Preliminary study on clinical efficacy of intra-arterial chemotherapy and intravenous chemotherapy for unilateral advanced retinoblastoma / 中华眼底病杂志

Objective:To compare the clinical efficacy and complications of intra-arterial chemotherapy (IAC) and intravenous chemotherapy (IVC) for unilateral advanced retinoblastoma (RB).Methods:A retrospective clinical study. From January 2020 to January 2021, 40 patients (40 eyes) unilateral group cT2 RB patients diagnosed at Baoding Children’s Hospital and Beijing Children’s Hospital were recruited in this study. There were 22 males (22 eyes) and 18 females (18 eyes). All were monocular. All the patients were assigned to two groups according to different treatment modalities they received: IVC group and IAC group. There were 26 eyes and 14 eyes, respectively. When the tumor invades the optic nerve, choroid, sclera, anterior chamber and iris, enucleation was performed. The globe salvage rate, tumor extraocular metastasis rate, solid tumor control rate, treatment-related complications and pathological high-risk factors after enucleation were observed. The globe salvage rate and solid tumor control rate were compared between the groups by chi square test.Results:The globe salvage rate of IAC group and IVC group were 88.5% (23/26) and 50.0% (7/14), respectively. Solid tumor control of IAC group and IVC group were 84.6% (22/26) and 42.9% (6/14), respectively. There were statistically significant differences in globe salvage rate and solid tumor control between the two groups ( χ 2=7.18, 7.56; P<0.05). Compared with IVC group, IAC group had less systemic complications, mild ocular and periocular side effects. Among 26 cases in IAC group and 14 cases in IVC group, 3 and 7 cases underwent enucleation respectively. The results of pathological examination showed that there were 2 cases and 3 cases with pathological high-risk factors in the two groups, respectively. During the follow-up period, 2 cases in IAC group had extraocular metastasis, there was no extraocular metastasis in IVC group. Conclusion:Compared with IVC, IAC has the advantages of high tumor control rate, high globe salvage rate, less and mild complications, however, there is still tumor recurrence.

Pay attention to the research on the mechanism of retinoblastoma and the methods of diagnosis and treatment / 中华眼底病杂志

Retinoblastoma (RB) is the most serious eye disease that causes blindness, disability and death in infant. Loss of tumor suppressor gene RB1 leads to tumorigenesis of RB. With continuous innovation and development of new methods, the management of retinoblastoma has experienced a dramatic change from enucleation, external radiotherapy, intravenous chemotherapy, to intra-arterial chemotherapy combined with local treatment, enabling a more favorable outcome for survival, salvage and vision. However, the pathogenesis of RB is unclear in many aspects, the rate of eyeball removal in children with advanced RB remains high, and the innovation of new treatment are needed to be further promoted. Therefore, the key to improve the overall treatment level of RB is to pay attention to the study on pathogenesis, early diagnosis and treatment, as well as strengthen multi-center clinical trials and translational medicine research.

Application progress of arterial isolated perfusion chemotherapy in pelvic tumors / 肿瘤研究与临床

Pelvic arterial isolated perfusion chemotherapy is a kind of regional chemotherapy. It works by two balloons placed in inferior vena cava and abdominal aorta and tourniquets placed in both lower extremities. Thus pelvic blood circulation can be isolated from the systemic circulation. The chemotherapy drugs are perfused into the pelvic region to achieve local exposure to higher drug concentration than the systematic chemotherapy. The pelvic arterial isolated perfusion chemotherapy is expected to be a new complementary therapy for unresectable pelvic tumors. The use of this technology in neoadjuvant therapy can achieve downgrading of unresectable tumors, and some patients achieve long-term survival after surgery. There are almost no relevant domestic reports yet, and this article discusses the principles, clinical efficacy, safety and complications of this technology.

