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1.
Liver Int ; 42(4): 918-929, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35065003

RESUMO

BACKGROUND & AIMS: Management of elderly patients with hepatocellular carcinoma (HCC) has become a major concern. Some data suggest that cryoablation improves the outcomes of elderly patients with HCC, but its efficacy and safety remain unknown. This study aimed to evaluate and compare the efficacy and safety of percutaneous cryoablation with those of radiofrequency ablation (RFA) for elderly HCC patients. METHODS: In all, 223 patients with small HCC aged ≥70 years, treatment-naïve, without metastasis were enrolled and randomized into a cryoablation group (n = 112) or a RFA (n = 111) group from July 2015 to October 2018. The primary endpoint was local tumour progression (LTP) at 3 years after treatment. The secondary endpoints including overall survival (OS), tumour-free survival (TFS), LTP and safety were analysed for these two groups after both treatments. RESULTS: LTP rates at 1-, 3- and 5-year were 12%, 17% and 20% for cryoablation and 17%, 18% and 21% for RFA respectively (P = .735). For lesions >3 cm in diameter, LTP rates at 1- and 3-year were 13% and 22% in cryoablation group and 22% and 42% respectively, in the RFA group (P = .039). The 1-, 3- and 5-year OS rates were 90, 75% and 62% for cryoablation and 90%, 68% and 63% for RFA respectively (P = .331). The 1-, 3- and 5-year TFS rates were 59%, 32% and 25% in the cryoablation and 59%, 28% and 20% in the RFA respectively (P = .309). Major complications occurred in 6 patients (5%) following cryoablation and 6 patients (6%) following RFA (P = .886). CONCLUSION: Cryoablation and RFA had similar LTP in elderly patients with small HCC and this study failed to meet the primary endpoint, although for a relatively large early-stage HCC the LTP rate after cryoablation was significantly lower than that after RFA.


Assuntos
Carcinoma Hepatocelular , Ablação por Cateter , Criocirurgia , Neoplasias Hepáticas , Idoso , Criocirurgia/efeitos adversos , Humanos , Estudos Prospectivos , Estudos Retrospectivos , Resultado do Tratamento
2.
J Nucl Med ; 63(4): 556-559, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34475235

RESUMO

This prospective nonrandomized, multicenter clinical trial was performed to investigate the efficacy and safety of 131I-labeled metuximab in adjuvant treatment of unresectable hepatocellular carcinoma. Methods: Patients were assigned to treatment with transcatheter arterial chemoembolization (TACE) combined with 131I-metuximab or TACE alone. The primary outcome was overall tumor recurrence. The secondary outcomes were safety and overall survival. Results: The median time to tumor recurrence was 6 mo in the TACE + 131I-metuximab group (n = 160) and 3 mo in the TACE group (n = 160) (hazard ratio, 0.55; 95% CI, 0.43-0.70; P < 0.001). The median overall survival was 28 mo in the TACE + 131I-metuximab group and 19 mo in the TACE group (hazard ratio, 0.62; 95% CI, 0.47-0.82; P = 0.001). Conclusion: TACE + 131I-metuximab showed a greater antirecurrence benefit, significantly improved the 5-y survival of patients with advanced hepatocellular carcinoma, and was well tolerated by patients.


Assuntos
Carcinoma Hepatocelular , Quimioembolização Terapêutica , Neoplasias Hepáticas , Anticorpos Monoclonais , Carcinoma Hepatocelular/patologia , Quimioembolização Terapêutica/efeitos adversos , Terapia Combinada , Artéria Hepática/patologia , Humanos , Radioisótopos do Iodo , Neoplasias Hepáticas/patologia , Recidiva Local de Neoplasia , Estudos Prospectivos , Resultado do Tratamento
3.
J Cancer Res Ther ; 17(5): 1141-1156, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34850761

RESUMO

The Expert Consensus reviews current literatures and provides clinical practice guidelines for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The main contents include the following: (1) clinical evaluation of GGN; (2) procedures, indications, contraindications, outcomes evaluation, and related complications of thermal ablation for GGN; and (3) future development directions.


