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With the extension of human life expectancy, the threat of cancer to human beings has become increasingly prominent. Cancer has become the first cause of death for urban and rural residents in China. As the disease progresses, many patients have metastases in other sites besides the primary malignant tumors. Hence, it is of significance to choose effective treatment methods. Body gamma knife treatment is an accurate stereotactic radiotherapy that can render higher doses to the tumors and better protect surrounding normal tissues. A large number of clinical trials have demonstrated that body gamma knife treatment of lung metastases, liver metastases and adrenal metastases can obtain relatively high local control rates. In this article, the application of body gamma knife in the treatment of metastatic tumors was reviewed.
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Objective@#To investigate the expression of DNA damage repair factor PDZ binding kinase (PBK) and matrix metalloproteinase 9 (MMP-9) in cervical cancer and the effect on clinical outcomes of concurrent chemoradiotherapy.@*Methods@#A total of 65 cervical cancer pathological specimens were collected from January 2014 to July 2016. Immunohistochemistry was used to detect PBK and MMP-9 expression in the specimens.External irrsdeation was treated with intensity-modulated radiation therapy at a dose of 50 Gy/25 F. After 18 times of external irradiation, high-dose rate postoperative treatment was giver at a dose of 30-36 Gy/5-6 F which lasts 3-4 weeks. Weekly chemotherapy with Cisplatin(DDP) begins simultaneously at the beginning of external irradiation. DDP was administered intravenously at a dosage of 40 mg/m2 for 2 to 6 week. All patients were followed-up as routine. The relationship between clinical characteristics and prognosis of patients and the expression of PBK and MMP-9 were analyzed.@*Results@#PBK was expressed in 92.3% of tissues and MMP-9 was expressed in 69.2% of tissues. The expression of PBK was positively associated with overall survival (OS) and disease progression-free survival (PFS) of cervical cancer patients (χ2=4.324, 8.068, P<0.05). The expression of MMP-9 was related with PFS (χ2=5.134, P<0.05). Patients with PBK and MMP-9 expression suffered poor OS and PFS (χ2=5.382, 9.364, P<0.05).@*Conclusions@#PBK and MMP-9 could be a biomarker to predict the prognosis of cervical cancer.
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Objective To retrospectively analyze the nutritional status of patients with malignant tumors prior to the primary radiotherapy,aiming to to provide clinical evidence for the rational application of nutritional support during radiotherapy. Methods The nutritional status of 68 patients with malignant tumors admitted our department from August 2016 to May 2017 was investigated. All patients received primary radiotherapy. The Nutrition Risk Screening 2002 was utilized to assess the nutrition risk. The body mass index ( BMI ) , hemoglobin, total protein, albumin, pre-albumin and C-reactive protein levels were detected and statistically analyzed. Results The incidence of nutritional risk of 68 patients with primary radiotherapy was 6％, and the incidence of malnutrition was 5. 9％. All patients presenting with nutritional risk and malnutrition were diagnosed with head and neck and gynecological malignant tumors. Twenty-four patients had elevated levels of C-reactive protein, 16 had decreased levels of hemoglobin, 17 developed decreased levels of prealbumin,1 had a decline in the level of albumin and 5 presented with a decrease in the levels of total protein. The nutritional status and clinical parameters were evaluated between patients who had/had not received chemotherapy before radiotherapy. The BMI,C-reactive protein,hemoglobin and prealbumin levels significantly differed between two groups ( all P< 0. 01 ) , whereas the remaining parameters did not significantly differ. The BMI, C-reactive protein, hemoglobin and prealbumin levels significantly differed between patients who had/had not underwent surgery prior to radiotherapy ( all P<0. 01 ) . Conclusions Analysis of the nutritional status of patients receiving primary radiotherapy demonstrates that patients with head and neck, and gynecological malignant tumors are more likely to suffer from nutritional risk and malnutrition compared with those with other types of malignant tumors. Compared with patients who have not received chemotherapy/surgery before radiotherapy, those who have underwent chemotherapy/surgery have worse nutritional status. Besides,more significant changes are observed in the levels of C-reactive protein, hemoglobin and prealbumin than the levels of albumin and total protein.