Clinical analysis of intraoperative hyperthermic intraperitoneal chemotherapy combined with total laparoscopic D2 radical gastrectomy in treatment of gastric cancer / 肿瘤研究与临床

Objective:To explore the efficacy and safety of intraoperative hyperthermic intraperitoneal chemotherapy combined with total laparoscopic D2 radical gastrectomy in the treatment of gastric cancer.Methods:The clinical data of 127 patients with gastric cancer who were admitted to the Central Hospital of Hanzhong in Shaanxi Province from August 2017 to July 2019 were retrospectively analyzed. All patients underwent total laparoscopic D2 radical gastrectomy, of which 58 patients underwent total laparoscopic D2 radical gastrectomy combined with intraoperative hyperthermic intraperitoneal chemotherapy (observation group), and 69 patients underwent total laparoscopic D2 radical gastrectomy (control group). Observation indicators included surgical and postoperative recovery situations and postoperative tumor-related indicators. Follow-up was performed by using outpatient examination and telephone interview, and the content of follow-up included patient's adjuvant chemotherapy, tumor recurrence and metastasis, and surgery-related complications.Results:In the observation group, the intraoperative blood loss was (199±48) ml, the number of lymph node dissection was 35±8, the total hospitalization cost was (53 261±4 316) yuan, alanine aminotransferase was (30±10) U/L, and creatinine was (124±26) μmol/L; in the control group, the intraoperative blood loss was (184±46) ml, the number of lymph node dissection was 34±13, the total hospitalization cost was (52 146±4 817) yuan, alanine aminotransferase was (31±10) U/L, and creatinine was (128±33) μmol/L; there were no significant differences between the two groups ( t values were 1.833, 0.618, 1.363, 0.721, and 0.856, all P > 0.05). In the observation group, the operating time was (352±44) min, carcinoembryonic antigen (CEA) at 1 month after operation was (3.9±2.1) ng/ml,CEA at 6 months after operation was (12.7±7.2) ng/ml, tumor abnormal protein (TAP) at 1 month after operation was (75±36) μm 2,TAP at 6 months after operation was (131±33) μm 2; in the control group, the operating time was (308±58) min,CEA at 1 month after operation was (8.3±4.5) ng/ml, CEA at 6 months after operation was (15.8±4.2) ng/ml, TAP at 1 month after the surgery was (88±24) μm 2, TAP at 6 months after operation was (149±37) μm 2; there were significant differences between the two groups ( t values were 4.792, 7.185, 2.832, 2.284, and 2.984, all P<0.05). One hundred and twenty seven patients were followed up for 12-24 months. Fifty-one and 58 patients in the observation group and control group received postoperative adjuvant chemotherapy, and there was no significant difference between the two groups ( χ2 = 0.389, P = 0.533). Tumor recurrence was respectively detected in 0 and 6 patients in the observation group and control group at 6 months after operation; tumor recurrence was respectively detected in 2 and 11 patients in the observation group and control group at 1 year after operation; the differences in the recurrence rates between the two groups were statistically significant (both P < 0.05). Conclusion:Intraoperative hyperthermic intraperitoneal chemotherapy combined with total laparoscopic surgery for gastric cancer does not increase the patient's perioperative risk and the incidence of postoperative complications, and it can reduce the risk of postoperative recurrence and improve the short-term efficacy.

Progress of hepatic artery infusion chemotherapy of advanced hepatocellular carcinoma / 中国介入影像与治疗学

Interventional therapy of advanced hepatocellular carcinoma(HCC) was constantly developing, and hepatic artery infusion chemotherapy (HAIC) had present significant therapeutic effect. With the update of chemotherapy drugs and compatibility, clinical research and application of HAIC for advanced HCC increased gradually. The main drugs and clinical progress of HAIC for advanced HCC were reviewed in this article.

