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Objective:To analyze the differences in clinical outcomes and toxicities between postoperative radiotherapy alone and postoperative radiochemotherapy for soft tissue sarcoma (STS), as well as the related factors affecting clinical prognosis of STS patients.Methods:Retrospective analysis of patients diagnosed with primary STS admitted to Zhejiang Cancer Hospital from May 2012 to May 2019 was performed, who received adjuvant radiotherapy after surgery, combined with or without postoperative chemotherapy. A total of 100 patients were enrolled and divided into postoperative radiotherapy group ( n=52) and postoperative radiochemotherapy group ( n=48). The median follow-up time was 65 months (24-124 months). The local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), overall survival (OS), and treatment-related toxicities were recorded in two groups. The survival rate was calculated by Kaplan-Meier analysis. Log-rank test was used for univariate analysis, and Cox model was used for multivariate analysis. Results:In multivariate analysis, the maximum tumor diameter was an independent predictor of local tumor recurrence ( HR=4.80, 95% CI=1.16-19.85, P=0.031), distant metastasis ( HR=4.67, 95% CI=1.53-14.26, P=0.007) and OS ( HR=4.10, 95% CI=1.35-12.48, P=0.013). In addition, the degree of myelosuppression in patients in postoperative radiochemotherapy was significantly higher than that in their counterparts in postoperative radiotherapy group ( P<0.001). Conclusions:In the limited number of patients, radiochemotherapy has no advantages over radiotherapy alone in distant metastasis or survival rate. Besides, it increases toxicities, but the overall tolerability is favorable. It is necessary to conduct prospective randomized studies in a large population and subgroup analysis of histological subtypes, aiming to obtain results with better reference value.
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After the preoperative concurrent chemoradiotherapy for local advanced rectal cancer, the down-staging of tumor is obvious, the rate of anal preservation and the local control rate are improved, and the side reactions are acceptable, but the individual clinical efficacy varies greatly. Recent studies have found that cyclooxygenase-2, G protein coupled receptor, P53 binding protein 1, fibrinogen-to-albumin ratio, programmed cell death factor 4, tumor infiltrating lymphocytes, microRNA are related to the sensitivity of neoadjuvant therapy for locally advanced rectal cancer, which can predict the sensitivity of preoperative concurrent chemoradiotherapy.
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Pancreatic cancer,one of the common malignant tumors of the digestive system,is secretive in incidence and morbidity.Eighty percent of pancreatic cancer patients have already missed the opportunity of eradicative resection surgery when they were diagnosed,among whom,thirty to fifty percent of patients are in locally advanced tumor stage (specifically signifying the local extensive infiltration of tumor with serious vascular invasion and without distant metastasis) with a five-year survival rate of five to ten percent after excision.The pathogenesis of pancreatic cancer is still unclear,with a low rate of early diagnosis due to its lack of characteristic clinical manifestations.This paper reviewed the relevant studies on the clinical therapy of pancreatic cancer patients in locally advanced tumor stage,which is the key to improve the prognosis of pancreatic cancer.
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Objective To investigate the prognoses of patients with ruptured hepatocellular carcinoma (HCC) after resection combined with interventional therapy.Methods This retrospective study was conducted on 50 consecutive patients with ruptured hepatocellular carcinoma treated from March 2013 to December 2016 in the First Affiliated Hospital,Anhui Medical University.The patients were divided into two groups according to the different therapies,they underwent:Group A resection after interventional therapy (n =20) and Group B interventional therapy after resection (n =40).The COX regression multivariate analysis was performed and the 1-year,2-year,3-year overall survival rates (OS) were calculated.Results The 3-year OS rates were significantly different (OS:34％ vs.0％,P =0.044).Multivariate survival analysis showed that age (HR 1.376,P ＜0.001,95％ CI 1.191 ～ 1.589) and blood transfusion (HR 1.001,P ＜ 0.05,95％ CI 1.000 ～ 1.003) were the two prognostic factors which affected OS rates of patients.Conclusions Combined surgical resection and interventional therapy was effective in treating patients with ruptured hepatocellular carcinoma.Resection after interventional therapy gave a better overall survival rate than interventional therapy after resection.
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BACKGROUND:Conventional therapies for lumbar spondylolisthesis can result in trauma,bleeding and low back pain.With the vigorous development of spinal biomechanics and novel spinal fixation systems,we have more understanding on the reduction and fusion after spondylolisthesis.OBJECTIVE:To observe the clinical effects of transforaminal lumbar interbody fusionvia the quadrant system on lumbar spondylolisthesis and related biomechanical changes.METHODS:A retrospective analysis was done in 23 patients with lumbar spondylolisthesis undergoing transforaminal lumbar interbody fusionviathe quadrant system admitted from June 2012 to September 2013.Oswestry disability index and visual analog scale score were detected at 3 months and 1 year after treatment,as wel as fusion conditions and internal fixation with or without loosening or breakage.RESULTS AND CONCLUSION:Al patients were successfuly treated,with no cerebrospinal fluid leakage and nerve injury.Incisions were healed wel in al cases except one case suffered from incision infection that wascontroled after 10 days of antibiotic treatment.Al the patients were folowed up.The Oswestry disability indexes and visual analog scale scores were significantly improved at 3 months and 1 year after treatment (P ＜0.05),but there was no difference in these two scores at 3 months and 1 year after treatment (P＞0.05).The improvement rates of Oswestry disability index and visual analog scale score were (65.3±14.8)％and (58.2±12.0)％,respectively.These findings indicate that the transforaminal lumbar interbody fusionvia the quadrant system is safe and effective to correct lumbar spondylolisthesis,maintains the biomechanical stability,improves patient's symptoms,reduces the incidence of low back pain and improves the quality of life.