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Immunotherapy combined with targeted therapy can benefit the survival of patients with unresectable hepatocellular carcinoma. Atezolizumab combined with bevacizumab has achieved remarkable efficacy in patients with advanced hepatocellular carcinoma, but the efficacy of conversion therapy in patients with unresectable hepatocellular carcinoma still needs more evidences. The authors report the clinical efficacy of a case of unresectable hepatocellular carcinoma with hepatitis B virus related liver cirrhosis who was treated with immunotherapy plus targeted therapy combined with local treatment. Results show a good effect in patient without tumor recurrence after postoperative 9 months.
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Previous studies believe that oligometastasis has unique biological characteristics. Early active treatment for patients with oligometastatic prostate cancer can delay disease progression and improve survival. However, the current definition of oligometastasis is still unclear, and its optimal treatment is still a major concern of the medical community. This article reviewed recent research progresses in term of the definition and comprehensive treatment strategy of oligometastatic prostate cancer.
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@#Recently, in situ gel has been widely used as a local delivery system for periodontitis treatment because of its lesion injectability, local drug depot function, and drug sustained-release effect.Different therapeutic purposes can be achieved by loading different types of drugs such as antibiotics, bioactive factors, etc.In this review, different types of in situ gel with temperature-sensitive, ion-sensitive, pH-sensitive and solvent-exchanged characteristics were introduced for their applications and limitations in the delivery of drug for periodontitis;and the elimination of periodontal inflammation, periodontal tissue repair and the long-term role after loading microsphere achieved by the in situ gel system were also reviewed.
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Objective To analyze the clinical efficacy of different anti-tumor therapies for recurrence and metastasis after liver transplantation for primary liver cancer (liver cancer). Methods Clinical data of 145 recipients undergoing liver transplantation for liver cancer were retrospectively analyzed. The overall survival and recurrence and metastasis after liver transplantation for liver cancer were analyzed. The clinical efficacy of different anti-tumor therapies for recipients with recurrence and metastasis were compared. Results Sixty-five recipients (44.8%) developed recurrence and metastasis. The median recurrence time was 6 months. Among them, 1 case underwent secondary liver transplantation after recurrence and died of intestinal perforation. Twenty-four recipients (37%) received targeted drug therapy with a median tumor-bearing survival of 22 months. Eleven recipients (17%) received radiotherapy or chemotherapy with a median tumor-bearing survival of 11 months. Nine recipients (14%) received local treatment (surgical resection or radiofrequency ablation), and the median tumor-bearing survival was 8 months. Twenty recipients (31%) abandoned anti-tumor therapy, and the median tumor-bearing survival was 3 months. The tumor-bearing survival of recipients receiving anti-tumor therapy was significantly longer than that of recipients without anti-tumor therapy (P < 0.001). The tumor-bearing survival of recipients receiving targeted drug therapy was significantly longer than that of those receiving other anti-tumor therapies (P=0.03). The tumor-bearing survival of recipients receiving local treatment, radiotherapy and chemotherapy was considerably longer than that of those who abandoned anti-tumor therapy (P=0.004). Conclusions Surgical resection and radiofrequency ablation are the optimal therapies for recipients with recurrence and metastasis after liver transplantation for liver cancer. For recipients with multi-focal tumors who fail to receive local treatment, those receiving targeted drug therapy obtain the longest survival. In addition, radiotherapy and chemotherapy can also prolong the survival of recipients with recurrence and metastasis.
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Non-small cell lung cancer (NSCLC) is the most common pathological type of primary lung cancer. Currently, main treatment approaches for NSCLC patients include surgical resection, radiotherapy, chemotherapy, targeted therapy and so on. In recent years, thermal ablation has received increasing attention in the treatment of various stages of NSCLC. As a safe and efficient local treatment, thermal ablation may bring potential clinical benefits to NSCLC patients. However, many issues remain unsolved and further investigation is needed in the clinical application of thermal ablation in NSCLC. In this review, we aim to summarize the applications of thermal ablation in NSCLC and further discuss the emerging controversies as well as future research directions.
