Analysis of risk factors of surgical site infections in breast cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Adjuvant chemotherapy has become an important component of standard therapy for breast cancer. However, until now, there have been few reports on the surgical site infections (SSI) after breast cancer surgery, specially after adjuvant chemotherapy. To study the risk factors of SSI of breast cancer, we analyzed patients diagnosed with breast cancer and treated with surgery.</p><p><b>METHODS</b>Fifty-five patients diagnosed with breast cancer and received breast conserving or modified radical operations in our hospital during January 2008 to March 2008 were selected. Factors (patients' age, body mass index (BMI), diabetes mellitus, no or administered adjuvant chemotherapy, with or without onset of myelosuppression and the degree, surgical approaches, duration of operation, postoperative drainage duration and total drainage volume) associated with SSI were retrospectively reviewed and statistically analyzed by single factor analysis.</p><p><b>RESULTS</b>Five patients suffered SSI (5/55, 9.1%); nineteen receiving adjuvant chemotherapy experienced Grade III + myelosuppression, among which 4 had SSI; only 1 out of the remaining 36 patients without adjuvant chemotherapy had SSI. The difference between the two groups was significant (P = 0.043). The incidence of SSI in patients with post-operative drainage tube indwelling longer than 10 days was 5/21, whereas no SSI occurred in that less than 10 days (P = 0.009). In our study, there was no significant difference in other associated factors.</p><p><b>CONCLUSIONS</b>Concurrent Grade III + myelosuppression after adjuvant chemotherapy is an important risk factor of SSI in breast cancer and needs further study. No SSI was detected with indwelling time of post operative drainage less than 10 days.</p>

Prospective study on the role of MRI and B ultrasonography in evaluating the tumor response to neoadjuvant chemotherapy in breast cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the role of breast B ultrasonography and magnetic resonance imaging in assessing the tumor response to neoadjuvant chemotherapy in breast cancer.</p><p><b>METHODS</b>Eighty-five patients with breast cancer diagnosed by core needle biopsy received neoadjuvant chemotherapy entered this prospective study. Breast B ultrasonography and dynamic enhanced MRI was performed before chemotherapy induction, after the second course and the fourth course of chemotherapy prior to the surgery. Clinical evaluation was made through the tumor reduction measured by B ultrasonography and MRI, based on the response evaluation criteria in solid tumors (RECIST).</p><p><b>RESULTS</b>Measured by dynamic enhanced MRI, 56 patients got partial response (PR), 27 got stable disease (SD) and 2 got progressive disease (PD), none complete response (CR). Measured by B ultrasonography, 52 patients got PR, 31 got SD, 2 got PD, no CR. Residual tumor size after chemotherapy on MRI correlated well with post-operative pathologic findings (r = 0.783, P < 0.05), and B ultrasonography correlated moderately with microscopic findings (r = 0.576, P < 0.001).</p><p><b>CONCLUSION</b>Dynamic enhanced MRI is a reliable method to evaluate tumor response to neoadjuvant chemotherapy in breast cancer.</p>

Intraoperative 125I brachytherapy combined with chemotherapy for pancreatic cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy, toxicity and survival of intraoperative 125I brachytherapy combined with chemotherapy for advanced pancreatic cancer.</p><p><b>METHODS</b>Thirty-six patients with advanced pancreatic cancer were randomized to two groups: brachy-chemotherapy group (n = 18) and control group (n = 18). For the combined group, intraoperative 125I implantation and gemcitabine, 5-Fu were given. For the control group, intratumoral injection of absolute alcohol was done.</p><p><b>RESULTS</b>The CR + PR rate of brachy-chemotherapy group was 38.9% with pain relief in 77.8%, while that of control group was 0 with pain relief in 22.2% (P < 0.05). Although there were some toxicity in brachy-chemotherapy group, treatment was well tolerated. The 6-, 12-month survival rates of brachy-chemotherapy group were 71.4% and 21.4% and those of control group were 38.5% and 7.7%, respectively. The median survival time was 10.6 months and 5.2 months for the two groups, between which the difference was significant (P < 0.05).</p><p><b>CONCLUSION</b>Interoperative 125I brachytherapy combined with chemotherapy for advanced pancreatic cancer can control tumor, relieve pain and improve quality of life. It is safe and effective.</p>