Efficacy of Yanshu injection (a compound Chinese traditional medicine) combined with concurrent radiochemotherapy in patients with stage Ⅲ nasopharyngeal carcinoma

Objective To evaluate the efficacy and toxicity of Yanshu injection (a compound Chinese traditional medicine from Sophora flauescens Ait) combined with concomitant radiochemotherapy in patients with stage Ⅲ nasopharyngeal carcinoma. Methods Sixty patients with stage Ⅲ nasopharyngeal carcinoma were randomized into Yanshu group and control group (n =30, each). Patients in the Yanshu group received Yanshu injection in addition to intensity modulated radiation therapy ( IMRT) and concomitant chemotherapy, and those in the control group were treated with IMRT and concurrent chemotherapy. Results The 1-year, 2-year, 3-year and 4-year overall survival rates were 100%, 93.3%, 86.7% , 80. 0% for Yanshu group, and 96. 7% , 90. 0% , 83. 3% , 76. 7% for the control group, respectively, with no significant difference between the two groups ( P = 0.565). The 1 -year, 2-year, 3-year and 4-year progression-free survival rates were 96.7% , 90. 0% , 83. 3% , 70. 0% for Yanshu group, and 90.0% , 86.7% , 76. 7% , 66. 7% for control group, respectively, with no significant difference (P = 0.554). However, the reaction of mucosa of oral cavity, myelosuppression and thrombocytopenia in the Yanshu group were significantly lower than that in the control group (P < 0. 05). The quality of life of the patients in the Yanshu group was significantly higher than that in the control group ( P < 0. 05 ). Conclusions Yanshu injection combined with radiochemotherapy in patients with stage Ⅲ nasopharyngeal carcinoma show a good efficacy and can reduce the side effects of radiochemotherapy of nasopharygeal carcinoma, and improve the quality of life of the patients.     

Efficacy of Yanshu injection (a compound Chinese traditional medicine) combined with concurrent radiochemotherapy in patients with stage Ⅲ nasopharyngeal carcinoma

Objective To evaluate the efficacy and toxicity of Yanshu injection (a compound Chinese traditional medicine from Sophora flauescens Ait) combined with concomitant radiochemotherapy in patients with stage Ⅲ nasopharyngeal carcinoma. Methods Sixty patients with stage Ⅲ nasopharyngeal carcinoma were randomized into Yanshu group and control group (n =30, each). Patients in the Yanshu group received Yanshu injection in addition to intensity modulated radiation therapy ( IMRT) and concomitant chemotherapy, and those in the control group were treated with IMRT and concurrent chemotherapy. Results The 1-year, 2-year, 3-year and 4-year overall survival rates were 100%, 93.3%, 86.7% , 80. 0% for Yanshu group, and 96. 7% , 90. 0% , 83. 3% , 76. 7% for the control group, respectively, with no significant difference between the two groups ( P = 0.565). The 1 -year, 2-year, 3-year and 4-year progression-free survival rates were 96.7% , 90. 0% , 83. 3% , 70. 0% for Yanshu group, and 90.0% , 86.7% , 76. 7% , 66. 7% for control group, respectively, with no significant difference (P = 0.554). However, the reaction of mucosa of oral cavity, myelosuppression and thrombocytopenia in the Yanshu group were significantly lower than that in the control group (P < 0. 05). The quality of life of the patients in the Yanshu group was significantly higher than that in the control group ( P < 0. 05 ). Conclusions Yanshu injection combined with radiochemotherapy in patients with stage Ⅲ nasopharyngeal carcinoma show a good efficacy and can reduce the side effects of radiochemotherapy of nasopharygeal carcinoma, and improve the quality of life of the patients.     

Correlation of prothrombin time with clinicopathological features and prognosis of patients with osteosarcoma北大核心CSCD

