每周化疗合并局部放疗治疗晚期肺癌的临床研究

目的　对比每周化疗加局部放疗与单纯化疗对晚期非小细胞肺癌的疗效。方法　对初次化疗失败的非小细胞肺癌患者行每周化疗合并局部放疗 ,对初次化疗有效的病例继续行同一方案化疗。结果　放化疗组有效率为 6 6 .6 % ,单纯化疗组有效率为 70 .2 % ,二者之间无显著性差异 (P>0 .0 5 )。二者副作用 - 级白细胞减少的发生率 ,放化疗组较单纯化疗组明显下降 (P<0 .0 5 )。结论　每周化疗结合局部放疗是改善晚期肺癌初次化疗失败的一种有效方法     

Prevention of MHC-alloimmunization by UV-B irradiation in a murine model: effects of UV dose and number of transfused cells

The optimal dose of UV-B radiation for prevention of in vivo alloimmunization (AI) against major histocompatibility complex (MHC) antigens was investigated in a murine transfusion model. Two groups with five C57BL/6 mice (H2^b) each were transfused at weekly intervals with 1 x 10⁵ or 1 x 10⁶ DBA/2 (H-2^d) leucocytes. Both suspensions induced anti-H-2^d antibodies in all mice after the second transfusion. The minimal UV-B dose required for abolition of alloreactivity in the mixed leucocyte reaction (MLR) was 0.6 J/cm². This dose completely prevented the onset of MHC-AI in all five mice transfused with six suspensions containing 1 x 10⁵ leucocytes. In contrast, suspensions with 1 x 10⁶ leucocytes and exposed to 0.6 J/cm² induced immunization in 4/5 mice. Further increase of the dose to 1.8 or 5.4 J/cm² did not prevent the onset of MHC-AI. The use of UV radiation for prevention of secondary MHC-AI was investigated in five mice with a primed immune system. Transfusion of suspensions with 1 x 10⁵ leucocytes and irradiated at a dose of 1.8J/cm² did not prevent booster reactions. We conclude that the number of leucocytes per transfusion determines the efficacy of UV irradiation for the prevention of MHC-AI. For UV irradiation of human platelet concentrates (PCs) we propose to reduce the number of leucocytes by centrifugation prior to UV exposure. UV-B irradiation of PCs with high numbers of leucocytes may not be effective for prevention of alloimmunization.     

Treatment of Hematologic Malignancies with Alternate Hemibody Irradiation Combined with High-Dose Chemotherapy: A Single-Center Experience

The objective of this study was to evaluate the clinical outcome of the treatment of hematologic malignancies with alternate hemibody irradiation (AHBI) combined with high-dose chemotherapy. Seventeen patients with hematologic malignancies were treated with AHBI combined with high-dose chemotherapy. Following high-dose chemotherapy, upper hemibody irradiation (UHBI) and lower hemibody irradiation (LHBI) were given sequentially in a dose of 6 to 9 Gy. UHBI was given 14 days (range, 12-22 days) after high-dose chemotherapy, and LHBI was performed 23 days (range, 7-34 days) after UHBI. Meanwhile, we treated a control group of 14 patients with acute lymphoblastic leukemia (ALL) with autologous hematopoietic stem cell transplantation (AHSCT). Hematopoietic reconstitution was observed in all of the patients. The median follow-up period was 927 days (range, 428-1446 days). The 3-year probabilities of disease-free survival (DFS) were 52.38% +/- 13.47% for the patients in complete remission who underwent AHBI. No patient died of AHBI-related toxicity. The 3-year DFS rates for the 2 groups of patients with ALL were not significantly different (47.73% +/- 17.55% in the AHBI group and 53.88% +/- 14.08% in the AHSCT group; P > .05). AHBI combined with high-dose chemotherapy is a feasible approach for patients with hematologic malignancies and has the advantages of a desirable effectiveness, low costs, simple operation, and acceptable side effects.     

Linear lesions for treating the recurrence of persistent atrial tachyarrhythmia after cryoballoon ablation of atrial fibrillation

Overall, 133 patients underwent 170 procedures for the treatment of persistent ATa following an index cryoballoon pulmonary vein isolation (n = 715). After all the procedures, > 90% of the patients had a roof line, a mitral isthmus and/or septal line, and a cavotricuspid isthmus line. Ninety-two patients (69.2%) were in sinus rhythm after a median of 36 months since the index cryoballoon PVI. ATa: atrial tachyarrhythmia; cryo: cryoballoon; CTI: cavotricuspid isthmus; LSPV: left superior pulmonary vein; LIPV: left inferior pulmonary vein; PVI: pulmonary vein isolation; RF: radiofrequency; RSPV: right superior pulmonary vein; RIPV: right inferior pulmonary vein.

     

Definitive management of rectal cancer by contact (endocavitary) irradiation

In a retrospective review, 62 patients treated for rectal cancer by contact (endocavitary) irradiation at The Cleveland Clinic Foundation were analyzed. This treatment modality delivers high dose, low penetration irradiation to a rectal cancer by direct contact of a 50 KV x-ray source through a special proctoscope. Cancers selected for this treatment include small (3 cm or less), mobile tumors without presacral lymphadenopathy that are within reach of digital examination and are well- or moderately well-differentiated adenocarcinomas. Between 1973 and 1984, 62 patients (37 males, 25 females) were treated—46 by contact irradiation alone and 16 by contact irradiation after excisional biopsy. The median tumor dose was 12,000 rads administered in four fractions at monthly intervals. Mean follow-up was 31 months. Fiftysix patients (90 percent) were disease-free at the time of review or death (ten died from unrelated causes). Eleven patients (18 percent) developed local recurrence but eight of these without distant metastases were rendered disease-free by other treatment—six by surgical resection and two by further radiotherapy. Mean time since secondary treatment is 20 months. Three patients are alive with incurable disease and three have died from cancer—in three of these six patients there was no evidence of local disease. Ulcerated tumors developed local recurrence in five of 17 cases (29 percent) while polypoid tumors recurred locally in six cases (14 percent). Morbidity from the treatment was minor in nature. It is suggested that contact (endocavitary) irradiation is effective treatment for carefully selected cases of rectal cancer Read at the meeting of the American Society of Colon and Rectal Surgeons, Washington, D.C., April 5 to 10, 1987.     

