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Background@#There are only very few reports on clinical outcomes using multi-channel applicators (MCA) for patients with endometrial cancer (EC) in China. We aimed to evaluate the clinical experience of treating intermediate-risk (IR) to high-risk (HR) stage I EC using in-house made multi-channel applicators (IH-MCA) in a single institution.@*Methods@#Three hundred and ninety patients with stage I IR to HR EC were treated with hysterectomy and adjuvant radiotherapy from 2003 to 2015. All patients received post-operative vaginal cuff brachytherapy (VBT) alone or as a boost after external beam radiotherapy (EBRT). The prescriptions were 500 cGy per fraction for a total of 5 to 6 fractions with brachytherapy alone or 400 to 600 cGy per fraction for 2 to 3 fractions if it was combined with EBRT. Two types of applicators including a traditional rigid IH-MCA and a recent model custom-made with 3 dimension printing technology were used for treatment. The Kaplan-Meier method was used to calculate survival rate.@*Results@#Follow-up rate was 92.8% and the median follow-up time was 48 months (range 4–172 months). The 5-year overall survival (OS), progression-free survival, local recurrence, and distant metastasis rates for all patients were 96.3%, 92.1%, 2.9%, and 4.8% respectively. Two patients had isolated relapse in vagina outside the irradiated volume. The univariate and multivariate analysis showed that age and grade were the prognostic factors correlated with OS (hazard ratio: 0.368, 95% confidence interval [CI]: 0.131–1.035, P = 0.048; hazard ratio: 0.576, 95% CI: 0.347–0.958, P = 0.026,).@*Conclusions@#For patients with IR to HR stage I EC, adjuvant VBT alone or in combination with EBRT using IH-MCA led to excellent survival and recurrence rates. Age and grade were the prognostic factors correlated with OS.
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Objective To investigate the demand for scientific information among cervical cancer patients and to evaluate the quality of the relevant information available for these patients.Methods The demand for medical science information among patients with cervical cancer was investigated via questionnaire.The Discernn scoring system was used to score the cervical cancer science articles retrieved by Baidu and Sogou.A model was established to analyse the reading difficulty of these articles.Results Nearly half(53.6%)of the respondents searched for online science information at least weekly.The main target readings were the etiology and risk factors of diseases,symptoms,treatment options,adverse reactions of treatments,and prognosis.Most respondents(96.4%)thought that the network science information was reliable.Of the 104 search results included in the sample bank,13(12.5%)met the inclusion criteria,91(87.5%)were not selected,including 32 duplicates(30.8%),6 non-text webpages(5.8%),18 short texts(less than 300 Chinese characters)(17.3%),7 advertisements(6.7%),3 news articles(2.9%),22 forum posts(21.2%),and 3 academic articles(2.9%).According to the Discern scoring system,the reliability(=0.728, <0.001),the quality of treatment-related information(=0.431, <0.001),and the overall scores(=0.559,<0.001)of the enrolled 13 publications were consistent,as evaluated by two professional physicians.The mean overall score was 3.A lower score(less than 3)in the reliability assessment was due to the source of the content,generation methods,sponsors,citations,and the undefined parts.During the evaluation of treatment information,the average score was below 3 for each item.Analysis of the reading difficulty showed that,among these 13 articles,4 were at postgraduate thesis level(level 5),4 at undergraduate thesis level(level 4),0 at high school textbook level(level 3),and 8 was higher than middle school level(≥level 3).Eight articles(61.5%)were suitable for readers with an education background of higher middle school and only 5 articles(38.5%)were suitable for readers with an education background of middle school or lower(≤ level 2).Conclusions The vast majority of patients with cervical cancer search for clinical information through the Internet and trust their reliability.Chinese search engines have lower detection rates for high-quality medical science articles.The currently available high-quality medical science articles are small in number and difficult to read.More physicians are urged to write easy-to-read high-quality articles for these patients.