Objective: To investigate the correlation of prothrombin time (PT) with clinicopathological features and prognosis of the patients with osteosarcoma. Methods: The activated partial thromboplastin time (APTT), PT, fibrinogen (FIB) and D-dimer in peripheral blood of 111 patients with osteosarcoma and 35 concurrent healthy volunteers (as the control) from May 2011 to May 2018 were tested. The correlation of PT with clinicopathological features and prognosis of the patients with osteosarcoma was analyzed. Results: The median survival time of 111 patients with osteosarcoma was 25 months, and the one-and two-year survival rates were 76.6% and 51.4%, respectively. The levels of D-dimer and FIB in the patients with osteosarcoma were higher than those in the control group (both P < 0.01), and the PT was shorter than that in the control group (P < 0.01), while the APTT was not statistical different between these two groups (P > 0.05). The PT was longer in the patients with osteosarcoma younger than 20 years old (P = 0.002), while PT had no correlation with gender, tumor size, clinical stage, tumor location and metastatic status (all P> 0.05). The overall survival time of the patients with osteosarcoma in PT ≥ 10.4 s group was shorter than that in PT < 10.4 s group (P = 0.024), the progression-free survival time of the patients with osteosarcoma had no significant difference between these two groups (P= 0.594). The overall survival time and progression-free survival time of the patients with osteosarcoma in metastasis group were shorter than those in non-metastasis group (both P< 0.001). The overall survival time (P= 0.004) and progression-free survival time (P= 0.013) of the patients with osteosarcoma in stage I / II group were longer than those in stage EI/IV group. The clinical stage, PT and metastasis status were related with the prognosis of patients with osteosarcoma (all P< 0.05). The PT and metastasis status were independent predictive factors for the prognosis of patients with osteosarcoma (both P < 0.05). Conclusion: The changes of PT may provide a reference for monitoring the condition and prognosis of patients with osteosarcoma. © 2019 by TUMOR. All rights reserved.     

Evaluation of Intraoperative Radiotherapy for Gastric Carcinoma

OBJECTIVE To study the proper sites and doses of intraoperative radiotherapy (IORT) for gastric carcinoma and the effects of this treatment.METHODS A total of 106 cases of stage Ⅰ- Ⅳ gastric carcinoma who received a D2 or D3 radical resection operation combined with IORT were analyzed. Sixty-seven patients with gastric cancer of the antrum and body received distal gastrectomy. The sites of irradiation were at the celiac artery and hepatoduodenal ligament area. Another 39 patients with carcinoma of the cardia and upper part of the gastric body and whole stomach received proximal gastrectomy or total gastrectomy. The sites of irradiation for this group were the upper margin of the pancreas and the regional paraaorta.The therapeutic effects (including survival and complications) of these 106cases who received a combined operation IORT (IORT group) were compared with 441 cases treated during the same time period by a radical resection operation alone (operation group).RESULTS The radiation dose below 30 Gy was safe. The therapeutic method of the operation combined with IORT did not prolong the survival time of patients with stage Ⅱ and Ⅳ gastric cancer, but the 5-year survival rates of patients with stage Ⅱ and Ⅲ gastric cancers were significantly improved.While the 5-year survival rates of the stage Ⅲ cancer patients receiving D2 resection combined with IORT had marked improvement, for those receiving a D3 radical resection, only the postoperative survival rates at 3 and 4 years of those cases in stages Ⅲ cancers were improved (P＜0.005-0.001). The 5-year survival rate for those patients was raised only 4.7%(P＞0.05).CONCLUSION The 5-year survival rates of patients with stages Ⅱ and Ⅲ gastric carcinoma who received a D2 lymphadenectomy combined with IORT were improved and had no influence on the postoperative complications and mortality.     

Operable Breast Cancer： a Clinical Analysis of 6,263 Cases

OBJECTIVE In Europe and America breast cancer commonly occurs in women of middle and old age, with a median age of about 57 years. Modified radical mastectomy now called standard radical mastectomy, has taken the place of traditional radical mastectomy. Patients with breast cancer at an early stage commonly receive BCT (breast conservative therapy). The TNM stage (especially the lymph node status) affects the prognosis, and adjuvant therapy can improve survival. In China, only a few reports have been pubIished studying large numbers of breast cancer patients. This study was designed to analyze the clinical features, surgical pattern and treatment outcome of resectable breast cancer, as well as to explore the prognostic factors and the effect of adjuvant therapy, with a goal to improve the level of diagnosis and treatment.METHODS Records of the 6,263 patients with resectable breast cancer who had been admitted into our hospital from June 1964 to June 2003 were analyzed retrospectively.RESULTS Of the 6,263 cases, 98.8% were female. Breast cancer occurred most frequently in patients of ages 40～49 years (41.0%), especially in patients 45～49 years old (25.2%). A breast lump, which occurred in 96.2% of the patients, was the main clinical manifestation. The overall 5- and 10-year survival rates were 75.16% and 40.44%. Of the patients in TNM stages 0-1,Ⅱ, and Ⅲ, the 5-year survival rates were 96.8%, 73.7% and 46.4% respectively and the 10-year survival rates were 78.7%, 64.6% and 33.5% respectively. The 5-, and 10-year survival rates were higher in the lymph node negative group than in the lymph node positive group (80.3% vs. 55.6%, and 59.2% vs. 31.9%, P＜0.01). Since the 1980s there was no significant difference in survival rates of patients who received a radical mastectomy compared to a modified radical mastectomy(P＞0.05). Of the 73 patients who underwent breast conservative therapy, no local recurrence or metastasis occurred during a maximal follow-up of 17 years. Of the patients in stage T2T4, the 5-, and 10-year survival rates were significantly higher in the group treated with adjuvant chemotherapy compared to the non-chemotherapy group (78.2% vs. 60.1%, and 48.9% vs. 30.7%, P＜0.01).CONCLUSION According to our data, breast cancer most frequently occurred in patients of ages 45～49 years. The TNM stage (especially the lymph node status) relates to breast cancer prognosis. The prognosis was worse in patients with positive lymph nodes compared to the patients with negative lymph nodes. The efficacy of a modified radical mastectomy is equal to that of a radical mastectomy, and breast conservative therapy can be applied to patients in an early stage. Adjuvant chemotherapy and endocrine therapy can improve the survival of resectable breast cancer patients.     