Assuntos
Hipertermia Induzida/métodos , Neoplasias Pulmonares/cirurgia , Nódulos Pulmonares Múltiplos/cirurgia , Lesões Pré-Cancerosas/cirurgia , Nódulo Pulmonar Solitário/cirurgia , Consenso , Prova Pericial , Humanos
4.
Zhongguo Fei Ai Za Zhi ; 24(5): 305-322, 2021 May 20.
Artigo em Chinês | MEDLINE | ID: mdl-33896152

RESUMO

"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
.


Assuntos
Neoplasias Pulmonares/cirurgia , Nódulo Pulmonar Solitário/cirurgia , Técnicas de Ablação , Tomografia Computadorizada Quadridimensional , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Nódulo Pulmonar Solitário/diagnóstico por imagem
5.
Thorac Cancer ; 12(4): 475-483, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33319493

RESUMO

BACKGROUND: This study compared a co-ablation (CA) system, which is a novel ablation device, with an argon-helium cryoablation (AHC) system. We aimed to compare the efficacy and safety of CA and AHC for the treatment of stage III-IV non-small cell lung cancer (NSCLC). METHODS: We conducted a multicenter randomized controlled trial (RCT) to determine whether CA was noninferior to AHC. The primary efficacy endpoints were the iceball coverage rate (ICR) and the disease control rate (DCR) one month after treatment. Noninferiority was declared if the lower limit of two-sided 95% confidence interval (CI) was less than 10%. The ICR and DCR were identified by logistic regression. Treatment safety was assessed. RESULTS: A total of 81 patients underwent randomization (41 assigned to the CA and 40 assigned to the AHC groups)and transthoracic ablation. The ICRs in the CA and AHC groups were 99.24% ± 2.18% and 98.66% ± 3.79%, respectively. Central lesions were associated with an increased risk of an incomplete ICR. The DCRs in the CA and AHC groups were 97.6% and 95%, respectively. A smaller lesion area in the CA group was significantly correlated with a better DCR. The rate of complications was 29.26% in the CA group and 30% in the AHC group. (P = 0.943). There was less probe usage per patient in the CA group. CONCLUSIONS: We determined that CA is noninferior to AHC in terms of efficacy and safety for the treatment of stage III-IV NSCLC. A smaller lesion area in the CA group was significantly correlated with a better DCR. KEY POINTS: CA was noninferior to AHC for stage III-IV NSCLC.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/terapia , Criocirurgia/métodos , Neoplasias Pulmonares/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/patologia , Feminino , Humanos , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Prospectivos , Resultado do Tratamento , Adulto Jovem
6.
J Cancer Res Ther ; 17(7): 1736-1741, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35381747

RESUMO

Aims: This study aimed to evaluate the efficacy and survival factors of cryoablation in the treatment of patients with recurrent or metastatic soft tissue sarcoma (STS). Subjects and Methods: A total of 67 patients with recurrent and metastatic STS who underwent percutaneous cryoablation were included. The neutrophil/lymphocyte ratio (NLR) was calculated based on routine blood test results. The receiver operating characteristic curve (ROC) was used to determine the cut-off NLR value. The efficacy of local ablation for the patients was assessed using the modified Response Evaluation Criteria in Solid Tumors. The primary endpoints were 1-, 2-, and 3-year overall survival (OS) and progression-free survival (PFS). Statistical Analysis Used: Statistical analysis of survival indicators was performed. Results: All 67 patients with STS were evaluated. The prognostic data indicated 1-, 2-, and 3-year OS and PFS rates of 83.58%, 70.15%, and 53.73% and 82.09%, 59.70%, and 46.29%, respectively. ROC analysis demonstrated 3.5 as the cut-off NLR value. A total of 189 cryoablations were performed for 104 lesions in 67 patients with an average ablation rate of 77.92% ± 24.55%. The objective response rate was 65.38%, and the disease control rate was 86.54%. Univariate analysis exhibited that the preablation NLR, ablation efficacy, postoperative combined treatment regimens, and number of metastasis were associated with the prognosis after cryoablation. The Cox multivariate analysis suggested that these three factors also predicted the superior prognosis of the patients. Conclusions: Cryoablation for patients with recurrent or metastatic STS was associated with potentially superior prognosis in real-world clinical setting. Preablation NLR ≤3.5, <3 metastasis, and postoperative combined treatment regimens could be potential biomarkers to predict patient survival.


