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BACKGROUND/AIMS: The purpose of this study is to observe and compare the preliminary efficacy and side effects of docetaxel, 5-fluorouracil and leucovorin intravenous chemotherapy in combination with cisplatin hyperthermic intraperitoneal perfusion chemotherapy for the treatment of advanced gastric cancer. METHODOLOGY: Retrospectively analyzed 101 patients with advanced gastric cancer receiving docetaxel, 5-fluorouracil, leucovorin and cisplatin intravenous chemotherapy or intravenous administration of docetaxel, 5-fluorouracil and leucovorin combined with cisplatin hyperthermic intraperitoneal perfusion chemotherapy, 49 patients in intravenous chemotherapy (VC) group, 52 patients in hyperthermic intraperitoneal perfusion chemotherapy (HIPEC) group. RESULTS: The response rate was 44.9% (22/49) in VC group and 65.4% (34/52) in HIPEC group, among which there was 1 case of CR, and the difference was statistically significant (p= 0.038). For CBR evaluation, the effective rate was 65.3% (32/49) in VC group and 82.7% (43/52) in HIPEC group, and the difference was statistically significant (p= 0.0458). The median progress free survival time (PFS) was 3.4 months in VC group and 4.6 months in HIPEC group, the difference was statistically significant (p= 0.045). The median overall survival time (OS) was 6.7 months in VC group and 7.5 months in HIPEC group, the difference was not statistically significant (p= 0.201). The main side effects in two groups were well tolerated, and there was no statistically significant difference. CONCLUSIONS: The short-term efficacy and PFS of HIPEC plus intravenous chemotherapy were better than single intravenous chemotherapy, and there was no significant improvement in OS, the side effects were similar in two groups with good tolerability.
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Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Hipertermia Inducida , Neoplasias Gástricas/tratamiento farmacológico , Adulto , Anciano , Estudios de Cohortes , Terapia Combinada , Docetaxel , Femenino , Fluorouracilo/administración & dosificación , Humanos , Hipertermia Inducida/efectos adversos , Inyecciones Intraperitoneales , Leucovorina/administración & dosificación , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Estudios Retrospectivos , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/patología , Taxoides/administración & dosificaciónRESUMEN
BACKGROUND/AIMS: The objectives of the present study were to investigate human epidermal growth factor receptor-2 (HER2) and topoisomerase II alpha (T2a) expressions in rectal cancer (RC) and to evaluate their correlation. METHODOLOGY: The status of HER2 and T2a in tumor specimens from 302 RC patients was retrospectively assessed using immunohistochemistry. Clinicopathological parameters were compared. RESULTS: HER2 overexpression (2+ or 3+) was found in only 31 patients (10.3%), whereas positive immunostaining for the T2a protein was detected in most patients (n=272, 90.1%). HER2 expression tended to positively correlate with T2a level (r=0.224; p<0.001). Relationships between HER2 expression and patients' age and gender, tumor size, differentiation, and TNM stage, lymph node metastasis, and lymphovascular invasion were not found (p>0.05). Logistic regression analysis identified TNM stage III and lymphovascular invasion as independent risk factors for T2a overexpression (p<0.05). CONCLUSIONS: As the contribution of HER2 appears minimal, it has low potential as a therapeutic target in RC. T2a may play an important role in cancer cell progression and invasion, and T2a inhibitors could be used in the treatment of RC.
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Antígenos de Neoplasias/análisis , ADN-Topoisomerasas de Tipo II/análisis , Proteínas de Unión al ADN/análisis , Receptor ErbB-2/análisis , Neoplasias del Recto/química , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias del Recto/patologíaRESUMEN
The conversion of frequency modulation to amplitude modulation (FM-to-AM) effect is harmful to the high power laser facility based on the phase modulation technique. The FM-to-AM effect of phase modulation pulse induced by the weak etalon effect in wave plates was investigated theoretically and experimentally. A bulk phase modulator with a modulation frequency of 9.2GHz was employed. The numerical simulation results show that the FM-to-AM effect with a temporal modulation depth of 2.5% and 29.7% on the top of the pulse shape was induced by the weak etalon effect in half-wave plate with thickness of 1mm and residual reflectance ratio of 0.5% for 1 pass and 12 passes respectively. On the same condition, the temporal modulation depth is 3.0% and 23.4% respectively in the experiment. The results are in good agreement with numerical simulation results. To our knowledge, it is the first time to introduce the weak etalon effect in wave plates for a complex phase modulation laser system.
