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Objective:To analyze long-term outcomes of inoperable non-metastatic pancreatic cancer patients treated with definitive radiotherapy-based comprehensive treatment.Methods:Clinical data of 168 patients with medically unfit, refusal to surgery or inoperable non-metastatic pancreatic cancer treated with radiotherapy-based comprehensive treatment in PLA General Hospital between January 2016 and December 2020 were retrospectively analyzed. Survival outcomes,prognostic factors and patterns of treatment failure were analyzed in the radiotherapy ( n=95) and combined chemoradiotherapy ( n=73) groups. The survival analysis was conducted by Kaplan-Meier method. The survival curve was compared by log-rank test. Independent prognostic factors were identified by Cox proportional harzard model. Results:With a median follow-up of 20.2 months in the entire group, the median overall survival (OS) and median progression-free survival (PFS) were 18.0 and 12.3 months. The corresponding median OS and median PFS after receiving radiotherapy were 14.3 and 7.7 months. The 1-, 2-and 3-year OS rates were 72.1%, 36.6% and 21.5%, and the 1- and 2-year local control rates were 82.6% and 64.3%, respectively. The median OS for stage Ⅰ, stage Ⅱ and stage III were 27.1, 18.0 and 17.0 months, respectively. There was no significant difference in the median OS of patients with localized disease (stage Ⅰ-Ⅱ) between the radiotherapy and combined chemoradiotherapy groups (21.1 vs. 20.4 months, P=0.470). In patients with locally advanced disease (stage Ⅲ), combined chemoradiotherapy group showed better median OS compared with radiotherapy group (19.2 vs. 13.8 months, P=0.004). Clinical stage, CA19-9 before radiotherapy, comprehensive treatment and biological effective dose (BED 10) were identified as the independent prognostic factors for OS ( P=0.032, 0.011, 0.003 and 0.014). The cumulative 1- and 2-year actuarial rates of treatment failure, local-regional recurrence and distant metastasis were 48% and 74.4%, 15.0% and 27.4%, 23.6% and 33.1%, respectively. Liver metastasis (16.1%, 27/168) and local recurrence (11.9%, 20/168) were the primary patterns of treatment failure. Conclusions:Definitive radiotherapy-based comprehensive treatment effectively prolongs long-term survival in patients with inoperable non-metastatic pancreatic cancer. Definitive radiotherapy can be an alternative treatment option with curative intent for patients with localized pancreatic cancer who are medically unfit or refuse to undergo surgery. The combination of radiotherapy and chemotherapy remains an effective treatment choice for locally advanced unresectable pancreatic cancer.
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Objective:To evaluate and compare the early and long-term outcomes of rheumatic patients who underwent left-side heart valve replacement with concomitant tricuspid valve replacement, and analyze the difference of early mortality and long-term survival rate between mild pulmonary artery systolic pressure (PASP) and moderate to severe PASP patients.Methods:From January 2009 to December 2018, 79 cases of patients were reviewed and summarized. The mean age before operation was (45.7±7.8) years old. These patients were divided into mild PASP group(<50 mmHg, 38 cases) (1 mmHg=0.133 kPa) and moderate-severe PASP group (>50 mmHg, 41 cases) . Kaplan- Meier method was used to estimate the overall long-term survival rate and the incidence of complications, and to compare the long-term survival rate of patients with mild and moderate -severe PASP elevation. Results:The mortality rate of early postoperative patients was 8.9% (7/79). The causes of death included: low cardiac output syndrome in 3 cases, multiple organ failure caused by pulmonary infection in 2 cases, acute renal insufficiency in 1 case, sudden cardiac arrest in 1 case. Although the mortality rate of early moderate-severe PASP group (12.2% vs. 5.3%) was higher than that of mild PASP group, there was no significant difference ( P>0.05). The mean follow-up time was (51.8±31.7) months (3-115 months). Kaplan- Meier method was used to estimate the 10-year survival rate, the rate of avoiding thrombosis, the rate of avoiding serious bleeding event and the rate of avoiding reoperation, which were (67.2±10.6)%, (85.7±6.2)%, (83.4± 6.9)% and (93.7 ± 3.7)%, respectively. Although the long-term survival rate of mild PASP (78.0±10.6) % was higher than that of moderate-severe PASP (62.8 ± 13.4) %, there was no significant difference ( P>0.05). Conclusion:The early mortality rate of rheumatic patients who underwent left-side heart valve replacement with concomitant tricuspid valve replacement is still relatively high. The recurrent heart failure is the major causes of long-term death.
