OBJECTIVETo observe and evaluate a method that is effective and practical for treatment of cerebral palsied (CP) children in China.

METHODThe patient's age and disease type and individual specific conditions were considered in choosing therapy methods accordingly: Chinese herbs, acupuncture, auricular seed pressure, point finger pressing, massage, orthopedic hand manipulation, physiotherapy, occupational therapy, language therapy, etc. Meanwhile we created a new CP treatment model that combines hospitalized treatment with family therapy.

RESULTSThe majority of CP patients improved greatly in motor and social adaptation capacities after treatment. Wilcoxon paired rank sum test analysis showed that there were significant differences between the data before and after treatment (P<0.01).

CONCLUSIONThis combined therapy method, based on traditional Chinese medicine and western medicine plus family supplemental therapy, is an effective and practical treatment strategy for CP children in China.

Adolescent ; Cerebral Palsy ; epidemiology ; rehabilitation ; Child ; Child, Preschool ; China ; epidemiology ; Combined Modality Therapy ; methods ; statistics & numerical data ; Female ; Humans ; Infant ; Male ; Medicine, Chinese Traditional ; methods ; Treatment Outcome

OBJECTIVETo summarize the effectiveness of Chinese and Western integrative medicine in treating medium and advanced lung cancer, and to provide guidelines for clinical application.

METHODSFor this metaanalysis, a comparative search of Chinese medicine data in Chinese National Knowledge Infrastructure (CNKI) and Chinese BioMedical Literature Database (CBM) was undertaken to identify articles related to randomized comparative research of Chinese and Western integrative medicine in treating medium and advanced lung cancer between 1996 to 2006. Quality of life (QOL) was estimated using RevMan 4.2 software for data processing, adopting the odd ratio (OR) and the 95% confidence interval (CI).

RESULTSThrough meta-analysis of 10 qualified articles, the results were as follows: the merging effectiveness of QOL [OR=3.80, 95% CI (2.65, 5.47)]; the rate of survival [OR=3.44, 95% CI (2.04, 5.80)]; the tumor response rate [OR=1.88, 95% CI (1.37, 2.58)]; the tumor developing rate [OR=0.33, 95% CI (0.23, 0.48)]. Significant differences existed between the Chinese and Western integrative medicine treatment group and the Western treatment group (P<0.01).

CONCLUSIONSChinese and Western integrative medicine treatment of medium and advanced lung cancer has shown to improve patients' QOL and survival rate; it also can control tumor development in the short term.

Carcinoma ; epidemiology ; pathology ; therapy ; Combined Modality Therapy ; Disease Progression ; Humans ; Integrative Medicine ; methods ; Lung Neoplasms ; epidemiology ; pathology ; therapy ; Medicine, Chinese Traditional ; methods ; Neoplasm Staging ; Publication Bias ; statistics & numerical data ; Randomized Controlled Trials as Topic ; statistics & numerical data ; Treatment Outcome ; Western World

OBJECTIVETo compare the results of different treatment modalities for the advanced tongue squamous cell carcinoma and investigate the factors that influence its prognosis.

METHODSNinety-two patients with advanced tongue squamous cell carcinoma without distant metastasis, treated in our hospital from Jan. 1990 to Dec. 1999 were retrospectively reviewed. Survival rate was estimated by Kaplan-Meier method, and multivariate analysis was performed by the Cox Proportional hazard model.

RESULTSThe overall 3-year and 5-year survival rates were 52.40% and 37.23% respectively. There was a significant difference in the overall between the two groups survival rate (chemotherapy only and radiotherapy after induced chemotherapy) and the three groups (operation only, operation after induced chemotherapy, radiotherapy after operation) cTNM stage, operation for the primary lesion and local recurrence were the independent factors that influenced the prognosis.

CONCLUSIONSRisk factors that independently influence the survival of patients with advanced tongue squamous cell carcinoma were the local recurrence, cTNM and receiving operation or not for the primary lesion. Operation only or comprehensive therapy including operation could give a better prognosis, but the results of chemotherapy only or radiotherapy after chemotherapy were poor.

Adult ; Aged ; Combined Modality Therapy ; statistics & numerical data ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasms, Squamous Cell ; pathology ; therapy ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Tongue Neoplasms ; pathology ; therapy

OBJECTIVETo analyze the clinical and pathological features in order to investigate appropriate way of diagnosis and treatment for non-functional islet cell tumors of the pancreas (NFICT).

METHODSThe data and experience of surgically treated 43 patients with pathologically confirmed NFICT over the last 30 years were retrospectively reviewed. The survival rate was estimated using Kaplan-Meier method and the potential risk factors affecting survival were compared with Log rank test.

