ABSTRACT
Objective To investigate the value of multi-b value DWI combined with PSA evaluation on the effect of endocrinotherapy for prostate cancer (PCa), and to study the correlation between the signal intensity(SI), apparent diffusion coefficient(ADC) with PSA.Methods Forty patients with PCa diagnosed by pathology or biopsy were tested for serum PSA levels before and after endocrine therapy.All patients underwent DWI at b-value of 300,800 and 1 000 s/mm2 by using a GE Signa HDx 3.0T MRI scanner.The serum PSA,the value of SI and ADC at different b values before and after endocrine therapy,and their correlation with PSA were observed and measured, respectively.Results (1)The serum PSA before and after endocrine therapy were (35.63±20.91) ng/mL and (5.98±3.84) ng/mL, respectively.The difference was statistically significant (P0.05).(3)Pearsoncorrelation analysis showed that ADC value was negatively correlated with serum PSA (r300=-0.58,P<0.01;r800=-0.60,P<0.01;r1 000=-0.66,P<0.01) before endocrine therapy.ADC value was also negatively correlated with serum PSA (r300=-0.55,P<0.01;r800=-0.52,P<0.01;r1 000=-0.61,P<0.01) after endocrine therapy.In addition,SI was negatively correlated with serum PSA (r300=-0.09,P<0.01;r800=-0.18,P<0.01;r1 000=-0.28,P<0.01) before the treatment, as well.Conclusion ADC value at different b values increased after endocrine therapy in Pca, and is negatively correlated with serum PSA.The correlation is the most significant at b value of 1 000 s/mm2.The combination of DWI and serum PSA could be used to monitor and evaluate the effect of endocrinotherapy for Pca, and better guide the clinical treatment of Pca.
ABSTRACT
Castration-resistant prostate cancer is a fatal disease with rapid progress. This malignancy usually presents with metastasis and poor prognosis. This type of disease also often causes 100%mortality, of which the median survival time is less than 20 months. Thus, treatment of castration-resistant prostate cancer remains challenging, and the underlying mechanisms of this cancer have yet to be identified. Several new therapies for castration-resistant prostate cancer have been proposed, such as androgen receptor antago-nists, immunotherapeutic drugs, taxanes, antiangiogenic agents, radionuclides, and bone-targeting drugs. These therapies can im-prove the survival time of patients. The advances in the treatment of castration-resistant prostate cancer are briefly reviewed in this ar-ticle.
ABSTRACT
O tratamento neoadjuvante do câncer de mama consiste no uso de diferentes modalidades terapêuticas prévias à remoção cirúrgica da doença. Tem sido aceito como uma opção para pacientes com doença não metastática, porque pode converter tumores inoperáveis em operáveis e aumentar os índices de cirurgias conservadoras, com os mesmos resultados oncológicos em longo prazo do tratamento adjuvante. A estratégia neoadjuvante está sendo cada vez mais aceita como uma plataforma de pesquisa, em que os efeitos biológicos dos agentes antitumorais podem ser avaliados, os biomarcadores preditivos e os prognósticos podem ser identificados e o desenvolvimento de terapias-alvo pode ser acelerado. Desfechos alternativos que podem predizer resultado clínico em longo prazo e estão disponíveis precocemente, como a resposta patológica completa, oferecem oportunidades únicas para a imediata avaliação dos agentes antitumorais. Além disso, esforços para determinar o perfil molecular da doença residual pós-tratamento neoadjuvante podem levar a uma terapia personalizada do câncer de mama em pacientes com doença de alto risco em estágio inicial.
Neoadjuvant therapy of breast cancer is related to the use of different treatment modalities prior to surgical removal of the disease. It has been accepted as an option for patients with nonmetastatic disease, because it renders inoperable tumors operable and increases the rates of breast-conserving surgery, while achieving the same long-term clinical outcomes as the adjuvant setting. The neoadjuvant strategy is being increasingly accepted as a research platform, where the biologic effects of anticancer agents can be evaluated, prognostic and predictive biomarkers can be identified, and the development of targeted agents can be accelerated. Surrogate endpoints that can predict long-term clinical outcome and are evaluable early on, such as the pathologic complete response, offer unique opportunities for prompt assessment of anticancer agents. Moreover, efforts for molecular profiling of the post-neoadjuvant residual disease may lead to a personalized therapy for breast cancer patients with early-stage high-risk disease.
ABSTRACT
Objective] To observe the clinical effect of Yiyuan Shengjing Decoction on similar climacteric syndrome of breast cancer after treated with tamoxifen. [Method] Choose 60 cases of breast cancer, randomly divide them into control group 30 cases and treatment group 30 cases, the control one were treated with tamoxifen and oryzanol, the treatment one, with tamoxifen and Yiyuan Shengjing Decoction. After 4w, evaluate the efficacy, compare their clinical symptoms score, hormone levels and endometrium thickness, and calculate the clinical relieving rate. [Result] After treatment, both groups clinical symptoms were relieved more than before treatment, with difference of statistical meaning; comparing on clinical symptoms scores, the treatment was much less than control one, with statistical meaning; on clinical relieving rates, the treatment group reached 83.33%, while 26.67% for control one, both had difference of statistical meaning. The comparison of reproductive hormone levels and endometrium thickness, the difference had no statistical meaning. [Conclusion] Yiyuan Shengjing Decoction treating breast cancer similar climacteric syndrome after treated with tamoxifen had marked cure effect, without influencing reproductive hormone level and endometrium thickness.
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Objective To determine the investigation progression on exemestane in the treatment of breast cancer. Methods The literatures of recent years on the studies of exemestane were reviewed. Results Exemestane is an effective steroidal aromatase inactivator with superior tolerability, safety and efficacy in the adjuvant, neo-adjuvant and metastatic therapy of breast cancer. Conclusion With the progression of clinical trial with exmestane, exemestane will be regarded as an important drug in comprehensive therapy of breast cancer.
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Objective To study the longterm result of endocrinotherapy and (or) radiotherapy for moderately and far advanced prostate cancer. Methods 256 cases of moderately or far advanced prostate cancer were treated with endocrinotherapy (surgical castration + postoperative drug administration) and (or) radiotherapy.182 cases were of stage C and 74 stage D.There were 236 adenocarcinoma,7 squamous cancer and 13 undifferentiated cancer.Gleason score was ≥6 in 202 patients and 134 had pelvic lymphoid metastasis. Results In 92.2%of the patients,the serum PSA dropped under 2 ng/ml shortly after the treatment.The overall 5,10,15 year survival rates were 48.8%,29.7% and 13.3% respectively.For stage C cases,these were 58.2%,38.4%,17.7% and for stage D 25.7%,6.4%,0.The 5 and 10 year survival rates were significantly different between stage C and D(P