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Primary cardiac undifferentiated pleomorphic sarcoma is rare and is associated with very poor survival. We report a case of a 45-year-old female who presented with dyspnea on effort, in whom an echocardiographic exam showed a large mass in the left atrium and the tumor resection was performed. The pathological diagnosis of the resected tumor was undifferentiated pleomorphic sarcoma which subsequently recurred. The patient needed four re-surgeries, and chemotherapy with Pazopanib was performed. A long-term survival of 5 years after the initial surgery was achieved.
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The clinical data of 1 patient with long-term survival metastatic prostate cancer were analyzed retrospectively, and the related literature was reviewed and discussed. The patient, male, 70 years old, was admitted to the hospital in 2009 due to dysuria with lower abdominal pain for one month.Blood PSA>1 000 ng/ml. The pathology of prostate biopsy was prostatic adenocarcinoma, Gleason score was 8 points (4+ 4), and was diagnosed as prostate cancer (T 4N 0M 1b) with bone metastasis. The patient underwent combined androgen-blocked treatment(castration and bicalutamide 50mg) for four years, then progressed to mCRPC. The initial treatment was continued in the fifth year due to the absence of novel therapeutic agents, and then symptoms progressed. The regimens were adjusted successively to increased anti-androgen (castration and bicalutamide 150 mg) from Jan 2015, then switch to another anti-androgen (Flutamide 250 mg) from Aug 2015, and then withdraw the anti-androgens from Feb 2016. All these treatments showed limited benefit for a relatively short time. The t-PSA increased steadily to over 1 000 ng/ml with persistent symptoms. In April 2017, he started the treatment with the original abiraterone acetate and underwent a PSA flare-up in the following month.tPSA decreased sharply since May 2017, less than 0.02ng/ml in Aug 2017. Meanwhile, the regimen relieved the ostealgia. He could take care of himself in daily life. raditional CAB therapy can maintain PSA-free progression and symptom-free progression for several years for some metastatic prostate cancer patients. After disease progression, the increased dosage of anti-androgens, the substitution of anti-androgen, and the withdrawal of anti-androgens showed limited benefit within a short time. However, the novel hormone therapy is still effective in relieving clinical symptoms and prolonging patients' survival time.
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Objective To investigate the effect of short-term complications after D2 radical gastrectomy on long-term survival rate of gastric cancer patients. Methods A retrospective case-control study was conducted on 421 patients with gastric cancer who underwent D2 radical gastrectomy. According to the short-term postoperative complications, they were divided into experimental group (complication group, n=76) and control group (without complication group, n=345). In order to reduce the selection bias, the long-term survival rate of the two groups was tested by Kaplan-Meier survival analysis method after balancing the variables by propensity score matching (PSM). Log rank method was used for univariate analysis and Cox multivariate analysis was used for prognostic factors. Results There was no significant difference in long-term survival rate between the experimental group and the control group (P > 0.05). Histological type, lymph node metastasis rate and pTNM stage were independent risk factors for long-term survival. Conclusion The short-term complications after D2 radical gastrectomy have no significant impact on the long-term survival rate of gastric cancer patients, but it has certain clinical significance to actively prevent and control complications.
