The 18F-fluorodeoxyglucose positron emission tomograhy in predicting residual retro-peritoneal tumor after chemotherapy of testis germ cell tumors / 中国肿瘤临床

Objective:To determine the value of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) scans in identify-ing the residual retroperitoneal tumor after chemotherapy of testis germ cell tumors. Methods:Sixteen testis germ cell tumor patients with metastasis of retroperitoneal lymph nodes who were treated in our hospital from February 2014 to December 2016 were select-ed for the study from February 2014 to December 2016. After 4-6 cycles of chemotherapy, their CT scans showed residual masses with diameters greater than 2 cm. The retroperitoneal lymph nodes were dissected after the 18F-FDG PET exam. The post-surgery pathology results were compared with the results of the 18F-FDG PET exam. Results:Residual tumors were found in 5 of 10 patients with 18F-FDG PET positive. Residual tumor was absent in 4 of 6 patients with 18F-FDG PET negative, while residual mature teratoma tumors were found in two patients. The accuracy rate, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the 18F-FDG PET exam were 56.25%(9/16), 71.42%(5/7), 44.44%(4/9), 50.00%(5/10), and 66.67%(4/6), respectively. Conclusion: 18F-FDG PET is highly sensitive. However, many factors influence the result of 18F-FDG PET. Mature teratoma leads to a false negative re-sult, whereas massive tissue inflammation leads to a false positive result. Therefore, more clinical examinations should be made.

Thermotherapy plus chemotherapy in treatment of retroperitoneal lymph node metastasis after radical gastrectomy and sequential radiochemotherapy / 肿瘤研究与临床

Objective To observe the efficacy and toxicity of thermotherapy plus chemotherapy in treatment of retroperitoneal lymph node metastasis after radical gastrectomy and sequential radiochemotherapy. Methods Sixty patients with retroperitoneal lymph node metastasis after radical gastrectomy and sequential radiochemotherapy were randomly divided into of microwave hyperthermia combined with chemotherapy group (experimental group, 30 cases) and chemotherapy group (control group, 30 cases) by using random number table method. The control group: oxaliplatin 130 mg/m2, intravenous drip (2 h), d1; S-1: 80 mg·m-2·d-1, P.O 2 times/d (after breakfast and after dinner), d1-14. 3 weeks was 1 cycle, a total of 4 cycles. The experimental group: chemotherapy on the basis of control group combined with microwave hyperthermia, d1, 8. the efficacy and toxicity of two groups were evaluated. Results The efficacy rate of the experimental group was higher than that of the control group, and the difference was statistically significant [66.7 % (20/30) vs. 33.3 %(10/30), P0.05]. There was no significant difference in bone marrow suppression of two groups [33.3%(10/30) vs. 30.0 % (9/30), P> 0.05]. Conclusion Microwave thermotherapy plus chemotherapy has a good efficacy for retroperitoneal lymph node metastasis after radical gastrectomy and sequential radiochemotherapy, and the patients can well tolerated, it is worthy of clinical promotion.

Value of ultrasound-guided fine needle aspiration cytology in the assessment of ovarian neoplasms and retroperitoneal metastatic lymph nodes / 中华医学超声杂志（电子版）

Objective To evaluate the diagnostic value of ultrasound-guided fine needle aspiration cytology(US-FNAC)in the assessment of radiologically detected ovarian neoplasms and retroperitoneal metastatic lymph nodes. Methods FNAC was performed under ultrasound guidance on 126 patients suspected of ovarian neoplasms and retroperitoneal metastatic lymph nodes. Cytologic examination was performed after staining smears with the haematoxylin and eosin method. Clinical data were retrieved from the medical records and all cytological specimens were reviewed. In these cases, the cytologic findings were correlated with histology of the primary tumor and were compared with surgical pathology. Results Satisfactory sampling was obtained in 86.2% of punctures, and cytological diagnosis was made in 85.7% cases. The size of the lymph nodes punctured was less than 20 mm in 93.5% cases, with the sensitivity of 81.6%、86.2%, specificity of 95.8%、100.0%, positive predictive value of 98.3%、100.0%, negative predictive value of 63.9%、33.3%, and accuracy of 85.3%、87.1%. Seven patients presented slight abdominal discomfort, and relieved without clinical treatment. Conclusions The fine needle aspiration technique has excellent positive predictive value and low morbidity. US-FNAC, as the valuable investigation, is not only useful in the diagnosis of ovarian masses and lymph nodes but can also help in choosing appropriate management. From our experience, US-FNAC can be added in follow-up of selected patients in whom the cytological identification of such masses and nodes is significant for the patient′s treatment.

Three dimensional conformal radiotherapy for metastasis of retroperitoneal lymph node / 中国癌症杂志

Purpose:To evaluate the feasibility of irradiat ion to the metastatic retroperitoneal lymph nodes using three-dimensional confo rmal radiotherapy (3-DCRT) and to assess the irradiation side effects. Methods:From Jun. 1997 to Sep. 2000, 52 patients of metastatic retroperitoneal lymph nodes were treated with 3-DCRT.These patients had receive d radical therapy for their primary tumors. 50 of them had been proved by pathol ogical examination. Radiotherapy was designed by Elekta company’s 3-D treatmen t plan. Dose volume histography (DVH) was used to verify and optimize the radiat ion plan. Using 5～6 conformal portals,the total irradiation dose was 40 Gy an d delivered at 4～5Gy per fraction every other day,to a total of 8～10 fractions in 16～20 days. The immediate responses and side effects were evaluated accordi ng to the WHO and RTOG criterion system. Results:According to Karnofsky criterion system the median scor e was raised 21.3. Three months after irradiation, the complete ,partial and tot al response rates were 38.6%(27/70), 54.3%(38/70)and 92.9%(65/70),respect ively. The early response was related to the target volume and pathological clas sification. The smaller the target volume, the better the response(? 2 = 1 5.211,P=0.004).The anaplastic carcinoma cases had better results than the squamous carcinomas and adenocarcinomas(? 2 =13.455,P=0.009).The 1- ,2- and 3- year survival rates were 59.6%(31/52)、23.1%(12/52)and 9.6%(5/ 52),respectively. Conclusions:Three dimensional conformal radiotherapy can be con sidered as an effective and feasible approach for the treatment of metastatic r etroperitoneal lymph nodes,and no serious complications were observed.