Assuntos
Criocirurgia , Sarcoma , Neoplasias de Tecidos Moles , Humanos , Linfócitos , Neutrófilos , Prognóstico , Curva ROC , Estudos Retrospectivos , Sarcoma/cirurgia , Análise de Sobrevida
7.
Oncologist ; 25(1): 15-18, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31848313

RESUMO

Cervical carcinosarcoma is an extremely rare type of neoplasm that lacks standard of care. Preclinical and clinical evidence has suggested that cryoablation in combination with immunotherapy may result in a synergistic effect, generating a more robust immune response to distant lesions. A few clinical trials have evaluated the efficacy of such combination treatment in a variety of solid tumors, but with conflicting results. This report describes the first clinical efficacy of cryoablation followed by pembrolizumab observed in a patient with tumor mutational burden (TMB)-high metastatic cervical carcinosarcoma that was negative for programmed cell death protein 1 expression, microsatellite instability stable, and had mutations in DNA polymerase epsilon (POLE). She had achieved complete response (CR) after 3 months of pembrolizumab treatment and had maintained CR as of the time of submission of this manuscript, with a progression-free survival of 11 months and counting. The case exhibited an exceptional response to cryoablation followed by pembrolizumab, potentially attributed to mutations in POLE, which lead to an extremely high TMB. This report paves the avenue for establishing treatment regimens for patients with TMB-high cervical carcinosarcoma. KEY POINTS: Owing to its rarity, cervical carcinosarcoma has not been well characterized, and currently, there is no standard of care for this disease. This report describes the first case of clinical efficacy of cryoablation followed by pembrolizumab observed in a patient with tumor mutational burden-high metastatic cervical carcinosarcoma. The case exhibited an exceptional response (maintained CR as of the time of submission of this article: 11 months) to cryoablation followed by pembrolizumab. This is the first POLE-mutated cervical carcinosarcoma case.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Antineoplásicos Imunológicos/uso terapêutico , Carcinossarcoma/tratamento farmacológico , Carcinossarcoma/cirurgia , Criocirurgia/métodos , Anticorpos Monoclonais Humanizados/farmacologia , Antineoplásicos Imunológicos/farmacologia , Feminino , Humanos , Pessoa de Meia-Idade , Carga Tumoral , Neoplasias do Colo do Útero
8.
J Cancer Res Ther ; 15(4): 831-835, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31436239

RESUMO

Aims: The aim of this study was to evaluate the efficacy, safety, and survival factors of high-intensity focused ultrasound (HIFU) ablation in the treatment of advanced pancreatic cancer. Subjects and Methods: A retrospective analysis was conducted between September 2010 and March 2016. Advanced pancreatic cancer patients with HIFU treatment were enrolled in the analysis to evaluate the efficacy of local ablation, pain relief, and relative complications of HIFU therapy. The main factors that affected Overall survival rate (OSR) and median survival time (MST) were also analyzed. Results: Eighty-six patients received HIFU treatment, with a total of 93 treatments performed, and 83 cases were evaluated. Complete response rate (RR) was 3.6% (3/83) and partial RR was 79.5% (66/83). After HIFU treatment, pain reduction was observed in 74 patients, and the total remission rate was 97.6% (74/76). The total MST was 9.9 months (2-58.7 months), the total OSR in 1 and 2 years was 41.5% and 9.6%, respectively. Minor complications occurred in 97.7% (42/43) patients, including transient fever, abdominal pain, skin burn, and amylase elevation. The univariate analysis showed that the clinical stage, treatment method, ablation efficacy, and combined treatment were significant prognostic factors. Conclusion: HIFU can significantly alleviate cancer-related pain and prolong the survival time of patients with pancreatic cancer.


