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Objective:To evaluate the clinical value of 125I seed implantation guided by CT in treatment of advanced pancreatic cancer. Methods:The data of 63 patients with advanced pancreatic cancer in the Affiliated Cancer Hospital of Zhengzhou University from Jun. 2015 to Jun. 2018 (48 males and 15 females) were retrospectively analyzed. All patients underwent CT-guided 125I seed implantation, and regular follow-up after operation. All patients were followed up for 3 to 36 months to evaluate the clinical efficacy, including the volume of cancer before and after treatment, tumor marker CA199 and changes in complications such as abdominal pain and jaundice, and the survival status of the patients. Results:Three months after seed implantation, 9 cases (14.3%) had complete remission of cancer in 63 patients, 33 cases had partial remission (52.4%) , 15 cases had no change (23.8%) , and 6 cases had disease progression (9.5%) . The total effective rate was 67.7%. Three months after treatment, the volume of cancer was (31.92±14.93) cm 3, which was significantly smaller than that before treatment [ (44.88±16.19) cm 3; t=6.79, P<0.01]. Three months after treatment, Serum CA199 (77.21±58.69 U/ml) was significantly lower than that before treatment (327.76±110.42) U/ml ( t=16.56, P<0.05) . 125I seed implantation for advanced pancreatic cancer had an average survival period of (13.04±0.92) months and a median delivery period of 11 months. Of the 57 patients with different degrees of abdominal pain, 49 were better than before, and the pain relief rate was 85.9%. Among 42 patients with jaundice symptoms of varying degrees, 31 were better than before, and the jaundice remission rate was 73.8%. There were no serious complications related to treatment in any patients. Conclusion:125I seed implantation therapy can safely and effectively treat advanced pancreatic cancer, and improve related clinical symptoms such as abdominal pain and jaundice.
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Objective To investigate the safety and efficacy of combination of CT-guided multiple minimally invasive techniques in the treatment of lung cancer. Methods All 34 patients with lung cancer (78 lesions) were treated with CT-guided physical ablation (39 lesions), chemical ablation (14 lesions) and/or 125I seed implantation (25 lesions). The efficacy and safety of the treatment were evaluated. Results CT-guided minimally invasive treatments were successfully performed in all 34 patients. During operation, a small amount of hemoptysis occurred in 5 patients, while mild to moderate pain were observed in 4 patients. Pneumothorax occurred in 4 patients after operation. No serious complication,such as massive hemorrhage or bronchial pleural fistula occurred intraoperation nor postoperation. According to the follow-up with CT, there were 69 (69/78, 88.46%) significantly effective lesions, 5 (5/78, 6.41%) stable lesions and 4 (4/78, 5.13%) advanced lesions. Conclusion Combination of CT-guided multiple minimally invasive techniques are safe and effective for treating lung tumor.
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Objective The objective of this study was to investigate the relationship between the expression of RAD18 and radiation resistance in glioblastoma multiforme(GBM)and to provide a new therapeutic target for improving the radiation resistance of GBM.Methods Human glioma A172 cells were transfected into blank and RAD18-containing plasmid vector.The cell proliferation of two groups after the same dose radiation was detected by cloning assay.The mRNA expression of RAD18 in primary and recurrent GBM samples after close proximity treatment were detected by qRT-PCR.All data were analyzed statistically.Results The proliferation of GBM cells transfected with RAD18 plasmid was higher than that of cells transfected with blank plasmid after radiation therapy(P<0.001).The expression level of RAD18 mRNA in recurrent GBM was higher than that in the untreated radioactive granules primary GBM(P<0.01).Conclusion The resistance of recurrent GBM to radiotherapy may be associated with the overexpression of RAD18 protein.
