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Objective To investigate the effect of three-dimensional conformal intensity-modulated radiotherapy combined with oxaliplatin plus capecitabine chemotherapy upon the postoperative median survival time of patients diagnosed with advanced gastric cancer. Methods A total of 74 patients with advanced gastric cancer admitted to Linyi Central Hospital from February 2010 to January 2012 were recruited and divided into the postoperative chemotherapy group (n＝37) and postoperative radiotherapy and chemotherapy group (n＝37) according to the treatment plan. All patients in two groups were treated with laparoscopic D2radical operation. In the postoperative chemotherapy group, patients were treated with oxaliplatin combined with capecitabine. In the postoperative radiotherapy and chemotherapy group, patients were treated with oxaliplatin combined with capecitabine plus three-dimensional conformal radiotherapy.In both groups, 4 cycles of chemotherapy were delivered. The incidence of adverse reactions, median progression-free survival, median overall survival, and 1-, 3-and 5-year recurrence rate and mortality rate were statistically compared between two groups. Results In the postoperative radiotherapy and chemotherapy group, the incidence rate of bone marrow suppression ( 41%), abnormal liver function ( 30%), nausea and vomiting (30%) and neutropenia ( 46%) did not significantly differ from 35%, 35%, 24% and 41% in the postoperative chemotherapy group ( all P＞0. 05).In the postoperative radiotherapy and chemotherapy group, the median progression-free survival and median overall survival were significantly longer compared with those in the postoperative chemotherapy group (both P＜0. 05).The 1-, 3-and 5-year recurrence rates were 8%, 14%and 16% in the postoperative radiotherapy and chemotherapy group, significantly lower than 32%, 41% and 46% in the postoperative chemotherapy group ( all P＜0. 05).The mortality rate was 11%( 4/37) in the postoperative radiotherapy and chemotherapy group, which was significantly lower than 30%(11/37) in the postoperative chemotherapy group ( P＜0. 05 ). Conclusions Three-dimensional conformal radiotherapy combined with oxaliplatin plus capecitabine chemotherapy can effectively prolong the median survival, reduce the recurrence rate and does not enhance the risk of adverse events for patients with advanced gastric cancer.
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[Objective]To discuss the significance of tissue repairing and functional reconstruction in treatment of extremity malignant tumors by allogeneic bone graft and replanting devitalized bone after malignant bone tumor resection. [Method]A retrospective study of 56 patients with malignant bone tumor was conducted, including 35 male patients and 21 female patients. The age was between 9 and 60, with an average of 18.Tumor in 9 cases was in the proximal hunerus, 30 in the distal femur, and 17 in the proximal cnemis.Thirty-two cases were osteogenic sarcoma,17 cases were chondroma sarcomatosum,3 cases were maligant giant cell tumor of bone and 4 cases were metastatic.Soft tissue was repaired and extremity function was reconstructed by adopting allogeneic bone graft and replanting devitalized bone. Extremity functions, bone healing conditions, and complication were estimated according to Mankin metheds.[Result]Among these 56 patients,results in 20(35.7%) were excellent,11(19.6%) were good,8(14.3%) were fair,17 (30%) were poor. The satisfactory rate was 70%.Thirty-eight patients survived for two years without tumor.Thirty patients survived for 5 years with the survival rate of 55%. Except local relapsed, the major complications were infection (4 cases), fracture (3 cases),collapse of articular facet (1 cases), and arthrocleisis (5 cases),with the infection rate of 7%.No internal fixation was broken.[Conclusion]For extremity malignant tumor, effective tissue repairing and functional reconstruction not only offer a limb-sparing effect, but also keep the limb in good function. This is an effective method for bone malignant tumor.
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[Objective]To observe the surgical treatment for the huge disc herniation of C3、4.[Method]Sixteen patients with huge disc herniation of C3、4 were operated upon with combined posterior decompression of expansive open-door laminoplasty with anterior decompression,bone graft and plate fixation.After operation,neurological findings,height of the interbody space and fusion rate of the space were observed.[Result]All the patients were followed up for an average of more than six months,all of them did not get secondary nerve injuries in operation,neurological function were improved obviously and all the affected interbody space got solid fusion.Based on the standard of Odom,50% of the patients were very good,25 % good,25 % general,and the effective rate was about 100%,excellent rate was about 75%.[Conclusion]The combined posterior with anterior decopression and interbody fusion for treatment of huge disc herniation of C3、4 has advantage of more security in removing the prolapsed disc,improvement of the interbody fusion rate,keeping the height ofinterbody space.This procedure is one of the effective operative methods in the treatment of huge disc herniation of C3、4.