Assuntos
Dor do Câncer/mortalidade , Ablação por Ultrassom Focalizado de Alta Intensidade/mortalidade , Neoplasias Pancreáticas/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Dor do Câncer/etiologia , Dor do Câncer/patologia , Feminino , Seguimentos , Ablação por Ultrassom Focalizado de Alta Intensidade/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/patologia , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento
9.
J Drug Target ; 27(4): 423-433, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30173577

RESUMO

Currently, with the rapid development of nanotechnology, novel drug delivery systems (DDSs) have made rapid progress, in which nanocarriers play an important role in the tumour treatment. In view of the conventional chemotherapeutic drugs with many restrictions such as nonspecific systemic toxicity, short half-life and low concentration in the tumour sites, stimuli-responsive DDSs can deliver anti-tumour drugs targeting to the specific sites of tumours. Owing to precise stimuli response, stimuli-responsive DDSs can control drug release, so as to improve the curative effects, reduce the damage of normal tissues and organs, and decrease the side effects of traditional anticancer drugs. At present, according to the physicochemical properties and structures of nanomaterials, they can be divided into three categories: (1) endogenous stimuli-responsive materials, including pH, enzyme and redox responsive materials; (2) exogenous stimuli-responsive materials, such as temperature, light, ultrasound and magnetic field responsive materials; (3) multi-stimuli responsive materials. This review mainly focuses on the researches and developments of these novel stimuli-responsive DDSs based on above-mentioned nanomaterials and their clinical applications.


Assuntos
Antineoplásicos/administração & dosagem , Sistemas de Liberação de Medicamentos , Neoplasias/tratamento farmacológico , Antineoplásicos/efeitos adversos , Antineoplásicos/farmacocinética , Preparações de Ação Retardada , Desenvolvimento de Medicamentos , Liberação Controlada de Fármacos , Humanos , Nanopartículas , Nanotecnologia
10.
J Cancer Res Ther ; 14(4): 730-744, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29970646

RESUMO

Although surgical resection with curative intent is the main therapy for both primary and metastatic lung tumors, about 80% of lung cancers cannot be removed by surgery. Because most patients with unresectable lung cancer only receive limited benefits from traditional radiotherapy and chemotherapy, many novel local treatment modalities have emerged including local ablation therapy. The Minimally Invasive Treatment of Lung Cancer Branch, Professional Committee of Minimally Invasive Treatment of Cancer of the Chinese Anti-Cancer Association and Committee on Tumor Ablations, Chinese College of Interventionalists have organized multidisciplinary experts to develop guidelines for this treatment modality. These guidelines aim at standardizing thermal ablation procedures, describing the indications for candidates, assessing outcomes, and preventing postablation complications.


Assuntos
Ablação por Cateter , Hipertermia Induzida , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/terapia , Ablação por Cateter/métodos , Humanos , Hipertermia Induzida/métodos , Neoplasias Pulmonares/diagnóstico por imagem , Metástase Neoplásica , Estadiamento de Neoplasias , Guias de Prática Clínica como Assunto , Cirurgia Assistida por Computador , Resultado do Tratamento
11.
Thorac Cancer ; 9(9): 1194-1208, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30039918

RESUMO

Lung cancer ranks first in incidence and mortality in China. Surgery is the primary method to cure cancer, but only 20-30% of patients are eligible for curative resection. In recent years, in addition to surgery, other local therapies have been developed for patients with numerous localized primary and metastatic pulmonary tumors, including stereotactic body radiation therapy and thermal ablative therapies through percutaneously inserted applicators. Percutaneous thermal ablation of pulmonary tumors is minimally invasive, conformal, repeatable, feasible, cheap, has a shorter recovery time, and offers reduced morbidity and mortality. Radiofrequency ablation (RFA), the most commonly used thermal ablation technique, has a reported 80-90% rate of complete ablation, with the best results obtained in tumors < 3 cm in diameter. Because the clinical efficacy of RFA of pulmonary tumors has not yet been determined, this clinical guideline describes the techniques used in the treatment of localized primary and metastatic pulmonary tumors in nonsurgical candidates, including mechanism of action, devices, indications, techniques, potential complications, clinical outcomes, post-ablation surveillance, and use in combination with other therapies. In the future, the role of RFA in the treatment of localized pulmonary tumors should ultimately be determined by evidence from prospective randomized controlled trials comparing sublobar resection or stereotactic body radiation therapy.