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Objective:To evaluate the clinical efficacy of thermal-therapy combined with 125 I radioactive particles by comparing the results of preoperative and postoperative images,serum carcino-embryonic antigen (CEA) and following-up after treatment of the patients with recurrent rectal cancer.Methods:Nineteen rectal cancer patients with postoperative recurrence after radiotherapy were treated with 125I implantation guided by CT (20 cases were treated with operation,but 1 patient was exited who couldn't tolerate the thermal-therapy).Radioactive particle treatment planning system (TPS) was used to make the plan before the particle implantation,and the distance of the particle was 1.0 cm;all patients received CT scanning and were quantificationally evaluatated after implantation;the number of seeded particles was about 12-58,the radioactivity of the 125I particle was 0.5 mCi,and the matching dose surrounding the tumor was 90-140 Gy.All patients were treated with microwave thermal-therapy after particle implantation,60 min per time,lasting the temprature at 43℃,twice per week,for three weeks.And the patients were followed up after treatment for 3 months,the efficacy was evaluated by image and CEA results,and the urinary frequency,dysuria,hematuria and rectal bleeding were evaluated.Results:Compred with before treatment,after following up for 6 months,the image results showed that the tumor volume was reduced,and the blood CEA level of all patients were decreased from (30.25±8.32) mg · L-1 to (11.89±5.22) mg · L-1 (t=13.158,P＜0.01);the local efficacy was 94.7％ (18/19),and the pain relief rate was 94.4％ (17/18);the NRS median was 6 (4,7) before treatment,and it was 1 (0,3) after treatment,there was significant difference (P＜0.001).There were no frequent urination,urinary pain,hematuria,rectal bleeding and other complications in all patients.Conclusion:Thermal-therapy combined with 125I radioactive particle implantation has good curative effects on the recurrent rectum cancer,and is effective means for recurrent rectum cancer treatment.
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Objective:To evaluate the clinical efficacy of thermal-therapy combined with 125 I radioactive particles by comparing the results of preoperative and postoperative images,serum carcino-embryonic antigen (CEA) and following-up after treatment of the patients with recurrent rectal cancer.Methods:Nineteen rectal cancer patients with postoperative recurrence after radiotherapy were treated with 125I implantation guided by CT (20 cases were treated with operation,but 1 patient was exited who couldn't tolerate the thermal-therapy).Radioactive particle treatment planning system (TPS) was used to make the plan before the particle implantation,and the distance of the particle was 1.0 cm;all patients received CT scanning and were quantificationally evaluatated after implantation;the number of seeded particles was about 12-58,the radioactivity of the 125I particle was 0.5 mCi,and the matching dose surrounding the tumor was 90-140 Gy.All patients were treated with microwave thermal-therapy after particle implantation,60 min per time,lasting the temprature at 43℃,twice per week,for three weeks.And the patients were followed up after treatment for 3 months,the efficacy was evaluated by image and CEA results,and the urinary frequency,dysuria,hematuria and rectal bleeding were evaluated.Results:Compred with before treatment,after following up for 6 months,the image results showed that the tumor volume was reduced,and the blood CEA level of all patients were decreased from (30.25±8.32) mg · L-1 to (11.89±5.22) mg · L-1 (t=13.158,P＜0.01);the local efficacy was 94.7％ (18/19),and the pain relief rate was 94.4％ (17/18);the NRS median was 6 (4,7) before treatment,and it was 1 (0,3) after treatment,there was significant difference (P＜0.001).There were no frequent urination,urinary pain,hematuria,rectal bleeding and other complications in all patients.Conclusion:Thermal-therapy combined with 125I radioactive particle implantation has good curative effects on the recurrent rectum cancer,and is effective means for recurrent rectum cancer treatment.
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Objective To investigate the value of IL-27,IL-29 and miRNA-497 in HER-2 positive radioactive particles combined targeted therapy. Methods Sixty-one elderly inpatients with HER-2 positive gastric cancer ascites in the Gaoming District People's Hospital, Wuchuan Municipal People's Hospital and Zhejiang Provincial Tumor Hospital were divided into the two groups. The treatment group(n= 31) was treated by the radioactive particles+ targeted drug Trastuzumab(initial dose 8 mg/kg, maintenance dose 66 mg/kg, once per 3 weeks) for 6 weeks; the control group(30 cases) was treated by targeted drug Trastuzumab (initial dose 8 mg/kg,maintenance dose 6 mg/kg, once per 3 weeks) for 6 weeks. The levels of ascites IL-27,IL-29 and miRNA-497 in the radioactive partcles combined targeted therapy group and control group were detected. Results The levels of ascites IL-27, IL-29 and miRNA-497 after treatment in the treatment group were significantly decreased compared with those before treatment and in the control group,the effective remission rate in the treatment group was 74. 19%, which was higher than 36.67% in the control group, the average median survival time in the treatment group was 155 d, which washigher than 72 d in the control group, the difference was statistically significant. Conclusion IL-27 ,IL-29 and miRNA-497 has the significance of curative effect evaluation and prognosis judgment in the radioactive particles combined targeted therapy for the patients with HER 2 positive gastric cance.