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The clinical application of triptolide (TPL) in tumor therapy has been greatly limited by its toxicity and inefficient delivery. Herein, a localized and sustained-release thermo-sensitive hydrogel was developed for the intra-tumor administration of TPL. Based on the amphiphilic structure of poly (
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@#AIM: To research the clinical effects of visual display terminal(VDT)syndrome after local treatment near the eyes in combination with systemic comprehensive treatment.<p>METHODS: Totally 62 patients(124 eyes)with VDT syndrome were randomly divided into a trial group and a control group, 31 cases(62 eyes)in each group. In the control group, artificial tears as eye drops were given. In addition to the above local treatment with artificial tears, the trial group was also treated with the auricular acupressure and tuina at the acupoints near orbits and the whole body. A health education was carried out in both of the two groups. The course of the treatment of the two groups was 2wk. The symptomatic scores, and the amplitude of accommodation, facility of accommodation, accommodative response, near point of convergence and the ratio of accommodative convergence to accommodation(AC/A)based on refractive error correction of all the patients were detected before and after the treatment. The parameters gained before and after the treatment were compared for evaluating efficacy. <p>RESULTS: After treatment, the symptomatic scores and facility of accommodation of the two groups were significantly improved compared with those before treatment(<i>P</i><0.05). Amplitude of accommodation and near point of convergence in the trial group were significantly improved after treatment(<i>P</i><0.05). <p>CONCLUSION: Local treatment near the eyes in combination with systemic comprehensive treatment can effectively improve the accommodative and convergent functions of patients with VDT syndrome, and relieve their symptoms of asthenopia and fatigue.
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Introducción: Existen varias curaciones para quemaduras. La sulfadiazina de plata se ha usado por años pero las membranas microporosas son cada vez más preferidas. Objetivos: Comparar la eficiencia de las membrana microporosa (Telfa Clear®) versus sulfadiazina de plata (Platsul®) en menores de 15 años hospitalizados por quemadura. Pacientes y Métodos: Estudio de cohorte retrospectivo de 87 pacientes, dividido en 2 grupos comparables en extensión y profundidad de la quemadura, edad y sexo. Durante enero a diciembre 2007 se curaron 52 pacientes con Platsul® y desde enero a octubre 2008 se curaron 35 con Telfa Clear®. Se evalúa tiempos y extensión de reepitelización, porcentaje de injertos, costos, días de hospitalización, número de curaciones, complicaciones, almacenamiento-estabilidad y costos. Estadística no paramétrica para el análisis univariado y regresión logística multivariado en Stata 11.2. Resultados: Los pacientes curados con Platsul® se injertaron más tardíamente y presentan más curaciones. Platsul® es peor evaluado por su almacenamiento-estabilidad y mayores costos. No hay diferencia en la incidencia de infección. Conclusiones: Ambas Técnicas son eficientes en permitir reepitelización, pero Platsul® puede demorar el injerto. La Telfa Clear® es mejor evaluado por el equipo de salud en cuanto a almacenamiento y estabilidad. El menor costo de Telfa Clear® es una ventaja.
Introduction: There are several dressings for burns. Silver sulfadiazine has been used for years but microporous membranes are increasingly preferred. Objectives: To compare the efficiency of microporous membrane (Telfa Clear®) versus silver sulfadiazine (Platsul®) in children younger than 15 years old hospitalized for burns. Patients and Methodology: Retrospective cohort study of 87 patients, divided into 2 comparable groups in extent and depth of the burn, age and sex. During January to December 2007, in 52 patients Platsul® were use and in 35 patients Telfa Clear® were use from January to October 2008. The time and extent of re-epithelialization, percentage of grafts, costs, length of stay, number of dressing change, complications, storage-stability and costs are evaluated. Non-parametric statistics were used for univariate analysis and logistic regression for multivariate analysis en Stata 11.2. Results: Platsul® was associate to a later graft and had a greater number of dressing changes. Platsul® is worst rated for its storage-stability and higher costs. No difference in infection rate was observed. Conclusions: Both techniques are efficient in allowing re-epithelialization, but burns treated with Platsul® were grafted later than when Telfa Clear® was used. Telfa Clear® is best evaluated by the health team in terms of storage and stability. The cost of Telfa Clear® is presented as an advantage.
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Humans , Male , Female , Infant , Child, Preschool , Child , Silver Sulfadiazine/therapeutic use , Bandages , Burns/therapy , Anti-Infective Agents, Local/therapeutic use , Retrospective Studies , Treatment Outcome , Re-EpithelializationABSTRACT
The choroid is one of the most common ocular sites for metastatic disease. Lung cancer is the first cause of choroidal metastasis among primary cancers in China. The current management of choroidal metastasis of lung cancer is based on the combination of systemic treatments and local treatments. The latter mainly include radiotherapy, transpupillary thermotherapy, photodynamic therapy, intravitreous injection and enucleation. This review covers the research progress in local treatments on choroidal metastasis of lung cancer.