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A new coupling method is proposed for high-power laser-diode-array (LDA) end-pumped large-aperture amplifiers. In this method, stacks in the LDA are distributed on a spherical surface, and a hollow duct is placed after them. Both numerical simulations and experimental research have been done for this method. All results show that high coupling efficiency and uniform pumping field can be obtained simultaneously using this method.
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Objective: To investigate the potential effect of Lysimachia capillipes capilliposide (LCC) on the chemo sensitivity and the stemness of human ovarian cancer cells. Methods: Cell Counting Kit-8 (CCK8) was used to measure the IC
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Objective To compare the irradiated dose to unprotected lymph node stations (LNS) between volume-modulated arc therapy (VMAT) and 5-field intensity-modulated radiotherapy (5F-IMRT) in the treatment of patients with upper thoracic esophageal cancer.Methods A total of 20 patients were selected for re-planning.LNS were not included in the GTV and CTV,instead,LNS were contoured as normal tissues.However,LNS were not constrained in the VMAT and 5F-IMRT inverse optimization for protection.Dosimetric parameters of conformal index (CI),homogeneity index (HI) of targets,V95,V110 of planning target volume (PTV),D V5,V20,V30 of lung,D V25 of heart,Dmax of spinal cord,MU,as well as the equivalent uniform dose (EUD) and V40 of LNS were compared between the two plans.Results 5F-IMRT was superior in PTV_ V95% (t=-9.4,P<0.05),but worse in terms of CI (t=-5.3,P<0.05) compared with VMAT.5F-IMRT reduced the V5 of lung by 10.9% (t=-7.8,P<0.05) and the Dmax of spinal cord by 9% (t=-10.2,P<0.05),but increased the MU (t=-6.2,P<0.05) compared with VMAT.The average EUD and V40 of LNS in upper thoracic were significantly increased by 4.7% and 2.4% in 5F-IMRT compared with VMAT,respectively.The irradiated doses to LNS were significantly associated with the volume of PTV (R =0.716-0.933,P<0.05) expect for 106tbL.Conclusions The irradiated doses to unprotected LNS were less for IMRT plans and were highly associated with PTV volume in patients with upper thoracic esophageal cancer.
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Objective@#To compare the irradiated dose to unprotected lymph node stations (LNS) between volume-modulated arc therapy (VMAT) and 5-field intensity-modulated radiotherapy (5F-IMRT) in the treatment of patients with upper thoracic esophageal cancer.@*Methods@#A total of 20 patients were selected for re-planning. LNS were not included in the GTV and CTV, instead, LNS were contoured as normal tissues. However, LNS were not constrained in the VMAT and 5F-IMRT inverse optimization for protection. Dosimetric parameters of conformal index (CI), homogeneity index (HI) of targets, V95, V110 of planning target volume (PTV), Dmean, V5, V20, V30 of lung, Dmean, V25 of heart, Dmax of spinal cord, MU, as well as the equivalent uniform dose (EUD) and V40 of LNS were compared between the two plans.@*Results@#5F-IMRT was superior in PTV_V95% (t=-9.4, P<0.05), but worse in terms of CI (t=-5.3, P<0.05) compared with VMAT. 5F-IMRT reduced the V5 of lung by 10.9% (t=-7.8, P<0.05) and the Dmax of spinal cord by 9% (t=-10.2, P<0.05), but increased the MU (t=-6.2, P<0.05) compared with VMAT. The average EUD and V40 of LNS in upper thoracic were significantly increased by 4.7% and 2.4% in 5F-IMRT compared with VMAT, respectively. The irradiated doses to LNS were significantly associated with the volume of PTV (R=0.716-0.933, P<0.05) expect for 106tbL.@*Conclusions@#The irradiated doses to unprotected LNS were less for IMRT plans and were highly associated with PTV volume in patients with upper thoracic esophageal cancer.
