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Objective:To conduct a meta-analysis to analyze the efficacy and adverse reactions of fractionated high dose rate brachytherapy (HDR-BT) as monotherapy for localized prostate cancer.Methods:Relevant databases were searched to collect the clinical trials on HDR-BT as monotherapy in patients with localized prostate cancer. Included studies were limited to full-text publications of fractionated HDR-BT as monotherapy with a median follow-up of at least 5 years, and adequate reporting of treatment outcomes and adverse reactions data. Stata 12.0 was used for data analysis.Results:According to the inclusion and exclusion criteria, a total of 11 clinical trials involving 2 683 patients with prostate cancer were included in this meta-analysis. The results of the meta-analysis showed that 5-year biochemical recurrence-free survival (bRFS) rate and overall survival (OS) rate were 94% (95% CI: 93% - 96%) and 96% (95% CI: 94% - 98%), respectively. Long-term (≥5 years) cancer-specific survival (CSS) rate and distant metastasis-free survival (DMFS) rate were 99% (95% CI: 98% - 100%) and 98% (95% CI: 98% - 99%), respectively. Long-term (≥5 years) late grade ≥3 grade gastrointestinal and genitourinary adverse reactions rates were 2% (95% CI: 1% - 3%) and 9% (95% CI: 6% - 13%), respectively. Conclusions:Fractionated HDR-BT as monotherapy is an effective treatment for patients with localized prostate cancer. Its long-term efficacy is encouraging, and the treatment is well tolerated and safe.
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Objective:To analyze the prognosis and risk factors for brain metastases (BM) in patients with limited-stage small cell lung cancer (LS-SCLC) after complete resection, aiming to identify those most likely to benefit from prophylactic cranial irradiation (PCI).Methods:Clinical data of 94 patients with LS-SCLC treated in Cangzhou Integrated Traditional Chinese and Western Medicine Hospital from January 2005 to December 2018 who underwent complete resection were retrospectively analyzed, including 31 cases treated with PCI and 63 without PCI. Prognostic factors and risk factors of BM were analyzed by Kaplan-Meier method. The differences between two groups were analyzed by log-rank test. Independent risk factors of overall survival (OS) and BM were assessed by multivariate Cox regression model.Results:The 2-year and 5-year OS rates were 80.6% and 61.3% in the PCI group, and 61.9% and 46.0% in the non-PCI group, respectively ( P=0.001). The 2-year and 5-year brain metastasis-free survival (BMFS) rates were 80.6% and 54.8% in the PCI group, and 57.1% and 42.9% in the non-PCI group, respectively ( P=0.045). The 2-year and 5-year progression-free survival (PFS) rates were 71.0% and 48.4% in the PCI group, and 49.2% and 34.9% in the non-PCI group, respectively ( P=0.016). PCI could improve OS in patients with pII/III stage LS-SCLC ( P=0.039, P=0.013), but the OS benefit in patients with pI stage LS-SCLC was not significant ( P=0.167). BM occurred in 3 patients (9.7%) in the PCI group, which was significantly lower than that in the non-PCI group ( n=17, 27.0%; P=0.044); there was no significant difference in the BM rate of patients with pI and pII stage LS-SCLC between PCI and non-PCI groups ( P=0.285, P=0.468); and the BM rate of patients with pIII stage LS-SCLC in the PCI group was significantly lower than that in the non-PCI group ( P=0.041). Multivariate analysis showed age ≥60 ( HR=2.803, P=0.001), BM ( HR=2.239, P=0.022), no PCI ( HR=0.341, P=0.004) and pathological stage pII/III ( HR=4.963, P=0.002) were the independent high-risk factors affecting OS; and pathological stage pII/III ( HR=11.665, P=0.007) was an independent high-risk factor affecting BM. Conclusions:LS-SCLC patients with pII-III stage have a higher risk of developing BM and poor prognosis after complete resection, and should receive PCI treatment. However, LS-SCLC patients with pI stage may not benefit significantly.
