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Purpose@#Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal malignancy that occurs primarily in children and adolescents. The clinical and pathological features of IMT in adult patients are not well understood. @*Materials and Methods@#We retrospectively searched for records of adult patients with IMT at Fudan University Shanghai Cancer Center from 2006 to 2021. Clinicopathological data, treatments, and outcomes were collected and analyzed. @*Results@#Thirty adult patients with IMT, mostly women (60.0%), were included. The median age of the patients was 38 (21-77). The most common primary site was abdominopelvic region (53.3%), followed by lungs (20.0%). Seven patients had an abdominal epithelioid inflammatory myofibroblast sarcoma (EIMS). The positivity rate of anaplastic lymphoma kinase (ALK) was 81.5% (22/27). Sixteen patients with advanced ALK-positive disease received crizotinib, with an objective response rate (ORR) of 81.3% and a disease control rate of 87.5%. The median progression-free survival was 20.8 months. EIMS was associated with more aggressive behavior; however, the prognosis was similar to that of non-EIMS patients after treatment with an ALK inhibitor. At a median follow-up time of 30 months (95% confidence interval [CI], 13.6 to 46.4), the 5-year overall survival was 77% (95% CI, 66 to 88) in all patients. @*Conclusion@#Adult IMTs appeared more aggressive, with a higher incidence of recurrence and metastases, and patients with EIMS had more aggressive cases. Treatment with ALK inhibitors resulted in a high ORR and a durable response, which suggested that ALK inhibitors could be used as a first-line treatment option in adult patients with ALK-positive advanced IMT.
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Objective To investigate the effects of cochlear implantation combined with subtotal resection of temporal bone in treatment of nasopharyngeal carcinoma after radiotherapy of temporal bone necrosis. Methods A prospective study method was used, and 76 cases of nasopharyngeal carcinoma after radiotherapy of temporal bone necrosis from February 2013 to October 2015 in our hospital for diagnosis and treatment were selected. According to the open control paired principle,the patients were equally divided into observation group and control group, each of 38 cases. Both groups received subtotal temporal bone resection in the treatment, and the observation group received cochlear implant therapy. The surgical effect and hearing improvement of two groups were observed. Results All patients successfully completed surgery. In the observation group, the patients showed normal reactions to intraoperative electrode detection and postoperative electrode impedance, without electrode slippage. There were no statistical differences between the two groups in postoperative pneumothorax and other complication (P>0.05). The sound intensity level of hearing test in postoperative 1 month in the observation group and control group were (21.23±5.22) dB and (28.42±4.19) dB, which was significantly lower than that in the preoperative 1d [(38.24 ±4.98) dB and (38.12 ±5.00) dB], with significantly statistical difference (P<0.05). The postoperative 1 month of hearing and speech score in the observation group were (87.24 ±2.98) points and (82.10 ±3.91) points respectively, which were significantly higher than those in the control group [(73.02 ±5.30) points and (71.84 ±3.11) points] (P<0.05). The two groups of postoperative 1 months of hearing and speech scores were also significantly higher than those in the preoperative 1 d [observation group: (34.29±3.49) points and (32.10±5.30) points; control group: (33.20±4.14) points and (31.98±4.92) points] (P<0.05). Conclusion Cochlear implantation combined with subtotal resection of temporal bone in treatment of nasopharyngeal carcinoma after radiotherapy of temporal bone necrosis shows high safety and success rate, which can promote the improvement of hearing and speech ability, and be widely used in clinic.
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Objective:To observe the clinical efficacy of chemotherapy for esophageal cancer in the elderly. Methods: A total of 74 patients diagnosed with esophageal cancer in our hospital were randomly divided into the observation group and the control group. The control group was treated with radiotherapy alone, while the observation group was treated with concurrent chemoradiotherapy. The efficacy, adverse reactions and 1 and 2-year survival were observed. Results:The recently response rate was 86.5% in the observation group, while the control group was 62.2% (x2=5.37, P<0.05). The disease control rate was 100.0% in the observation group, while it was 3.8% in the control group. The differences were significant (x2=4.53,P<0.05). The adverse reactions in the two groups were not significantly different. With 34 patients in the observation group followed up, the 1-year survival rate was 73.5%, 2-year survival rate was 55.9%, while it was 40.0% and 25.9% in 35 patients that followed up in the control group. The differences were statistically significant (x2=6.58,x2=5.32;P<0.05).Conclusion: Concurrent chemotherapy for esophageal cancer in the elderly has a significant effect. Compared with radiotherapy alone, it can significantly increase the 1, 2-year survival rate, and does not significantly increase the adverse reactions.