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Objective:To explore the efficacy and safety of treating advanced esophageal cancer by implanting the common stent and the radioactive 125I particle stent with endoscope. Methods:The clinical data of patients with advanced esophageal cancer admitted to Jingbian County People's Hospital of Shaanxi Province, the First Affiliated Hospital of Xi'an Medical University, Xijing Hospital of Digestive Diseases of Air Force Medical University and the First Hospital of Yulin of Shaanxi Province from December 2014 to December 2020 were retrospectively analyzed. Patients were divided into common stent group ( n=66) and radioactive particle stent group ( n=34) according to different stent types. The postoperative complications, Karnofsky performance status (KPS) score, dysphagia score, restenosis rate and quality of life were compared between the two groups. Results:The incidences of postoperative retrosternal pain in the common stent group and the radioactive particle stent group were 65.2% (43/66) and 47.1% (16/34) respectively. The incidences of pharyngeal pain and hoarseness were 12.1% (8/66) and 5.9% (2/34) . The incidences of abdominal pain were 9.1% (6/66) and 2.9% (1/34) . The incidences of errhysis were 3.0% (2/66) and 2.9% (1/34) . The incidences of vomiting and nausea were 7.6% (5/66) and 5.9% (2/34) respectively. There were no statistically significant differences between the two groups ( χ2=3.04, P=0.081; χ2=0.40, P=0.527; χ2=0.53, P=0.467; χ2<0.01, P>0.999; χ2<0.01, P>0.999) . In the two groups, KPS scores in the first, second, third and sixth month after operation were higher than those before operation (all P<0.05) . KPS scores of the radioactive particle stent group in the second, third and sixth month were significantly higher than those of the common stent group [ (89.73±7.84) points vs. (82.37±7.42) points, t=4.62, P<0.001; (93.63±8.13) points vs. (88.33±7.28) points, t=3.74, P<0.001; (92.78±6.26) points vs. (87.28±8.73) points, t=3.77, P<0.001]. The dysphagia scores of patients in the two groups in the first, second, third and sixth month were lower than those before operation (all P<0.05) . The dysphagia scores of the radioactive particle stent group in the third and sixth month after operation were significantly lower than those of the common stent group [ (0.68±0.12) points vs. (2.33±0.32) points, t=26.20, P<0.001; (0.82±0.22) points vs. (2.67±0.24) points, t=36.92, P<0.001]. In the third month after operation, the restenosis rate of the radioactive particle stent group was significantly lower than that of the common stent group [5.88% (2/34) vs. 42.4% (28/66) , χ2 =14.27, P<0.001]. The scores of QLQ-C30 and OES-18 scales in the first, second, third and sixth month after operation were lower than those before operation (all P<0.05) . The scores of QLQ-30 scale in the radioactive particle stent group in the second, third and sixth month were significantly lower than those in the common stent group [ (19.12±3.02) points vs. (21.22±2.87) points, t=3.39, P=0.001; (15.04±1.68) points vs. (20.43±2.23) points, t=12.39, P<0.001; (14.38±2.18) points vs. (19.77±3.67) points, t=9.20, P<0.001]. The scores of OES-18 scale in the radioactive particle stent group were also significantly lower than those in the common stent group [ (17.13±2.07) points vs. (20.64±2.11) points, t=7.95, P<0.001; (15.22±1.88) points vs. (19.24±1.76) points, t=10.62, P<0.001; (14.74±2.36) points vs. (18.53±3.27) points, t=6.01, P<0.001]. Conclusion:The radioactive particle stent can improve the quality of life of patients with advanced esophageal cancer with esophageal stenosis, so as to improve dysphagia and reduce the restenosis rate after operation. However, whether it is obviously superior to common stent in prolonging survival time and reducing complications needs to be further confirmed by a multicenter, prospective, large-sample randomized controlled study.
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ObjectiveTo investigate the clinical effect and safety of albumin-bound paclitaxel (Nab-P) as the first-line treatment for advanced primary liver cancer. MethodsA retrospective analysis was performed for the clinical data of 23 patients with advanced primary liver cancer who were admitted to the Department of Medical Oncology in Chinese PLA General Hospital from May 2014 to December 2015. According to the treatment regimen, these patients were divided into observation group and control group. The 12 patients in the observation group were treated with Nab-P, among whom 5 were treated with Nab-P combined with tegafur, gimeracil and oteracil, 5 were treated with Nab-P combined with capecitabine, and 2 were treated with Nab-P alone; the 11 patients in the control group were treated with gemcitabine combined with oxaliplatin. One cycle of the treatment was 21 days for each treatment regimen; therapeutic effect was evaluated every 2 cycles, and adverse events were evaluated every cycle. The chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups, the Kaplan-Meier survival curves were used to analyze progression-free survival, and the log-rank test was used to compare survival rates between groups. ResultsAll the patients were eligible for evaluation of clinical outcome and adverse events. In the observation group, 2 patients achieved partial remission, 7 had a stable disease, and 3 had a progressive disease; in the control group, 2 achieved partial remission, 5 had a stable disease, and 4 had a progressive disease. There was no significant difference in disease control rate between the two groups (75% vs 64%, χ2=0.350, P＞0.05). There was also no significant difference in the median progression-free survival between the two groups ［5.1 (2.7-6.7) months vs 4.3 (2.5-5.4) months, χ2=0.647, P＞0.05］. As for adverse events, no patient experienced serious adverse events, and there were significant differences in the incidence rates of platelet toxicity and increased aspartate aminotransferase between the two groups (χ2=5.490 and 6.135, P=0.036 and 0.027). ConclusionIn the treatment of advanced primary liver cancer, the medication based on Nab-P shows a good clinical effect and tolerable toxic and side effects; however, due to the small sample size in this study, the clinical studies with a large sample size are needed.