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Objective To analyze the feasibility of using minimally invasive thoracoscopic surgery to treat stage Ⅲ silicosis complicated by pulmonary tuberculosis and secondary pneumothorax. Methods This study retrospectively analyzed the clinical data of a patient with stage Ⅲ silicosis complicated by pulmonary tuberculosis and secondary pneumothorax. Results The patient had stage Ⅲ silicosis complicated with active pulmonary tuberculosis for 1.5 years. In March 2021, a left-sided pneumothorax occurred and was conservatively treated with closed chest drainage. In April 2022, the patient was admitted with sudden frequent coughing and left-sided chest discomfort. Based on occupational history, dust exposure history, high-kilovolt anterior-posterior chest radiography, chest computed tomography, and sputum smear results, the diagnosis was "stage Ⅲ silicosis; active tuberculosis (positive for acid-fast bacilli in sputum smear); left-sided pleural effusion, pulmonary bulla rupture; secondary pneumothorax (recurrent tension type in left, encapsulated in right); left pleural adhesion". On the second day of admission, left-sided closed chest drainage was performed with poor outcome. On the fifth day of admission, minimally invasive thoracoscopic treatment was performed, including left lung volume reduction, pleural adhesion cauterization, and pleural fixation. Postoperative anti-inflammation, anti-tuberculosis, and symptomatic supportive treatments were administered. Due to the patient's severe underlying disease, wound healing was slow postoperatively, but no serious complications occurred. The pneumothorax completely absorbed and recovered in 17.0 days. Conclusion Minimally invasive thoracoscopic surgery is an effective treatment for silicosis complicated with pulmonary tuberculosis and secondary pneumothorax, and it is worth promoting.
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Objective:To preliminarily evaluate the safety and efficacy of 3D printing template-assisted brachytherapy in the treatment of solitary metastatic lymph nodes adjacent to iliac vessels.Methods:Clinical data of 12 cases of para-iliac lymph node metastasis after radiotherapy admitted to our hospital from October 2018 to April 2020 were retrospectively analyzed. All patients received 3D printing template-assisted brachytherapy at a prescription dose of 20-30 Gy/fraction. CT scan was reviewed every 1 month in the first 3 months after treatment and every 3 months at 3 months after treatment.Local control rate, symptom relief rate and adverse events were evaluated.Results:All the 12 patients successfully completed the treatment and follow-up. At 1, 3 and 6 months after 3D printing template-assisted brachytherapy, 2, 2 and 3 patients obtained complete remission of lymph nodes, 9, 8 and 8 cases of partial remission, 1 case of stable disease and no case of disease progression. The symptoms were relieved in 10 patients. Acute radiation enteritis occurred in 2 patients and myelosuppression in 2 patients, which were mitigated after symptomatic treatment.Conclusion:3D printing template-assisted brachytherapy may be an efficacious and safe treatment of para-iliac lymph node metastasis, which yields tolerable adverse events.
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Objective:To evaluate the clinical efficacy and adverse events of 192Ir high-dose rate brachytherapy (HDR-BT) in the treatment of locally recurrent non-small cell lung cancer (NSCLC). Methods:Clinical data of 22 cases of recurrent NSCLC after radiotherapy admitted to our hospital from September 2013 to March 2018 were retrospectively analyzed. 192Ir HDR-BT was adopted for reradiotherapy. The prescription dose was 30Gy for 1 fraction. CT scan was reviewed every 1 month in the first 3 months after treatment and every 3 months after 3 months. Local control rate and adverse events were evaluated. The 1-and 2-year overall survival (OS) rates of re-treatment after relapse were calculated. Results:All the 22 patients completed the treatment successfully. The 1-, 3-and 6-month complete response (CR) rates were 9%, 14% and 14%, 82%, 82% and 82% for the partial response (PR) rates, 5%, 0% and 0% for the stable disease (SD) rates, 5%, 5% and 5% for the progressive disease (PD) rates, 91%, 96% and 96% for the objective response rates (ORR), respectively. The 1-and 2-year OS rates of re-treatment after relapse were 59% and 27%. Five patients (23%) experienced acute radiation-induced pneumonitis (3 cases of grade 1 and 2 cases of grade Ⅱ), 4 cases (18%) of radiation-induced bone marrow suppression (3 cases of grade I leukopenia and 1 case of grade I thrombocytopenia) and 1 case of postoperative pneumothorax. All these adverse events were mitigated after symptomatic treatment.Conclusion:192Ir HDR-BT is an efficacious and safe treatment of locally recurrent NSCLC.