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@#Objective To investigate the prognostic survival status and influence factors for surgical treatment of esophageal squamous cell carcinoma (ESCC) in pathological stage T1b (pT1b). Methods The patients with ESCC in pT1b undergoing Ivor-Lewis or McKeown esophagectomy in Lanzhou University Second Hospital from 2012 to 2015 were collected, including 78 males (78.3%) and 17 females (21.7%) with an average age of 61.4±7.4 years. Results The most common postoperative complications were pneumonia (15.8%), anastomotic leakage (12.6%) and arrhythmia (8.4%). Ninety-three (97.9%) patients underwent R0 resection, with an average number of lymph node dissections of 14.4±5.6. The rate of lymph node metastasis was 22.1%, and the incidence of lymph vessel invasion was 13.7%. The median follow-up time was 60.4 months, during which 25 patients died and 27 patients relapsed. The overall survival rate at 3 years was 86.3%, and at 5 years was 72.7%. Multivariate Cox regression analysis showed that lymph node metastasis (P=0.012, HR=2.60, 95%CI 1.23-5.50) and lympovascular invasion (P=0.014, HR=2.73, 95%CI 1.22-6.09) were independent risk factors for overall survival of pT1b ESCC. Conclusion Esophagectomy via right chest approach combined with two-fields lymphadenectomy is safe and feasible for patients with pT1b ESCC. The progress of pT1b ESCC with lymph node metastasis or lymphovascular invasion is relatively poor.
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BACKGROUND: In recent years, umbilical cord blood has gradually become a crucial alternative source of stem cells for related and unrelated bone marrow or peripheral blood hematopoietic stem cell transplantation, which is increasingly used in the treatment of hematological malignancies in children. OBJECTIVE: To compare the clinical efficacy of sibling donor umbilical cord blood transplantation and unrelated umbilical cord blood transplantation for treating hematological malignancies in children. METHODS: The clinical data of children with hematological malignancies who received umbilical cord blood transplantation at the Hematopoietic Stem Cell Transplantation Center of the First Affiliated Hospital of Zhengzhou University between January 1, 1998 and December 31, 2018 was retrospectively analyzed. All the patients received myelablative conditioning regimen, and cyslosporine A combined with or without mycophenolate mofetil were concurrently adopted for graft-versus-host disease prophylaxis. RESULTS AND CONCLUSION: (1) Two patients in the sibling donor umbilical cord blood transplantation group and three in the unrelated umbilical cord blood transplantation group did not attain hematological engraftment and subsequently died from infection, and other patients succeeded in hematological engraftment. The median time of neutrophil and platelet engraftment in the sibling donor umbilical cord blood transplantation and unrelated umbilical cord blood transplantation groups was [17 days (11-43 days), 18 days (12-45 days), P=0.307] and [20.5 days (15-50 days), 27 days (18-56 days), P=0.773]. There was no significant difference between the two groups. (2) The incidence of acute graft-versus-host disease and chronic graft-versus-host disease in the sibling donor umbilical cord blood transplantation and unrelated umbilical cord blood transplantation groups was 36% vs. 43% (P=0.737) and 15% vs. 33% (P=0.412). There was no significant difference between the two groups. There was also no significant difference in the incidence of infection after transplantation between sibling donor umbilical cord blood transplantation and unrelated umbilical cord blood transplantation groups (56% vs. 71%, P=0.343). (3) There were no significant differences in the 2-year overall survival (61% vs. 36%, P=0.301), or 2-year relapse-free survival (56% vs. 33%, P=0.151). The 5-year overall survival and 5-year relapse-free survival in the sibling donor umbilical cord blood transplantation and unrelated umbilical cord blood transplantation groups were 54% vs. 24% (P=0.044) and 50% vs. 20% (P=0.039). The results showed that there was a significant difference in long-term survival rate between two groups. (4) Our results reveal that both sibling donor umbilical cord blood transplantation and unrelated umbilical cord blood transplantation are safe, effective and applicable for children with hematological malignancies. In particular, there are significant benefits in the long-term survival of substitute donor transplantation for pediatric patients with hematological malignancies.
