The value of three-dimensional medical imaging guided ultrasound in the treatment of huge hepatic hemangioma / 中华医学超声杂志（电子版）

Objective To evaluate the clinical application value of three-dimensional medical image guided ultrasound in the chemotherapy of huge hepatic hemangioma.Methods Seventy-six cases were enrolled in a randomized control study.All cases were randomly divided into two groups (group A and group B).In group A,all cases underwent treatment based on the traditional two-dimensional medical images.Under the assistance of three-dimensional medical image information,preoperative treatment planning was performed in group B.After puncture treatment,therapeutic efficacy was evaluated by color ultrasound during follow-up.Results For treating huge hepatic hemangioma (tumor diameter ≥ 10.0 cm),the insertion number and pingyangmycin dosage in the group B were less than those in the group A [(6.2± 0.5)times vs (9.3±0.6) times,t=24.467,P=0.035;(99.2±8.0) mg vs (148.8±9.6) mg,t=34.613,P=0.029].The success rate of first treatment in the group B was higher than that in group A [73.6％(28/38) vs 100％(38/38),x2=131.91,P=0.032].Conclusion For huge hepatic hemangioma,the three-dimensional medical image information can be applied to reduce the insertion number and anesthetics dosage,improving the success rate of first treatment and therapeutic effect.

Clinical significance of preoperative imatinib therapy in stomach gastrointestinal stromal tumors / 实用肿瘤学杂志

Objective Gastrointestinal stromal tumor( GIST) is a rare mesenchymal tumor from gastroin-testinal tract,and surgery remains the only curative treatment.In order to improve the outcome of surgical treat-ment,reduce the risk of surgery,and increase the quality of life,preoperative imatinib( IM) treatment for GIST is investigated.Methods We retrospectively studied the multidisciplinary team model treatments for 8 GIST cases receiving preoperative IM treatment.The cases were prescribed IM of 400 mg daily for 12 to 40 weeks and exten-sively followed until surgery was considered feasibleg.The clinical significance and safety profile were analyzed. Results Partial responsive rate was 62.5% in this study.There was no intolerable sever adverse effects by IM preoperative treatment.All the cases received R0 dissection,with no intraoperative tumor rupture.The postopera-tive recovery was satisfied.Conclusion IM preoperative treatment brings significant clinical benefit to large stomach GISTs and cardiac region GISTs.The preoperative treatment should be monitored carefully under a multi-disciplinary team.Preoperative IM treatment is an evocative treatment strategy for high risk GIST.

Preoperative Concurrent Radiochemotherapy for Locally Advanced Esophageal Cancer: Treatment Outcome and Prognostic Factors / 대한방사선종양학회지

PURPOSE: This study reports the results of the use of preoperative concurrent radiochemotherapy (CRCT) for the treatment of locoregionally advanced esophageal cancer. MATERIALS AND METHODS: From 1998 through 2005, 61 patients with intrathoracic esophageal cancer at stages II-IVB (without distant organ metastasis and presumed to be respectable) received preoperative CRCT. CRCT consisted of radiotherapy (45 Gy /25 fractions /5 weeks) and FP chemotherapy (5-FU 1 g/m2/day, days 1-4 and 29-32, Cisplatin 60 mg/m2/day, days 1 and 29). An esophagectomy was planned in 4~6 weeks after the completion of CRCT. RESULTS: There were two treatment-related deaths. Among the 61 patients, 53 patients underwent surgery and 17 patients achieved a pathological complete response (pCR). The overall survival (OS) rates of all 61 patients at 2 and 5 years were 59.0% and 38.0%, respectively. The rates of OS and disease-free survival (DFS) of the surgically resected patients at 2 and 5 years were 61.6%, 40.1% and 53.3%, 41.8%, respectively. By univariate analysis, achieviement of pCR and a clinically uninvolved distant lymph node (cM0) were favorable prognostic factors for OS and DFS. There were 27 patients that experienced a relapse-a locoregional relapse occurred in 5 patients, a distant metastasis occurred in 12 patients and combined failure occurred in 10 patients. CONCLUSION: The results of the current study are favorable. pCR and an uninvolved distant lymph node were found to be favorable prognostic factors.

Preoperative Concurrent Radio-chemotherapy for Rectal Cancer: Report of Early Results / 대한방사선종양학회지

PURPOSE: To report the early results of preopeartive concurrent radio-chemotherapy (CRCT) for treating rectal cancer. MATERIALS AND METHODS: From June 1999 to April 2002, 40 rectal cancer patients who either had lesions with a questionable resectability or were candidates for sphincter-sacrificing surgery received preoperative CRCT. Thirty-seven patients completed the planned CRCT course. 45 Gy by 1.8 Gy daily fraction over 5 weeks was delivered to the whole pelvis in the prone position. The chemotherapy regimens were oral UFT plus oral leucovorin (LV) in 12 patients, intravenous bolus 5-FU plus LV in 10 patients, and intravenous 5-FU alone in 15 patients (bolus infusion in 10, continuous infusion in 5). Surgery was planned in 4~6 weeks of the completion of the preoperative CRCT course, and surgery was attempted in 35 patients. RESULTS: The compliance to the current preoperative CRCT protocol was excellent, where 92.5% (37/40) completed the planned treatment. Among 35 patients, in whom surgery was attempted after excluding two patients with new metastatic lesions in the liver and the lung, sphincter-preservation was achieved in 22 patients (62.9%), while resection was abandoned during laparotomy in two patients (5.7%). Gross complete resection was performed in 30 patients, gross incomplete resection was performed in one patient, and no detailed information on the extent of surgery was available in two patients. Based on the surgical and pathological findings, the down-staging rate was 45.5% (15/33), and the complete resection rate with the negative resection margin 78.8% (26/33). During the CRCT course, grade 3~4 neutropenia developed in four patients (10.8%). Local recurrence after surgical resection developed in 12.1% (4/33), and distant metastases after the preoperative CRCT start developed in 21.6% (8/37). The overall 3-years survival rate was 87%. CONCLUSION: Preoperative CRCT in locally advanced rectal cancer is well tolerated and can lead to high resection rate, down-staging rate, sphincter preservation rate, however, longer term follow-up will be necessary to confirm these results.