Assuntos
Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/terapia , Ablação por Radiofrequência , Terapia Assistida por Computador , Humanos , Ablação por Radiofrequência/efeitos adversos , Ablação por Radiofrequência/métodos , Terapia Assistida por Computador/métodos
12.
Talanta ; 187: 65-72, 2018 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-29853067

RESUMO

Photoacoustic imaging is an emerging detection tool of metal ions. Mercury is a typical heavy metal pollutant that can cause severe water and soil pollution. Therefore, it is particularly meaningful to develop a photoacoustic probe with excellent selectivity and sensitivity for the detection of mercury ions. In this study, gold nanorods modified with (11-mercapto-undecyl)-trimethylammonium (MTA) molecules containing sulfydryl groups were designed and synthesized for the photoacoustic detection of mercury ions (Hg2+). In the present of Hg2+, MTA molecules would be displaced quickly from the surface of gold nanorods due to the high affinity of Hg2+ toward sulfydryl group. Then gold nanorods were aggregated due to the loss of ligand protection on their surface, resulting in the enhancement of photoacoustic signals. In addition, this work showed a good linear relationship between the change of photoacoustic signal at 780 nm and the concentrations of Hg2+ (0-10 µM). More importantly, the devised photoacoustic detection system performs good stability and anti-interference compared to the traditional colorimetric detection system, making it possible to apply to the actual Hg2+-contaminated water samples.

14.
Asia Pac J Clin Oncol ; 14(5): e490-e497, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29316291

RESUMO

AIM: Thermal ablation therapy has recently emerged as a promising noninvasive treatment modality for localized solid malignancies. Except its direct tumor-cell-killing effect on local tumor tissues, the immunomodulatory effect has also long been noticed which too has substantial effect on clinical outcome, but it is complicated. Though much has been investigated and rich evidences have been achieved, the fundamental state and profile of immunomodulation by thermal ablation in cancer patients, its exact mechanism, especially the systematic mechanism, and its effect on antitumor immunity remain unclear. METHODS: In this study, we dynamically monitored the immunomodulation by thermal ablation through combined analysis of peripheral lymphocyte populations, functional T cell subtype Th1 (CD3+CD4+IFN-r+), Th2 (CD3+CD4+IL-4+), Tc1 (CD3+CD8+IFN-r+), Tc2 (CD3+CD8+IL-4+) and mRNA expression of several immune-active and -suppressive molecules including CD25, CD28, cytotoxic T-lymphocyte-associated protein 4, programmed cell death protein 1, Foxp3, transforming growth factor beta (TGF-ß) and interleukin (IL-10) in 16 cancer patients. RESULTS: The results show that local cancer thermal ablation modulated the cellular immunity characterized by obviously downregulation of regulatory T cells (Treg) and cytotoxicity T cells followed by CD4, CD8 and suppressor T cells (Ts), but upregulation of natural killer (NK) cells and mRNA expression of TGF-ß and IL-10, suggesting a slight inhibition of the cellular immunity which may affect antitumor immunity. CONCLUSIONS: We suggest a further immunomodulation therapy after thermal therapy for recovering a Th1- and Tc1-dominant immune response for pursuing a better long-term antitumor immunity.


Assuntos
Criocirurgia/métodos , Ablação por Ultrassom Focalizado de Alta Intensidade/métodos , Imunomodulação/imunologia , Neoplasias/imunologia , Neoplasias/cirurgia , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
15.
Artigo em Inglês | MEDLINE | ID: mdl-29044971

RESUMO

Drug nanocrystals (NCs) with fascinating physicochemical properties have attracted great attention in drug delivery. High drug-loading efficiency, great structural stability, steady dissolution, and long circulation time are a few examples of these properties, which makes drug NCs an excellent formulation for efficient cancer therapy. In the last two decades, there are a lot of hydrophobic or lipophilic drugs, such as paclitaxel (PTX), camptothecin (CPT), thymectacin, busulfan, cyclosporin A, 2-devinyl-2-(1-hexyloxyethyl) pyropheophorbide (HPPH), and so on, which have been formulated into drug NCs for cancer therapy. In this review, we summarized the recent advances in drug NCs-based cancer treatment. So far, there are main three methods to synthesize drug NCs, including top-down, bottom-up, and combination methods. The characterization methods of drug NCs were also elaborated. Furthermore, the applications and mechanisms of drug NCs were introduced by their administration routes. At the end, we gave a brief conclusion and discussed the future perspectives of drug NCs in cancer therapy. This article is categorized under: Implantable Materials and Surgical Technologies > Nanomaterials and Implants Therapeutic Approaches and Drug Discovery > Nanomedicine for Oncologic Disease Nanotechnology Approaches to Biology > Nanoscale Systems in Biology.