The cardiotoxicity and long-term efficacy of different doses of epirubicin in the adjuvant treatment of breast cancer patients：A case control study

Abstract Objective： The aim of the study was to observe the cardiac toxicity caused by different doses of epirubicin in the adjuvant treatment of breast cancer and to evaluate the long-term efficacy. Methods： The 180 cases of breast cancer patients received epirubicin based adjuvant chemotherapy. The patients were randomly assigned to high-dosage group （90 rag/m^2）, medium-dosage group （70 mg/m^2） and low-dosage group （50 rag/m^2）, the primary endpoint was cardiac toxicity. The secondary outcomes were the 5-year overall survival （OS） and 5-year disease-free survival （DFS）. Results： During chemo- therapy, the clinical symptoms such as palpitation, dyspnea and paroxysmal nocturnal dyspnea occurred in 6 patients with the high-dosage group, 4 patients with the medium-dosage group and 3 patients with the low-dosage group. The number of patients who had changed in electrocardiogram （ECG） was 7, 5 and 4 in three groups, respectively. The echocardiographic showed each group had only one case with LVEF 〈 50%, there was no significantly difference （P 〉 0.05）. In the three groups, the 5-year DFS rates were 73.3% （44/60） in high-dose group, 53.3% （32/60） in medium-dose group and 41.6% （25/60） in low dose group. The 5-year OS rates were 85.0% （51/60）, 68.3% （41/60） and 58.3% （35/60） in three groups, respectively. The differences were statistically significant （P 〈 0.05）. Conclusion： The high-dose epirubicin in adjuvant chemotherapy with CEF （cyclophosphamide, epirubicin and fluorouracil） regimen could improve the 5-year OS rate and 5-year DFS rate on patients of breast cancer. The cardiotoxicity was mild-moderate and well tolerated.     

延迟辅助化疗对乳腺癌患者生存期的影响(英文)

Objective: The proper time to commence adjuvant chemotherapy after primary surgery for breast cancer is unknown. It is usually prescribed within 2-3 months after definitive surgery. The aim of this retrospective study was to assess the impact of adjuvant chemotherapy (CT) delay beyond 3 weeks ( 21 days) in premenopausal patients with ER-absent tumors being treated for early stages breast cancer on overall survival (OS) and disease-free survival (DFS). Methods: This retrospective study was conducted through revision of medical records of premenopausal patients diagnosed with early stage Ⅰ-ⅢA breast cancer and ER-absent tumors who received adjuvant CT after definitive surgery at the Department of Clinical Oncology, Ain-Shams University Hospitals. Results: Between 2005 and 2008, 105 patients were retrospectively analyzed and included. Patients were divided into 2 groups: Group A including 48 patients who started adjuvant CT<21 days of surgery and group B which included 57 patients who had CT delay ≥ 21 days. Both groups were matched demographically. Comparisons of overall survival, and disease-free survival between group A and group B patients all favored group A. At 5-year the OS rates were 87% and 73% for groups A and B respectively (P=0.001), while DFS rates were 85% and 64% in groups A and B respectively (P=0.001). Analysis of other prognostic factors (age, T, N, grade, HER2 status, surgery type, CT type, local radiotherapy received) were analyzed. Only nodal status predicted for worse DFS (P=0.05) and OS (P=0.006). Conclusion: Delay in initiating adjuvant chemotherapy for early stage breast cancer patients with ER-absent tumors was associated with a decrease in both OS and DFS rates.     