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Female , Humans , Health Services Needs and Demand , Information Seeking Behavior , Internet , Reproducibility of Results , Search Engine , Surveys and Questionnaires , Uterine Cervical NeoplasmsABSTRACT
To investigate the sexual quality of life and its influencing factors in patients with cervical cancer undergoing radiotherapy. Methods Totally 205 patients with cervical cancer who received radiotherapy in Peking Union Medical College Hospital from December 2013 to December 2018 were enrolled in this study.The Female Sexual Function Index(FSFI)scale was used to assess the sexual quality of life of these patients.The demographic data(including age,education level,marital status,family status,and occupation)and clinical data(including tumor stage and treatment method)were collected.Mann-Whitney test and Kruskal-Wallis test were used to analyze the influence of various factors on the sexual quality of life. Results Female sexual dysfunction was common among patients with cervical cancer undergoing radiotherapy.The total FSFI score was 5.5(3.6,16.3),and the scores of subscales were as follows:desire,1.20(0,1.80);sexual arousal,0.90(0,1.80);vaginal lubrication,0.30(0,3.30);orgasm,0(0,2.80);satisfaction,2.40(1.60,3.60);and sexual pain,0(0,2.80).Age(=0.010),duration of radiotherapy(=0.008),marital status(=0.020),family status(=0.010),and occupation(=0.024)were influential factors of sexual quality of life in cervical cancer patients undergoing radiotherapy. Conclusions The sexual quality of life of patients with cervical cancer undergoing radiotherapy is affected by multiple factors.Instructions on treatment,mental status,and post-treatment sexual life should be offered in an individualized way to improve the sexual quality of life of these patients.
Subject(s)
Female , Humans , Quality of Life , Sexual Dysfunction, Physiological , Surveys and Questionnaires , Uterine Cervical Neoplasms , RadiotherapyABSTRACT
BACKGROUND@#There are only very few reports on clinical outcomes using multi-channel applicators (MCA) for patients with endometrial cancer (EC) in China. We aimed to evaluate the clinical experience of treating intermediate-risk (IR) to high-risk (HR) stage I EC using in-house made multi-channel applicators (IH-MCA) in a single institution.@*METHODS@#Three hundred and ninety patients with stage I IR to HR EC were treated with hysterectomy and adjuvant radiotherapy from 2003 to 2015. All patients received post-operative vaginal cuff brachytherapy (VBT) alone or as a boost after external beam radiotherapy (EBRT). The prescriptions were 500 cGy per fraction for a total of 5 to 6 fractions with brachytherapy alone or 400 to 600 cGy per fraction for 2 to 3 fractions if it was combined with EBRT. Two types of applicators including a traditional rigid IH-MCA and a recent model custom-made with 3 dimension printing technology were used for treatment. The Kaplan-Meier method was used to calculate survival rate.@*RESULTS@#Follow-up rate was 92.8% and the median follow-up time was 48 months (range 4-172 months). The 5-year overall survival (OS), progression-free survival, local recurrence, and distant metastasis rates for all patients were 96.3%, 92.1%, 2.9%, and 4.8% respectively. Two patients had isolated relapse in vagina outside the irradiated volume. The univariate and multivariate analysis showed that age and grade were the prognostic factors correlated with OS (hazard ratio: 0.368, 95% confidence interval [CI]: 0.131-1.035, P = 0.048; hazard ratio: 0.576, 95% CI: 0.347-0.958, P = 0.026,).@*CONCLUSIONS@#For patients with IR to HR stage I EC, adjuvant VBT alone or in combination with EBRT using IH-MCA led to excellent survival and recurrence rates. Age and grade were the prognostic factors correlated with OS.
