Résumé
Cervical stump cancer is rare in clinic, which leads to insufficient understanding of it by clinicians. Radiotherapy alone is often used in the early stage, but the treatment mode has gradually changed recently. However, there is still no uniform treatment standard for residual cancer, and the prognostic differences of residual cancer patients under the new treatment mode have not been reported in real time. In order to improve the management of cervical stump, this article reviewed its clinical characteristics, treatment and prognosis.
Résumé
Objective To compare the effect of intensity modulated radiotherapy (IMRT) and conventional radiotherapy (CRT) combined with intracavitary brachytherapy on patients with cervical stump cancer. Methods A total of 47 patients with cervical stump cancer who were admitted to the First Hospital of China Medical University from October 2007 to September 2017 were retrospectively reviewed. Of the 47 patients, 19 patients received CRT combined with intracavitary brachytherapy (CRT group), and 28 patients received IMRT combined with intracavitary brachytherapy (IMRT group). In order to reduce the effects of selection bias and confounding factors, propensity score matching was performed to compare the groups. Results After the propensity score matching, there were 19 patients in each group. The 1-, 3-and 5-year overall survival (OS) rate for matched patients were 100.0％, 85.1％ and 63.8％ in IMRT group, and 84.2％, 57.9％ and 42.1％ in CRT group, respectively, and the difference in survival between the two groups was statistically significant (PLog-rank= 0.029, PCox= 0.043, HR= 3.723, 95％CI 1.044-13.280). The median progression-free survival (PFS) time of the IMRT group was better than that of the CRT group [median PFS time had not been reached (7-72 months) vs. 17 months (2-125 months), PLog-rank= 0.032, PCox= 0.042, HR=2.773, 95％CI 1.037-7.417]. The incidence of late rectal and bladder radiation injury was 15.8％ (3/19) and 0 (0/19) in IMRT group, and 57.9％ (11/19) and 26.3 ％(5/19) in CRT group, respectively, and the difference was statistically significant (P= 0.017, P= 0.046). Conclusion Compared with CRT combined with intracavitary brachytherapy, IMRT combined with intracavitary brachytherapy has a better effect on patients with cervical stump cancer, and the incidence of complications is low, this method is worthy of clinical application.
Résumé
Cervical stump cancer is rare in clinic,which leads to insufficient understanding of it by clinicians.Radiotherapy alone is often used in the early stage,but the treatment mode has gradually changed recently.However,there is still no uniform treatment standard for residual cancer,and the prognostic differences of residual cancer patients under the new treatment mode have not been reported in real time.In order to improve the management of cervical stump,this article reviewed its clinical characteristics,treatment and prognosis.
Résumé
Metabolomics,a hot field of research of life science in recent years,is to analyze endogenous smallmolecule metabolites in biological samples for an overall understanding of the characteristics of metabolic disorders.A growing number of studies have confirmed the application of metabolomics for clinical diagnosis and treatment of diseases."Metabolic fingerprint" of biological fluids can be employed for disease prevention,timely diagnosis,accurate treatment,prognostic assessment and drug discovery.Clinical metabolomics is to measure low-molecule-weight metabolites' alterations of individuals in response to physiological stressors,disease processes,or drug therapy,aiming to discover potential biomarkers and drug targets.Coronary artery disease (CAD) is characterized as complex molecular events.Metabolic disturbances are involved in CAD progression.The application of metabolomics to CAD is an emerging field.Advances in metabolomics improve our knowledge on CAD in early diagnosis,prognostic prediction,and personalized therapy.