RESUMO
Objective:To study the effects of docetaxel, cisplatin and fluorouracil (TPF) regimen simultaneous intensity modulated radiotherapy (IMRT) on immune function and survival prognosis of patients with advanced esophageal cancer.Methods:A total of 93 patients with advanced esophageal cancer were screened in Hebei Veterans General Hospital from June 2015 to December 2017, and were divided into two groups using randomized envelope method. The observation group (47 cases) was given synchronous TPF regimen and IMRT, and the control group (46 cases) was given synchronous PF regimen (cisplatin combined with fluorouracil) and IMRT. Esophageal barium meal, chest and upper abdominal CT were reviewed within 1 month after treatment to assess the short-term efficacy and compare the immune function of the two groups before and after treatment. Kaplan-Meier survival curve was plotted to evaluate the long-term efficacy based on overall survival (OS). The incidence of adverse reactions in the two groups was collected to evaluate their safety.Results:After treatment, the T cell subgroup CD8 + level of the observation group was higher than that of the control group [(33.55±4.46)% vs. (29.06±3.61)%, P<0.05], while CD3 + [(51.29±5.22)% vs. (56.04±6.10)%, P<0.05], CD4 + [(28.27±3.63)% vs. (30.35±3.52)%, P<0.05] and CD4 + /CD8 + (0.84±0.25 vs. 1.04±0.08, P<0.05) levels were lower than those of the control group. The effective rate of recent treatment in the observation group was 82.98% (39/47), while the effective rate in the control group was only 63.04% (29/46), with a statistically significant difference ( χ2=4.70, P=0.030). The median OS of the observation group was 25.3 months (95% CI: 17.9-26.1), and that of the control group was 18.2 months (95% CI: 14.4-25.5), with a statistically significant difference ( χ2=3.28, P=0.038). Adverse reactions during the follow-up period of the two groups of patients were mainly nausea/vomiting, fatigue, anorexia, hematological toxicity, esophagitis and pneumonia, etc., which were mostly grade 1-2, and disappeared after symptomatic treatment or termination of treatment. Compared with the control group, the incidence of nausea/vomiting (46.81% vs. 78.26%, χ2=9.80, P=0.002), anorexia (44.86% vs. 71.74%, χ2=6.99, P=0.008), leukopenia (36.96% vs. 73.91%, χ2=13.37, P<0.001) and esophagitis (61.70% vs. 82.61%, χ2=5.05, P=0.025) adverse reactions was lower in the observation group. Conclusion:TPF combined with IMRT has high efficacy and low adverse reactions, which can be used as an effective treatment to improve the survival prognosis of patients with advanced esophageal cancer.
RESUMO
Objective@#This study aimed to investigate the influence of monobutyl phthalate (MBP) on the expressions of epithelial-mesenchymal transition (EMT)-related proteins, migration and invasion of mouse Leydig tumor cells (MLTC-1) cells.@*Methods@#After exposed to different doses of MBP (0、10-7、10-6, 10-5, 10-4, 10-3 mol/L) for 24 h or 48 h, cell viability was determined by 3-(4 5-dimethyl-2-thiazolyl)-2 5-diphenyl-2-H-tetrazolium bromide (MTT) assay. Expressions of vimentin, E-cadherin, N-cadherin and Snail proteins related to EMT were detected by Western blot. The ability of migration and invasion of MLTC-1 were assessed by wound healing assay and Transwell Boyden chamber assay, respectively.@*Results@#Relative expressions of vimentin, Snail and N-cadherin proteins were promoted ((1.56±0.07) vs (1.78±0.08), (1.22±0.06) vs (1.44±0.07), (1.33±0.11) vs (2.19±0.06), all P values were<0.001) and E-cadherin (0.66±0.09) vs (0.47±0.06), P<0.001,protein was inhibited after the cells stimulated with MBP (0, 10-7 and 10-6 mol/L). The capability of wound closure of MLTC-1 cells were (6.64±2.07)%, (15.61±2.83)%, (39.91±0.33)%, respectively and the invading/migrating cells were (32.67±3.51), (57.67±2.52), (82.67±6.51), respectively, which were obviously increased under MBP treatments (0, 10-7 and 10-6 mol/L) (all P values were <0.001).@*Conclusion@#Monobutyl phthalate affected the expressions of EMT-related proteins and enhanced the migration and invasion of MLTC-1 cells.
RESUMO
Objective To explore the prognostic factors of middle and advanced esophageal neoplasms treated by traditional Chinese medicine combined with radiotherapy.Methods A total of 462 esophageal neoplasms patients treated by traditional Chinese medicine combined with radiotherapy from March 2009 to March 2012 in Civil Administration Hospital of Hebei Province were retrospectively analyzed.The overall median survival time and the survival rate of 1,3 and 5 years were calculated by using life table.Log-rank test was used for single-factor analysis and Cox model was used for multiple-factor analysis.Results The median survival time of 462 esophageal neoplasm patients was 24.2 months (12.9-36.6 months).The survival rate of 1,3 and 5 years was 80.3 ％,30.6 ％ and 10.5 ％ respectively.Single-factor analysis showed that the age (x2 =89.773,P =0.000),tumor diameter (x2 =102.373,P =0.000),clinical staging (x2 =128.903,P =0.000),concomitant with other diseases (x2 =65.366,P =0.000) and the short term effect (x2 =64.948,P =0.000) were associated with prognosis of middle and advanced esophageal neoplasms treated by traditional Chinese medicine combined with radiotherapy.Multiple-factor analysis showed that the age (RR =1.625,95 ％ CI 1.251-2.111,P=0.000),clinical staging (RR =2.437,95 ％ CI 1.874-3.168,P=0.000),concomitant with other diseases (RR =1.1.628,95 ％ CI 1.278-2.076,P =0.000) and the short term effect(RR =1.865,95 ％ CI 1.594-2.182,P =0.000) were the independent prognosis factors for middle and advanced esophageal neoplasms treated by traditional Chinese medicine combined with radiotherapy.Conclusion Elderly patients,esophageal neoplasms in stage Ⅲ,concomitant with other diseases and poor short-term effect could influence the prognosis of the patients with middle and advanced esophageal neoplasms treated by traditional Chinese medicine combined with radiotherapy.