Assuntos
Antineoplásicos , Portadores de Fármacos , Nanopartículas , Neoplasias , Animais , Linhagem Celular Tumoral , Humanos , Camundongos , Modelos Biológicos , Neoplasias/tratamento farmacológico , Neoplasias/metabolismo
16.
Cancer Biol Ther ; 19(3): 198-204, 2018 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-29261005

RESUMO

Sarcomas are rare but malignant tumors with high risks of local recurrence and distant metastasis. Anti-angiogenic therapy is a potential strategy against un-controlled and not-organized tumor angiogenesis. We aimed to assess the safety and efficacy of apatinib, an oral tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor-2, in patients with advanced sarcoma. Thirty-one patients who received initial apatinib between September 2015 and August 2016 were retrospectively reviewed. Among them, 19 (61.3%) patients were heavily pretreated with two or more lines of cytotoxic chemotherapy. Apatinib was given at a start-dose of 425 mg qd. During therapy, 9 (29.0%) patients required dose interruption and 7 (22.6%) needed dose reduction, and the mean dosage of apatinib was 372.9 ± 68.4 mg/day. In the study cohort, one patient was treated as adjunctive therapy and 6 patients stopped treatment before radiographic response assessment. Thus, 24 patients were eligible for tumor response evaluation. The objective response rate was 33.3% and clinical benefit rate was as high as 75.0%. The progression free survival was 4.25 (95% confidence interval [CI], 2.22-5.11) months, whereas the overall survival was 9.43 (95% CI, 6.64-18.72) months. Compared with other histological subtypes, leiomyosarcoma did not show significant survival benefits. Most of the adverse events (AEs) were at grade 1 or 2. The main grade 3 AEs were hypertension (6.5%), hand foot skin reaction (6.5%), and diarrhea (3.2%). In conclusion, apatinib showed promising efficacy and acceptable safety profile in metastatic or recurrent sarcoma, giving rationale clinical evidence to conduct clinical trials.


Assuntos
Antineoplásicos/uso terapêutico , Neoplasias Ósseas/tratamento farmacológico , Leiomiossarcoma/tratamento farmacológico , Recidiva Local de Neoplasia/tratamento farmacológico , Osteossarcoma/tratamento farmacológico , Piridinas/uso terapêutico , Adolescente , Adulto , Idoso , Antineoplásicos/farmacologia , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/mortalidade , Neoplasias Ósseas/patologia , Criança , Pré-Escolar , Diarreia/induzido quimicamente , Diarreia/epidemiologia , Feminino , Síndrome Mão-Pé/epidemiologia , Síndrome Mão-Pé/etiologia , Humanos , Hipertensão/induzido quimicamente , Hipertensão/epidemiologia , Estimativa de Kaplan-Meier , Leiomiossarcoma/diagnóstico por imagem , Leiomiossarcoma/mortalidade , Leiomiossarcoma/patologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/patologia , Osteossarcoma/mortalidade , Osteossarcoma/patologia , Intervalo Livre de Progressão , Piridinas/farmacologia , Critérios de Avaliação de Resposta em Tumores Sólidos , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Receptor 2 de Fatores de Crescimento do Endotélio Vascular/antagonistas & inibidores , Adulto Jovem
18.
Thorac Cancer ; 6(1): 112-21, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26273346

RESUMO

Although surgical resection is the primary means of curing both primary and metastatic lung cancers, about 80% of lung cancers cannot be removed by surgery. As most patients with unresectable lung cancer receive only limited benefits from traditional radiotherapy and chemotherapy, many new local treatment methods have emerged, including local ablation therapy. The Minimally Invasive and Comprehensive Treatment of Lung Cancer Branch, Professional Committee of Minimally Invasive Treatment of Cancer of the Chinese Anti-Cancer Association has organized multidisciplinary experts to develop guidelines for this treatment modality. These guidelines aim at standardizing thermal ablation procedures and criteria for selecting treatment candidates and assessing outcomes; and for preventing and managing post-ablation complications.

