ABSTRACT
Objective: To compare the effects of preoperative neoadjuvant chemotherapy and postoperative adjuvant chemotherapy on the long-term survival of patients with radical resection for esophageal squamous cell carcinoma. Methods: Totally 1 082 patients with stage T3-4aN0-3M0 thoracic esophageal squamous cell carcinoma were recruited in this study who underwent radical resection at Department of Thoracic Surgery, Fourth Hospital, Hebei Medical University from January 2005 to January 2015. There were 798 males and 284 females, with a median age of 61 years (range: 37 to 86 years). There were 138 patients undergoing preoperative neoadjuvant chemotherapy, 392 patients postoperative adjuvant chemotherapy, and 552 patients surgery alone. The neoadjuvant chemotherapy group was used as the benchmark group to match the propensity score with the adjuvant chemotherapy group and the surgery-only group respectively at a ratio of 1∶3. A total of 7 covariates including tumor location, number of positive lymph nodes, tumor invasion depth, tumor differentiation degree, surgical procedure, vascular tumor thrombus and nerve invasion were included, and the caliper value was taken as 0.1. After matching, a total of 699 patients were included for the analysis, including 128 patients in the neoadjuvant chemotherapy group, 267 patients in the adjuvant chemotherapy group, and 304 patients in the surgery alone group. The Kaplan-Meier method was used to generate the survival curves which was tested by the Log-rank method for survival analysis. Results: After matching analysis, the 5-year overall survival rate was 41.5% in the neoadjuvant chemotherapy group with a median overall survival time of 43 months (95%CI: 27 to 59 months), 57.6% in the adjuvant chemotherapy group with a median overall survival time unreached, and 24.9% in the surgery alone group with a median overall survival time of 28 months (95%CI: 25 to 31 months) (χ²=60.475, P<0.01). For overall survival after matching, the adjuvant chemotherapy group was better than the neoadjuvant chemotherapy group (χ²=11.384, P=0.001), the neoadjuvant chemotherapy group was better than the surgery alone group (χ²=8.654, P=0.003), and the adjuvant chemotherapy group was better than surgery alone group (χ²=60.234, P<0.01). Conclusion: Both preoperative neoadjuvant chemotherapy and postoperative adjuvant chemotherapy can improve the long-term survival of patients with locally advanced esophageal squamous cell carcinoma undergoing radical resection, and the improvement effect of postoperative adjuvant chemotherapy is more obvious.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Chemotherapy, Adjuvant , Esophageal Neoplasms/pathology , Esophageal Squamous Cell Carcinoma , Neoadjuvant Therapy , Neoplasm Staging , Prognosis , Propensity Score , Retrospective Studies , Survival RateABSTRACT
@#ObjectiveTo explore the influence of slow and mild movements in Taichiquan kinesitherapy.MethodsForty healthy males were divided into Taichiquan group and walking group with 20 persons in each group. The shift of practicing a 5-min bout of the simplified Taichiquan exercise, time of walking 18 m at a comfortable pace and change of one person's body center of gravity during exercise were measured respectively.ResultsTaichiquan group had (1796.4±91)cm shift during 5 min Taichiquan exercise; walking group spent (14.1±1.7)s when walking 18 m at a comfortable pace; and the downward shift of body center of gravity due to the exercise style undulated ( 5.5 ±12.7)cm vertically below the umbilicus (P>0.05).ConclusionSlow, mild and continual movement is the kinesiological basis of Taichiquan kinesitherapy.
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@#ObjectiveTo explore the change of ranges of abduction motion of hip joint in the simplified Taichi quan exercise.MethodsThe ranges of abduction motion of hip joint of 30 healthy male young subjects were measured using a goniometer.ResultsThe ranges of abduction motion of both hip joints had markedly exceeded their normal ranges of 0°-45°abduction motion during the exercise.ConclusionThe simplified Taichi quan can strengthen hip abductors to prevent and correct the deformity of hip adduction.
ABSTRACT
@#ObjectiveTo explore changes of the reacting force of the ankle joint (J) and the achilles tendon force (A) in the sagittal plane in a weight-bearing leg in a bout of the simplified-style Taijiquan exercise.MethodsJ and A determined from 30 healthy young males were analyzed using the simplified free body method.ResultsJ and A increased during exercise, J produced by movement 10, 14 and A produced by movement 8, 12 were about 2.4 times and 0.7 times body weight of 67.3kg respectively.ConclusionTaijiquan can increase the force of ligment and muscle around the ankle joint, especially that of triceps muscle of calf, and it is helpful for remaining the stability of the ankle structure.