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<p><b>OBJECTIVE</b>To evaluate the clinical characteristics and outcomes of patients with Gleason score 10 prostate cancer treated by external radiotherapy and hormone therapy.</p><p><b>METHODS</b>From January 2003 to March 2014, 1832 patients with prostate cancer were treated, among which 9 patients (represented 0.49%) were identified as Gleason score 10 disease on prostate core biopsy without distant metastases when first diagnosed. All 9 patients were treated by whole pelvic external radiotherapy (The whole pelvic dose was 50.0 Gy and the boost dose ranged from 76.2 to 78.0 Gy) and long-term hormone therapy. We assessed the clinical characteristics, treatment outcomes and treatment toxicities. Survival curves were calculated using the Kaplan-Meier method.</p><p><b>RESULTS</b>The median follow-up was 4.8 years. Six patients' pre-treatment prostate-specific antigen (PSA) levels were lower than 20.0 μg/L and three patients' pre-treatment PSA levels were higher than 70.0 μg/L. The median percentage of positive biopsy cores was 91%. Three, four and two cases were classified as T2c, T3a and T3b stage, respectively. Three cases were assessed as N1 stage. The 5-year biochemical failure-free survival, distant metastasis-free survival, cancer specific survival and overall survival rates were 28.6%, 57.1%, 66.7% and 57.1%, respectively. Five patients experienced grade 1-2 acute gastrointestinal toxicities and six patients complained of grade 1-2 acute genitourinary toxicities. No bone fracture or cardiovascular disease was detected.</p><p><b>CONCLUSIONS</b>Gleason score 10 prostate cancer on core biopsy is usually combined with other high risk factors. The pre-treatment PSA levels lie in two extremes. Timely and active treatments are urgent needed because unfavourable oncological outcomes are often presented.</p>
Subject(s)
Aged , Aged, 80 and over , Humans , Male , Middle Aged , Biopsy , Combined Modality Therapy , Neoplasm Grading , Neoplasm Staging , Prostate-Specific Antigen , Blood , Prostatic Neoplasms , Blood , Mortality , Pathology , TherapeuticsABSTRACT
<p><b>OBJECTIVE</b>To compare the effectiveness and safety of different treatment modes for limited-stage small cell lung cancer(SCLC).</p><p><b>METHODS</b>The clinical data of 171 SCLC patients who had received different therapies were retrospectively analyzed.</p><p><b>RESULTS</b>Of these 171 patients,55 had received concurrent radiochemotherapy,66 received sequential radiochemotherapy,and 50 received chemotherapy alone. For these 171 patients,the overall response rate(ORR)was 73.1%,overall survival(OS)and progression-free survival(PFS)were 23.5 months and 15.2 months,respectively,and the 1-,3-,and 5-year survival rates were 76.2%,30.4%,and 16.3%,respectively. For the concurrent group,sequential group,chemotherapy alone group,the median OS were 30.6,23.1,and 19.1 months,the median PFS were 19.7,13.3,and 11.5 months,and the 5-year survival rate was 28.7%,13.6%,and 9.4%,respectively(all P<0.05). The main toxic effects were myelosuppression,radiation pneumonia,and radiation esophagitis. The incidences of 1-2 grade myelosuppression were 92.7%,89.4%,and 92% in the concurrent group,sequential group,and chemotherapy alone group(P=0.25). For concurrent group and sequential group,the incidence of 1 grade radiation pneumonia were 47.2% and 50%,respectively(P=0.61),whereas the incidence of 1-2 grade radiation esophagitis were 94.5% and 75.8%(P=0.02). Multivariate analysis showed that gender,ECOG score,TNM stage,and thoracic radiation therapy were the independent prognostic factors for SCLC.</p><p><b>CONCLUSION</b>Concurrent radiochemotherapy is the treatment of choice for SCLC patients because it can improve the survival with tolerable toxicities.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Chemoradiotherapy , Methods , Drug Therapy , Methods , Esophagitis , Epidemiology , Lung Neoplasms , Mortality , Pathology , Therapeutics , Neoplasm Staging , Radiation Pneumonitis , Epidemiology , Retrospective Studies , Small Cell Lung Carcinoma , Mortality , Pathology , Therapeutics , Survival RateABSTRACT
