RESUMO
Objective: The aim of the study is to evaluate the effectiveness of ultrasound (US)-guided interventional treatments in local tumor control (LTC) for thoracoabdominal wall seeding tumor (TAWST) from hepatocellular carcinoma (HCC), and explore the survival outcomes of the patients underwent surgical resection (SR) and microwave ablation (MWA) for intrahepatic tumor. Materials and Methods: A total of 40 patients with 47 TAWST from HCC were recruited from April 2007 to May 2018. LTC was evaluated by contrast-enchanced image. Long-time survival outcomes were compared. Overall survival (OS), disease-free survival (DFS), and local seeding progress-free survival (LSPFS) were analyzed. Results: One-year LTC rate was 65.2% in all patients; 72%, 0%, 50%, and 0% in the patients who underwent MWA, high-intensity focused US, iodine-125 (125I) brachytherapy and MWA combined with 125I brachytherapy, respectively. The 3-year OS, DFS rates and LSPFS rates were 51.8% and 28.6%, 12.0% and 23.8%, and 10.0% and 10.0% after MWA and SR, respectively. Univariate analysis results showed that age (P = 0.049), Karnofsky performance scale (KPS) (P = 0.002), and chemoradiation (P = 0.032); and multivariate analysis results showed that age (P = 0.045) and KPS (P = 0.010) might be predictors for LCT. While univariate analysis results showed that KPS (P = 0.032), intrahepatic tumor size (P = 0.006), chemoradiation (P = 0.003), preoperative alpha-fetoprotein level (P = 0.007), metastasis (P = 0.049), and albumin-bilirubin grade (P = 0.002), and multivariate analysis results showed that comorbidities (P = 0.004), KPS (P = 0.007), and metastasis (P = 0.009) might be predictors for OS. The pain degree of patients was improved obviously after treatments. Conclusions: US-guided interventional treatments were an effective option in LTC for TAWST from HCC, and MWA could achieve comparable long-time survival outcomes with SR for HCC patients with TAWST
RESUMO
Objective To review the efficacy and safety of combination of iodine-125 brachytherapy and concurrent chemoradiotherapy for middle and advanced stage non-small cell lung cancer (NSCLC).Methods Eighty-two cases of peripheral NSCLC patients were divided into the experimental group (n =32)and the control group (n =50) by different treatment methods.The patients in experimental group were treated by iodine-125 brachytherapy combined with concurrent chemoradiotherapy,and the patients in control group were treated by concurrent chemoradiotherapy.The two groups were treated with helical tomotherapy,and the chemotherapy regimen was PC regimen (paclitaxel + cisplatin) or TP regimen (taxotere + cisplatin).The response rate (RR),progression free survival (PFS),overall survival (OS) and adverse reactions were observed.Results The RR of experimental group and control group was 87.5％ and 76.0％,and the difference was not statistically significant (x2 =0.992,P =0.319).The median PFS was 16 months and 11 months,and the difference was statistically significant (x2 =5.216,P =0.022).The median OS was 26 months and 19 months,and the difference was not statistically significant (x2 =1.085,P =0.298).There were no statistically significant differences of the occurrence rates of adverse reactions in the experimental group and the control group such as radioactive pneumonia (18.75％ vs.24.00％,x2 =0.314,P =0.575),radiation esophagitis (25.00％ vs.30.00％,x2 =0.242,P =0.623),digestive tract reaction (21.88％ vs.26.00％,x2=0.180,P =0.671),bone marrow suppression (12.50％ vs.16.00％,x2 =0.014,P =0.907) and hemopneumothorax (6.25％ vs.0,P =0.149).Conclusion The combination of iodine-125 brachytherapy with concurrent chemoradiotherapy is a safe and effective treatment for middle and advanced stage NSCLC,which is worthy of further research and promotion.