Objective To evaluate the effect and the radiation reaction of esophageal cancer patients treated by LCHR.Methods 96 patients of esophageal cancer were treated by LCHR. 76 patients had pathology evidence. There were 65 males and 31 females. The ages ranged from 41 to 70 years with median 57.5 years. The patients with lesion in upper thoracic segment 21 cases, Middle thoracic segment 63 cases, lower thoracic segment 12 cases. The length of lesions: 7.0?cm 10 cases. They were randomly divided into two groups, The conventional radiation group (48 cases). And late course hyperfractionation (48 cases).Both groups were treated by 60Co ?- ray external radiation 2.0?Gy every time each day, five times in each week in conventional group, the total dose 64?Gy/32 fractions/44d; in the late course hyperfractionation group. 40?Gy in four weeks at first and then two times each day with 1.15～1.25?Gy every time and with 6～8 hours, interval, from the fifth week, ten times in each week, ale total dose 68～70?Gy/44～45d. Results All patients were followed at more then five years. The follow-up rate was 96.9%. The survival rate of 1,3,5-year in late course hyperactionation group were 81.1%, 44.1%, 26.8% and 61.7%, 25.1%, 16.9% in conventional group respectively. The survival rate of late course hyperactionation group is better than conventional group. Between the two groups , there was significant difference in the survival rate of 1,3-year (P0.05). Conclusions The result showed that the 1,3,5-year survival rate of LCHR of esophageal cancer is better than conventional radiotherapy. Between the two groups , there was significant difference in the survival rate of 1,3-year ,However there is no significant difference in the survival rate of 5-year. It is well tolerated, without late reactions in long term survivors.

Objective To investigate the safety and efficiency of 125I radioactive stents for advanced extra-hepatic cholangio-carcinoma.Methods We retrospectively reviewed data of 15 consecutive patients with advanced and un-resectable extra-hepatic cholangiocarcinoma,who were treated by radioactive stents.Postoperative complications,patency time of stents,and survival of the patients were assessed.Results Fifteen patients underwent 32 endoscopic sessions of radioactive stents placement.Successful operations were achieved in all patients,and there were no life-threatening complications including perforation,bleeding or bone marrow depression.The average patency time of radioactive stents was 117 ± 105 days (8-295 days).The actual radiation dose was 56.55 ± 17.42 Gy (7.86-82.48 Gy).The median survival time was 420 days (90-1175 days) and survival of 6 patients exceeded 12 months.Conclusion The 125I radioactive stent is safe and effective for patients with advanced unresectable extra-hepatic cholangio-carcinoma.

Objective To evaluate the clinical efficacy and prognostic factors of limited-stage small cell lung cancer ( LS-SCLC) treated with 125 I radioactive seed implantation guided by CT combined with systemic chemotherapy. Methods A total of 128 limited-stage small cell lung cancer patients were treated with 125 I radioactive seed implantation combined with chemotherapy from Jun 2008 to Jun 2012 in Tianjin Medical University Second Hospital. Theχ2 test was used to analyze the influencing factors of short-term efficacy. Survival rate was calculated by Kaplan-Meier method, single factor analysis was performed by Log-rank, and multivariate analysis was performed by Cox proportional hazard model. Results Totally 128 patients finished the treatment. The overall response rate was 86.7％ ( 111/128 ) after 6 months of treatment. The 1-, 2-and 3-year overall survival rate was 77.9％, 39.8％and 28.0％, respectively, and the median survival time was 21.0 months. The univariate analysis showed that the following factors were main prognostic factors:age, performance status ( PS) , hemoglobin≥120 g/L before treatment, smoking index, the maximum diameter of tumor, neuron-specific enolase before treatment, subscribe for prophylactic cranial irradiation ( PCI) , number of chemotherapy cycle, chemotherapy response, prescribed dose ( PD ) , postoperation dose covering 100％ volume ( D100 ) , remedial model. multivariate analysis revealed that age, PS, hemoglobin≥120 g/L before treatment and PD, the maximum diameter of tumor, number of chemotherapy cycle, chemotherapy response, and remedial model were the independent prognostic factors for survival. 29 patients of 128 suffered from aerothorax and the incidence rate of aerothorax was 27.7％. Totally 16 patients occurred hemoptysis and theincidence rate was 12.5％. Conclusions 125 I radioactive seed implantation therapy showed good effecacy in the treatment of LS-SCLC. Age, PS, hemoglobin≥120 g/L before treatment, the maximum diameter of tumor, number of chemotherapy cycle, chemotherapy response, and remedial model might be the main prognostic factors for LS-SCLC patients.

Objective To evaluate the safety and efficacy of therapeutic ERCP for patients above 90 years of age.Methods The data of 37 patients of above 90 years who underwent 42 ERCP procedures from January 2001 to December 2009 were studied retrospectively and compared with those of 152 matched patients ( 168 procedures) below 65 years old at a 1∶4 ratio for success rate and complications.Results The rate of complete success,partial success,and failure in observation group was 73.81％ (31/42),19.05％(8/42) and 2.38％ (1/42),respectively,which were similar (P ＞0.05) with those in control group,with complete success rate at 85.12％ ( 143/168),partial success rate at 12.50％ (21/168) and failure rate at 2.38％ (4/168).The rate of terminated operation in observation group (4.76％,2/42) was significantly higher than that of the control group (0.00％,0,P =0.039).The overall rate of complication in observation group was 7.14％ ( 3/42 ),slightly higher than that of the control group ( 6.55％,11/168,P ＞0.05 ).There was no significant difference between the two groups regarding the rates and severity of such complications as pancreatitis,hemorrhage and infection ( P ＞ 0.05 ).No perforation or death was observed.Conclusion Therapeutic ERCP for patients of 90 years or older is safe and effective.Adverse events related to chronic concomitant diseases need early detection and proper management.