局部晚期食管鳞癌新辅助放疗剂量与病理完全缓解关系分析

目的 探讨接受新辅助放化疗的局部晚期食管鳞癌患者新辅助放疗剂量与病理完全缓解(pCR)的关系。方法 收集2017-2019年间在四川大学华西医院肿瘤中心经病理确诊为食管鳞癌并接受新辅助放化疗和手术的 116例局部晚期患者临床资料。116例患者中 40~45Gy组 80例,≥45Gy组 36例,分析两组术后pCR率。结果 全组患者的pCR率为38.8%(45/116),40~45Gy组与≥45Gy组的pCR率分别为44%(35/80)和28%(10/36)(P=0.105)。结论 术前新辅助采用较高的放疗剂量不增加局部晚期食管鳞癌的pCR率,有必要进行前瞻性的临床研究确定合适的新辅助放疗剂量。     

阿米福汀对同步放化疗杀伤肺癌细胞作用的影响

目的　探讨阿米福汀在多烯紫杉醇和同步放射治疗非小细胞肺癌过程中对肺癌组织细胞是否有保护作用。方法　使用MTT方法评价在多烯紫杉醇和同步照射 (10Gy)体外培养的SPC A1肺癌细胞过程中 ,阿米福汀对SPC A1肺癌细胞的影响 ;以Lewis肺癌荷瘤鼠模型评价在多烯紫杉醇同步放射 (10Gy)在体Lewis肺癌过程中 ,阿米福汀对Lewis肺癌的影响。结果　体外实验表明同步放化疗加阿米福汀组和同步放化疗组的吸光度分别相当于对照组的 2 2 .8%和 2 4 .4 % ,两组之间比较 ,经过t检验P >0 .0 5。体内实验表明 ,同步放化疗加阿米福汀组和同步放化疗组在实验观察的 2 0d内 ,相同时间点两组动物的肿瘤体积差异无统计学意义。结论　在多烯紫杉醇和放疗同步治疗肺癌过程中 ,阿米福汀无论是对离体还是在体的肿瘤细胞没有保护作用 ,多烯紫杉醇和同步放射治疗肺癌的疗效不会因为使用阿米福汀而减弱     

局部进展期胰腺癌调强放疗剂量递增临床研究

目的探索调强放射治疗 (IMRT)提高进展期胰腺癌局部肿瘤靶区剂量以及减少周围正常组织照射剂量的可能性。　方法 2 1例局部进展期胰腺癌患者接受同期放化疗。放射治疗分第一阶段予常规放射治疗 ,剂量30Gy/ 15次 / 3周 ;第二阶段强调放射治疗 ,肿瘤靶区分割剂量 3Gy/次 ,总剂量为 2 1～30Gy ,在 2周内分 7～10次完成。总剂量递增水平 :5 1、5 4、5 7、6 0Gy。在放射治疗过程中 ,每个治疗日 5 -FU静脉点滴。　结果 16例完成治疗计划 ,分别为 5 1Gy 3例、5 4Gy 3例、5 7Gy 3例 ,6 0Gy 7例。 13例治疗前CA19- 9值升高 ,中位值治疗前后分别为 716、2 5 5U/ml(P <0 .0 0 1)。 14例以疼痛为主的患者至少减少 1/ 3～1/ 2的麻醉药品用量 ,其中 5例疼痛症状完全消失。10例患者治疗后卡氏评分有提高。　结论局部进展期胰腺癌患者接受适形调强放疗并同期应用 5 -Fu化疗增敏 ,可获得确切的姑息治疗作用 ,肿瘤剂量 6 0Gy分 2 5次在 5周完成 ,无严重的放射治疗相关的急性毒性反应     

Combined large cell neuroendocrine carcinoma

We report a case of combined large cell neuroendocrine carcinoma. A 78-year-old man with vertigo was referred to our hospital where chest X-ray revealed a tumor shadow in the right lung. A transbronchial lung biopsy specimen verified a diagnosis of non-small cell lung carcinoma (cT1N0M0). Right lower lobectomy with mediastinal lymph node dissection (#7,8,9) was performed. A postoperative histological diagnosis was combined large cell neuroendocrine carcinoma of a component of squamous cell carcinoma [pT4 (pm) N2M0]. The patient received concurrent chemoradiotherapy due to upper mediastinal lymph node metastasis 4 months after surgery. The chemoradiotherapy well responded and the patient remains well 9 months after surgery.     

Characteristics and Risk Factors of Hospitalized and Nonhospitalized COVID-19 Patients,Atlanta, Georgia,USA, March–April 2020

We compared the characteristics of hospitalized and nonhospitalized patients who had coronavirus disease in Atlanta, Georgia, USA. We found that risk for hospitalization increased with a patient’s age and number of concurrent conditions. We also found a potential association between hospitalization and high hemoglobin A1c levels in persons with diabetes.     