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Objective To establish a long-term survival prediction model for hepatocellular carcinoma (HCC) patients after liver transplantation based on up-to-seven (Up7) criteria, and to validate the prediction model in different liver transplantation criteria, so as to assist clinical decision-making for the treatment of HCC. Methods We retrospectively analyzed the clinical and follow-up data of 251 HCC patients who underwent liver transplantation with Up7 criteria. Stepwise regression method was used to conduct multivariate Cox regression analysis to obtain the independent predictors of long-term survival after HCC liver transplantation, and to establish the survival Cox regression prediction model. R 3.4.3 software was used to score the prediction model, and the decision tree technique was used to determine the cut-off value. The Kaplan-Meier survival curve of the HCC patients after liver transplantation was drawn to validate the prediction model in different criteria (Shanghai Fudan criteria, University of California, San Francisco [UCSF] criteria and Italy Milancriteria), and the difference between groups was analyzed by log-rank test. The receiver operating characteristic (ROC) curve was used to test the predictive effectiveness of the model. Results Multivariate Cox regression analysis suggested that α-fetoprotein (AFP), total bilirubin (T-Bil), microvascular invasion (MVI) and tumor maximal diameter (Diameter) were the independent predictors of long-term survival of HCC liver transplant recipients after liver transplantion. We built the ATMD (AFP, T-Bil, MVI, Diameter) model using these factors: h (t, x)=h0 (t) exp (0.284×Diameter [cm]+0.773×MVI [yes=1; no=0]+0.404×lg AFP [ng/mL]+0.003×T-Bil [μmol/L]). The cut-off value of ATMD model was 1.44. The scores being more than 1.44 were defined as the high-risk group, and scores being 1.44 or less were defined as the low-risk group. The cases in the high-risk and low-risk groups who met the Up7 criteria, Shanghai Fudan criteria, UCSF criteria and Italy Milan criteria had 87 and 164, 33 and 144, 29 and 134, and 29 and 131, respectively. Kaplan-Meier survival analysis showed that the cumulative survival rates of the liver transplantation recipients with Up7 criteria, Shanghai Fudan criteria, UCSF criteria or Milan criteria were significantly different between the high-and low-risk groups (P<0.001, P=0.008, P<0.001, P=0.001). The areas under the ROC curve of the three-year survival of the liver transplantation recipients predicted by ATMD model were 76.63%, 75.87%, 73.32% and 69.41%, respectively. Conclusion The ATMD model has a good survival prediction ability for the HCC patients meeting Up7 criteria, Shanghai Fudan criteria, UCSF criteria or Milan criteria. It is of great significance for preoperative decision-making and postoperative risk assessment of HCC liver transplantation recipients meeting the above criteria.
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In this study,we compared the serum levels of transforming growth factor-β1 (TGF-β1),interleukin-10 (IL-10),and arginase-1 in long-term survival kidney transplant recipients (LTSKTRs) with those in short-term survival kidney transplant recipients (STSKTRs).We then evaluated the relationship between these levels and graft function.Blood samples were collected from 50 adult LTSKTRs and 20 STSKTRs (graft survival approximately 1-3 years post-transplantation).All patients had stable kidney function.The samples were collected at our institution during the patients' follow-up examinations between March 2017 and September 2017.The plasma levels of TGF-β1,IL-10,and arginase-1 were analyzed using enzyme-linked immunosorbent assays (ELISA).The levels of TGF-β1 and arginase-1 were significantly higher in the LTSKTRs than in the STSKTRs.The time elapsed since transplantation was positively correlated with the levels of TGF-β 1 and arginase-1 in the LTSKTRs.The estimated glomerular filtration rate was positively correlated with the TGF-β1 level,and the serum creatinine level was negatively correlated with the TGF-β1 level.Higher serum levels of TGF-β1 and arginase-1 were found in LTSKTRs than in STSKTRs,and we found that TGF-β1 was positively correlated with long-term graft survival and function.Additionally,TGF-β1 and arginase-1 levels were positively correlated with the time elapsed since transplantation.On the basis of these findings,TGF-β1 and arginase-1 may play important roles in determining long-term graft survival.Thus,we propose that TGF-β1 and arginase-1 may potentially be used as predictive markers for evaluating long-term graft survival.