19.
Hepatology ; 61(5): 1579-90, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25284802

RESUMO

UNLABELLED: Radiofrequency ablation (RFA) is considered a curative treatment option for hepatocellular carcinoma (HCC). Growing data have demonstrated that cryoablation represents a safe and effective alternative therapy for HCC, but no randomized controlled trial (RCT) has been reported to compare cryoablation with RFA in HCC treatment. The present study was a multicenter RCT aimed to compare the outcomes of percutaneous cryoablation with RFA for the treatment of HCC. In all, 360 patients with Child-Pugh class A or B cirrhosis and one or two HCC lesions ≤ 4 cm, treatment-naïve, without metastasis were randomly assigned to cryoablation (n = 180) or RFA (n = 180). The primary endpoints were local tumor progression at 3 years after treatment and safety. Local tumor progression rates at 1, 2, and 3 years were 3%, 7%, and 7% for cryoablation and 9%, 11%, and 11% for RFA, respectively (P = 0.043). For lesions >3 cm in diameter, the local tumor progression rate was significantly lower in the cryoablation group versus the RFA group (7.7% versus 18.2%, P = 0.041). The 1-, 3-, and 5-year overall survival rates were 97%, 67%, and 40% for cryoablation and 97%, 66%, and 38% for RFA, respectively (P = 0.747). The 1-, 3-, and 5-year tumor-free survival rates were 89%, 54%, and 35% in the cryoablation group and 84%, 50%, and 34% in the RFA group, respectively (P = 0.628). Multivariate analyses demonstrated that Child-Pugh class B and distant intrahepatic recurrence were significant negative predictors for overall survival. Major complications occurred in seven patients (3.9%) following cryoablation and in six patients (3.3%) following RFA (P = 0.776). CONCLUSION: Cryoablation resulted in a significantly lower local tumor progression than RFA, although both cryoablation and RFA were equally safe and effective, with similar 5-year survival rates.


Assuntos
Carcinoma Hepatocelular/cirurgia , Ablação por Cateter , Criocirurgia , Neoplasias Hepáticas/cirurgia , Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/patologia , Criocirurgia/métodos , Feminino , Humanos , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Taxa de Sobrevida
20.
J Natl Cancer Inst ; 106(9)2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25210200

RESUMO

To assess the efficacy of combining radioimmunoconjugate [(131)I] metuximab with radiofrequency ablation (RFA) in hepatocellular carcinoma (HCC) treatment compared with RFA alone, a single-center randomized controlled trial was conducted on 127 patients with Barcelona Clinic Liver Cancer staging system (BCLC) classifications of 0-B stage. Patients received either RFA followed by [(131)I] metuximab (n = 62) or RFA alone (n = 65). The primary outcome was overall tumor recurrence. Statistical tests were two-sided. The one- and two-year recurrence rates in the combination group were 31.8% and 58.5%, whereas those in the RFA group were 56.3% and 70.9%, respectively. The median time to overall tumor recurrence was 17 months in the combination group and 10 months in the RFA group (P = .03). The RFA-[(131)I] metuximab treatment showed a greater antirecurrence benefit than RFA in the metuximab target (ie, CD147)-positive subpopulation (P = .007). [(131)I] metuximab may yield prevention of tumor recurrence after RFA.


Assuntos
Anticorpos Monoclonais/uso terapêutico , Antineoplásicos/uso terapêutico , Carcinoma Hepatocelular/terapia , Ablação por Cateter , Imunoconjugados/uso terapêutico , Radioisótopos do Iodo/uso terapêutico , Neoplasias Hepáticas/terapia , Adulto , Idoso , Carcinoma Hepatocelular/tratamento farmacológico , Carcinoma Hepatocelular/patologia , Carcinoma Hepatocelular/cirurgia , Feminino , Humanos , Estimativa de Kaplan-Meier , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/cirurgia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/prevenção & controle , Estadiamento de Neoplasias , Resultado do Tratamento
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