<p><b>OBJECTIVE</b>To evaluate the efficacy of neoadjuvant radiotherapy alone versus chemoradiotherapy in patients with mid-low locally advanced rectal cancer.</p><p><b>METHODS</b>Data of 69 patients with advanced (stage T(3) or T(4)) rectal cancer, undergone neoadjuvant therapy in our hospital from October 1997 to October 2007, were analyzed retrospectively. Forty patients received preoperative radiotherapy (50 Gy in 25 fractions over 5 weeks) alone (RT group), and 29 patients received preoperative radiotherapy concomitant with 5-FU/leucovorin -based preoperative chemoradiotherapy (CRT group). Radical surgery was performed 4-6 weeks after radiation therapy by the rule of TME.</p><p><b>RESULTS</b>All the patients underwent operations, including 26 abdominoperineal resections, 27 anterior resections, 10 Parks operations and 6 Hartmann's procedures. The sphincter preservation rate was 47.5%(19/40) in RT group, and 62.1%(18/29) in CRT group(P>0.05). In pathological findings, tumor and nodal downstaging were observed in 12 patients of RT group (30.0%), and 17 of CRT group (58.6%)(P<0.05). In RT group, 3 patients (7.5%) showed pathological complete regression (pCR), and the overall response rate (CR plus PR) was 60%(24/40). In CRT group, 4(13.8%) showed pCR and the overall response rate was 79.3%(23/29). There was significant difference of the overall response rate between two groups. Three-year disease-free survival for all patients was 77.3%.</p><p><b>CONCLUSION</b>For patients with locally advanced rectal cancer, neoadjuvant chemoradiotherapy provides higher sphincter preservation rate, overall response rate and better down-staging as compared to radiotherapy alone.</p>
Subject(s)
Female , Humans , Male , Middle Aged , Chemotherapy, Adjuvant , Neoadjuvant Therapy , Methods , Neoplasm Staging , Radiotherapy, Adjuvant , Methods , Rectal Neoplasms , Pathology , Radiotherapy , Therapeutics , Retrospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To investigate the changes in the expressions of inducible cyclooxygenase type 2 (COX-2) and membrane associated prostaglandin E-1(mPGES-1) in human carotid atherosclerotic plaques and to explore possible mechanisms of inflammatory process involved in plaque stability.</p><p><b>METHODS</b>The mRNA and protein levels of COX-2 and mPGES-1 were compared between minimally and grossly atherosclerotic arterial tissues. COX-2 and mPGES-1 gene expression were established by immunohistochemistry and reverse transcriptase-polymerase chain reaction (RT-PCR) in 10 mesenchymal artery controls and 24 atherosclerotic specimens. Presence of COX-2 and mPGES-1 protein was assessed by Western blotting.</p><p><b>RESULTS</b>Immunohistochemical staining showed that the COX-2 and mPGES-1 immunoreactive substances were present in the cytoplasm of smooth muscle cell. Compared with the control group, immunostaining positive cells increased in carotid atherosclerotic plaque group. COX-2 and mPGES-1 gene expression was significantly elevated in atherosclerotic plaques (P< 0.05, respectively). The increased mRNA and protein levels of COX-2 and mPGES-1 were correlated in atherosclerotic tissue (P< 0.05). The mRNA and protein levels of COX-2 and mPGES-1 related to degree of pathological damage in atherosclerotic tissue (P< 0.05). COX-2 and mPGES-1 were not found in the control group (mesenteric vascular walls).</p><p><b>CONCLUSION</b>COX-2 and mPGES-1 expression in plaques is significantly higher than that in the control group. These findings suggests that COX-2 and mPGES-1 might play a role in pathogenesis of atheroscleros and modulation of inflammatory process involved in plaque stability, and COX-2 may have proinflammatory enzyme properties.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Atherosclerosis , Genetics , Metabolism , Blotting, Western , Carotid Artery Diseases , Genetics , Metabolism , Cyclooxygenase 2 , Genetics , Metabolism , Gene Expression , Immunohistochemistry , Intramolecular Oxidoreductases , Genetics , Metabolism , Prostaglandin-E Synthases , Reverse Transcriptase Polymerase Chain ReactionABSTRACT