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In this study,we compared the serum levels of transforming growth factor-β1 (TGF-β1),interleukin-10 (IL-10),and arginase-1 in long-term survival kidney transplant recipients (LTSKTRs) with those in short-term survival kidney transplant recipients (STSKTRs).We then evaluated the relationship between these levels and graft function.Blood samples were collected from 50 adult LTSKTRs and 20 STSKTRs (graft survival approximately 1-3 years post-transplantation).All patients had stable kidney function.The samples were collected at our institution during the patients' follow-up examinations between March 2017 and September 2017.The plasma levels of TGF-β1,IL-10,and arginase-1 were analyzed using enzyme-linked immunosorbent assays (ELISA).The levels of TGF-β1 and arginase-1 were significantly higher in the LTSKTRs than in the STSKTRs.The time elapsed since transplantation was positively correlated with the levels of TGF-β 1 and arginase-1 in the LTSKTRs.The estimated glomerular filtration rate was positively correlated with the TGF-β1 level,and the serum creatinine level was negatively correlated with the TGF-β1 level.Higher serum levels of TGF-β1 and arginase-1 were found in LTSKTRs than in STSKTRs,and we found that TGF-β1 was positively correlated with long-term graft survival and function.Additionally,TGF-β1 and arginase-1 levels were positively correlated with the time elapsed since transplantation.On the basis of these findings,TGF-β1 and arginase-1 may play important roles in determining long-term graft survival.Thus,we propose that TGF-β1 and arginase-1 may potentially be used as predictive markers for evaluating long-term graft survival.
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@#The surgical treatment of acute aortic dissection is difficult, and the mortality is associated with anastomosis site complications. Therefore, it is essential to make sure the end-to-end anastomosis safe and avoid bleeding. The methods of anastomosis include: direct anastomosis, adventitial inversion technique and sandwich technique. The latter two methods are both effective in hemostasis and reducing the postoperative complications. According to the recent literatures, the adventitial inversion technique may facilitate thrombotic closure of the false lumen in acute type A aortic dissection management and increase the long-term survival of the patients. This review introduces 2 modified methods of anastomosis as well, and summarizes clinical outcomes of different end-to-end anastomotic methods for surgical treatment of acute Stanford type A aortic dissection, in order to recommend the most proper method of end-to-end anastomosis.
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Objective:To study influence study of near and long term survival rate on different resection regions for patients with gastric cancer in M region.Methods:110 patients with M region gastric cancer received treatment in our hospital were divided into observation group(with total gastrectomy) 57 cases and control group (with subtotal gastrectomy) 53 cases,compared with clinical pathology data and radical degree,two groups of patients' operation index,and local recurrence rate and near and long term survival rate in the two groups.Results:Two groups of patients were compared with clinical pathology data and radical degree,the difference was not statistically significant (P＞0.05).The observation group's nearly cutting edge outside distance and lymph nodes were significantly higher than the control group,the difference was statistically significant (P＜0.05).There was no significant difference between the two groups(P＞0.05).The recurrence rate(3.51％) and recurrence rate (15.79％) of the observation group were significantly less than the control group of 16.98％ and 33.96％,and the difference was statistically significant (P＜0.05).The 1 and 3 year survival rates of the observation group were compared with the control group,the difference was not statistically significant (P＞0.05).But the 5 year survival rate of the observation group was 57.89％,which was significantly higher than that in the control group of 35.85％,the difference was statistically significant (P＜0.05).Conclusions There is no significant difference in the survival rate of total gastrectomy in patients with gastric cancer in M region and total gastrectomy,but the long-term survival rate is higher,it is worthy of clinical attention.
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Objective · To compare the efficacy and prognostic factors of HCAG regimen with traditional IA regimen in the treatment of newly diagnosed elderly acute myeloid leukemia (AML) patients. Methods · Forty-one patients with AML (aged 55-71 years) were randomly divided into two groups (Group HCAG and Group IA) between 2014 and 2016 for induction and consolidation therapy. Multivariate analysis was applied to identify prognostic factors for relapse-free survival (RFS). Results · A total of 29 patients (70.7%) achieved complete remission (CR). The estimated 2-year overall survival (OS) was 66.8% in Group HCAG and 75.4% in Group IA (P=0.913). The estimated 2-year RFS was 61.8% in Group HCAG and 49.1% in Group IA (P=0.411). Age remained as the unfavorable prognostic factor, leading to significant differences in OS and RFS. In addition, RFS was influenced by cytogenetic/molecular risk stratification. Conclusion · Although HCAG seemed not to particularly benefit the group, the dose reduction of anthracyclines may be applied in elderly patients with comparable short-time outcome. Furthermore, the introduction of homoharringtonine resulted in an improvement of treatment response for more than 20% compared with CAG regimen.
