ABSTRACT
PURPOSE: This study was conducted to validate the prognostic influence of treatment response among patients with positive circumferential resection margin for locally advanced rectal cancer. MATERIALS AND METHODS: Clinical data of 197 patientswith positive circumferential resection margin defined as ≤ 2 mm after preoperative chemoradiotherapy followed by total mesorectal excision between 2004 and 2009 were collected for this multicenter validation study. All patients underwent median 50.4 Gy radiation with concurrent fluoropyrimidine based chemotherapy. Treatment response was dichotomized to good response, including treatment response of grade 2 or 3, and poor response, including grade 0 or 1. RESULTS: After 52 months median follow-up, 5-year overall survival (OS) for good responders and poor responders was 79.1% and 48.4%, respectively (p < 0.001). In multivariate analysis, circumferential resection margin involvement and treatment response were a prognosticator for OS and locoregional recurrence-free survival. In subgroup analysis, good responders with close margin showed significantly better survival outcomes for survival. Good responders with involved margin and poor responders with close margin shared similar results, whereas poor responders with involved margin had worst survival (5-year OS, 81.2%, 57.0%, 50.0%, and 32.4%, respectively; p < 0.001). CONCLUSION: Among patients with positive circumferential resection margin after preoperative chemoradiotherapy, survival of the good responders was significantly better than poor responders. Subgroup analysis revealed that definition of positive circumferential resection margin may be individualized as involvement for good responders, whereas ≤ 2 mm for poor responders.
Subject(s)
Humans , Chemoradiotherapy , Drug Therapy , Follow-Up Studies , Multivariate Analysis , Radiation Dosage , Rectal NeoplasmsABSTRACT
Objective: To observe the clinical effects of Hua Chan Su injection in adjuvant chemotherapy for non small cell lung cancer. Methods: Sixty four patients with non small cell lung cancer were randomized into two groups. Control group received chemotherapy only and the treatment group received chemotherapy and Hua Chan Su injection simultaneously. The multiple clinical indexes were observed and analyzed. Results: The clinical symptoms were significantly improved, the lesions were markedly alleviated, the survival periods were prolonged, and the living qualities were apparently promoted in the treatment group compared with the control group. Conclusion: Hua Chan Su injection is effective and safe as an adjuvant chemotherapy for non small cell lung cancer.