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The effect of the treatment of 112I particle therapy in solid tumor is remarkable and with less side effect.This study retrospectively analyzed the clinical data of 125I particles implantation combined systemic chemotherapy in the treatment of locally advanced pancreatic cancer patients.Main observation indexes included:the overall median survival,1 year survival rate,pain relief rate,the postoperative complications.Intraoperative 125I particles implantation combined with postoperative chemotherapy in treatment of locally advanced pancreatic cancer patient was safety,which can effectively prolong patient survival and relieve patients' pain.
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The choroid is one of the most common ocular sites for metastatic disease.Lung cancer is the first cause of choroidal metastasis among primary cancers in China.The current management of ehoroidal metastasis of lung cancer is based on the combination of systemic treatments and local treatments.The latter mainly include radiotherapy,transpupillary thermotherapy,photodynamic therapy,intravitreous injection and enucleation.This review covers the research progress in local treatments on choroidal metastasis of lung cancer.
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Intrahepatic cholangiocellular carcinoma (ICC) is a primary tumor originating from the epithelial cells of bile duct. In recent years, incidence of ICC in the world is on the rise, and it has become the second common malignant tumors of the liver, with its incidence being next only to hepatocellular carcinoma (HCC). The onset of ICC is insidious, its clinical manifestations are lack of specificity, most of the patients are already in the advanced stage when the diagnosis is confirmed, thus, affecting the treatment and prognosis. Therefore, early diagnosis and treatment is essential. The radical treatment plan is mainly surgical excision, and other treatment options include systemic chemotherapy, local ablation, transcatheter arterial chemoembolization (TACE), selective intraarterial radiotherapy with yttrium-90 microspheres (SIRT-90Y), 125I seed implantation, etc. This article aims to make a comprehensive introduction about the recent advances in the diagnosis and treatment of ICC. (J Intervent Radiol, 2018, 27:285-289)
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Since a skin infiltration of breast cancer may increase hemorrhage and malodorous exudates, it significantly reduces the quality of life. Local treatment is usually performed with zinc oxide starch, Mohs paste or its alternatives. However, the Mohs paste causes pain due to necrobiosis of normal tissues, while the topical therapy with zinc oxide starch ineffectively suppresses hemostasis and odor. We hereby report a case of an 86-year old woman with skin infiltration by breast cancer. The patient’s symptoms including bleeding, infection signs, odor, exudates, necrotic tissue objectively improved with Shiunko ointment, Zinc oxide starch, and Metronidazole (MNZ) combination therapy. The gauze was exchanged once a day and this treatment was simple and easy. The combination therapy with Shiunko ointment, Zinc oxide starch, and MNZ may become an effective new regimen for bleeding and odor from skin involvement in breast cancer.
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This study aims to investigate the effect of different local testicular treatments and validate common prognostic factors on primary testicular lymphoma (PTL) patients. We retrospectively reviewed the clinical records of 32 patients from 1993 to 2017 diagnosed with PTL and included 22 patients for analysis. The Kaplan-Meier method, Log-rank test, and multivariate Cox proportional hazard regression analysis were applied to evaluate progression-free survival (PFS), overall survival (OS), and determine prognosis predictors. The median follow-up time was 30 months. Median OS and PFS were 96 months and 49 months, respectively. In univariate analysis, advanced Ann Arbor stage (III/IV) (P < 0.001), B symptoms (P < 0.001), and extranodal involvement other than testis (P = 0.001) were significantly associated with shorter OS and PFS. In multivariate analysis, Ann Arbor stage was significantly associated with OS (OR = 11.58, P = 0.049), whereas B symptom was significantly associated with PFS (OR = 11.79, P= 0.049). In the 10 patients with the systemic usage of rituximab, bilateral intervention could improve median OS from 16 to 96 months (P = 0.032). The study provides preliminary evidence on bilateral intervention in testes in the rituximab era and validates common prognostic factors for Chinese PTL patients.