Clinical analysis of 66 patients of retinoblastoma / 中华眼底病杂志

Objective To observe the clinical characteristics ofretinoblastoma (RB) in Southwest China.Methods A retrospective clinical study.From January 2010 to December 2017,66 RB patients diagnosed in Ophthalmology Department of West China Hospital of Sichuan University were included in the study.All the patients underwent ocular B-ultrasound,orbital CT or MRI examination.Ten patients underwent RetCam examination at the same time.Twenty-nine patients were diagnosed by histopathological examination,and 37 patients were diagnosed by clinical symptoms and imaging examination.According to whether the tumor invaded the orbit and optic nerve,it could be divided into extraocular stage and intraocular stage.Intraocular tumors were divided into A-E stages according to the international intraocular RB classification.Treatments were performed according to different stages.The general information,age at diagnosis,course of diseases (the time between onset symptoms and diagnosis),causes of visiting a doctor,classification,treatment methods and eyeball preservation rate were retrospectively analyzed.Results Patients all came from Southwest China (56 patients from Sichuan Province,2 patients from Yunnan Province,2 patients from Guizhou Province,and 6 patients from Tibet).The permanent residence were identified in 43 patients,including 27 patients (62.8％) from rural areas.There were 38 males (57.6％);50 unilateral tumors (75.8％) and 16 bilateral tumors (24.2％);51 firstvisiting patients (77.3％) and 15 re-visiting patients (22.7％).The average diagnostic age of first-visiting patients was 20.9 ± 14.4 months,with 23.2 ± 14.7 and 11.2 ± 7.6 months for unilateral and bilateral tumors,respectively.There were 41 patients had definite course and causes,of whom the average course was 90.6± 115.2 days.The most common cause was leucocoria in 32 patients (62.7％),followed by redness and swelling in 4 patients (9.8％),and other causes in 5 patients (12.2％).Among the 15 re-visiting patients,the average diagnostic age was 63.6± 46.8 months,the average course was 32.8 ± 45.5 months.Recurrence was occurred in 5 patients (33.3％),leucocoria in 4 patients (26.7％),postoperative complication in 3 patients (20.0％),protrusion in 2 patients (13.3％) and redness in 1 (6.7％) patient,respectively.Fifty out of 82 eyes were admitted to hospital,including 37 eyes of first-visiting patients and 13 eyes of re-visiting patients.Among 37 first-visiting eyes,there were 5 eyes (13.5％) in stage A-C,26 eyes (70.3％) in stage D-E,6 eyes (16.2％) in extraocular stage.Five eyes in stage A-C were treated with laser photocoagulation and (or) cryotherapy combined with systemic chemotherapy.Four eyes in stage D were treated with intraocular arterial chemotherapy.Nineteen eyes (51.3％) were performed with enucleation,2 eyes (5.4％) with evisceration and 7 eyes (18.9％) abandoned treatment.Among 13 re-visiting eyes,6 eyes (46.2％,with 5 eyes of recurrence) had been enucleated before,4 eyes (30.8％) were in extraocular stage and 3 eyes (23.1％) in stage D-E.Five eyes (38.5％) were treated with evisceration,4 eyes (30.8％) with enucleation,1 eye with oculoplastic surgery and 3 eyes (23.1％) abandoned treatment.The rate of eye preservation was 18.0％,29.0％ for intraocular stage and 0％ for extraocular stage,respectively.Conclusion RB patients in Southwest China have a longer course between onset symptoms and diagnosis,more advanced classification and lower rate of eye preservation.

Clinicopathological characteristics of surgically treated localized renal masses in patients previously exposed to chemotherapy

ABSTRACT Purpose: To explore the potential association between renal mass characteristics and a history of chemotherapy. Materials and methods: A retrospective review of records of patients surgically treated for a localized renal mass between 2000 and 2012 was undertaken following an institutional review board approval. Patients age and sex, renal mass clinical characteristics (radiological size and mode of presentation) and pathological characteristics (diagnosis, renal cell carcinoma subtype, Fuhrman grade and stage) were compared between patients with and without a history of chemotherapy, using Fisher's exact test, Student's t-test and Wilcoxon rank sum test. A multivariate logistic analysis was performed to evaluate the independent association of chemotherapy and tumor pathology. Results: Of the 1,038 eligible patients, 33 (3%) had a history of chemotherapy. The distribution of clinical stage, renal mass diagnosis, renal cell carcinoma subtype, Fuhrman grade, pathological stage, sex and median age were similar between the general population and the chemotherapy group. However, the latter had a higher rate of incidental presentation (P = 0.003) and a significantly smaller median radiological tumor size (P = 0.01). In a subset analysis of T1a renal cell carcinoma, the chemotherapy group presented an increased rate of high Fuhrman grade (P = 0.03). On multivariate analysis adjusted for radiological tumor size, sex and age the chemotherapy cohort had a 3.92 higher odds for high Fuhrman grade. Conclusion: Patients with a history of chemotherapy typically present with smaller renal masses that, if malignant, have higher odds of harboring a high Fuhrman grade and thus may not be suitable for active surveillance.