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Objective To investigate the curative effects and adverse reactions of pure radiotherapy and concurrent chemotherapy and radiotherapy for patients with cervical cancer.Methods One hundred and twenty-seven patients with cervical cancer who accepted treatment in the Affliated Hospital of Inner Mongolia Medical Unive.rsity from May 2010 to May 2012 were collected.All patients were divided into two groups:pure radiotherapy group (n =65) and concurrent chemotherapy and radiotherapy group (n =62).The curative effects,adverse reactions and survival of two groups were observed.Results All patients were completed treatment.The median follow-up time was 42 months.The rate of complete response in the pure radiotherapy group was 80.0％ (52/65),and the rate in the concurrent chemotherapy and radiotherapy group was 82.26％ (51/62),with no significant difference (x2 =1.22,P =0.352).The 1-year overall survival rates in the pure radiotherapy group and the concurrent chemotherapy and radiotherapy group were 95.38％ and 95.16％ respectively,with no significant difference (x2 =0.32,P =0.533),but the 3-year overall survival rates were 81.54％ and 90.32％ respectively,the 5-year overall survival rates were 72.31％ and 83.87％ respectively,with significant differences (x2 =5.09,P =0.015;x2=3.87,P =0.039).However,for the patients who were ≥ 60 years,the 1-year overall survival rates in the two groups were 94.62％ and 93.91％ respectively,the 3-year overall survival rates were 85.02％ and 87.25％ respectively,the 5-year overall survival rates were 70.06％ and 73.58％ respectively,with no significant differences (x2 =0.06,P =0.753;x2 =1.16,P =0.279;x2 =0.48,P =0.511).The adverse reactions were mainly in grades 1-2.There were significant differences in the rates of leucopenia (56.10％ vs.72.20％),thrombocytopenia (58.82％ vs.76.80％),nausea and vomiting (34.04％ vs.56.90％) among the two treatment groups (x2 =11.23,P =0.003;x2 =11.82,P=0.002;x2 =12.77,P =0.000).Conclusion The curative effect of concurrent chemotherapy and radiotherapy is better than that with pure radiotherapy for patients with cervical cancer,which can improve the 3-year and 5-year overall survival.But at the same time,it should be noted that the rates of adverse reactions may be increased during the same period.For the age of 60 or more patients with cervical cancer,concurrent chemotherapy and radiotherapy does not achieve even greater survival benefit.
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The incidence of rectal cancer has been increasing in recent years .It leads to more attention of scholars at home and abroad ,which the efficacy of rectal cancer has been improved by using neoadjuvant therapy all over the world .It is included preoperative radiotherapy ,preoperative chemotherapy and preoperative chemora-diotherapy .Preoperative radiotherapy ,which can be divided into short radiotherapy and conventional radiotherapy , are evaluated by comparison of T drop rate ,sphincter preservation rate ,complete remission rate and other indica-tors of clinical effect .Although the experience of pure preoperative chemotherapy is not rich enough ,it still has an advantage in lowering the tumour stage and other aspects .Currently, preoperative chemoradiotherapy is a good choice for rectal cancer ,because it could make an obvious advantage in the treatment ,at the same time ,three-di-mensional radiotherapy can make target more evenly distributed and focus treatment more precise .However,neo-adjuvant therapy has insufficient support in clinical in our country.So it needs to get more information for clinical effectiveness of applying preoperative chemoradiotherapy .This study is to summarize the new adjuvant treatment of rectal cancer .