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Objective:To analyze the role of parenchymal-sparing hepatectomy (PSH) in surgical treatment of colorectal liver metasta-ses (CRLM). Methods:All CRLM patients registered in our database who underwent liver resection were assigned into two groups:the PSH group and the major hepatectomy (MH) group. Clinical characteristics were retrospectively analyzed. Surgical outcomes, survival time, and recurrence were compared between the two groups. Results:A total of 377 patients were enrolled. Except for tumor num-bers, no significant difference was found in patient demographics and tumor characteristics between the 2 groups. The rate of PSH in-creased over the study period. Short-term surgical outcomes were better in the PSH group than in the MH group. Surgery time was sig-nificantly shorter (177.5 min vs. 220 min, P=0.000), blood loss was significantly reduced (150 mL vs. 300 mL, P=0.000), and morbidity was significantly reduced (47.4%vs. 64.8%, P=0.008). No significant difference was found in overall survival (OS) time (43 m vs. 41 m, P=0.750) between the 2 groups. Hepatic recurrence-free survival time (21 m vs. 13 m, P=0.344) was similar between the 2 groups. However, local treatment was more frequently performed in the PSH group (42.8%vs. 25.6%, P=0.040) when disease recurred. The 5-year OS was significantly better in patients undergoing local treatment than in those without undergoing local treatment (58 m vs. 24 m, P=0.000), for hepatic recurrence. Conclusion:PSH did not increase hepatic recurrence but improve salvage ability in case of recur-rence with a better short-term surgical outcome. PSH should be the recommended approach at initial hepatectomy.
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Objective To evaluate the effect of local treatment for the prognosis of hormonesensitive metastatic prostate cancer.Methods A systematic review of the literature about local treatment for the prognosis of hormone-sensitive metastatic prostate cancer was performed,searching Medline,Embase,Cochrane Library,CBM,CNKI,VIP and Wan Fang database from January 2001 to October 2016.Two authors reviewed the records to identify comparative studies.A meta-analysis was conducted using Review Manager 5.0.Results Five studies were enrolled,including 29 354 patients.Meta-analysis showed that,compared with no local treatment,local treatment had a significant beneficial effect in 5-year overall survival rate (OR =0.18,95 ％ CI 0.15-0.22,P ＜ 0.01),5-year disease specific survival rate (OR =0.39,95 ％ CI 0.31-0.49,P＜0.01) as well as 3-year overall survival rate (OR =0.47,95％ CI 0.35-0.62,P＜0.01).Sub-group analysis showed that,compared with no local treatment,prostatectomy had a significant beneficial effect in 5-year overall survival rate (OR =0.17,95 ％ CI 0.12-0.25,P ＜ 0.01),5-year disease specific survival rate (OR =0.30,95％ CI 0.22-0.40,P ＜0.01) as well as 3-year overall survival rate (OR=0.25,95％CI 0.19-0.32,P ＜0.01),and external beam radiation therapy only had a significant beneficial effect in 3-year overall survival rate (OR =0.54,95％ CI 0.42-0.69,P ＜ 0.01).Conclusions Prostatectomy and external beam radiation therapy may have a survival benefit for hormone-sensitive metastatic prostate cancer.Prospective randomized controlled studies are necessary because of the limits of current studies.
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Objective To evaluate the effect of local treatment for the prognosis of hormonesensitive metastatic prostate cancer.Methods A systematic review of the literature about local treatment for the prognosis of hormone-sensitive metastatic prostate cancer was performed,searching Medline,Embase,Cochrane Library,CBM,CNKI,VIP and Wan Fang database from January 2001 to October 2016.Two authors reviewed the records to identify comparative studies.A meta-analysis was conducted using Review Manager 5.0.Results Five studies were enrolled,including 29 354 patients.Meta-analysis showed that,compared with no local treatment,local treatment had a significant beneficial effect in 5-year overall survival rate (OR =0.18,95 ％ CI 0.15-0.22,P ＜ 0.01),5-year disease specific survival rate (OR =0.39,95 ％ CI 0.31-0.49,P＜0.01) as well as 3-year overall survival rate (OR =0.47,95％ CI 0.35-0.62,P＜0.01).Sub-group analysis showed that,compared with no local treatment,prostatectomy had a significant beneficial effect in 5-year overall survival rate (OR =0.17,95 ％ CI 0.12-0.25,P ＜ 0.01),5-year disease specific survival rate (OR =0.30,95％ CI 0.22-0.40,P ＜0.01) as well as 3-year overall survival rate (OR=0.25,95％CI 0.19-0.32,P ＜0.01),and external beam radiation therapy only had a significant beneficial effect in 3-year overall survival rate (OR =0.54,95％ CI 0.42-0.69,P ＜ 0.01).Conclusions Prostatectomy and external beam radiation therapy may have a survival benefit for hormone-sensitive metastatic prostate cancer.Prospective randomized controlled studies are necessary because of the limits of current studies.