Manejo del mesotelioma peritoneal maligno con citorreducción quirúrgica más quimioterapia hipertérmica intraperitoneal en el Instituto Nacional de Cancerología, Colombia: reporte de un caso y revisión bibliográfica / Peritoneal malignant mesothelioma treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy at the National Cancer Institute, Colombia: case report and literature review

El mesotelioma peritoneal es una neoplasia que se origina en las células mesoteliales del peritoneo. Histórica-mente, la supervivencia de los pacientes con mesotelioma peritoneal maligno sin tratamiento, es menor de 12 meses y se considera una neoplasia resistente a la quimioterapia. La citorreducción quirúrgica y la quimioterapia regional administrada como quimioterapia hipertérmica intraperitoneal (Hyperthermic Intraperitoneal Chemothe-rapy, HIPEC) se asocia con mejor supervivencia a largo plazo.Se presenta el caso de un paciente con antecedentes de exposición al asbesto y con diagnóstico de mesotelioma peritoneal maligno de tipo epitelioide, que fue tratado con cirugía citorreductora más quimioterapia hipertérmica intraperitoneal en el Instituto Nacional de Cancerología con una supervivencia de un año libre de enfermedad

Peritoneal mesothelioma is originated at the mesothelial cells of the peritoneum. Historically the survival of patients with this disease is less than 12 months without treatment and it is considered a neoplasm resistant to chemotherapy. Citorreductive surgery with hiperthermic intraperitoneal chemotherapy (HIPEC) is associated with an increased long-term survival. Here we present the case of a patient who had a past history of asbestos exposure and who was diagnosed with peritoneal mesothelioma of the epithelioid subtype. The patient was treated with cytoreductive surgery and HIPEC at the Instituto Nacional de Cancerología (Bogotá, Colombia) and has had a 12 month disease free survival

Clinical value of neoadjuvant chemotherapy combined with cytoreductive surgery and intraperitoneal hyperthermia in advanced ovarian cancer / 中国基层医药

Objective@#To evaluate the efficacy of neoadjuvant chemotherapy combined with cytoreductive surgery and intraperitoneal hyperthermia in the treatment of advanced ovarian cancer.@*Methods@#From June 2014 to April 2017, 72 patients with advanced ovarian cancer who were treated in the Maternal and Child Health Care Hospital of Weihai were selected as the research subjects.According to the digital table method, the patients were randomly divided into two groups, with 36 cases in each group.The control group was treated with neoadjuvant chemotherapy combined with cytoreductive surgery.The observation group was treated with neoadjuvant chemotherapy combined with cytoreductive surgery and intraperitoneal hyperthermic perfusion.After 3 months of chemotherapy, the curative effect was statistically analyzed.@*Results@#The operation time, the amount of ascites and the amount of bleeding in the observation group were significantly less than those in the control group (all P<0.05). There were no statistically significant differences in surgical incision stage I healing rate and the rate of pelvic infection between the two groups (P>0.05). After treatment, the remission rate in the control group was 55.5%(20/36), which was significantly lower than 77.8%(28/36) in the observation group (χ2=4.92, P<0.05). All patients were followed up for 1 year.The recurrence rate of the control group was 33.3%, which was significantly higher than 22.2% of the observation group (χ2=5.71, P<0.05).@*Conclusion@#Neoadjuvant chemotherapy combined with cytoreductive surgery and intraperitoneal hyperthermia in the treatment of advanced ovarian cancer is effective and worthy of clinical application.

Clinic analysis of rhegmatogenous retinal detachment secondary to conservative therapy in retinoblastoma patients / 中华眼底病杂志

