Clinical outcomes of hepatic arterial infusion chemotherapy combined with tyrosine kinase inhibitors and anti-PD-1 immunotherapy for unresectable intrahepatic cholangiocarcinoma.

OBJECTIVE: To compare the treatment efficacy and safety of tyrosine kinase inhibitors (TKIs) and anti-programmed cell death 1 (PD-1) immunotherapy combined with transarterial chemoembolization (TACE) or hepatic arterial infusion chemotherapy (HAIC) for patients with unresectable intrahepatic cholangiocarcinoma (ICC). METHODS: Patients with unresectable ICC received TKIs and anti-PD-1 immunotherapy combined with HAIC (HTP group) or TACE (TTP group) were included. The clinicopathological characteristics, treatment efficacy, and adverse events (AEs) were compared between the two groups. The factors associated with response rate to the treatments were evaluated. RESULTS: A total of 58 patients were enrolled, with 39 in the HTP group and 19 in the TTP group. Patients in the HTP group exhibited a better objective response rate (ORR; Response Evaluation Criteria in Solid Tumors [RECIST] 48.7% vs 15.8%, P = 0.02; modified RECIST [mRECIST] 61.5% vs 21.1%, P = 0.004) and disease control rate (DCR; 82.1% vs 36.8%, P = 0.001) compared to the TTP group. The median progression-free survival (PFS) rate was not reached and the 1-year PFS rate was 61.9% in the HTP group, whereas the median PFS was 11.0 months and the 1-year PFS rate was 31.6% in the TTP group. The type of treatment and tumor size were significant factors for the response rate. More patients in the HTP group presented rash, abdominal pain and hand-foot syndrome, but all AEs were relieved after symptomatic treatment, and no treatment-related death occurred. CONCLUSIONS: For unresectable ICC, treatment with a combination of HAIC with TKIs and anti-PD-1 immunotherapy was effective and safe. Tumor size might serve as a significant factor for the response rate following treatment for unresectable ICC.

[Measurement of personal noise exposure in a cold rolling mill].

OBJECTIVE: To measure and evaluate the personal noise exposure of cold rolling mill workers by using noise dosimeter. METHODS: According to job category and work type, all workers were divided into 11 groups. 3 to 5 day shift (8:00 to 16:00) workers from each group were selected as subjects for personal noise exposure measurement. SH-126 dosimeters were worn by each subject and collect noise data by a phone fix at collar. All subjects were asked to take notes about their working activities when they were wearing SH-126 dosimeters. Each worker's L(A)(eq) of 8 hours, geometric mean and range of each group were computed. RESULTS: There were many noise sources in the workshop. Recorded data showed that noise exposure of cold rolling mill was unstable. The varieties of personal noise levels were quite large. Among 53 workers, the highest noise exposure level was 100.0 dB (A), the lowest was 81.2 dB (A); the highest work type was of the foreside welders [94.20 dB (A)], and the lowest was of the straight-cutters [89.02 dB (A)]; quality checkers had the biggest rang [16.3 dB (A)], and primary rolling workers had the lest [2.3 dB (A)]. CONCLUSION: Noise exposure of all the 11 groups were more than 85 dB (A). Noise protection of these workers should be improved. It suggested that measuring personal noise exposure individually with dosimeters might obtain the noise exposure level more integrally in the complicated environment.