Evaluation of Quality of Life Using EORTC QLQ‐BM22 in Patients with Bone Metastases after Treatment with Magnetic Resonance Guided Focused Ultrasound

Objective

To reveal the alterations in quality of life (QOL) in bone metastases patients after magnetic resonance guided focused ultrasound (MRgFUS).

Methods

This retrospective study enrolled 26 patients diagnosed with bone metastases. Patients had various primary malignant tumors and tumor lesions in different locations. All patients received MRgFUS for bone metastasis. Each focal spot sonication pulse that was applied to create energy deposition lasted 20 s and was performed at a frequency of 1.05 MHz. The visual analog scale (VAS) was used to measure pain level and the EORTC QLQ‐BM22 was applied to evaluate QOL for 12 months. The lower the QLQ‐BM22 score, the better the QOL of patients.

Results

The painful site subscale of the EORTC QLQ‐BM22 was observed without significant change. Significant reductions in the functional subscales were observed after therapy compared with the baseline. The functional interference was reduced significantly during the first 12 months. From the 2‐month time point onwards, the pain characteristics subscale also decreased significantly. VAS scores had decreased by 40.8% 1 month after the operation and had decreased 10.9% compared with VAS scores preoperation. Scores for pain characteristics decreased by 28.8% after the operation and the scores were still down by 10.8% 1 year after the treatment. VAS scores indicated a significant reduction in pain over the course of the research until the 12‐month time point follow‐up compared with the baseline.

Conclusion

MRgFUS therapy improved the QOL of patients with bone metastasis by relieving bone pain.

     

Nomogram to Predict Incomplete Cytoreduction for Pseudomyxoma Peritonei

Backgrounds

The completeness of cytoreduction is one of the most important prognostic factors for patients with pseudomyxoma peritonei (PMP). To date, no nomograms have been established to predict incomplete cytoreduction (IC) for patients with PMP. The current study therefore proposed a nomogram to predict individual IC risk for PMP patients.

Methods

Between 1 June 2013, and 22 November 2019, 144 consecutive PMP patients who underwent cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) for the first time in our center were included in a retrospective study. Possible predictors of cytoreducibility were analyzed using logistic regression modeling to predict IC for PMP patients. A nomogram was developed based on the multivariate analysis and further investigated for internal validation.

Results

After CRS, the 144 participants were divided into complete CRS (CCRS) (n = 46) and IC (n = 98) subgroups. Four independent predictors (sex, disease duration, anemia, and carbohydrate antigen 19-9 (CA 199)) were included in the prediction model. Then, a nomogram predicting IC was established based on the aforementioned variables, which demonstrated good predictive accuracy (C-index, 0.837; 95 % confidence interval [CI], 0.764–0.894). The predicted probability was close to the actual observed outcome according to the calibration plot.

Conclusions

The current work led to the development of a nomogram capable of predicting IC for PMP patients who demonstrated good performance. Risk stratification by the established nomogram had ability to optimize individual IC prediction and help physicians to establish meticulous preoperative plans.

     

老年腹股沟疝患者行疝修补术后并发症的多因素Logistic回归分析

目的探讨老年腹股沟疝患者行疝修补术后并发症的危险因素,为预防并发症的发生提供依据。 方法选取2017年1至12月安徽医科大学附属六安医院收治的行疝修补术的老年腹股沟疝患者122例作为研究对象,搜集患者的基本临床资料,并随访术后1年的并发症发生情况,采用单因素分析与多因素Logistic回归分析术后并发症发生的危险因素。 结果随访1年,失访患者9例,随访成功的113例患者中有21例存在相关并发症,总发生率为18.58%：其中手术部位感染6例（切口浅表感染4例,皮下脓胀1例,补片感染1例）,术后疼痛4例,尿潴留3例,血清肿3例,股静脉血管损伤2例,术后复发2例,膀胱损伤1例。单因素分析结果显示,并发症发生与年龄、粘连程度、内环口大小、术前合并慢性阻塞性肺疾病、麻醉ASA分级与疝内容物是否完全回纳相关（P<0.05）;多因素Logistic回归分析结果显示：年龄、粘连程度、内环口大小与疝内容物是否完全回纳是术后并发症发生的独立危险因素（P<0.05）。 结论老年患者腹股沟疝进行手术治疗后一年内的并发症发生率不低,其中高龄、疝环重度粘连、内环口较大与疝内容物无法完全回纳的患者术后并发症的风险更高,需要重点关注这类术后并发症高危患者以采取相应预防措施。     

Multi-Scale Deep Neural Network (MscaleDNN) Methods for Oscillatory Stokes Flows in Complex Domains

In this paper, we study a multi-scale deep neural network (MscaleDNN) as a meshless numerical method for computing oscillatory Stokes flows in complex domains. The MscaleDNN employs a multi-scale structure in the design of its DNN using radial scalings to convert the approximation of high frequency components of the highly oscillatory Stokes solution to one of lower frequencies. The MscaleDNN solution to the Stokes problem is obtained by minimizing a loss function in terms of $L^2$ norm of the residual of the Stokes equation. Three forms of loss functions are investigated based on vorticity-velocity-pressure, velocity-stress-pressure, and velocity-gradient of velocity-pressure formulations of the Stokes equation. We first conduct a systematic study of the MscaleDNN methods with various loss functions on the Kovasznay flow in comparison with normal fully connected DNNs. Then, Stokes flows with highly oscillatory solutions in a 2-D domain with six randomly placed holes are simulated by the MscaleDNN. The results show that MscaleDNN has faster convergence and consistent error decays in the simulation of Kovasznay flow for all three tested loss functions. More importantly, the MscaleDNN is capable of learning highly oscillatory solutions when the normal DNNs fail to converge.     

A comparison between raltitrexed plus cisplatin and docetaxel plus cisplatin in concurrent chemoradiation for non-surgical esophageal squamous cell carcinoma

PurposeChemoradiotherapy (CRT) is considered as a standard treatment for unresectable and inoperable esophageal cancer (EC) patients. However, no consensus has been reached regarding the optimal synchronous chemotherapy regimen and the best combination of radiotherapy and chemotherapy. The aim of this study was to evaluate the efficacy and toxicity of raltitrexed plus cisplatin and docetaxel plus cisplatin to find a safe and effective concurrent chemotherapy schedule.Patients and methodsOur retrospective study included 151 EC patients treated with raltitrexed and cisplatin (RP) (n = 90) or docetaxel and cisplatin (DP) (n = 61) from 2011 till 2018. Survival outcomes and treatment related toxicity were analyzed between the two groups.ResultsPFS and OS were 18 and 34 months in the RP group, while 13 and 20 months in the DP group (P = 0.118 and P = 0.270). The 1-, 2-, 3-year survival rates of the RP group were 71.1, 55.4 and 46.4%. For the DP group, these were 63.9, 44.3 and 37.6%, respectively. Compared with DP group, RP group received a superior CR rate (68.9% versus 52.5%, P = 0.041). There was a trend that the total number of toxic reactions in RP group was lower than that in DP group (P = 0.058).ConclusionsEven RP and DP groups have the similar survival outcomes and toxicity, raltitrexed/cisplatin get a higher complete response rate. Our study suggests that raltitrexed combined with cisplatin is a safe and effective concurrent chemotherapy regimen and it might be used as an alternative for cisplatin/5-FU and cisplatin/docetaxel in CCRT for EC patients.