Objective To observe the clinical characteristics of rhegmatogenous retinal detachment (RRD) secondary to conservative therapy in retinoblastoma (RB) patients.Methods A retrospective study. From July 2013 to May 2017, 20 RRD patients (20 eyes) of 456 RB patients (573 eyes) treated in Xinhua Hospital of Shanghai Jiao Tong University School of Medicine were included in the study. Eleven patients (11 eyes) were boy and 9 patients (9 eyes) were girls. Thirteen patients demonstrated bilateral RB and 7 patients had unilateral RB. Average age when diagnosed with RB was 25 months. International Classification of Retinoblastoma groups were C in 1 eye, D in 17 eyes, and E in 2 eyes. These patients received intra-arterial chemotherapy (17 eyes), intravenous chemotherapy (11 eyes), intravitreal chemotherapy (8 eyes), laser (14 eyes) and/or cryotherapy (5 eyes). Twelve patients (12 eyes) received vitreoretinal surgery including vitrectomy (6 eyes) and scleral buckling (7 eyes). The mean follow-up was 39 months. Fundus examination was performed under general anesthesia during comprehensive treatment and follow-up. The time interval of fundus examination varied from 1 to 6 months depending on the stability of the tumor.Results RRD was noted in 20 eyes (3.5％) with RB. Retinal hole was found in 15 eyes (75％). The cause of RRD was atrophic hole in calcified tumor (6 eyes, 30％), cryotherapy-related hole (5 eyes, 25％) and laser-related hole (9 eyes, 45％). Multiple atrophic hole in calcified tumor was noted in 3 eyes. Size of hole smaller than 2 DD was noted in 8 eyes (53％), and larger than 2 DD was noted in 7 eyes (47％). Holes were in posterior (3 eyes), equator (2 eyes) and periphery (10 eyes). Severe proliferated was noted in 1 eye. No tear was found. No bulbar retinal detachment and choroidal detachment was noted. Among 12 eyes who underwent vitreoretinal surgery, reattachment was achieved in 9 eyes (75％). No metastasis was noted.Conclusions Calcified regression of tumor, cryotherapy and laser were main reasons of RRD. Most of the holes are small in diameter and located in the periphery.

Clinical value of neoadjuvant chemotherapy combined with cytoreductive surgery and intraperitoneal hyperthermia in advanced ovarian cancer / 中国基层医药

Objective To evaluate the efficacy of neoadjuvant chemotherapy combined with cytoreductive surgery and intraperitoneal hyperthermia in the treatment of advanced ovarian cancer .Methods From June 2014 to April 2017,72 patients with advanced ovarian cancer who were treated in the Maternal and Child Health Care Hospital of Weihai were selected as the research subjects.According to the digital table method ,the patients were randomly divided into two groups,with 36 cases in each group.The control group was treated with neoadjuvant chemotherapy combined with cytoreductive surgery.The observation group was treated with neoadjuvant chemotherapy combined with cytoreductive surgery and intraperitoneal hyperthermic perfusion.After 3 months of chemotherapy ,the curative effect was statistically analyzed.Results The operation time,the amount of ascites and the amount of bleeding in the observation group were significantly less than those in the control group ( all P＜0.05).There were no statistically significant differences in surgical incision stage I healing rate and the rate of pelvic infection between the two groups (P＞0.05).After treatment,the remission rate in the control group was 55.5%(20／36),which was significantly lower than 77.8%(28／36) in the observation group (χ2 ＝4.92,P＜0.05).All patients were followed up for 1 year.The recurrence rate of the control group was 33.3%,which was significantly higher than 22.2%of the observation group (χ2 ＝5.71, P ＜0.05 ).Conclusion Neoadjuvant chemotherapy combined with cytoreductive surgery and intraperitoneal hyperthermia in the treatment of advanced ovarian cancer is effective and worthy of clinical application .

Effect of gifitinib combined with hydroxylcamptothecin pericardial perfusion in the treatment of advanced non-small cell lung cancer with pericardial effusion / 中国基层医药

Objective To observe the clinical effect of gifitinib combined with hydroxylcamptothecin pericardial perfusion in the treatment of patients with advanced non-small cell lung cancer(NSCLC) with pericardial effusion. Methods From January 2016 to September 2017,eighty-four cases of late NSCLC with pericardial effusion treated in the People′s Hospital of Jiaozhou were randomly divided into two groups according to the digital table,with 42 cases in each group.The control group was treated with gefitinib,and the observation group was treated with hydroxylcampto-thecin on the basis of the control group.The curative effect was evaluated after two courses of treatment in the two groups,and the clinical efficacy and adverse reactions were observed.Results The effective rates of the control group and the observation group were 47.6% (20/42) and 66.7% (28/42),respectively.The effective rate of the observa-tion group was significantly higher than that of the control group(χ2 =4.525,P<0.05).The effective rate of pericar-dial effusion was 33.3% (14/42) in the control group and 69.1% (29/42) in the observation group,the difference between the two groups was statistically significant( χ2 =10.720,P <0.05).There was no ststistically significant difference in the incidence rate of adverse reactions between the two groups during treatment(P<0.05).Conclusion Combination of gefitinib and hydroxylcamptothecin pericardial perfusion in the treatment of NSCLC with pericardial effusion has good tolerance and good safety for the patients.