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This meta-analysis aimed to comprehensively assess the efficacy and safety of hepatic resection combined with radiofrequency ablation versus hepatic resection (HR) alone for the treatment of multifocal hepatoeellular carcinomas (HCC).A literature search was conducted from the database including MEDLINE,Embase,Cochrane Central Register of Controlled Trials (CENTRAL) and China Biology Medicine (CBM) disc.The primary outcomes included the 1-,3-,5-year overall survival (OS) and disease-free survival (DFS) rate.The secondary outcomes contained the intraoperative parameters and postoperative adverse events (AEs).These parameters were all analyzed by RevMan 5.3 software.After carefully screening relevant studies,four retrospective studies of high quality involving 466 patients (197 in the combined group and 269 in the HR group) were included in this study.The pooled results showed that the 1-,3-,5-year OS rate in the combined group were comparable with those in the HR group (OR=0.77,0.96,0.88;P=0.33,0.88,0.70,respectively).Similarly,there was no significant difference in 1-,3-,5-year DFS rate between the combined group and the HR alone group (OR=0.57,0.83,0.72;P=0.17,0.37,0.32,respectively).And the intraoperative parameters and postoperative AEs were also comparable between the above two cohorts.However,two included studies reported that tumor often recurred in the ablation site in the combined group.The present meta-analysis indicated that the HR combined with RFA could reach a long-term survival outcome similar to curative HR for multifocal HCC patients.And this therapy may be a promising alternative for these patients with marginal liver function or complicated tumor distribution.Furthermore,high quality randomized controlled trials (RCTs) are imperative to verify this conclusion.
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Objective To investigate the expression of Fascin‐1 in colorectal cancer (CRC) and its clinical significance .Meth‐ods Immunohistochemistry MaxVision method was adopted to detect the protein expression of Fascin‐1 in 87 CRC tissues and 28 para‐cancer tissues ,and analyzed the expressions of them and the relations to clinicopathologic characteristics .Kaplan‐Meier plots and Cox proportional hazards regression model were used to analyze the prognostic value of Fascin‐1 expression .Results The posi‐tive rates of Fascin‐1 expression in CRC tissues and para‐cancer tissues were 43 .7% (38/87) and 7 .1% (2/28) respectively ,with significant difference (P0 .05) .In the Kaplan‐Meier analysis ,patients with Fascin‐1 over‐expression had significantly shorter overall survival than those patients with negative Fascin‐1 expression (P=0 .009) .Multivari‐able analysis by Cox regression model further showed that Fascin‐1 over‐expression was a significantly independent predictor of poorer overall survival (HR=2 .087;95% CI:1 .196-3 .642 ,P=0 .010) .Conclusion The expression of Fascin‐1 is high and its re‐lated to the long‐term survival time of patients with CRC .It is an independent prognostic factor for CRC .
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Lung transplantation has become the standard of care for select patients with advanced lung diseases of various etiologies. A relatively scarce donor pool limits wider application of lung transplantation. Donor selection criteria, donor management protocols, and improvement in postoperative management have lead to improved overall survival with a median survival rate of 5.7 years. Bilateral lung transplantation has become the procedure of choice for most indications due to significantly better long term survival, especially in patients younger than 60 years. Proper management of donor organs may increase the utilization rate of scarce organs and through the increasing number of lung transplantation and improvement in postoperative management, many patients on the waiting list may achieve a new life after lung transplantation with excellent quality of life and long term survival.