Eribulin combined with radiation therapy in a young patient re-irradiated for a new lesion of breast cancer

Eribulin is widely used in the treatment of metastatic breast cancer, with a manageable toxicity profile. This aggressive disease often requires systemic and local treatments, comprising surgery or radiotherapy. However, eribulin is usually discontinued during radiation therapy due to the lack of data concerning the safety of this combination, especially in the setting of repeat locoregional radiation therapy. Our patient was diagnosed with ER positive invasive ductal carcinoma of the left breast initially treated by surgery, radiation therapy, chemotherapy, and hormone therapy. She then received various lines of chemotherapy for multiple triple-negative relapses in the left axillary region. Since October 2020, she has been treated by eribulin. In order to improve local control, it was decided to add local radiation therapy to the region of recurrence in addition to systemic therapy. She underwent radiation therapy concomitantly with eribulin from February to March 2021. Treatment was very well tolerated, and no acute toxicity was reported. This is the first published case of repeat locoregional radiation therapy in combination with eribulin.     

Results of definitive radiotherapy with concurrent chemotherapy for maxillary sinus carcinomas with neck lymph node metastasis

The purpose of this study was to describe the results of definitive radiotherapy (RT) with concurrent chemotherapy for maxillary sinus carcinomas (MSCs) with neck lymph node metastasis to clarify its limitation. Local control (LC), progression-free survival (PFS) and overall survival (OS) rates were calculated using the Kaplan–Meier method and were compared between subgroups using the log rank test. Toxicity was classified using common terminology criteria of adverse events version 5.0. Eighteen patients with inoperable MSC with neck lymph node metastasis including 12 men and 6 women with a median age of 67 years were analyzed. The histologic diagnoses were as follows: 16 patients had squamous cell carcinomas and 2 had other histology. Four patients had stage T3 MSC, 6 had T4a and 8 had T4b. Among 18 patients, 7 received concurrent systemic chemotherapy and 11 received selective arterial chemo-infusion. The median follow-up period was 17 months. The 2-year LC, PFS and OS rates for the entire cohort were 34, 31 and 46%, respectively. No significant differences were observed for LC, PFS and OS rates between systemic chemotherapy and selective arterial chemo-infusion cohorts. Grade 3 or higher acute toxicity, including both non-hematological and hematological, was observed in nine patients (50%), while no grade 3 or higher late toxicity was observed. In conclusion, we described the results of definitive RT for MSCs with neck lymph node metastasis. Local recurrence of primary tumor was a frequent pattern of failure and it should be addressed in future study.     

食管癌放化疗前后可溶性肿瘤坏死因子受体变化

[目的]探讨食管癌患者放化疗前后血清可溶性肿瘤坏死因子受体水平的变化及其与疗效的关系。[方法]采用双单抗夹心酶联免疫吸附法,检测60例食管癌患者放化疗前和结束时血清sTNFR鄄Ⅰ和sTNFR鄄Ⅱ的水平变化,并观察其与肿瘤消退的关系。[结果]食管癌患者sTNFR鄄Ⅰ水平明显高于健康人(P<0.001),且放化疗后水平较治疗前明显下降;sTNFR鄄Ⅱ显著低于健康人(P<0.001),放化疗后有显著升高。[结论]同时检测血清sTNFR鄄Ⅰ和sTNFR鄄Ⅱ有助于判断肿瘤消退情况和评价疗效。     

The prediction of late rectal complications in patients treated with high dose-rate brachytherapy for carcinoma of the cervix

: The aim of this work is to invetigate an unusually high rate of late rectal complications in a group of 43 patients treated with concomitant irradiation and chemotherapy for carcinoma of the cervix between December 1988 and April 1991, with a view to identifying predictive factors.

: The biologically effective dose received by each patient to the rectal reference point defined by the International Commission of Radiation Units and Measurements, Report 38, were calculated. Radiotherapy consisted of 46 Gy external beam irradiation plus three dose-rate intracavitary treatments of 10 Gy each prescribed to point A. Cisplatin 30 mg/m² was given weekly throughout the duration of the irradiation. The results have been compared to data from 119 patients treated with irradiation alone to assess the cofounding effect of the cisplatin.

: The relationship between the biologically effective dose delivered to the rectal reference point and the development of late complications shows a strong dose-response with a threshold for complications occurring at aproximately the same biologically effective dose threshold as that found for external beam irradiation in the head and neck region. The date from the group of patients treated wihout cisplatin is comparable to the date from the first group of patients in the lower dose ranges; the higher doses were not used and thus are not available for comparison.

: Using the linear quadratic model applied to our clinical results, we have established a threshold for late rectal complications for patients treated with external beam irradiation and high dose-rate brachytherapy for carcinoma of the cervix. This threshold is consistent with similar data for external irradiation in the head and neck region.