RESUMO
BACKGROUND: Systemic chemotherapy is the major treatment modality for nasopharyngeal carcinoma (NPC) liver metastases. We investigated the effectiveness of radiofrequency ablation (RFA) treatment, which has not been well explored in this disease. METHODS: One-hundred and thirty-four cases of NPC with liver metastases treated with chemotherapy, chemotherapy with RFA, or RFA alone were retrospectively analyzed. Patient survival was evaluated by the log-rank test. Survival was analyses using the Kaplan-Meier method. Cox multivariate analyses of clinicopathological features and different treatment approaches were conducted. RESULTS: Local response rates were 58% in the RFA group, 78% in the chemotherapy group and 93% in the chemotherapy with RFA group (P < 0.001). Increased progression-free survival (PFS) and overall survival (OS) were observed in the chemotherapy with RFA group (P < 0.001). Cox multivariate analysis indicated that the number of liver metastases (1 vs. >1), the dimension of the largest liver metastases (≤3 cm vs. >3 cm), evaluation of treatment (response vs. no response) and disease-free survival (≤12 months vs. >12 months) were independent prognostic factors. CONCLUSIONS: RFA combined with chemotherapy is a promising treatment for NPC metastatic liver disease with improved local response, PFS, and OS compared to current chemotherapy protocols.
Assuntos
Carcinoma/patologia , Ablação por Cateter , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/terapia , Neoplasias Nasofaríngeas/patologia , Quimioterapia Adjuvante , Cisplatino/uso terapêutico , Intervalo Livre de Doença , Feminino , Fluoruracila/uso terapêutico , Humanos , Neoplasias Hepáticas/secundário , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Recidiva Local de Neoplasia , Paclitaxel/uso terapêutico , Prognóstico , Estudos RetrospectivosRESUMO
The practical synthesis of important natural polyphenolic stilbenes, including resveratrol, piceatannol and oxyresveratrol, through Perkin methodology is described. Starting from 3,5-dihydoxyacetophenone (1), the common intermediate 3,5-dimethoxyphenylacetic acid (3) can be obtained via methylation and Willgerodt-Kindler reaction. Perkin condensations between (3) and substituted phenylaldehydes 4 furnished E-2,3-diarylacrylic acids 5, followed by decarboxylation in Cu/quinoline giving stilbene intermediates 6 which bear the Z-configuration. Finally, through a simultaneous demethylation/isomerization process in AlI3/CH3CN system, the target compounds 7a-c can be obtained respectively in good to high overall yields. The synthetic method proved to be more concise, trans-specific, mild, economical and commonly applicable.