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Objective To investigate the relationship between the body mass index (BMI)/body mass index improved (BMIIMPd) and the dose of the small intestine as well as the acute radiation colitis in the intensity-modulated radiation therapy after cervical cancer surgery.Methods Thirty-nine cervical cancer patients underwent postoperative adjuvant radiotherapy.All patients received Philips large bore CT scan for enhanced CT scan,target delineation and organ at risk.All patients were treated with a single arc 10 MV VMAT plan.The correlation between the radiation dose of the small intestine and the acute radiation enteritis and BMI/BMIIMPd was analyzed.Results The BMI was calculated as (22.23±2.80) kg/m2,BMIIMPd was (21.49±3.95) kg/m2,the small intestine volume VSI was (1 155.71 ± 419.33)cc3.The volume of the small intestine received more than 10 Gy (V10_SI) VMAT was (66.50± 27.01) %,and the equivalent uniform dose (EUD) and normal tissue complication probability (NTCP) were (4 098.87± 184.93) cGy and (7.98±8.73)%.One way ANOVA demonstrated that under the VMAT technology,the BMIIMPd,V30,V40,EUD (or=50) and NTCP in the small intestine were the influencing factors of the occurrence of acute radiation enteritis.Conclusions If the improved BMIIMPd is utilized to distinguish the BMI,the high dose area of the small intestine will be larger and the incidence of acute radiation enteritis will be higher for patients with BMIIMPd between 10.1 and 16.9(normal and thin).Conventional BMI cannot be utilized as a basis for the prediction of the incidence of acute radiation enteritis in patients with cervical carcinoma.
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Radiotherapy is a critical approach for the comprehensive treatment of non-small cell lung cancer.Deep understanding of the individualized radiosensitivity of lung cancer patients plays a pivotal role in the selection of radiotherapy dosage and regime and establishment of comprehensive therapeutic strategies.Currently,multiple researchers have identified a variety of biomarkers in predicting the radiosensitivity of lung cancer patients.In this article,research progress on the biomarkers in predicting radiosensitivity of non-small cell lung cancer was reviewed.
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OBJECTIVE:To investigate the direction of examination reform of licensed pharmacists,and to provide a basis for setting up the courses for pharmaceutical major in higher vocational college. METHODS:By the method of literature analysis and comprehensive analysis,examination points and their distribution,the 7th edition of Pharmacy Expertise (Ⅱ) was analyzed in-depth in terms of the change of exam outline,score distribution and the contents of test papers,correlation between teaching ma-terials and scores of test papers,key and difficult points. RESULTS:The exam outline of the 7th edition of Pharmacy Expertise (Ⅱ)was changed from 7 systems into 16 chapters;each chapter contained 3 parts:pharmacological action and clinical evaluation, medication monitoring and clinical application of commonly used drugs;there were most examination points in pharmacological ac-tion and clinical evaluation which were important points. The quantity of test questions was reduced,but choice questions were add-ed,mainly on medication monitoring. The 5th,8th,10th chapters accounted for the most points in the test papers,and ratios of page numbers to points in chapters 1-2,4,9,and 14-16 were all lower than average level. The pharmacological action and clinical evaluation were key points,and the clinical application of commonly used drugs were difficult pints,which emphasized on practi-cal skills in pharmaceutical care. CONCLUSIONS:Licensed pharmacist examination is closely related to clinical practice,which re-flects the characteristics ofexamination based on practiceandpriority to practice,and provides reference for setting up pharma-cy courses.
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Objective To observe the effect of low temperature compound propofol on the changes of apoptosis protein Caspase-3,autophagy-related proteins Beclin-1 and LC3-Ⅱ and thier changes of hippocampal neurons.Methods The rats were randomly divided into blank control group (Group A),propofol group at low temperature (Group B) and chloral hydrate group at low temperature (Group C),Group B and C were treated with low temperature for 30 min.Then,each group was subjected to cardiac perfusion and decapitated brain to prepare rat hippocampal neuronal tissue samples.The expression of Caspase-3 was detected by immunohistochemistry,Beclin-1 and LC3-Ⅱ protein was detected by immunoblotting.The ultrastructural changes of neurons were observed by transmission electron microscopy.Results The expression of Caspase-3,Beclin-1 and LC3-Ⅱ protein in each group were statistically significant differences(P<0.05).The results of transmission electron microscopy showed that the neurons in group B and C were changed in different degrees,especially in group C neuronal apoptosis is obvious.Conclusion Autophagy and apoptosis in existence still exist in low temperature condition,while propofol can reduce this damage and have better protective effect on neurons.
