RESUMO
Feasibility and efficacy of sequentially performed endovascular stenting and Iodine-125 brachytherapy for malignant superior vena cava syndrome (SVCS) were evaluated. Thirty-four patients with malignant SVCS caused by NSCLC underwent sequential treatment of endovascular stenting and Iodine-125 brachytherapy. SVCS was diagnosed in all patients by CT images or vena-cavography. Pathology diagnosis was acquired by image guided biopsy. Endovascular stent placement was performed as first-line treatment for symptom relief. CT-guided Iodine-125 seed implantation performed 24hr after stenting. Clinical end points were resolution of symptoms and local efficacy of primary malignancy regression. Symptom relief rate was >90% after 24hr and 97% after 3 months. No migration of seeds or restenosis occurred in any patient. The local efficacy (defined as either partial or complete response) was 53%, 79%, 88% and 74% after 1, 3, 6 and 12 months, respectively. Mean SVCS-free survival time was 305 days (range 120-960 days). Two patients were still alive at the time of this writing, Thirty-one died from progression and one died from acute heart disease. Sequentially performed endovascular stenting and Iodine-125 brachytherapy provides a safe and effective alternative for malignant SVCS caused by NSCLC.
Assuntos
Braquiterapia , Carcinoma Pulmonar de Células não Pequenas/complicações , Radioisótopos do Iodo/uso terapêutico , Neoplasias Pulmonares/complicações , Stents , Síndrome da Veia Cava Superior/terapia , Idoso , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Terapia Combinada , Feminino , Humanos , Neoplasias Pulmonares/mortalidade , Masculino , Pessoa de Meia-Idade , Síndrome da Veia Cava Superior/mortalidade , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: To establish an HPLC method for the determination of three kind of diester diterpenoid alkaloids (DDAs) in Aconitum carmichaeli and its processed products namely mesaconitine, aconitine and hypaconitine. METHOD: A Zorbax Eclipse XDB C18 column was used, and ammonium acetate solution-acetonitrile as the mobile phase, with a flow rate of 1.0 mL x min(-1) and a detection wavelength of 230 nm. RESULT: Mesaconitine, aconitine and hypaconitine, were separated, and the calibration curves of them were in good linearity over the range of 0.035 7-1.784 microg (r = 0.9999), 0.0126-0.632 microg (r = 0.9997) and 0.0334-1.672 microg (r = 0.9997) respectively. CONCLUSION: This method is simple and accurate. It can be used in the identification and quality control of A. carmichaeli.
