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ObjectiveTo analyze the outcomes and prognostic factors of advanced esophageal carcinoma treated by three-dimensional conformal radiotherapy (3DCRT).MethodsFrom Jul 2001 to Dec 2006.375 patients with esophageal carcinoma treated by 3DCRT were retrospectively analyzed of which Ⅰ stage 9,Ⅱ stage 106,Ⅲ stage 158,Ⅳstage 102.The short-term effect,1-,3-,5-year local regional control rates and survival rates were investigated.The local regional control rates and survival rate were calculated by the Kaplan-Meier method. Univariate prognostic factor was analyzed by Logrank method.Multivariate prognostic factor was analyzed using Cox regression model.ResultsThe follow-up rate was 94.7％.The numbers of patients followed-up with 5 years was 191.The 1-,3-and 5-year local control rates were 80.5％,53.7％,44.9％respectively.The 1-, 3-and 5-year survival rates were 67.2％,29.4％,19.0％respectively.Univariate analysis showed the significant prognostic factors included the degree of dysphagia,tumor length,the largest diameter of lesion in CT image,T stage,N stage,clinical TNM stage,grades of acute radiation-induced esophagitis and grades of acute radiation-induced pneumonery ( x2 =46.75,18.52,30.24,42.53,32.71,75.68,7.13,4.64,P =0.000,0.000,0.000,0.000,0.000,0.000,0.008,0.031 ).Multivariate analysis revealed tumor length,clinical TNM stage,chemotherapy and grades of acute radiationinduced esophagitis were independent prognostic factors (x2 =6.70,18.00,4.87,1.1 8,P =0.030,0.000,0.027,0.011 ).Conclusions3DCRT is effective and feasible in treatment of the advanced esophageal carcinoma.Tumor lesion length,clinical TNM stage,chemotherapy and grades of acute radiation-induced esophagitis are independent prognostic factors for survival of patients.
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Oral mucositis is one of the most common toxicities observed during radiotherapy and chemotherapy treatment for cancers. Mucositis results in sore mouth, altered taste sensation, pain and dysphagia leading to malnutrition. Left untreated, oral mucositis leads to ulceration, orodental infection, bleeding and discontinuation of effective radiotherapy or chemotherapy. Frequent hospitalization, enteral or parenteral nutrition, increased demand for analgesics ultimately account for increased cost of healthcare. Quantification of oral mucositis using standardized grading system is important for appropriate evaluation, reporting and management. In the recent past there is a paradigm shift in the pathobiology of cancer therapy related mucositis. Clear understanding of its pathogenesis is essential for the formulation of effective mucositis care. Numerous drug therapies, radiation techniques and oral care protocols have been tried in the past to reduce oral mucositis, None have proven to be consistently effective. Current trends for the prevention and treatment of oral mucositis is multi-targeted treatment supplemented by aggressive oral hygiene, reactive oxygen species (ROS) inhibitors, growth factors and use of specific topical agents to improve treatment of oral mucositis in future.
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Objective:To observe the relationship between lymphocyte phenotype and clinical presentation in cancer patient receiving immunotherapy combined with chemoradiotherapy.Methods:42 patients were enrolled into the study.Among these patients,22 received stimulated normal peripheral blood lymphocytes(PBLs) as well as chemoradiotherapy,and 20 patients received chemoradiotherapy only as control group.Immunotherapy was administrated biweekly,totally 8 times.Results:22 patients receiving immunotherapy had lymphocyte phenotype change which was also in accordance with symptom improvement,but didn't reach statistical significance.Among 22 patients receiving immunotherapy had 15(68.18%) had lymphocyte phenotype change which was in accordance with symptom improvement,including elevation of CD3 + 3,CD + 4(P
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Purpose:To evaluate the effect of biological response modifiers for Ⅲ stage non-small-cell lung cancer.Methods:Fifty-nine patients were randomized into two groups.Twenty-nine patients were put into radiotherapy and chemotherapy(R+C) groups,thirty patients were into Biological response modifiers and radiotherapy chemotherapy(BRMS+R+C) groups.All patients received routine radiotherapy 2.0 Gy per day,5times a week to a total dose of 60-65 Gy,in 42-45 days.Radiation fields just covered clinical tumors.Chemotherapy consisted of cisplatin 25-30 mg/m 2 ,etoposide 50-70 mg/m 2 on days 1?2and 3 every 4 week,for squamous cell carcinoma.For adenocarcinoma,it was mitemycin 4-6 mg/m 2 on day1 and vindesine 3 mg on day1 and8,and cisplatin25-30 mg/m 2 on day1?2 and 3,every 4 weeks interferon-?(IFN-?)and interleukin-2(IL-2)were used in(BRMS+R+C)groups after the second chemotherapy was over. IFN-? was given on days 1?2?3 and IL-2 on days 2?4?6 to a total of forty-eight day.Results:The overall response rate was 51.7% and 76.6% in(R+C) and(BMRS+R+C) groups.The one.two year survival rates were 62.1% 17 3% and 83 3%,43 3% in (R+C) and (BMRS+R+C) groups respectively.Conclusions:The preliminary results from our study has shown that biological response modifiers combined with radiotherapy and chemotherapy for non -small cell lung cancer has better early response rate and survival rate.