<p><b>OBJECTIVE</b>To explore the method of inducing and building pancreatic cancer cell sublines with radiation resistance.</p><p><b>METHODS</b>Simulating the clinical radiotherapy, the pancreatic cell lines SW1990, Capan-1 (Cap), AsPC-1 (ASPC), P3, PANC-1 (Pan-1) and MIAPaCa-2 (MIA) were repeatedly given individual dose of X-rays with liner accelerator to induce radiation resistance, the changes of cell morphology, cell cycle and radio sensibility in the induced cell lines were compared with the parental cell lines at the end of inducing course.</p><p><b>RESULTS</b>Compared with the parental cells, there were significant changes in morphology in the pancreatic cancer cell sublines after the radiation. Cell cycle analysis suggested that SW1990-R, ASPC-R, MIA-R, PAN-R and P3-R had lower G(2)/M and greater SF(2) (survival fraction after 2 Gy irradiation) compared with the parental cell lines.</p><p><b>CONCLUSIONS</b>The method of radiating cells step by step and repeatedly is viable to establish radio-resistant pancreatic cancer cell lines.</p>
Subject(s)
Humans , Cell Culture Techniques , Methods , Cell Cycle , Radiation Effects , Cell Line, Tumor , Cell Proliferation , Radiation Effects , Cell Shape , Radiation Effects , Cell Size , Radiation Effects , Cell Survival , Radiation Effects , Dose-Response Relationship, Radiation , Pancreatic Neoplasms , Pathology , Radiation ToleranceABSTRACT
<p><b>OBJECTIVE</b>To investigate the effects of quercetin and X-ray on collagen synthesis of cultured human keloid-derived fibroblast and the mechanism.</p><p><b>METHODS</b>Collagen synthesis of cultured human keloid and normal fibroblasts were detected by hydroxyproline colorimetric analysis. Immunocytochemical staining was used to investigate collagen I and III expression. mRNA expression of collagen I and III, and transforming growth factor (TGF)-beta 1 were assayed by reverse transcription-polymerase chain reaction (RT-PCR) and real-time PCR.</p><p><b>RESULTS</b>Quercetin inhibited the collagen synthesis of both keloid and normal fibroblasts in a dose-dependent manner. Immunocytochemical staining indicated that collagen I and III were down-regulated by quercetin and X-ray (P < 0.05), particularly collagen I (P < 0.05). mRNA expression of both collagen I and III in quercetin groups significantly decreased compared with that in control group (P < 0.05), especially in the group treated with both quercetin and X-ray (P < 0.01). mRNA level of TGF-beta 1 gene was down-regulated by quercertin (P < 0.05).</p><p><b>CONCLUSIONS</b>Quercetin will probably be one of the new medicines which could effectively treat keloid. Quercetin combined with X-ray could reduce the dose of radiation.</p>
Subject(s)
Adult , Female , Humans , Male , Cells, Cultured , Collagen Type I , Genetics , Radiation Effects , Collagen Type III , Genetics , Radiation Effects , Dose-Response Relationship, Drug , Fibroblasts , Metabolism , Pathology , Radiation Effects , Keloid , Metabolism , Pathology , Quercetin , Pharmacology , RNA, Messenger , Skin , Cell Biology , Transforming Growth Factor beta1 , Genetics , Radiation EffectsABSTRACT
<p><b>OBJECTIVE</b>To evaluate the feasibility of autologous peripheral CD(34)(+) cell transplantation for the treatment of severe autoimmune disease.</p><p><b>METHODS</b>Ten patients received mobilized and purified CD(34)(+) cells transplantation. The mobilization regimen was CTX plus rhG-CSF and the CD(34)(+) cells were selected by CliniMACS. (1.98 +/- 0.95) x 10(8) CD(34)(+) cells were obtained. The purity of CD(34)(+) cells was (91.4 +/- 10.6)% and the recovering rate was (60.5 +/- 19.8)%. The conditioning regimens were CTX (200 mg/kg) plus ATG (90 mg/kg) or CTX (150 mg/kg) plus TBI (4 - 6 Gy). (2.14 +/- 1.05) x 10(6)/kg CD(34)(+) cells were infused. The time of ANC >or= 0.5 x 10(9)/L was 8.6 +/- 2.5 days, and platelet >or= 20 x 10(9)/L was 9.0 +/- 5.2 days. After the hematopoietic recovery, the levels of CD(3)(+) T cell, CD(19)(+) B cells and CD(16)(+)CD(56)(+) NK cells were all below that of pre-transplantation. The main transplant-related complication was CMV infection. The transplant-related mortality was 2/10. All patients who survived showed improvement of the disease with DAI score decreasing from 17 to 4 in systemic lupus erythematosus patients, DAS 28 score from 6.4 to 1.8 in rheumatoid arthritis patients.