Clinicopathologic characteristics and surgical outcome of gastric cancer in patients younger than 36 years of age

OBJECTIVE This study was designed to determine the clinicopathologic features of young patients who underwent gastrectomy for gastric cancer and to improve the clinical management of this disease. METHODS From 1981 to 2000, among 1,830 gastric cancer patients were admitted in our hospital for surgical treatment, 66 of them were 〈 36 years of age. The clinicopathologic data of these young patients were collected and reviewed. RESULTS The male ： female ratio was 1.2 ： 1. Most tumors were located in the lower third of the stomach （63.1%）. The overall 5-year survival rate of 66 cases was 28.7%. The 5-year survival rates in the patients with early stages and with advanced stages of gastric carcinoma were 77.8% （7/9） and 21.1% （12/57）, respectively. Unfavorable prognostic factors associated with poor 5-year survival included the degree of the invasion in the gastric wall （P 〈 0.05）, and curability of resection （non-curative vs. curative; P 〈 0.05）. CONCLUSION Gastric cancer in young adults tends to be more advanced presentation when diagnosed. However, young patients with early gastric cancer can tolerate radical treatments well. It is important to promptly make a precise diagnosis for gastric carcinoma in young patients and to treat it in early stage.     

应用前列腺特异抗原筛查诊断前列腺癌的临床意义

Objective To evaluate the clinical significance of prostate-specific antigen(PSA)screening in early detection of prostate cancer in Chinese men.Methods PSA screening was performed in 8562 asymptomatic men who had been enrolled for health checkup and all were ≥50 years old.Prostate biopsy was recommended for those with a serum PSA level≥4.0 ng/ml.The pathological and clinical features of the patients with prostate cancer detected by the PSA screening were compared with that of 82 clinically diagnosed prostate cancer patients during the same period.Results Of the 8562 asymptomatic men,719 had PSA levels ≥4.0 ng/ml and biopsy was performed in 295 of them.Fifty-eight prostate cancers were detected.The biopsy rate was 41.0% and positive detection rate was 19.7%.The overall age distribution in the screening group and the clinical groups was not significantly different(P = 0.176).However,41.4%(24/58)of the patients in screening group were ＞75 years old,and significantly more than that in the clinical group(25.6%,P = 0.0491).The proportion of the patients with PSA levels ≥20 ng/ml in the screening group was significantly less than that in the patients of the clinical group(44.8% vs.75.6%,P = 0.0002).Whether in the patients whose age was ＞ 75 years old(P ＜ 0.05)or ≤75 years old (P = 0.0002),the patients in the screening group had significantly lower Gleason scores ＜ 7(60.3% vs.34.1%,P =0.002),more T1 or T2 tumor(87.9% vs.26.8%,P ＜0.0001)and more chance to receive radical prostatectomy(50.0% vs.18.3%,P ＜ 0.0001)than the patients in the clinical group did.However,the distributions of PSA levels at diagnosis and biopsy Gleason scores were not significantly different between the above mentioned two groups(P ＞ 0.05).Conclusion Prostate-specific antigen (PSA)screening is useful for early detection of prostate cancer in Chinese men aged ≥ 50 years.The patients detected by PSA screening usually show a lower PSA level,Gleason scores and early clinical stage disease,and have more chance for radical prostatectomy than the clinically diagnosed patients.     

Occult cervical metastasis of squamous cell carcinoma of tongue among CN0 patients and its treatment

Objective： To explore the treatment of clinically negative neck （CN0） patients with squamous cell carcinoma of the tongue. Methods： 165 CN0 patients with squamous cell carcinoma of the tongue from 1985 to 2002 were investigated retrospectively. Parts of the patients staged at T1, T2 and T3 underwent resection of primary lesion followed by neck observation, and other patients staged above T2 or at T1 but without follow-up were treated with elective neck dissection （END）. All patients were followed up for more than 3 y or until their death. Results： Lymphatic metastasis was identified histologically after operation in 33 of 120 patients treated with END, and 9 of 45 patients treated with resection of primary lesion alone. The overall rate of occult lymphatic metastasis was 25.45%, which increased with the elevating of clinical T stage. The overall rate of neck uncontrolled death was 20.00% for observation group and 5.00% for END group, and significant difference was found between them （P〈0.05）. For T~ patients in the two groups, the rate of neck uncontrolled death was 7.71% and 4.00% respectively, and no significance was found between them （P〉0.05）. When stage T2 and T3 were considered as middle stage together, significant difference （P〈0.05） could be obtained between observation （70.00%） and END group （0%）. Conclusion： The occult metastasis rate of squamous cell carcinoma of tongue increases with the elevating of clinical stage, and elective neck dissection could be considered for NO patients staged over T2 to improve neck control and survival rate; and regional resection alone of primary lesion could be considered for T1N0 patients to improve quality of life if closely followed up is conducted.     

