ABSTRACT
This study aimed to evaluate the prognosis of pulmonary sequestration (PS) by measuring congenital cystic adenomatoid malformation volume ratio (CVR) value in fetal congenital PS. The fetal CVR in 49 cases of fetal PS diagnosed by prenatal ultrasound in Xiangyang No. 1 People's Hospital from March 2010 to June 2017 were measured, and the clinical outcomes were observed. According to the prenatal ultrasound CVR value, 49 fetuses diagnosed with PS were divided into 2 groups: group 1 with CVR≥1.26, and group 2 with CVR<1.26. The incidence rate of fetal edema, respiratory distress symptoms and survival rate were compared between the two groups. The risk factors of the fetal PS were evaluated by single and multiple Logistic regression analysis. The correlation between CVR and fetal prognosis was analyzed. Of the 49 fetuses, there were 34 cases of PS (ILS) type (69.39%, 34/49), 10 cases of PS (ELS) type I (20.41%, 10/49) and 5 cases of PS (ELS) type II (10.20%, 5/49). Forty-six cases (93.88%, 46/49) were born alive, there was 1 case (CVR ≥1.26) (2.04%, 1/49) of induced abortion, and 2 cases (CVR ≥1.26) (4.08%, 2/49) of stillbirths. In group 1 (n=24), 21 cases were born alive, and the incidence rate of newborn respiratory distress and fetal edema was 100% (21/21) and 79.17% (19/24) respectively. In group 2 (n=25), there were 3 cases (12%,3/25) of newborn respiratory distress, 3 cases (12%, 3/25) of fetal edema, and the rate of live birth was 100%. There were statistically significant differences between the two groups in the incidence of fetal edema, postpartum respiratory symptoms and survival rate. CVR was a risk factor for PS and was associated with fetal prognosis. CVR in the midtrimester of pregnancy is an effective index to evaluate the prognosis of fetal PS. CVR ≥1.26 is associated with an increased risk of fetal edema, infant respiratory distress and intrauterine or postnatal death.
Subject(s)
Bronchopulmonary Sequestration/diagnosis , Cystic Adenomatoid Malformation of Lung, Congenital/diagnostic imaging , Fetus/diagnostic imaging , Lung/diagnostic imaging , Bronchopulmonary Sequestration/diagnostic imaging , Bronchopulmonary Sequestration/pathology , Cystic Adenomatoid Malformation of Lung, Congenital/physiopathology , Female , Fetus/physiopathology , Humans , Infant, Newborn , Live Birth , Lung/physiopathology , Pregnancy , Prognosis , Treatment OutcomeABSTRACT
PURPOSE: To assess the effectiveness and safety of javanica oil emulsion injection (JOEI) when combined with radiotherapy (RT) in patients with esophageal cancer. METHODS: Electronic databases including EMBASE, PUBMED, the COCHRANE Library, China Academic Journals Full-text Database, Chinese Biomedical Literature Database, and Chinese Scientific Journals Database were searched. Two reviewers performed the search, identified and extracted eligible studies. Items including response rate, survival and safety were extracted and analyzed using Review Manager 5.3. RESULTS: A total of 16 clinical studies with 1269 esophageal cancer patients were included. The results showed that adding JOEI to RT could improve the complete response (CR rate) (Odds Ratio/OR 1.63; 95% confidence interval (CI), 1.27 to 2.10; p=0.0001), partial response (PR) (OR 1.25; 95% CI, 0.97 to 1.60; p=0.09), Relative Risk/RR (OR 1.42; 95% CI, 1.19 to 1.70; p<0.0001), quality of life (OR 3.01; 95% CI, 1.72 to 5.25; p=0.0001), and reduce the incidence of adverse events including nausea and vomiting (OR 0.81; 95% CI, 0.45 to 1.44; p=0.46) and radiation esophagitis (OR 0.47; 95% CI, 0.33 to 0.68; p<0.0001). The 1-, 2-, and 3-year survival rates in the JOEI group were significantly higher than those in the RT alone group (p<0.001). CONCLUSIONS: JOEI in combination with RT could benefit esophageal cancer patients with improved rate of response and quality of life, prolonged survival, and reduced incidence of adverse events. However, these results should be viewed with caution due to the limited quality of the included studies.
