , Mortality , Pathology , Oxonic Acid , TegafurABSTRACT
Objective To compare the treatment effects of senile intertrochanteric fracture with the dynamic hip screw(DHS),proximal femur locking compression plate (LCP),anti-spin femur proximal femoral nail(PFNA).Methods Ninety cases of femoral rotor fracture patients were treat in our hospital from September 2010 to March 2012 by DHS(n =30),LCP(n =30) and PFNA(n =30) treatment of femoral intertrochanteric fractures.We compared the surgical time,blood loss,fracture healing time,postoperative complications and hip function scores.Results In DHS,LCP and PFNA group,the blood loss ((287.1 ± 72.0) ml,(214.9 ± 65.8)ml,(85.0 ± 33.6) ml,F =88.7,P ＜ 0.05),the operative time ((1.51 ± 0.07) h,(1.49 ± 0.04) h,(0.70 ±0.10) h,F =445.8,P ＜ 0.05),and both were significant difference.But the fracture healing time ((15.2 ±1.7) weeks,(17.0 ± 1.4) weeks,(15.9 ± 1.8) weeks,F =1.4,P ＞ 0.05),there was no significant difference.The PFNA group had a good hip Sander' score of 96.7％,better than other two groups (87.5％、96.8％) (x2 =39.06,P ＜0.05).The weight-beating time of PFNA group is earlier than the other two groups ((1.00±0.36) cm,(0.80±0.12) cm,(0.60±0.19) cm,F=30.4,P＜0.05).Conclusion PFNAinthe treatment of femoral intertrochanteric fracture has advantages in minimally invasive,less blood loss,and help patients go through the perioperative period.