Clinical effects of treatment for lung cancer with double points cryoablation through percutaneous puncture guided by computed tomography

OBJECTIVE To investigate the clinical effects of the application of double points cryoablation through percutaneous puncture for advanced lung cancer patients. METHODS Forty-one patients diagnosed with stage III-IV pulmonary carcinoma were selected for the study. The patients were found to have from 1 to 3 foci of carcinoma, and in each case the disease was limited to one lung. The study patients were divided randomly into 3 groups. There were 16 cases receiving routine chemotherapy and radiotherapy in group I, 13 cases treated with cryoablation at a single point in group II, and 12 cases treated with cryoablation at 2 points simultaneously in group III. The patients in the 2 cryoablation groups also received the same treatment as the patients did in group I. The clinical effects were evaluated within 6 months after treatment, and the survival rate was followed-up for 3 years. RESULTS The clinical effects were improved significantly after treatment in group II and in group III compared with those in group I （P 〈 0.05）, including an enhanced regressive rate of 21%, postponed tumor progression of 50.58% and a clinical benefit rate of 92%. The effective rate of regression in group III was higher than that in group II, 43.59% （P 〈 0.05）, and the 3-year survival rate was 37.25%. Significant differences in side effects were not found between the 2 cryoablation groups. CONCLUSION Cryosurgery ablation at 2 points, simultaneously, and directed at I foci might improve the effects of treatment and the prognosis of lung cancer patients, when used in combination with routine treatment.     

Synchronous primary cancers of the endometrium and ovary： review of 43 cases

Objective:To investigate the clinicsl and pathological characteristics.treatment methods,and prognosis of synchronous primary cancer of the endometrium and ovary.Methods:The clinical data of 43 patients with synchronous primary cancer of endometrium and ovary were retrospectively reviewed.The survival was calculated by Kaplan-Meier method and compared using the log-rank test.Results:The median age of the patients at diagnosis was 49 years(range.28-73 years).The most common symptoms were abnormal vaginal bleeding(69.8%)and abdominal or pelvic pain(44.2%).Pelvic masses were found in 39.5%of the patients and enlarged corpus in 27.9%at physic examination.while pelvic masses were found in 67.4%of the 43 patients(29 cases)and thickening or abnormal endometrium in 23.3%(10 cases)during ultrasound exami-nation.Of 25 patients examined by CT/MRI.pelvic masses were found in 13 cases and enlarged uterus in 11 cases.All 15 patients who underwent endometriaI biopsies were proven to have endometrioid carcinomas.Serum CA125 level was found to be elevated in 22 of the 34 examined cases(64.7%)with median value 500 U/mL(range,39-3439 U/mL).FIGO stages of endometrial carcinomas:ⅠA 18 cases,ⅠB 20 cases.ⅠC 2 cases,and ⅡA 3 cases;Stages of ovarian cardnomas:ⅠA 19 case,ⅠB 4 cases,ⅠC 7 cases.Ⅱ 4 cases,and ⅢC 9cases.Twenty-four patients(55.8%)were in stage Ⅰ both endometrial and ovar-ian carcinomas.Thirty-one patients underwent total hysterectomy plus bilateral salpingo-oophorectomy with omentectomy and appendectomy,meanwhile,12 patients had pelvic lymph nedes dissection.Thirty-eight of the 43 patients(88.4%)had a pathologically proven endometrial adenocarcinomas.The predominant ovarian histologies were endometrioid or mixed tumors with endometrioid components(30/43,69.8%).Postoperatively,26 patients(60.5%)received adjuvant chemotherapy alone.12 had chemotherapy plus radiotherapy,only one patients had radiation alone and the remaining 4 cases received no adiuvant treatment.The 3-year and 5-year survival rates of the group were 87.4%and 71.1%respectively.The 3-year and 5-year survival rates of patients with endometriold carcinoma at both endometrial and ovarian were higher than that of those with non-endometriold or mixed histologic subtypes(93.8%,82% vs 79.7%.69%).The 3-year and 5-year survival rates of patients with earty stages disease were better than those of other patients(93.3%,93.3% vs 69.7%,36.7%).Recurrence developed in 15 patients(34.9%).It was showed by univariate analysis that lower CA125 level,early FIGO stage,and adjuvant chemotherapy plus radiotherapy significantly and positively affected the 5-year survival rate.while only eady FIGO stage and chemotherapy plus radiotherapy were revealed by multivariate analysis as independent prognostic factors.Conclusion:Syn- chronous primary cancers of the endometrium and ovary were different from either the primary endometrial or ovarian cancer,while usually it can be detected in early stage with a good prognosis.The impact of the CA125 level on prognosis needs to be further studied.Surgery treatment alone may be enough for early stage patients.Chemotherapy plus radiotherapy may benecessary for advanced patients.     