High-dose versus Low-dose 5-Fluorouracil and Cisplatin Based Hepatic Arterial Infusion Chemotherapy for Advanced Hepatocellular Carcinoma

BACKGROUND/AIMS: Hepatic arterial infusion chemotherapy (HAIC) has been reported as an effective treatment for advanced hepatocellular carcinoma. The aim of this study is to compare the effect and safety between a high-dose regimen (750 mg/m2 5-fluorouracil [FU] and 25 mg/m2 cisplatin on day 1–4) and a low-dose regimen (500 mg/m2 5-FU on day 1–3 with 60 mg/m2 cisplatin on day 2). METHODS: A total of 48 patients undergoing HAIC were retrospectively analyzed. Thirty-two patients were treated with the high-dose and 16 patients with the low-dose regimen. RESULTS: Complete response (CR), partial response (PR), stable disease (SD), and progressive disease were noted in one (3.1%), 15 (46.9%), three (9.4%), and 13 patients (40.6%) in the highdose group, and 0 (0%), one (6.3%), eight (50%), and seven patients (43.8%) in the low-dose group (P=0.002). The disease control rate (CR, PR, and SD) did not differ between groups (59.4% vs. 56.3%, P=1.000), but the objective response rate (CR and PR) was significantly higher in the high-dose group (50.0% vs. 6.3%, P=0.003). The median progression free survival did not differ between groups (4.0 vs. 6.0, P=0.734), but overall survival was significantly longer in the high-dose group (not reached vs. 16.0, P=0.028). Fourteen (43.8%) patients in the high-dose group and two patients (12.5%) in the low-dose group experienced grade 3–4 toxicities (P=0.050). CONCLUSIONS: High dose HAIC may achieve better tumor response and may improve overall survival compared to a low-dose regimen. However, the high-dose regimen should be administered cautiously because of the higher incidence of adverse events.

Clinical efficacy of transurethral resection of bladder tumor combined with gemcitabine intravesical instillation in the treatment of superficial bladder cancer / 中国基层医药

Objective@#To investigate the effect of transurethral resection of bladder tumor (TURBt) combined with gemcitabine intravesical instillation in the treatment of superficial bladder cancer.@*Methods@#From May 2011 to January 2016, 112 patients with superficial bladder cancer were treated in the Seventh Hospital of Ningbo.According to the digital table, the patients were randomly divided into two groups: A group was treated by TURBt, and B group was treated by TURBt combined with gemcitabine.The postoperative complications, postoperative recurrence and quality of life were compared between the two groups.@*Results@#The operation time, indwelling catheter time and hospitalization time between the two groups had no statistically significant differences (all P>0.05). The postoperative complications of the two groups were frequent urination, dysuria and hematuria.The incidence rate of complications of A group was 39.29%, which was significantly higher than that of B group (χ2=36.597, P<0.05). The recurrence rate of B group was significantly better than that of A group (χ2=8.617, P<0.05). After treatment, the quality of life of the two groups was significantly improved compared with that before treatment, and compared with that of A group, the psychology, physiology, independence, social environment, quality of life scores of B group increased more significantly (t=29.217, 25.446, 19.517, 24.339, 36.001, all P<0.05).@*Conclusion@#Transurethral resection of bladder tumor combined with gemcitabine intravesical instillation in the treatment of superficial bladder cancer can ensure the treatment effect, at the same time, it can effectively reduce the postoperative complications and the emergence of various risk, reduce postoperative recurrence and improve the quality of life of patients, it has great significance and is worthy of promotion.

