Effectiveness of preoperative concurrent chemoradiation therapy (CCRT) for locally advanced adenocarcinoma of cervix

Aim

To determine the efficacy of preoperative concurrent chemoradiation therapy (CCRT) to improve the prognosis of locally advanced adenocarcinoma of the uterine cervix.

Methods

Twenty-five patients with clinical stage IB2–IVB adenocarcinoma of the cervix were received preoperative CCRT. The CCRT protocol included: external radiotherapy to the pelvis: 39.6 Gy; intra-arterial or intravenous infusion of 70 mg/m² cisplatin, days 1 and 22; 24-h continuous intravenous infusion of 700 mg/m² 5-FU, days 1–4 and 22–25. Two weeks after the end of CCRT, patients underwent restaging followed by appropriate surgery with pelvic lymphadenectomy.

Results

The overall clinical response rate was 96% (24/25), with a complete response (CR) in 12/25 patients and partial response (PR) in 12/25. On pathological examination, 5 of 19 patients (26%) undergoing surgery showed a pathological CR, 13 patients showed a PR, and 1 patient no change (NC) in their disease. Grade 3 or 4 hematological toxicity was observed in 15 patients. Grade 3 gastrointestinal toxicity was observed in 8 patients. The median follow-up period was 34 months (range, 6–69). The 5-year overall survival (OS) rate was 84%, and the progression-free survival (PFS) rate was 76%.

Conclusions

Preoperative CCRT improves the survival of patients with locally advanced adenocarcinoma of the cervix, with manageable toxicities.     

次级淋巴组织趋化因子及其受体CCR7在肿瘤侵袭和淋巴转移中的研究进展

次级淋巴组织趋化因子（SLC）是近年发现的一种新的趋化因子,高表达于次级淋巴组织,能趋化并活化T淋巴细胞、树突状细胞和自然杀伤细胞等免疫效应细胞,在机体淋巴细胞的迁移归巢、抗肿瘤、抗感染过程中具有重要作用。CCR7是SLC的高亲和力受体,近年来研究发现,CCR7和SLC的表达与肿瘤的淋巴转移密切相关。现综述SLC及其受体CCR7的生物学特性和主要功能,并重点阐述SLC和CCR7在肿瘤侵袭和淋巴转移中的研究现状。     

A comparison of three measures of estimating premorbid intellectual level in dementia of the Alzheimer type

Estimation of premorbid intellectual function is becoming increasingly recognized as a crucial component of neuropsychological assessment in both research and clinical practice. Estimation based on accuracy of pronunciation of irregular words via the National Adult Reading Test (NART) has become popular. However, alternative methods have recently been developed, including the Cambridge Contextual Reading Test (CCRT) and the Spot-the-Word Test (STW). In the present study, the three methods were compared in 21 elderly patients with dementia of the Alzheimer type (DAT), relative to a large sample of healthy controls. Performance on all three measures was relatively unaffected by DAT, and in the controls, both the NART and the CCRT correlated relatively well with current verbal intelligence. However, the correlation between the STW and current verbal intelligence was disappointingly low. The DAT subjects showed a significantly greater improvement in performance (relative to controls) when the irregular words were placed in context (meaningful sentences). The results suggest that the CCRT may provide the fairest estimate of premorbid verbal intelligence in DAT.Copyright © 1998 John Wiley & Sons, Ltd.     

艾迪注射液联合同步放化疗治疗食管癌的临床观察

目的：观察艾迪注射液联合同步放化疗治疗食管癌的疗效和不良反应。方法：选取2008年3月-2009年12月经病理证实为食管癌患者62例,随机分为两组：艾迪注射液组（A组）31例采用艾迪注射液联合同步放化疗;对照组（B组）31例采用单纯同步放化疗。两组同步放化疗均采用适形调强放疗技术照射和PF方案（DDP35mg/m2 d1-3＋CF150mg/m2 d1-5＋5-FU350mg/m2d1-5,28天为一周期,共两周期）。艾迪注射液组中艾迪注射液80ml＋NS400ml,d1-d14/周期。治疗期间每周观察骨髓抑制、放射性食管炎、消化道反应等副作用。同步放化疗结束后2周观察患者机能状态及免疫功能。放化疗后3个月、12个月评价有效率（CR＋PR）及1、2年的生存率。结果：艾迪注射液组和对照组总有效率分别为93.55%和87.10%,无显著性差异（P〉0.05）;1、2年生存率无显著性差异（P〉0.05）。但对照组不良反应大于艾迪注射液组,骨髓抑制、胃肠道反应及放射性食管炎发生率差异有显著性（P〈0.01）。结论：艾迪注射液联合同步放化疗治疗食管癌能减轻放化疗的不良反应,提高肿瘤患者的生存质量,并能提高有效率,值得进一步研究。     