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Objective To investigate the clinical effect of lung equivalent uniform dose (LEUD)-based predictive model for radiation pneumonitis (RP) induced by volumetric modulated arc therapy (VMAT) and to determine the optimal a value.Methods A total of 65 patients with primary lung cancer who received VMAT from July 2015 to February 2016 were divided into RP group and non-RP group according to the presence or absence of RP after radiotherapy.Their dose-volume histogram (DVH) data and other data were obtained and analyzed by the self-compiled numerical analysis program.The LEUD values in the two groups were calculated at a=[-50, 50], and then the a value was identified when the relative difference of LEUD between the two groups was maximal.The paired t test was used for analyzing the differences in V5, V20, V30, minimum lethal dose (MLD), and LEUD (aoptimal) between the two groups.A Pearson correlation analysis was used to determine the correlation of Vdose and LEUD (aoptimal) with RP.The logistic regression method was used to establish the predictive model of RP.Results The maximum relative difference in LEUD between RP group and non-RP group was obtained at a=0.3(627.94 cGy vs.510.23 cGy, relative difference[R]=23.07%).R decreased slowly at t=[-50,-5], increased sharply at t=[-5, 0], and reached the maximum value at a=0.3.After a rapid decrease at a=[0.3, 4], R decreased slowly at a=[4, 50].The correlation analysis of the traditional physical volume dose threshold also showed that the LEUD (at a=0.3) was correlated with V5, V10, V20, and MLD (r=0.929, P<0.05).Conclusions For patients receiving VMAT for thoracic cancer, LEUD (at a=0.3) can distinguish between patients with and without RP.Therefore, LEUD is recommended to be<510 cGy.A combination of LEUD and conventional physical dose has a good clinical predictive value for RP under non-uniform irradiation.
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Objective To investigate the effects of dexmedetomidine on oxidative stress response after operation in patients with acute craniocerebral trauma. Methods Sixty patients who underwent intracranial hematoma and decompressive craniectomy within 24 h after acute craniocerebral trauma,were randomly divided into midazolam group and dexmedetomidine group(n=30). All patients were maintained seda-tion for 12 h after operation. Mean arterial blood pressure (MAP),heart rate (HR),blood glucose,S-100B protein (S-100B),malond-ia1ehyde(MDA) and superoxide dismutase (SOD) were recorded at the end of operation(T0),3 h(T1),6 h(T2),12 h(T3) after opera-tion. Results Postoperative MAP, HR and blood glucose were stability in two groups. MAP, HR and blood glucose of dexmedetomidine group were lower than those of midazolam group(P<0. 05). The serum concentrations of S-100B and MDA gradually reduced,and the serum levels of SOD gradually increased at T1 ~T3 in two groups. Compared with midazolam group, these changes were significantly higher in dexmedetomidine group(P<0. 05). Conclusion Dexmedetomidine can protect the brain by maintaining haemodynamic stability and attenu-ating oxidative stress response after operation in patients with acute craniocerebral trauma.
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Objective:To research the efficacy and adverse reactions of compound matrine injection combined with chemotherapy in the patients with advanced gastric cancer. Methods:According to the order of admission, 68 patients with advanced gastric cancer were divided into the observation group (34 cases) and the control group (34 cases). The two groups of patients were given chemo-therapy, and the observation group was treated with compound matrine injection additionally. After 3 months treatment, the curative effect and KPS score before and after the treatment were compared between the two groups. And adverse drug reactions were recorded for the two groups. Results:The total effective rate of the observation group (44. 12%) was significantly higher than that of the control group (20. 59%,P<0. 05). After the treatment, the KPS score of the observation group was significantly higher than that of the con-trol group (P<0. 05). The incidence of adverse drug reactions in the observation group was significantly lower than that in the control group (P<0. 05). Conclusion: The curative effect of compound matrine injection combined with chemotherapy for advanced gastric cancer is notable, which can significantly improve the KPS score and reduce the incidence of adverse reactions, and is worthy of promo-ted use in clinical practice.