Value of European Organisation for Research and Treatment of Cancer score system for predication of immediate postoperative intravesical instillation of pirarubicin after transurethral resection of non-muscle invasive bladder cancer / 中华肿瘤杂志

Objective@#To assess value of immediate postoperative intravesical instillation of pirarubicin after transurethral resection (TURBT)of non-muscle invasive bladder cancer.@*Methods@#484 patients diagnosed with non-muscle-invasive bladder cancer admitted to the Second Affiliated Hospital of Kunming Medical University were divided into two groups after transurethral resection of bladder tumor. 285 patients received postoperative intravesical instillation of pirarubicin within 6 hours after the surgery, 199 patients received first instillation of pirarubicin at 10 days after the surgery, after that, all the patients received routine bladder perfusion chemotherapy. Patients who received intravesical instillation of pirarubicin within 6 hours were defined as immediate intravesical instillation group and the other patients as the control group. Based on the European Organisation for Research and Treatment of Cancer risk tables, scores of recurrence and progression of patients were calculated and then stratified into risk groups accordingly. Recurrence and progression rates of the immediate intravesical instillation group were analyzed and then compared with the corresponding reference of the risk tables.@*Results@#The 1-year and 5-year recurrence rate of patients with EORTC table scoring 0 in the immediate intravesical instillation group were significantly lower than that of the EORTC reference group (5.3% and 14.0% vs 15.0% and 31.0%, P<0.05). 1-year recurrence free rate between the immediate intravesical instillation group and the control group in patients scoring 1-4 was significantly different (81.3% vs 76.7%, P=0.014). However, 1-year recurrence free rate of the immediate intravesical instillation group was comparable with that of the control group in patients scoring 5-9, 10-17(P>0.05), which is quite close to the EORTC reference. The probability rates of 1-year and 5-year progression of the 285 patients who received immediate intravesical instillation group did not show significant difference with the EORTC reference. On multivariate analysis, previous recurrence, tumor grade G2-3, tumor multiplicity, delay of immediate intravesical instillation were independent risk factors of recurrence(P<0.05).@*Conclusions@#With the help of EORTC recurrence risk table stratifying the patients into different risk groups, our study showed that delay of immediate postoperative intravesical instillation of chemotherapy after TURBT was an independent risk factor of post-surgery recurrence of tumor. Moreover, patients with EORTC scoring 1-4 might obtain greatest benefits.

Effects of dezocine combined with dexmedetomidine on reducing adverse reaction of hyperthermic intraperitoneal chemotherapy after intestinal operation / 天津医药

@#Objective To observe the effect of dezocine combined with dexmedetomidine on reducing adverse reaction of hyperthermic intraperitoneal chemotherapy (HIPEC) after intestinal operation, and provide reference for clinical application. Methods A total of 80 patients with HIPEC were divided into intervention group and routine group according to different methods of sedation and analgesia. On the basis of routine sedation and analgesia，the 5 mg muscle injection of dizocine was given for patients in intervention group, and normal saline 48 mL+ dexmedetomidine 200 μg were continuously pumped at 0.3 μg/(kg·h) until the end of the HIPEC. The occurrence of adverse reactions in HIPEC was compared between the two groups of patients. Results Results showed that the heart rates [(83.34±8.25) times/min vs. (90.11±10.69) times/ min] and body temperature [(37.33±0.42)℃ vs. (37.95±0.51)℃] were significantly lower in the intervention group than those of routine group (P＜0.01). The incidence rates of nausea, vomiting, pain and irritability were significantly lower in the intervention group than those of routine group (P＜0.05). Conclusion Dezocine combined with dexmedetomidine can significantly reduce the incidence of adverse reactions in patients undergoing HIPEC after intestinal surgery.

Hyperthermic perfusion chemotherapy combined with bevacizumab for treatment of malignant ascites or pleural effusion: a meta-analysis of efficacy / 肿瘤研究与临床

Objective To make a meta-analysis of the effectiveness of hyperthermic perfusion chemotherapy (HPC) combined with bevacizumab for malignant ascites or malignant pleural effusion,and to provide the references for further practice and studies.Methods VIP,Wanfang data,PubMed and CNKI were searched from inception to January 2018.HPC combined with bevacizumab or HPC alone for malignant ascites or pleural effusion were collected for controlled clinical trial (CCT).According to inclusion and exclusion criteria,two reviewers checked studies,extracted data and assessed quality of the included studies.RevMan 5.3 software was used to make a meta-analysis.Results A total of 4 CCT involved 226 patients.Meta-analysis showed that compared with the HPC alone,HPC combined with bevacizumab had a higher rate in clinical efficiency (OR =4.82,95 ％ CI 2.45-9.49,P ＜ 0.000 01),malignant ascites or pleural effusion control rate (OR =4.06,95 ％ CI 1.09-15.11,P ＜ 0.05),quality of life improvement rate (OR =6.79,95 ％ CI 3.53-13.08,P ＜ 0.000 01),and the difference was statistically significant.Conclusion HPC combined with bevacizumab can improve the clinical effective rate,effusion control rate and quality of life improvement rate of the patients with malignant ascites or pleural effusion.

