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Objective@#To analyze the efficacy and its impacting factors of pelvic confined muscle invasive bladder cancer (MIBC) treated with radiotherapy, also including the preservation of functional bladders and the treatment related late toxicity.@*Methods@#Forty-five MIBC patients who received radiotherapy from March 1999 to October 2016 in our hospital were analyzed.41 of the patients were transitional cell carcinomas. The radiation volume included the bladder±pelvic lymph node with or without local tumor boost, with a median bladder dose of 45 Gy and median tumor dose of 56 Gy.24 patients received concurrent chemoradiotherapy.14 patients received neoadjuvant chemotherapy, and 29 underwent transurethral resection of bladder tumors before radiotherapy.@*Results@#The median follow-up duration was 28 months (range, 4–101 months). The 3-year overall survival were 51%.Concurrent chemoradiotherapy had a better survival than that of radiation alone, with 3-year overall survival of 64% and 30%(P=0.001). The effect of neoadjuvant chemotherapy on 3-year overall survival was not obvious, 59% and 47%(P=0.540) with or without neoadjuvant chemotherapy. The 3-year overall survival were 58% and 43%(P=0.160), respectively for patients with or without the transurethral resection of bladder tumors. The 3-year overall survival were 20% and 79%(P=0.001) for patients with or without relapse. Nine patients recurred locally and fourteen patients developed metastases. The highest bowel toxicity of more than 3 months after radiotherapy was grade 2 in 2 patients. Late grade 2 urinary toxicity occurred in 4 patients, grade 3 in 2 patients. All other patients preserved their functional bladders except 7 patients who had an uncontrolled bladder tumors or radiation induced severe injury of bladder function.@*Conclusions@#A better survival could be obtained for localized muscle invasive bladder cancer treated with concurrent chemoradiotherapy. Most of the patients can preserve their functional bladders after radiotherapy, and the late toxicity is acceptable.
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Objective@#To investigate the relationship between the polymorphism of upstream regulatory region (URR) in human leukocyte antigen-G (HLA-G) gene and the pathogenesis of severe preeclampsia.@*Methods@#Thirty-nine gravidas with severe preeclampsia, who were admitted to the Third Affiliated Hospital of Zhengzhou University from October 2008 to March 2009, were enrolled as the case group. Another 43 healthy gravidas at the third trimester were chosen as the control group. All gravidas in both groups were Han nationality. URR polymorphism in HLA-G gene was detected by PCR sequencing. Allele frequencies and genotype frequencies of all single nucleotide polymorphisms (SNPs) were compared between the two groups.@*Results@#(1) Eight SNPs were detected between -1179 and -689 in HLA-G gene URR in Chinese Han pregnant women. (2) In the severe preeclampsia group, the genotype frequency of -964GG was 12.8% (5/39), which was significantly lower than the frequency of 37.2% (16/43) found in the control group (P=0.012). The allele frequency of -964G was also significantly lower in the severe preeclampsia group than in the control group [38.5% (30/78) vs 57.0% (49/86), P=0.018). (3) In the severe preeclampsia group, the genotype frequency of -716TT was 17.9% (7/39), which was significantly lower than the frequency of 41.9% (18/43) found in the control group (P=0.019). In the severe preeclampsia group, the allele frequency of -716T was 39.7% (31/78), which was also significantly lower than the frequency of 60.5% (52/86) found in the control group (P=0.008). (4) No significant differences were found in the allele or genotype frequencies of -1140A/T, -762C/T or -725C/G in HLA-G gene URR between the two groups (P>0.05).@*Conclusion@#Some of the SNPs in HLA-G gene URR are associated with the susceptibility of severe preeclampsia in Chinese Han gravidas. Pregnant women carrying -964G or -716T may have reduced risk of severe preeclampsia.