A Prospective Randomized Study of Adjuvant Chemotherapy in Completely Resected Stage III-N2 Non Small Cell Lung Cancer

Objective: To evaluate the effect of postoperative adjuvant chemotherapy on survival after complete resection of stage III-N2 non-small-cell lung cancer. Methods: From Jan. 1999 to Dec. 2003, one-hundred and fifty patients, who were diagnosed as stage III-N2 non-small cell lung cancer after operation, were randomly devided into chemotherapy group and control group. The former received four cycles of chemotherapy with NVB (25 mg/m2, D1, D5)/paclitaxel (175 mg/m2, D1) and Carboplatin (AUC=5, D1). Results: In chemotherapy group, 75.8% (68/79) of patients had finished the 4 cycles of chemotherapy and no one died of toxic effects of chemotherapy. Twenty-five percent of the patients had grade 3?4 neutropenia and 2% had febrile neutropenia. The median survival for the entire 150 patients was 879 d, with 1-year survival rate of 81%, 2-year survival rate of 59% and 3-year survival rate of 43%. There was no significant difference in median survival between chemotherapy and control group (897 d vs 821 d, P=0.0527), but there was significant difference in the 1-year and 2-year overall survival (94.71%, 76.28% vs 512 d, P=0.122), but there was significant difference in the 2-year survival rate between two groups with brain metastases (66.7% vs 37.6% P<0.05). The median survival after brain metastasis appeared was 190 days. Conclusion: Postoperative adjuvant chemotherapy does not significantly improve median survival among patients with completely resected stage II-N2 non-small-cell lung cancer, but significantly improves the 1-year and 2-year overall survival. It neither decreases the incidence of brain metastasis but put off the time of brain metastasis.     

Observation of the Curative Effect of Mabthera in Combination with the CHOP Regimen in Treating Invasive B-Cell Lymphoma： A Report of 45 Cases

OBJECTIVE To observe the clinical effcacy and toxic effects of Mabthera (rituximab) in combination with the CHOP (R-CHOP) regimen for treating invasive B-cell non-Hodgkin’s lymphoma. METHODS A total of 45 patients with CD20 positive B-cell non-Hodgkin’s lymphoma were randomly divided into the R-CHOP (22 cases) and CHOP groups (23 cases for controls).They received the regimens of Mabthera in combination with CHOP or single CHOP therapy respectively.An appraisement of the curative effect could only be performed following 4 cycles of chemotherapy for the 45 patients.Follow-up was conducted to observe the conditions of survival. RESULTS The rate of complete remission(CR)in the R-CHOP group was 68.2%,with a total effective rate of 81.8%,and in the CHOP group these rates were 34.8% and 78.3% respectively.There was a significant difference in comparing the CR rates between the two groups (P<0.05).The 1,2 and 3-year overall survival (OS) rates of the RCHOP group were 90.9%,81.8% and 77.3%,respectively.In the CHOP group,the OS rates were respectively 91.3%,69.5% and 47.8%.The difference in the 3-year OS between the two groups was significant (P<0.05).The toxic effects of the two groups were mainly a slight and moderate bone marrow depression and a gastrointesinal reaction,with similar tolerable toxic effects in the two groups (P>0.05). Adverse effects related to the Mabthera infusions occurred in 6 cases of the R-CHOP group (27.2%).These effects lessened after symptomatic treatment. CONCLUSION The therapeutic regimen of Mabthera,in combination with CHOP (R-CHOP) has an obvious curative effect for treating invasive B-cell non-Hodgkin's lymphoma,with a favorable tolerance.It is highly recommended as the treatment of choice.     