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Humans , Donor Selection , Lung Diseases , Lung Transplantation , Lung , Patient Selection , Quality of Life , Standard of Care , Survival Rate , Tissue Donors , Waiting ListsABSTRACT
OBJECTIVE:To investigate the effect of α-interferon on long-term survival rate and tumor recurrence after radical hepatic resection. METHODS:104 patients with primary hepatocellular carcinoma underwent radical hepatic resection were divided into observation group(62 cases)and control group(42 cases). Observation group was treated with IFN-α for 18 months 4-6 weeks after surgery;control group received rountine treatment. Total survival rate and disease-free survival rate after surgery were com-pared between 2 groups. RESULTS:In observation group after surgery,1-year survival rate was 82.26%(51/62),3-year survival rate 61.29%(38/62),and 5-year survival rate 24.19%(15/62);in control group after surgery,1-year survival rate was 41.94%(26/62),3-year survival rate 28.57%(12/42)and 5-year survival rate 9.52%(4/42);there was statistically significant difference in postoperative survival rate between 2 groups (P<0.05). In observation group after surgery,1-year disease-free survival rate was 61.29%(38/62),3-year disease-free survival rate 40.32%(25/62),and 5-year disease-free surial rate 17.74%(11/62);in control group after surgery,1 year disease-free survival rate was 43.55%(27/62),3 year disease-free survival rate 22.58%(14/62),and 5-year disease-free surial rate was 0(0/62);there was statistically significant difference in postoperative disease-free survival rate be-tween 2 groups (P<0.05). CONCLUSIONS:The application of α-interferon after radical hepatic resection can significantly inhibit the recurrence of postoperative tumor,improve the long-term survival rate,and is worthy of clinical research.
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Objective To explore the efficacy and safety of high-dose methotrexate (MTX) and L-asparaginase (L-Asp) for the treatment of adult patients with high risk Ph acute lymphoblastic leukemia (ALL).Methods Five adult patients with high risk Ph-ALL were treated with several courses of MTX (3-5 g/m2 by continually intravenous drip for 24 h) and L-Asp (8 000-10 000 U/time, once a day, 10 times for one cycle).Results Five patients were disease-free survival, their survival time was 60-96 months and the median survival time was 73 months.The chemotherapy-related bone marrow depression was mild.No obvious liver and kidney damage, severe allergic reaction and pancreatitis were observed.Conclusion Highdose MTX and L-Asp are effective and well tolerated, and may contribute to long-term survival of adult patients with high risk Ph-ALL.
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No abstract available.
Subject(s)
Aged , Humans , Male , Carcinoma, Squamous Cell/pathology , Chemoradiotherapy , Endoscopy, Gastrointestinal , Esophageal Neoplasms/pathology , Neoplasm Invasiveness , Neoplasm Staging , Positron-Emission Tomography , Remission Induction , Tomography, X-Ray Computed , Trachea/pathology , Treatment OutcomeABSTRACT
Objective To investigate prognostic predictors of long-term survival of patients with cardiac amyloidosis (CA), and to determine predictive value of high-sensitivity cardiac troponin T (hs-cTnT) in CA patients. Methods We recruited 102 consecutive CA cases and followed these patients for 5 years. We described their clinical characteristics at presentation and used a new, high-sensitivity assay to determine the concentration of cTnT in plasma samples from these patients. Results The patients with poor prognosis showed older age (56 ±12 years vs. 50 ±15 years, P=0.022), higher incidences of heart failure (36.92%vs. 16.22%, P=0.041), pericardial effusion (60.00%vs. 35.14%, P=0.023), greater thickness of interventricular septum (IVS) (15 ±4 mm vs. 13 ±4 mm, P=0.034), higher level of hs-cTnT (0.186 ±0.249 ng/mL vs. 0.044 ±0.055 ng/mL, P=0.001) and higher NT-proBNP (N-terminal pro-B-type natriuretic pep-tide) levels (11,742 ± 10,464 pg/mL vs. 6,031 ± 7,458 pg/mL, P=0.006). At multivariate Cox regression analysis, heart failure (HR:1.78, 95%CI:1.09-2.92, P=0.021), greater wall thickness of IVS (HR:1.44, 95%CI:1.04-3.01, P=0.0375) and higher hs-cTnT level (HR:6.16, 95%CI:2.20-17.24, P=0.001) at enrollment emerged as independent predictors of all-cause mortality. Conclusions We showed that hs-cTnT is associated with a very ominous prognosis, and it is also the strongest predictor of all-cause mortality in multivariate analysis. Examination of hs-cTnT concentrations provides valuable prognostic information concerning long-term outcomes.