消癌平联合同步放化疗治疗局部晚期鼻咽癌的临床观察

目的：观察消癌平注射液联合同步放化疗治疗晚期鼻咽癌的临床疗效。方法：选取２００７年７月１日～２００７年１０月３１日经病理学证实为局部晚期鼻咽癌６９例患者（按９２年福州分期Ⅲ、ⅣＡ期的低分化鳞状细胞癌）,随机分成两组：消癌平组（同步放化疗联合消癌平）３９例和对照组（同步放化疗）３０例。两组同步放化疗均采用常规放疗技术照射和ＴＰ方案化疗（多西他赛７５ｍｇ／ｍ２ｄ１,顺铂１００ｍｇ／ｍ２ｄ２,２８天重复）。消癌平组中消癌平注射液４０ｍｌ＋５％葡萄糖注射液２５０ｍｌ,ｄ１～ｄ７。治疗期间每周观察口咽反应、皮肤反应、骨髓抑制等副反应。同步放化疗结束后２周观察患者机能状态及免疫功能。放疗后３个月、１２个月评价有效率（ＣＲ＋ＰＲ）。结果：消癌平组患者的体力状况评分（ＫＰＳ评分）较对照组优。口咽反应、皮肤反应、骨髓抑制等不良反应在消癌平组均较对照组轻（Ｐ＜０.０５）。消癌平组有效率高于对照组（８９.７４％ ｖｓ．７３.３３％）,差别有统计学意义（Ｐ＝０.０３７５）。结论：消癌平注射液联合放化疗治疗局部晚期鼻咽癌能减轻放化疗的副反应,提高肿瘤患者的生存质量,并能提高有效率,值得进一步研究证实。     

Relational schemas as mediators of innovative moments in symptom improvement in major depression

Objectives: Innovative moments (IMs) are exceptions to the maladaptive framework of meaning that typically motivates clients to seek psychotherapy, and previous studies have shown that IMs are associated with psychotherapy outcomes. While IMs are exceptions that occur at the level of the therapeutic conversation, relational schemas are more stable patterns, and their increased flexibility may facilitate change during psychotherapy. With this in mind, we tested the hypothesis that IMs contribute to outcomes by improving the flexibility of relational schemas. Method: The Core Conflictual Relationship Theme (CCRT) was used to assess relational schemas. IMs were evaluated using the Innovative Moments Coding System. The sample included 22 clients diagnosed with major depressive disorder. The flexibility of the three components of the CCRT (Wishes, responses of the self (RS), and responses of others (RO)) were tested as mediators between IMs and outcomes. Results: The flexibility of the RS was a mediator between IMs and outcomes, but Wishes and RO were not. Conclusion: These findings align with previous research showing that RS is the component most open to change, whereas the other components seem less sensitive to change during brief therapy.     

Intensity-modulated radiation therapy (IMRT)-based concurrent chemoradiotherapy (CCRT) with Endostar in patients with pelvic locoregional recurrence of cervical cancer: Results from a hospital in the Qinghai-Tibet Plateau

The treatment of recurrent cervical cancer, especially pelvic locoregional recurrence, is very challenging for gynecologic oncologists. This study investigated the efficacy and safety of intensity-modulated radiation therapy (IMRT)-based concurrent chemoradiotherapy (CCRT) with Endostar, a novel modified recombinant human endostatin, in patients with pelvic locoregional recurrence of cervical cancer following surgical treatment.This phase 2 study was conducted between May 2018 and May 2019 at a single center in the Qinghai-Tibet Plateau and enrolled 31 patients with pelvic locoregional recurrence of cervical cancer following surgical treatment. All patients were treated with IMRT-based CCRT for 6 weeks and intravenous infusions of Endostar (15 mg/m²), which were administered on days 1 to 7 of CCRT, followed by rest for 4 weeks. After resting, chemotherapy with cisplatin (70 mg/m²) plus paclitaxel (135–175 mg/m²) was given every 3 weeks for a total of 4 treatments.Thirty-one patients were evaluable for the primary endpoint. The mean age was 50.03 years (SD 7.72). The objective response rate was 67.74% and the disease control rate was 83.87% (48.39% achieved a complete response, 19.35% a partial response, 16.13% had disease stabilization, and 16.13% had progressive disease). The most common adverse events were nausea, vomiting, alopecia, neutropenia, and leukopenia; most events were grade 1 or 2 in intensity. Grade 3 toxicities included thrombocytopenia and neutropenia in 2 patients each, and leukopenia in 4 patients. No cases of grade 4 acute toxicity were observed.IMRT-based CCRT with Endostar infusions is effective and safe. Our results support the use of this treatment for patients with pelvic locoregional recurrence of cervical cancer following surgical treatment.