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OBJECTIVE:To establish the system of curriculum based on working process and occupation ability for pharmacy major in higher vocational colleges. METHODS:Investigation was conducted among medical practitioners from pharmaceutical companies,hospitals,pharmaceutical factories,scientific research institutions and other related professionals. RESULTS:150 ques-tionnaires were sent out,and 141 valid questionnaires were collected with effective recovery rate of 94.00%. Results of investiga-tion showed that respondents most valued graduates with interpersonal and communication skills,followed by professional skills and practical ability. They were mainly clinical application of drugs,pharmacological effects and adverse reactions of drugs in the pharmacology theory teaching,the mechanism of action of drugs were weakened. The ability of prescription distribution,symptoms inquiring and drugs recommending should be strengthened in the pharmacology theory practice teaching. More than half of the re-spondents thought that confirmatory tests were necessary to keep,which helped to train students’practical ability and deepen the understanding of the theory. Meanwhile,it was important to strengthen the students’communication with the patients or their fami-lies and doctors to cultivate the ability of acquiring professional knowledge. CONCLUSIONS:The investigation provides basis for the making of curriculum standards of pharmacology,through which teaching contents are selected,teaching methods are de-signed,and it makes the pharmacology course full of post applicability and provides better decision-making basis to meet the posi-tion requirements.
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Objective To study the geometric difference between six different ITV generation methods from 4DCT for patients with non?small cell lung cancer ( NSCLC) treated with stereotactic ablative radiotherapy technique ( SABR) . Methods Between Dec. 2013 and Mar. 2014,16 patients were enrolled in this retrospective study. All patients underwent imaging with 4DCT scans. The MI and DI index were evaluated between six ITV generation methods:combining GTV from all 10 respiratory phases ( ITV10 );combining GTV from four respiratory phases, including two extreme phases ( 0% and 50%) plus two intermediate phases ( 20% and 70%) ( ITVYeo ) which was proposed by Seung?Gu Yeo of Soonchunhyang University;combining GTV from two extreme phases ( ITVEI+EE ) . And combining GTV from five odd phases (10%,30%,50%,70%,90%)(ITVodd).Accordingly the ITVEVEN which was combined from the remaining five even phases (20%,40%,60%,80%,0%),and ITVAVG,ITVMIP were contoured from two reconstructed 4DCT sequences,finally,a method which was not sensitive to the tumor volume and motion characteristic was selected for clinical use. Data were compared using a variance analysis followed by Student?Newman?Keulsa test both in same group or between groups. At the same time, the volume and the three dimensional movements of the tumor, the relativity of MI and DI were analyzed by Multi?parameter regression analysis. Results The mean (range) tumor motion (RLR,RAP,RCC,and R3D) are 3. 5 mm (1. 4?8. 4 mm),4. 5 mm (1. 1?8. 6 mm),9. 5 mm (0?10 mm),12. 3 mm (2. 5?55. 3 mm) respectively. The IGTVx volume are Underestimated by 25. 7%,35. 6%,17. 9%,12. 8%,3. 6%,4. 8%( P=0. 000) respectively. The MI index comparisons between six ITV generation methods and ITV10 showed statistical significance:0. 69,0. 62,0. 80, 0. 86,0. 93,0. 91 ( P=0. 006 ) . The DI index showed no statistical significance:0. 98, 0. 98, 0. 97, 0. 97, 0. 99,0. 98(P=0. 130).The tumor size and motion amplitude were certified not the independent factors for the MI index of ITVodd and ITVEVEN . Conclusions IGTVODD/EVEN based on odd or even 4DCT phases is not sensitive to the tumor size or motion characteristic and is proved to have a good marching with ITV10 meanwhile maintaining a reasonable contouring efficiency,it can be recommend to the institutions which was not equipped with the deformable registration systems.
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Berberine is the main active ingredients in Coptis.The content determination of berberine can provide the basis for its quality evaluation.Relevant provessinal literatures about determination methods of berberine were summarized,and the main methods included TLC,UV, HPLC,HPEC,fluorescence,and so on.HPLC was the most widely used method because of its high separation efficiency,specificity and sensitivity.