Surface Morphology of Superficial Cells in Irradiated Oral Mucosa: An Experimental Study in Beagle Dog

Abstract

Objectives: The aim of the present study is to investigate if radiation induces changes in the superficial cells of the oral mucosa and secondly to describe morphological characteristics of the cell surface structure by scanning electron microscopy (SEM).

Materials and methods: Ten beagle dogs aged 1–2 years were used in this study. One side of each mandible was irradiated in two sessions, each lasting 1 week. The total dosage was 40?Gy (Group A; 5 dogs) and 50?Gy (Group B; 5 dogs), in five fractions of 4?Gy. The other side of mandible (non-irradiated) served as a control. The specimen was harvested with a scalpel from the alveolar mucosa of the irradiated area 1 year after irradiation and studied with SEM.

Results: In the control side, the surface structure of the cell contains straight parallel or branched microplicae (MPL), which were equally spaced over the cell surfaces. Discontinuous and short MPL were typical cell structure of irradiated mucosa. In 50?Gy group, the surface structure of epithelial cell was pitted and the cell boundaries were thick.

Conclusions: The novelty of the present study is that radiation disrupts superficial cells of the oral mucosa. The role of the MPL structure of the superficial cells in mucositis development is discussed.     

Citrate Buffer Alternative to Picric Acid for Masson Trichrome Stain

Abstract

An alternative to picric acid as a mordant in the staining of cytoplasm, keratin, muscle fibers, and intercellular fibers in the Masson trichrome stain is a citrate acid-sodium citrate buffer used as the microwave pretreatment of the tissue mounted on a slide. The Masson trichrome stain, a combination of Biebrich scarlet-acid fuchsin and aniline blue dye can be done within 1 hr and avoids the hazards associated with picric acid, a highly explosive compound in the dry state. (The J Histotechnol 19:341–342, 1996)     

Predicting adherence of dose–volume constraints for personalized partial-breast irradiation technique

PurposeMulticatheter interstitial brachytherapy (MIB) and external-beam (EB) radiotherapy are established partial-breast irradiation (PBI) techniques. Although EB-PBI is widely available, it requires extra irradiated margins for target uncertainties. We examined the impact of EB-PBI on dose–volume constraints as compared to MIB-PBI.Methods and MaterialsAmong 653 patients receiving MIB-PBI between October 2008 and April 2020, consequent 159 patients after September 2018 were examined. Clinical target volume (CTV) included the lumpectomy cavity plus 1.0 cm. Planning target volume (PTV) for EB-PBI was defined as CTV with 1.0-cm expansion. Because the ratio of PTV to breast volume (RPB) was related to cosmesis, <25% of RPB was defined as suitable for the ipsilateral breast constraints. Preoperative breast size was classified as very small (<350 cm³), small (350–699 cm³), and medium or large (≥700 cm³). According to each category, the dose–volume constraints of the organs at risk were compared between the two PBI techniques.ResultsPatients including 84 very small, 59 small, and 16 moderate to large breasts were examined. Although RPB was suitable in all patients receiving MIB-PBI, it was achieved in 74 patients (46.5%) receiving EB-PBI (p < 0.0001). The suitable RPB in patients with very small, small, and moderate to large breast was 32.1%, 55.9%, and 100%, respectively (p < 0.0001). Normal-tissue constraints for the other organs could be satisfied in patients with moderate to large breasts.ConclusionAlthough EB-PBI may be an appropriate option for patients with moderate to large breasts, MIB-PBI could still be a crucial technique, especially for patients with small breasts.     

Long-Term Effect of Gamma Irradiation on the Functional Properties and Cytocompatibility of Multiblock Co-Polymer Films

Abstract

The purpose of this work was to investigate the long-term effect of gamma-irradiation treatment on the functional properties of PEG-PDLLA and PEG-PLGA films and to evaluate the cytocompatibility of sterilized samples. Chemical and thermal properties, and cytocompatibility of sterilized films were detected for samples at time zero and after storage at 5 ± 3°C for 60 days. An in vitro degradation study was carried out on polymer samples to examine the effect of sterilization on the degradation performances of co-polymer films. Incubated samples were characterized in terms of film surface structure (SEM), chemical (GPC) and thermal (DSC) properties. The study performed on films upon gamma sterilization showed no significant changes of the PEG-PDLLA and PEG-PLGA film structure, while GPC analysis highlighted that the effect of gamma irradiation was dependent on the M_w and composition of polymers. DSC traces suggested more pronounced gamma-ray effects on the PEG-PLGA multiblock co-polymer. During the stability study important changes in terms of structure surface, thermal properties and cytocompatibility were observed and investigated. Data collected during the in vitro degradation study emphasized the need to know and investigate the degradation performances and behaviour of polymer or polymer systems (as DDS, scaffolds and bandage) treated with gamma rays.