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Objective To investigate the efficacy of 125I radioactive particle implantation combined with surgery and chemotherapy in the treatment of locally advanced urinary tract urothelial carcinoma (UTUC).Methods The clinical data of 128 patients of locally advanced (T3,T4) UTUC treated with surgery with radioactive particle implantation plus postoperative GC chemotherapy (experimental group) and surgery plus postoperative GC chemotherapy (control group) were retrospectively analyzed.All the patients underwent complete resection of the tumor.The postoperative pathology was urinary tract epithelium cancer.In the experimental group,there were 45 (69.2％) males and 20 (30.8％) females,with median age 56.5 years.There were 39 (60.0％) patients diagnosed with renal pelvic cancer,including 13 (33.3 ％) patients with local lymph node metastasis;26 patients (40.0％) with ureteral cancer,11 patients (42.3％) with local lymph node metastasis.In the control group,there were 46 males (73.0％) and 17 females (27.0％),with median age 57.1 years.There were 40 (63.5％) patients with renal pelvic cancer,including 12 (30％) cases of local lymph node metastasis;23 patients with ureteral carcinoma (36.5％),including 10 patients (43.4％) with local lymph node metastasis.There was no significant difference in basehne data between the two groups (P ＞ 0.05).The recurrence and distant metastasis,recurrence-free survival,distant disease free survival(DDFS),disease-specific survival(DSS),overall survival (OS) and comphcations of two groups were compared.Results The follow-up time was 50.5 months (ranged 5 to 62 months).In experimental group,there were 2 cases,5 cases,11 cases,16 cases and 21 cases occurred recurrence and distant metastasis in 6 months,1 year,2 years,3 years and 5 years respectively,and the 5-year cumulative recurrence and distant rate was 32.3％ (21/65).In control group,there were 3 cases,5 cases,17 cases,21 cases and 32 cases,occurred recurrence and distant metastasis in 6 months,1 year,2year,3 year,5 year respectively,and the 5-year cumulative recurrence and distant rate was 50.8％(32/63).There was significant difference between the two groups (P =0.034).In the experimental group and the control group,the 5-year non-metastatic survival rates were 61.5％ (40/65)and 41.3％ (26/63),respectively.There was significant difference in 5-year non-metastatic survival rate between the two groups (P =0.033).The 5-year DSS rates were 69.2％ (45/65) and 50.8％ (32/63),respectively.The 5-year DSS rate of the two groups was significantly different (P =0.033).The 5-year OS rates were 53.8％ (35/65) and 36.5％ (23/63) respectively.There was significant difference in the 5-year OS rate between the two groups (P =0.049).Condusions Compared with surgery and chemotherapy,the use of 125I radioactive particle implantation combined with surgery and chemotherapy in the treatment of locally advanced stage (T3-T4) UTUC could achieve the total survival benefit,and less adverse reactions.
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Objective:To investigate the effects of 125I radioactive particle implantation in the treatment of maxillofacial malignancy. Methods:43 patients with maxillofacial malignancy were treated with 125I radioactive particle implantation.The procedure was carried out according to the treatment planning system(TPS),with the particles spaced uniformly at 1 cm intervals and with the activity of 0.7 m Ciby 41 particles per case on a verage.All patients were followed up for 6-60 months.Results:The whole treatment procedurewas successful,and no particle displaced.The follow-up rate was 93.02% and treatment effective rate(CR+PR) was 90.70%.Norecur-rence was foundinall target areas.The mortality due to tumor was 9.30%and total survival rate was 74.43%.The cumulative survival rate of the patients in 0.5,1,2,3 and 5 years was 93.0%,85.7%,79.3,69.8% and 56.9% respectively.Survival periodon aver-age was 36.06-50.04 months,with the median of 43.05 months.The longest tumor-free survival period was 60 months.Radiation in-jury rate was 20.93% and only level 1 radiation injury was observedinall the cases.Facial nerve dys function was found in 2 cases and recovered after treatment.Conclusion:Treatment of maxillofacial malignancy by implantation of 125I particles is convenient and mini-mally invasive.The treatment canincrease survival rate of the patients and guaran tee the oropharynxes' function.