1030例早期乳腺癌术后放疗不同年龄组的预后分析

Objective To analyze the prognostic value of age in patients with early stage breast cancer. Methods The clinical characteristics of 1030 patients with early stage breast cancer (the number of positive axillary lymph nodes was less than 3) were retrospectively reviewed. Of all the patients, 468(stage Ⅰ, n = 227; and stage Ⅱ , n = 241) received breast conserving surgery (BCS) and 562 (stage Ⅰ, n =184; and stage Ⅱ, n= 378) received modified mastectomy. Patients were divided into young-age group (≤35,136 patients), middle-age group (> 35-≤60,738 patients) and old-age group (> 60,156 patients).The number of patients without postoperative radiation therapy after BCS is 16, 60 and 39 in the three groups, respectively. Two-dimensional conventional fractionated radiotherapy was administered. The prognostic value of the tumor size, status of axillary lymph nodes or hormonal receptors, postoperative radiation therapy were analyzed. Results The follow-up rate was 97.86%. Of 795 patients followed up more than 5 years, 110,569 and 116 patients were devided into the three groups, respectively. There were 40, 202 and 87 patients without radiation therapy in the three groups. The 5-year recurrence rates of the three groups were 6. 2%, 8. 7% and 10. 4% (χ2 = 1.14, P= 0.567). The 5-year distant metastasis rates were4.3% , 9.5 % and2. 5% (χ2 = 5.31 , P = 0. 070) . The5 - year survival rates were9l. 2% , 92. 6%and 82. 1% (χ2 = 6. 83, P = 0.033). The young-age group had more tumors smaller than 2. 0 cm (65.4%), less positive axillary lymph nodes (13.2%), poorer differential tumor and less positive hormone acceptors (48.0%). Of patients with tumor larger than 2. 0 cm who had no radiotherapy after BCS, the 5-year survival rates were 94%, 87% and 71% (χ2= 20.69, P= 0.000) in the three groups. The corresponding recurrence rates were 23%, 18% ,7%, (χ2 = 9. 97, P = 0. 007), and distant metastasis rates were23%, 25% and 10% (χ2 =8.51, P=0. 014). Conclusions The age is an important prognostic factor in patients with early stage breast cancer undergoing BCS, but not in those undergoing modified mastectomy.     

1030例早期乳腺癌术后放疗不同年龄组的预后分析

Objective To analyze the prognostic value of age in patients with early stage breast cancer. Methods The clinical characteristics of 1030 patients with early stage breast cancer (the number of positive axillary lymph nodes was less than 3) were retrospectively reviewed. Of all the patients, 468(stage Ⅰ, n = 227; and stage Ⅱ , n = 241) received breast conserving surgery (BCS) and 562 (stage Ⅰ, n =184; and stage Ⅱ, n= 378) received modified mastectomy. Patients were divided into young-age group (≤35,136 patients), middle-age group (> 35-≤60,738 patients) and old-age group (> 60,156 patients).The number of patients without postoperative radiation therapy after BCS is 16, 60 and 39 in the three groups, respectively. Two-dimensional conventional fractionated radiotherapy was administered. The prognostic value of the tumor size, status of axillary lymph nodes or hormonal receptors, postoperative radiation therapy were analyzed. Results The follow-up rate was 97.86%. Of 795 patients followed up more than 5 years, 110,569 and 116 patients were devided into the three groups, respectively. There were 40, 202 and 87 patients without radiation therapy in the three groups. The 5-year recurrence rates of the three groups were 6. 2%, 8. 7% and 10. 4% (χ2 = 1.14, P= 0.567). The 5-year distant metastasis rates were4.3% , 9.5 % and2. 5% (χ2 = 5.31 , P = 0. 070) . The5 - year survival rates were9l. 2% , 92. 6%and 82. 1% (χ2 = 6. 83, P = 0.033). The young-age group had more tumors smaller than 2. 0 cm (65.4%), less positive axillary lymph nodes (13.2%), poorer differential tumor and less positive hormone acceptors (48.0%). Of patients with tumor larger than 2. 0 cm who had no radiotherapy after BCS, the 5-year survival rates were 94%, 87% and 71% (χ2= 20.69, P= 0.000) in the three groups. The corresponding recurrence rates were 23%, 18% ,7%, (χ2 = 9. 97, P = 0. 007), and distant metastasis rates were23%, 25% and 10% (χ2 =8.51, P=0. 014). Conclusions The age is an important prognostic factor in patients with early stage breast cancer undergoing BCS, but not in those undergoing modified mastectomy.     

Retrospective analysis of results of treatment for nasopharyngeal carcinoma in Macao