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Objective:To evaluate therapeutic efficacy and adverse reactions of synchronous chemoradiotherapy combined with gamma knife therapy for pelvic lymph node metastasis of cervical cancers. Methods:Data of 42 cervical cancer patients who suffered from residual pelvic lymph node metastasis and received concurrent chemoradiotherapy were retrospectively analyzed. Intensity-modu-lated radiotherapy was used in the treatment. The prescribed doses of planning target volume and pelvic metastasized lymph node of the planned gross tumor volume were 50.4 Gy/28 F and 59.92 Gy/28 F, respectively. The combined internal irradiation dose was 6 Gy/6 F. Concurrent chemotherapy was administered with 40 mg/m2·w cisplatin. Three months after chemoradiotherapy was completed, the pa-tients with residual pelvic positive lymph node received additional dose ranging from 10 Gy to 15 Gy at three or four fractions by using a gamma knife. Results:Near-term efficacy was 83.3%(35/42) in three months. Local control rates were 88.1%(37/42), 83.3%(35/42), and 76.2%(32/42) in 6, 9, and 12 months, respectively. The 1-and 2-year survival rates were 77.5%(31/40) and 70.0%(28/40), re-spectively. The incidence rates of radiation enteritis, proctitis, cystitis, gut toxicity, and neutrocytopenia were 11.9%(5/42), 38.1%(16/42), 7.1%(3/42), 90.5%(38/42), and 85.7%(36/42), respectively, and the majority of these conditions were classified as grades I and II. Conclusion:Synchronous chemoradiotherapy combined with gamma knife therapy is an effective and feasible treatment method for pelvic lymph node metastasis of cervical cancer;this method exhibits a minimal adverse reaction.
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Objective The aim of this study is to investigate the expression of Survivin in laryngeal car-cinoma and to elucidate the relationship between cell proliferation and the expression of Survivin .Methods The expression and DNA quantification of Survivin in 63 cases of laryngeal carcinoma and 15 cases of normal laryngeal tissues were detected by immunohistochemical staining ( SP) and flow cytometry .Results Forty-five sections of laryngeal carcinoma were positive for survivin as determined by immunohistochemical staining ,but Survivin was undetected in normal laryngeal tissues .The intensity of Survivin expression was significantly increased with tumor differentiation and lymph node metastasis (P0.05).High DNA index(DI)and proliferation index(PI)were detected in laryngeal carcino-ma(P<0.05),and PI was positively correlated with expression of Survivin (P<0.05).Conclusion Survivin overexpression triggers laryngeal carcinoma cell hyperproliferation ,especially in development of laryngeal carcino-ma.These data identify Survivin as an important target in laryngeal carcinoma and provide a translational pathway for developing new therapies against this target .
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Objective: To evaluate the clinical effect and adverse reactions of radioactive seed interstitial brachytherapy com-bined with etoposide (EP) regimen concurrent chemoradiotherapy treatment for locally advanced non-small cell lung cancer. Methods:All 24 cases of locally advanced non-small cell lung cancer received three-dimensional conformal intensity modulated radiation therapy by using 6 MV X-ray to obtain 95%60-66 Gy/30-33 F planning target volume. All cases received radiation therapy five times a week. EP regimen chemotherapy concurrent with radiotherapy was given to 24 patients. The therapy included VP-16, 60 mg/m2 intravenous in-fusion for 1 d to 5 d, and DDP 50 mg/m2 intravenous infusion on the 1st, 8th, and 28th therapy day. Chemotherapy with EP regimen was given for four cycles, in which two cycles were given during radiotherapy and the remaining cycles were completed after radiotherapy. The patients were reexamined three months after concurrent chemoradiotherapy was completed. Patients with residual tumor, con-firmed via positron emission tomography/computed tomography, underwent 125I radioactive seed implantation interstitial brachytherapy to complement the dose of tumor. Results: The response rate was 83.3% (20/24); the local control rates of 3, 6, 9, 12, 18, and 24 months were 87.5% (21/24), 83.3% (20/24), 75.0% (18/24), 70.8% (17/24), 58.3% (14/24), and 50.0% (12/24). The median survival was 20.2 months. The one-year survival rate was 62.5%, and the two-year survival rate was 37.5%. The following main toxicities were observed:the incidence of radiation-induced lung injury was 25%;the incidence of radiation esophagitis was 33.3%;the incidence of grades Ⅰ to Ⅱ gastrointestinal reactions was 82.3%; the incidence of reducing neutropenia was 87.5%, in which the incidence of gradesⅠtoⅡwas 75.0%, gradeⅢwas 12.5%, and gradeⅣwas 0%. Conclusion:EP regimen concurrent radiotherapy and chemo-therapy combined with radioactive seed interstitial brachytherapy for locally advanced non-small cell lung cancer is effective and has few serious adverse reactions, thus making this approach worthy of promotion.