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Objective To analyze the biophysical dosimetric characteristics and clinical application ability of VMAT technology for breast cancer post-mastectomy.Methods 28 patients with breast cancer (10 at left side and the other at right side) were planned in different ways respectively.One was two 90 degree arc VMAT plan and the other were 5 beam IMRT plan.The dosimetric parameters of two different plans including tumor control probability (TCP),conformity index(CI),homogeneity index (HI),V95and V110 in target,normal tissue complication probability (NTCP),V5,V20,V30 for ipsilateral lung,NCTP,D V25 for heart,D for the contralateral breast in OARs,MU and times were compared.Results The average tumor control probability (TCP) in VMAT and IMRT group was(96 ±2)% and (90 ±2)% (t =-6.28,P < 0.01),respectively.The PTV dose average homogeneity index (HI) of VMAT plans was better than that of IMRT plan (0.15 ±0.04 vs 0.22 ±0.02,t =13.29,P <0.01).For cancer position in left side,the mean dose of heart was decreased by 433.24 cGy in the VMAT plan.The NTCP of the hearts in VMAT plans had statistically significant difference compared with IMRT plans [(1.00±0.12)% vs (1.70±0.13)%,t =2.14,P <0.05].For plans of right breast cancer,the average mean dose of hearts in two control group was (3.27 ± 0.26) Gy and (6.00 ± 0.47) Gy (t =9.21,P<0.01).The total monitor unit (MU) was 530.7 in the VMAT arm and 693.9 in the IMRT arm (t =9.58,P <0.01).The treatment time was shorter in VMAT arm (t =8.40,P <0.05).Conclusions VMAT plans have better clinical value and more superior biophysical dosimetric characteristics for breast cancer post-mastectomy.
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Objective: To observe the safety and clinical efficacy of tumor antigen-pulsed dendritic cell(DC) vaccine in treatment of advanced malignant tumor.Methods: Ninety-one patients with non-small cell lung cancer,colon and rectal cancer,melanoma,renal carcinoma,breast cancer and other malignant tumors were enrolled in this study.All patients met the selecting standard and signed informed consent.Human dendritic cells were obtained from peripheral blood monocytes by culturing them with granulocyte macrophage-colony stimulating factor and interleukin-4.DC vaccine was prepared from tumor antigen pulsed immature dendritic cells in vitro.Patients received the vaccine therapy once every week and one cycle was defined as once every week for 3 weeks.Results: All the patients received 96 cycles of DC vaccine treatment.Symptoms of toxicity included fever,shivering,aching pain of muscle,asthenia,itching,stifle and transient fatigue;most of the symptoms automatically recovered.Clinical efficacy of the treatment was evaluated in 76 patients.Thirty-one of the 76 patients were stable after treatment and 45 were in progressive situation,with the clinical benefiting rate being 40.8%.Eighty-five patients were followed up.The median time for progression was 2.6 months;the overall survival time was 0.9-30.6 months;and the median survival period was 4.5 months,with the one year survival rate being 9.2%.Conclusion: The results suggest that the DC vaccine therapy is well tolerated in treating patients with advanced malignant tumors and has satisfactory clinical benefit;the clinical value of DC vaccine therapy needs to be further observed.
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Objective: To evaluate the efficacy of granulocyte(-macrophage) colony stimulating factor[G(M)-CSF] inthe treatment of concomitant chemoradiotherapy-induced oral mucositis in locally advanced head and neck cancer patients.Metheds: Fifteen patients with locally advanced head and neck cancer was received concomitant chemoradiotherapy, whilewhite blood cell count were less than 1. 5?10~9/L with grade Ⅲ/Ⅳ oral mucositis, they were subcutaneously given G(M)-CSF at dose of 100-300?g daily for 3~10 days. Results: After administration of G(M)-CSF, all of the patients had anaugmantation of white blood cell count more than 5. 0?10~9/L. Complete healing of oral mucositis occurred in 1 patient(CR), partial in 8 patients(PR), whereas 6 patients had no change and none was progressive, the objective response rate(CR+PR) was 60%. Condusions: G(M)-CSF is proved effective for oral mucositis caused by concomitant chemoradio-therapy in locally advanced head and neck cancer patients.