1H-MRS evaluation of breast lesions by using total choline signal-to-noise ratio as an indicator of malignancy: a meta-analysis.

The aim of this study was to evaluate the diagnostic performance of the use of total choline signal-to-noise ratio (tCho SNR) criteria in MRS studies for benign/malignant discrimination of focal breast lesions. We conducted (1) a meta-analysis based on 10 studies including 480 malignant breast lesions and 312 benign breast lesions and (2) a subgroup meta-analysis of tCho SNR ≥ 2 as cutoff for malignancy based on 7 studies including 371 malignant breast lesions and 239 benign breast lesions. (1) The pooled sensitivity and specificity of proton MRS with tCho SNR were 0.74 (95 % CI 0.69-0.77) and 0.76 (95 % CI 0.71-0.81), respectively. The PLR and NLR were 3.67 (95 % CI 2.30-5.83) and 0.25 (95 % CI 0.14-0.42), respectively. From the fitted SROC, the AUC and Q* index were 0.89 and 0.82. Publication bias was present (t = 2.46, P = 0.039). (2) Meta-regression analysis suggested that neither threshold effect nor evaluated covariates including strength of field, pulse sequence, TR and TE were sources of heterogeneity (all P value >0.05). (3) Subgroup meta-analysis: The pooled sensitivity and specificity were 0.79 and 0.72, respectively. The PLR and NLR were 3.49 and 0.20, respectively. The AUC and Q* index were 0.92 and 0.85. The use of tCho SNR criteria in MRS studies was helpful for differentiation between malignant and benign breast lesions. However, pooled diagnostic measures might be overestimated due to publication bias. A tCho SNR ≥ 2 as cutoff for malignancy resulted in higher diagnostic accuracy.

[Radiotherapy with concurrent chemotherapy for treatment of advanced nasopharyngeal carcinoma].

OBJECTIVE: To evaluate the effect of radiotherapy combined with concurrent chemotherapy for the treatment of advanced nasopharyngeal carcinoma. METHODS: From February 2001 to August 2003, 80 cases of nasopharyngeal carcinoma (stage III and IVa) were randomized into two groups to receive radiotherapy with concurrent chemotherapy (Group A, n=40) consisted of leucovorin (CF, 100 mg/m(2), days 1-5), 5-fluorouracil (5-Fu, 500 mg/m(2), days 1-5), cisplatin (DDP, 60 mg/m(2), day 1) for one course followed by another 4 weeks later, or radiotherapy alone (Group B, n=40). In all cases, the radiotherapy followed the same protocol, with the nasopharyngeal (NP) total dose (DT) of 66-76 Gy given in 6.6-7.6 weeks, and cervical lymphnode (LN) DT of 60-72 Gy completed in 6.0-7.2 weeks. RESULTS: All patients completed the treatment course, and the complete response rates of the primary lesions and cervical nodes in A and B groups were 77.5% and 60.0% (P>0.05) and 92.5% vs 70.0% (P<0.05), respectively, which were 92.5% vs 72.5% (P<0.05) and 100% vs 85.0% (P<0.05), respectively, 3 months after treatment. No obvious toxicity was observed in the two groups except for vomiting and leukopenia. CONCLUSION: Radiotherapy with concurrent chemotherapy can improve the elimination rate of advanced nasopharyngeal carcinoma, and can be completed in shorter treatment course in comparison with neoadjuvant chemotherapy before radiotherapy, eligible for clinical practice in the treatment of advanced nasopharyngeal carcinoma.

[Efficacy of hypofractionated radiotherapy combined with docetaxel for treatment of bone metastasis of lung cancer].

OBJECTIVE: To evaluate the efficacy of hypofractionated radiotherapy combined with docetaxel for treatment of bone metastasis of lung cancer and explore the factors related to the prognosis. METHODS: Seventy-two patients with bone metastasis of lung cancer were divided into group A with hypofractionated radiotherapy at 3.0 Gy /fraction (once a day, 5 days per week for 30 Gy) and weekly docetaxel treatment at 60 mg for 2 weeks, and group B with radiotherapy alone at 2.0 Gy/fraction (once a day, 5 days per week for 40 Gy). RESULTS: The total effective rate was 93.1% (67/72) in these patients, with a non-response rate of 6.9% (5/72). The total effective rate was 97.2% (35/36) in group A and 88.9% (32/36) in group B. After the radiotherapy, the analgesic effect showed no significant difference between the two groups, but the onset of the effect was faster in group B than in group A. CONCLUSION: Local radiotherapy provides effective pain relief in patients with bone metastasis of lung cancer. High-dose fractionated irradiation can rapidly achieve the analgesic effect.