</p><p><b>CONCLUSION</b>The result suggests that autologous peripheral CD(34)(+) cell transplantation is an alternative choice for the treatment of severe autoimmune disease. The short-term outcome is satisfying.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Antigens, CD34 , Autoimmune Diseases , Allergy and Immunology , Therapeutics , Hematopoiesis , Hematopoietic Stem Cell Mobilization , Immune Tolerance , Peripheral Blood Stem Cell Transplantation , Mortality , Transplantation, AutologousABSTRACT
Sperm must be capacitated before sperm-ovum fusion. Capacitation was once considered as hyperactivation. But now many investigators thought that capacitation wasn't equal to hyperactivation, and that sperm hyperactivation might be a moiety of capacitation or the result of capacitation. In the present, the methods used to study sperm capacitation include fertilization in vitro, induction of sperm acrosome reaction, FITC-labeled chlortetracycline and plant hemoagglutinin. The studies on sperm capacitation in vitro mainly focused on the inductive substances of sperm capacitation and subsequent results analysis. It could lay foundation for the manifestation of molecular mechanism of sperm capacitation and destination of sperm capacitation in molecular levels.
Subject(s)
Humans , Male , Adenylyl Cyclases , Physiology , Bicarbonates , Metabolism , Calcium , Metabolism , Phosphorylation , Sperm Capacitation , Physiology , Sperm MotilityABSTRACT
Objective To investigate the changes of the expressions of ATP-binding cassette transporter A1(ABCA1)and the retinoid X receptor(RXR?in human carotid atherosclerotic plaques and to explore the possible mechanisms by which ABCA1 affects the formation of carotid atherosclerosis(CAS). Methods 24 carotid atherosclerotic plaque and 10 intestinal artery specimens were respectively collected to compared the expression levels of ABCA1 mRNA.RXR?mRNA and those protein,ABCA1 and RXR?gene expressions were determined by reverse transcriptase polymerase chain reaction(RT-PCR)in the specimens,meanwhile the presence of ABCAI and RXRcprotein was assessed by Western blot.Results ABCA1(0.79?0.04)and RXR?(0.73?0.04)gene expression were significantly elevated in carotid atherosclerotic plaques(P
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Objective To evaluate the serum prostate specific antigen(PSA)change after I-125 radioactive seed implantation without androgen ablation therapy for prostate cancer,Methods A total of 13 patients with prostate cancer were included.The clinical stage was T_(1c)N_0M_0 in 8 cases,and T_(2a)N_0M_0 in 5. The Gleason scores were 5 in 4 cases and 6 in 9.The mean serum PSA was 8.2 ng/ml(range,2.8-14.6 ng/ml).I-125 seed implantation(D90=140-155 Gy)was performed.Serum PSA was monitored every month for the first 3 months and every 3 months for the next 20 months.Results The range of follow-up time was 3-23 months.At 1,2,3,6,9,12,15,18 and 21 months after implantation,the median serum PSA values were 6.7,5.0,2.7,1.6,1.2,0.9,0.8,0.8 and 0.7 ng/ml;and the median percentage change in ser- um PSA were 72%,51%,29%,20%,13%,11%,9%,9% and 8%,respectively.One month after brachy- therapy,30% of the patients had fluctuation in PSA.Conclusions Compared with radical prostatectomy and androgen ablation therapy,the rate of PSA decline is slower with fluctuation at early phase.The most sig- nificant decline of PSA occurs in the first 12 months,especially in the first 3 months after I-125 seed implan- tation.