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Objective To construct the drug delivery system of gentamicin/chitosan microspheres for local injection, and evaluate its physicochemical properties and cell cytotoxicity.Methods Gentamicinwas used as model drug, chitosan as carrier, lecithinand hydroxypropyl-β-cyclodextrin as accessories, and the microspheres of gentamicin/chitosan/lecithin/hydroxypropyl-β-cyclodextrinwas prepared by spray drying method.The physicochemical properties and cell cytotoxicity of themicrospheres were investigated by UV spectrophotometry , scanning electron microscopy, X-ray diffraction, dynamic membrane dialysis and MTT assay.Results Five kinds of chitosan microspheres ( A, B, C, D and E) with different drug/carrier ratios were successfully prepared by spray drying method.The yield, drug loading and entrapment efficiency of the drug-loaded microspheres were 34.38%~46.94%, 10.20% ~18.67%, 61.20% ~74.72%, respectively.SEM results showed that compared with microspheres A, B and C, microspheres D and E own the spherical shape with wrinkled surface and uniform particle size, particle size between 0.5 ~3 μm, no adhesion.X-ray diffraction analysis showed that the drug was encapsulated in the microspheres.The results of in vitro release indicated that microspheres D had a good sustained release effect in the four drug-loaded microspheres.The results of cytotoxicity test showed that when the concentration of gentamicin reached 400 μg/mL, the relative growth rate of microspheres D was still higher than 80% with the cytotoxicity grade was one, ie, no cytotoxicity.Conclusion The microspheres D with good physicochemical properties, sustained-release effect and biocompatibility, is expected to be a good carrier of prostate local drug delivery.
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With the advances in the imaging techniques, it is now possible to more accurately diagnose and stage pancreatic cancer. However, there is no uniform definition of "borderline resectable pancreatic cancer (BRPC)" and consensus on this terminology has not been reached yet. Although there has been much progress in the therapeutic strategies for pancreatic cancer, the optimal treatment scheme for BRPC is still under debate. In order to overcome these problems, prospective studies using multidisciplinary approaches are warranted. This article is intended to review the currently available definitions and management of BRPC. Promising novel ablative methods that are used as local treatments for locally advanced pancreatic cancer are also introduced. In the near future, these ablative methods might prove to be invaluable for those with BRPC.
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Consensus , Pancreatic NeoplasmsABSTRACT
La úlcera varicosa es una complicación frecuente en la insuficiencia venosa de los miembros inferiores que condiciona múltiples trastornos locales y sistémicos, con una mala calidad de vida del paciente. El objetivo del presente trabajo fue evaluar el efecto cicatrizante del oleozón en ulceras varicosas de los miembros inferiores en la atención primaria. Se tomó una muestra de 60 pacientes con úlceras varicosas en miembros inferiores que fueron divididos en dos grupos: A) 30 tratados con oleozón®, B) 30 tratados convencionalmente, de forma ambulatoria desde enero de 2007 hasta mayo de 2008. Se consideró como buen resultado cuando a los 45 días de tratamiento o antes, el paciente presentó una remisión parcial o total y se consideró fracasado cuando no hubo remisión. Se utilizó la prueba de comparación de frecuencias de X² al 95 % de confianza y obtuvo un incremento significativo del doble de casos con remisión total bajo tratamiento con oleozón®, de manera que la eficacia quedó comprobada para el tratamiento ambulatorio en la Atención Primaria de Salud, de las úlceras varicosas de miembros inferiores, rebeldes a tratamiento convencional.
Varicous ulcers are frequent complications of the venous insufficiency of the lower limbs, leading to multiple local and systemic impairments, producing patients having bad quality of life. The aim of the present paper was to evaluate the scarring effect of oleozón®, on various ulcers of the lower limbs at the Primary Health Care level. A sample of60 patients were divided into two groups: A) 30 patients, receiving ozonized oil (oleozón®), B) 30 patients conventionally treated, in ambulatory way since January 2007 to May 2008. A good result was considered when after 45 days of treatment or before that time a partial or total remission was obtained, and failure when no remission was observed. X2 test was used to compare frequencies at 95 % of certainty. There was two fold number of cases under on remission in group A, showing the efficacy of the treatment, otherwise rebels to the conventional treatment.