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Purpose:To study the adjuvant therapy in uterine sarcomas,to decrease local recurrence and metastases and improve survival.Methods:Analysis of the management of 113 cases of uterine sarccoma , retrospectively. 30 cases were treated weith surgery alone , 25 with adjuvance radiation , 34 with postoperative chemotherapy, 21 with surgery and chemo radiation.Results:The 2 year pelvic recurrence and metastases with surgery alone were 43.3 % and 30 0 %,32 0 % and 28 0 % with postoperative radiation,44.1 % and 20.6 % with postoperative chemotherapy, 23.8 % and 23.8 % with postoperative combination of chemo radiation.But there was no significant difference between surgery alone and postoperative adjuvant therapy.Conclusions:Postoperative radiotherapy can improve local control,adjuvant chemotherapy can decrease metastases,both can improve disease free survival,but can not improve overall survival for uterine sarcomas.
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Eighty-two patients with unresectable primary hepatic carcinoma were divided randomly into 4 groups. Twenty patients (group A) were treated with hepatic artery ligation and embolization. Twenty-three patients (group B) were treated with whole liver moving strip irradiation. Eighteen (group C) were treated with hepatic artery ligation and embolization and portal vein perfusion chemotherapy. Twenty-one (group D) were treated with the therapy as the group C and the whole liver moving strip irradiation. All were followed-up to 12～37 months. The 1-year survival rates of these four groups were 25.0%(5/20), 13.0%(3/23), 33.3%(6/18) and 61.9%(13/21), respectively. The authors believe that combined treatment of group D is recommended for advanced and unresectable primary hepatic carcinoma.
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Purpose: To detect the prognostic factors for early primary gastrointestinal non-Hodgkin's lymphoma treated by various treatments.Materials and Methods:32 aptients with stages Ⅰ and Ⅱ primary gastrointestinal non-Hodgkin's lymphoma treated from January, 1970 to November, 1987 were retrospectively reviewed. The primary sites of cancers were: 15 in stomach, 10 in ileocecal region, 4 in large bowel and 3 in small bowel. 24 patients underwent curative resection, 7 patients underwent incomplete resection and 1,unresectable. Postoperative radiotherapy was given to all patients.Among them, 14 patients received radiotherapy plus chemotherapy.Results: The overall 5-year survival rate was 59.4%(19/32).Conclusion: The main prognostic factors are the site of primary tumor, depth of invasion, stages and modalities of managements.Sex, age, and histologic does not influence the survivals.
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From August 1989 to March 1994, 240 patients with esophageal carcinoma were studied. They were randomly divided into combined group (BFP chemotherapy plus radiotherapy, 120 cases), and radiotherapy alone group (120 cases). Both groups were treated by the same radiotherapy with dose of D T 50～70 Gy/5～7wk. The 1-,2-,3- and 4-year survival rates were 68.3%(82/120), 49.5%(47/95), 27.1%(19/70) and 15.6%(5/32) in BFP chemotherapy plus radiotherapy group and 44.1%(53/120), 28.4%(27/95), 22.9%(16/70), 15.6%(5/32) in radiotherapy alone group. The 1- and 2-year survival rates were obviously different in the two groups(P