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Objective:To evaluate the safety and efficacy of tumor-treating fields (TTFields) and chemoradiation in patients with high-grade glioblastoma.Methods:Clinical data of 38 patients admitted to the Jiangsu Cancer Hospital from September 2021 to May 2023 who were diagnosed with high-grade glioblastoma (36 cases of World Health Organization grade Ⅳ and 2 cases of grade Ⅲ) were retrospectively analyzed. All patients received TTFields combined with concurrent chemoradiation after surgery. Response assessment in neuro-oncology (RANO) criteria was used to evaluate the glioma responses as tumor remission, stable or progression. Common terminology criteria for adverse events v5.0 and TTFields related skin adverse reaction (dAE) criteria were used to evaluate the adverse events. Treatment compliance was assessed by data on the NovoTTF-200A therapeutic device, calculated as a percentage of daily TTFields usage time. Survival analysis was estimated by the Kaplan-Meier method and compared by the log-rank test.Results:The median duration of treatment with TTFields in 38 patients was 20 h (rang: 2.4-22.6 h), and the median treatment compliance was 83% (range: 10%-94%). After 42 days of TTFields combined with concurrent chemoradiation, 12 patients who underwent complete tumor resection were assessed as stable according to RANO criteria. Among the 26 patients who underwent partial tumor resection, 23 (88%) were evaluated as disease remission according to RANO criteria. The 7-, 10-, 13-month progression-free survival rate was 81.0%、64.0%、49.5%, repectively. The common adverse events included grade 1 (45%) and grade 2 (8%) dAE, without grade 3-4 dAE. Typical presentations included contact dermatitis, blisters, lesions or ulcers, and abscesses. The median follow-up time was 10.0 months (range: 1.6-21.3 months). At follow-up as of July 2023, 26 of the 38 patients were stable and 12 had disease progression (8 died).Conclusion:The preliminary results show that TTFields combined with chemoradiation is effective, safe and reliable treatment for high-grade glioblastoma.
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Objective To investigate the relationship between the expressions of serum vascular endothelial growth factor (VEGF), matrix metalloproteinases 9 (MMP-9) before and after chemoradiotherapy and biological behaviors for patients with esophageal cancer. Methods The data of 65 cases with esophageal cancer were analyzed respectively, including 44 cases of primary esophageal cancer and 21 cases of postoperative esophageal cancer. Serum VEGF and MMP-9 before and after chemoradiotherapy were measured, and their relationship with clinicopathological features of esophageal cancer patients was also investigated. Results Serum VEGF level in primary patients [613.50 ng/ml (387.00 - 1127.00 ng/ml)] was significant higher than that in postoperative patients [78.00 ng/ml (40.00 - 196.50 ng/ml)] (Z= -3.493, P= 0.000). There was no difference in serum MMP-9 level with or without surgery, and serum MMP-9 level in primary patients [686.00 ng/ml (434.00 - 1211.25 ng/ml)] has no difference in postoperative patients [637.00 ng/ml (362.00-906.50 ng/ml)] (Z=-0.743, P=0.457). There was no significant correlation in serum VEGF, MMP-9 level with gender, age, tumor pathological type and tumor location in postoperative and primary patients (all P>0.05). There was no significant difference in serum VEGF, MMP-9 level before or after chemoradiotherapy in postoperative patients (P=0.339, P=0.689), but there was a difference in primary patients (P= 0.000, P= 0.001). The changes of serum VEGF, MMP-9 levels were synergistic (r= 0.451, P<0.001). Conclusion The dynamic monitoring and comparison of serum VEGF, MMP-9 levels can predict the efficacy of esophageal cancer and guide the individualized therapy.