Background： Nasopharyngeal carcinoma （NPC） is a common malignancy in Southeast Asia, however, a full consensus has not yet been reached as to the value of comprehensive treatment for NPC. This study was designed to evaluate the epidemiological characteristics of NPC and their prognostic value, as well as the long-term efficacy of NPC treatment. Patients and methods： A total of 248 patients, with different stages of NPC, were included in this study. Results： The 5-year overall survival （OS） rates for patients in stages I, II, lII and IV were 90.48%, 76.71%, 76.89% and 33.87%, respectively （P=0.000）, while the respective 5-year progression-free survival （PFS） rates were 85.15%, 72.36%, 63.88% and 26.26% （P=0.000）. The respective 5-year OS rates, according to stage, for the group that received radiotherapy combined with chemotherapy and for the group that received radiotherapy only were as follows： stages I and II, 81.67% and 79.59% （P=0.753）; stage III, 79.91% and 70.38% （P=0.143）; stage IV,, 35.22% and 0% （P=0.000）. The respective 5-year PFS rates in these groups were as follows： stages I and II, 75.83% and 74.98% （P=0.814）; stage III, 74.08% and 42.25% （P=0.027）; stage IV,, 27.31% and 0% （P=0.000）. Conclusions： Clinical staging appears to be the most important prognostic factor for NPC. As the stage number increases, both the 5-year OS and PFS significantly decrease. Adding chemotherapy to radiotherapy was not advantageous for patients with stage I or II NPC, however the addition of chemotherapy to radiotherapy significantly improved OS and PFS in patients with stage IV NPC. The addition of chemotherapy improved PFS, but not OS in patients with stage III NPC.     

卡孕栓、双氯芬酸钠栓在宫颈癌后装放疗术中镇痛效果的临床分析

Objective:To observe the effects of Methyl Carboprost and Diclofenac Sodium on opening orifice of uterus and pain controlling in patients with uterine cervix cancer (UCC) when receiving intracavitary brachytherapy. Methods: Sixty patients with UCC of stage IIA-IIIB were divided into three groups randomly before receiving the intracavitary brachytherapy: the patients in group A received Methyl Carboprost in the hind fornix of the vagina, group B received Diclofenac Sodium in the anus, while group C was the control group. Results: The painlessness rates in groups A, B and C were 89.9%, 91.3% and 36.4%, respectively. The incidences of patients with relaxed uterus cervix in groups A, B and C were 91.7%, 85.9% and 48.9%, respectively. Conclusion: Methyl Carboprost and Diclofenac Sodium are useful in relaxing uterus cervix and pain controlling in patients with UCC when receiving intracavitary brachytherapy.     

近端胃切除术和全胃切除术治疗贲门癌

Objective： To evaluate the treatment effects of total gastrectomy （TG） and proximal gastrectomy （PG） for cancer of the cardia and esophagogastric junction. Methods： forty-five patients with cancer of the cardia and esophagogastric junction underwent surgical resection. Of them, 29 were treated using proximal gastrectomy and 16 total gastrectomy. The 3-year and 5-year survival rate and the postoperative complication rate and mortality rate were followed up and compared between the two groups. Results： The 3-year and 5-year survival rates of group PG were 44.8% and 20.7%, of group TG were 37.5% and 18.8%, respectively, and the differences were not statistically significant （X^2= 3.84, P 〉 0.05; X^2= 3.89, P 〉 0.05）. The postoperative complication and mortality rate of group PG were 13.7% and 6.8%, of group TG was all 6%, respectively. Conclusion： Proximal and total gastrectomy treatment effects can not significantly influence the prognosis of patients in progressive stage of cancer of cardia and esophagogastric junction.     

局部晚期食管鳞状细胞癌术后放疗和化疗的前瞻性研究

Objective To investigate the role of postoperative chemoradiotherapy ( CRT) as a multimodality treatment option for locally advanced thoracic esophageal squamous cell carcinoma (ESCC) by a prospective comparison between surgery alone and postoperative CRT. Methods Using preoperative computed tomography (CT)-based staging criteria, 158 patients with ESCC (stage Ⅱ-Ⅲ) were enrolled in this prospective study. With informed consent, the patients were randomized into two groups: postoperative CRT (78 cases ) and surgery alone (S, 80 cases). After a few minor adjustments to the enrolled patients, the actual patients of postoperative CRT group and S group were 74 cases and 77 cases, respectively. Comparison of the complications, local recurrence rate, distant metastasis rate, survival rate and progression-free survival in the two groups was carried out. Results With a median follow-up of 37.5 months, the 1-,3-,5-, 10-year overall survival (OS) rates were 91.0% , 62.8%,42.3%,24.4% and 87.5% , 51.3% , 33.8% , 12. 5% for the postoperative CRT and S arm, respectively. A significant difference in OS was detected between the two arms (P =0.0276). There was a significant difference of progression-free survival (PFS) between the two arms (P=0.0136). The local recurrence rates in the postoperative CRT group and S group were 14.9% and 36.4% , respectively (P<0.05). No significant difference was detected between the complications of the two groups ( P > 0. 05). Toxicities of chemoradiotherapy in the postoperative CRT arm were moderate, which can be relieved rapidly by adequate therapy. Conclusion Rational application of postoperative chemoradiotherapy can provide a benefit in progression-free survival and overall survival in patients with locally advanced esophageal squamous cell carcinoma.