The main points in the treatment for retinoblastoma / 中华眼底病杂志

Thanks to the treatment of retinoblastoma (RB) having improved significantly in recent years,there is an increasing trend to use conservative treatment modalities that aim to preserve the globe as well as vision with minimum mortality.RB therapy is a long-term systemic treatment in clinical practice.Although there are many treatment options for RB therapy,such as cryotherapy,photocoagulation,systemic chemotherapy,enucleation and ophthalmic chemotherapy,it is recommended to consider in accordance with the following key points in gaining a reasonable treatment strategies:to make sure that RB is an intraocular period;to determine whether the intraocular RB to be treated with eye preservation or enucleation;what is the case of eye preservation therapy combined with chemotherapy and how to arrange the follow-up of RB patients.It's more complicated to choice the therapeutic measures for RB in clinical practice.So,the patient's condition,economic capability and medical condition should be evaluated comprehensively.The principle of RB treatment should be followed,which is protecting eyeball and visual function without life damage.

The influence of postoperative hyperthermic intraperitoneal perfusion chemotherapy on serum tumor markers in advanced adenocarcinoma of esophagogastric junction / 中华普通外科杂志

Objective To evaluate the changes of CEA,CA19-9,CA72-4 of patients with advanced adenocarcinoma of the esophagogastric junction (AEGJ) who received ultra-early precise hyperthermic intraperitoneal perfusion chemotherapy (HIPEC) with paclitaxel (PTX) after radical surgery.Methods From Jul 2014 to Dec 2015 postoperative advanced AEGJ patients were divided to receive ultraearly precise HIPEC (87 cases,HIPEC group) and conventional therapy group (85 cases) in early stage after radical surgery.Serum levels of CEA,CA19-9 and CA72-4 were examined on preoperative day 1 and postoperative day 9.Results On post-op day 9,the level of CEA,CA19-9 and CA72-4 was (2.8 ± 1.3)ng/ml,(22 ±8)IU/ml,(4.1 ± 1.9)IU/ml in HIPEC group,while that was (3.4 ± 1.2)ng/ml,(25 ±11) IU/ml,(4.8 ± 2.1) IU/ml in control group respectively (t =2.453,P =0.015;t =2.241,P =0.026;t =2.154,P =0.033).Conclusion Ultra-early PTX-based HIPEC with advanced AEGJ after radical surgery lowers serum tumor makers of CEA,CA19-9,CA72-4,reducing body's tumor burden.

Clinical effect of selective bronchial artery infusion chemotherapy for central squamous cell carcinoma of the lung / 中国医师杂志

Objective To investigate the clinical effect of selective bronchial artery infusion chemotherapy for central squamous cell carcinoma of the lung.Methods 93 cases of central lung squamous cell carcinoma patients who were treated in our hospital from February 2015 to February 2017 were enrolled in the study.They were divided into the observation group (n =45) and the control group (n =48) according to the patients'final treatment.The observation group was treated with bronchial artery perfusion chemotherapy,and the control group was treated with systemic venous chemotherapy.The short-term effect and the improvement of lung function in the two groups were observed,and the prognosis of the patients was followed up.Results The short-term effect of the observation group was better than that of the control group (P ＜0.05),and the total effective rate of the observation group was 95.56％;The forced vital capacity (FVC)and forced expiratory volume in the first second (FEV,) of the observation group were (75.39 ± 6.88)％and (78.19 ± 7.79)％,respectively,which were significantly higher than those in the control group (P ＜0.05).The reoperation ratio of the observation group was 44.44％ after chemotherapy,which was significantly higher than that of the control group,with statistically significant difference (P ＜ 0.05).The median total survival time of the observation group was 17 months,which was significantly higher than that of the control group,with statistically significant difference (P ＜ 0.05).The incidence of adverse reaction in the observation group was 6.67％,which was significantly lower than that in the control group,with statistically significant difference (P ＜ 0.05).Conclusions Selective bronchial artery infusion chemotherapy for central lung cancer is effective and worthy of clinical application.