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Objective@#To investigate the efficacy and feasibility of 192Ir high-dose rate brachytherapy for recurrent intrapulmonary oligometastasis after colorectal cancer surgery.@*Methods@#Patients from May 2013 to October 2017 with intrapulmonary oligometastasisafter colorectal cancer surgery in Cangzhou Integrated Traditional Chinese and Western Medicine Hospital were enrolled. A total of 15 lesions were obtained from 10 patients, which were treated with CT-guided high dose rate of 192Ir. The implant needles were inserted into the tumor and were adjusted to appropriate positions under the guidance of CT. Then the images after transplanting were uploaded to the planning system to delineate the target area and the organ at risk volume. Patients underwent a single radiation dose of 20 Gy.@*Results@#All 10 patients were successfully treated. Grade 1 adverse events were observed for 30% of patients. Of the 10 patients, one patient had a mild cough, and two had bloody sputum. There was no serious adverse events occurred. The local control rate (LC) of the patients at 1 year after treatment was achieved in 93.3%. Only one developed local advancement after six months, who received the secondary brachytherapy. The median progression-free survival(PFS) was 8.5 months and the median overall survival(OS) was 14.7 months.@*Conclusions@#High dose rate brachytherapy is effective in terms of recurrent lung metastases after surgery for colorectal cancer, with a moderate rate of adverse reactions and a favorable local tumor control rate.
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Objective:To observe the effects of genistein on proliferation and apoptosis of human non -small cell lung cancer cell line A549/DDP.Methods:①MTT assay was applied to evaluate the resistance index of A 549/DDP cell line to cisplatin and half in-hibitory concentration ( IC50 ) .②Inhibition rate of A549/DDP cell proliferation and IC 50 value were evaluated by MTT assay after treat-ment with 0, 1.25, 2.5, 5.0, 10, 20, 40, 60, 80 μg/ml genistein for 48 hour respectively.③A549/DDP cell cycle and apoptosis were evaluated by flow cytometry after treatment with 6.25, 12.5, 25 μg/ml genistein for 24 hours respectively.Results:①In expo-sing to cisplatin, the IC50 of A549 and A549/DDP was 33.6 μmol/L and 76.9 μmol/L respectively.The resistance index was 2.3. Cell growth inhibition rate increased following the cisplatin concentration increasing gradually .②A549/DDP growth inhibition rate in-creased at first and later decreased gradually following treatment with the genistein dose increased .The IC50 of A549 and A549/DDP was about 85.1 μg/ml and 80.2μg/ml respectively.③After treatment with 6.25, 12.5, 25μg/ml genistein for 24 hours, there were more A549/DDP cells arresting and showing apoptosis along with the genistein dose increased .Conclusion: Genistein can inhibit A549/DDP proliferation, cause A549/DDP arresting in G2/M phase and induce A549/DDP cell apoptosis with dose dependently .
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AIMTo study the influences of hesperidin on the regula tion of serum lipids levels by simvastatin and its mechanism. METHODS Wistar rats were divided randomly into five groups:control group,model g roup,simvastatin group(SV group), low dose hesperidin +SV group(LDHS group) and high dose hesperidin+SV group(HDHS group).The control group were fed with common diet. The model group were fed with high lipid diet. Other groups were fed with diet containing high lipid,5 mg?kg -1 SV and different doses of hesperid in accordingly. After 8 experimental weeks,the serum lipids levels and CYP4503Am RNA expression in livers and small bowels of the rats were detected. RE SULTSAfter 8 weeks of high lipid diet, the levels of TC,TG and LDL-C in model groups increased significantly (P