RESULTSThere were 7 males and 36 females in this series with a mean age of 31.6 years ranged from 8 to 67 years. Twenty-eight patients were diagnosed as having non-functional islet cell carcinomas of the pancreas (NFICC) and 15 patients benign islet cell tumors. The most common symptoms in NFICT were abdominal pain 55.8%, nausea and/or vomiting (32.6%), fatigue (25.6%) and abdominal mass (23.3%). Preoperatively, all of those were found to have a mass in their pancrease by ultrasonic and computed tomography examination, with 21 in the head, 10 in the body and 6 in the tail of the pancreas. Multicemtric tumor were found in one patient. Thirty-nine of these 43 patients (90.7%) underwent surgical resection, with a curative resection in 30 (69.8%) and palliative in 9 (20.9%). The resectability and curative resection rate in 28 patients with nonfunctioning islet cell carcinomas of the pancreas was 78.6% and 60.7%, respectively. None of the 15 patients with benign nonfunctioning islet cell tumor of the pancreas died of this disease. While the overall cumulative 5- and 10-year survival rate in 28 patients with non-functional islet cell carcinomas of the pancreas was only 58.1% and 29.0%, respectively. Curative resection, female, younger than 30 years old and mass diameter < 10 cm were found to be positive prognostic factors. But multivariate Cox regression analysis indicated that radical resection was the only independent prognostic factor (P = 0.007).

CONCLUSIONNonfunctioning islet cell tumor of the pancreas is frequently found in young female. Surgical resection, especially curative resection can achieve satisfactory long-term survival.

Adenoma, Islet Cell ; diagnosis ; therapy ; Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Islet Cell ; diagnosis ; therapy ; Chemotherapy, Adjuvant ; methods ; statistics & numerical data ; Child ; Combined Modality Therapy ; Doxorubicin ; therapeutic use ; Female ; Fluorouracil ; therapeutic use ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Mitomycin ; therapeutic use ; Multivariate Analysis ; Pancreatic Neoplasms ; diagnosis ; therapy ; Pancreaticoduodenectomy ; methods ; statistics & numerical data ; Proportional Hazards Models ; Regression Analysis ; Retrospective Studies

OBJECTIVE: Arsenic trioxide (As2O3) can be used as a possible pharmaceutical alternative that augments radiofrequency (RF) ablation by reducing tumor blood flow. The aim of this study was to assess the effect of intraarterial and intravenous administration of As2O3 on RF-induced ablation in an experimentally induced liver tumor. MATERIALS AND METHODS: VX2 carcinoma was grown in the livers of 30 rabbits. As2O3 (1 mg/kg) was administered through the hepatic artery (n = 10, group A) or ear vein (n = 10, group B), 30 minutes before RF ablation (125 mA +/- 35; 90 +/- 5degrees C). As a control group, 10 rabbits were treated with RF ablation alone (group C). RF was intentionally applied to the peripheral margin of the tumor so that ablation can cover the tumor and adjacent hepatic parenchyma. Ablation areas of the tumor and adjacent parenchymal changes among three groups were compared by the Kruskal-Wallis and Mann-Whitney U test. RESULTS: The overall ablation areas were 156 +/- 28.9 mm2 (group A), 119 +/- 31.7 (group B), and 92 +/- 17.4 (group C, p < 0.04). The ablation area of the tumor was significantly larger in group A (73 +/- 19.7 mm2) than both group B (50 +/- 19.4, p = 0.02) and group C (28 +/- 2.2, p < 0.01). The ratios of the tumoral ablation area to the overall ablation area were larger in group A (47 +/- 10.5%) than that of the other groups (42 +/- 7.3% in group B and 32 +/- 5.6% in group C) (p < 0.03). CONCLUSION: Radiofrequency-induced ablation area can be increased with intraarterial or intravenous administration of As2O3. The intraarterial administration of As2O3 seems to be helpful for the selective ablation of the tumor.
Animals ; Arsenicals/*pharmacology ; Catheter Ablation/*methods ; Combined Modality Therapy ; Contrast Media/diagnostic use ; Disease Models, Animal ; Liver/radiography ; Liver Neoplasms, Experimental/*drug therapy/radiography/*surgery ; Oxides/*pharmacology ; Rabbits ; Statistics, Nonparametric ; Tomography, X-Ray Computed

OBJECTIVE: Although radiation therapy (RT) and concurrent chemoradiotherapy (CCRT) are the global standards for adjuvant therapy treatment in cervical cancer, many Japanese institutions choose chemotherapy (CT) because of the low frequency of irreversible adverse events. In this study, we aimed to clarify the trends of adjuvant therapy for intermediate/high-risk cervical cancer after radical surgery in Japan. METHODS: A questionnaire survey was conducted by the Japanese Gynecologic Oncology Group to 186 authorized institutions active in the treatment of gynecologic cancer. RESULTS: Responses were obtained from 129 facilities. Adjuvant RT/CCRT and intensity-modulated RT were performed in 98 (76%) and 23 (18%) institutions, respectively. On the other hand, CT was chosen as an alternative in 93 institutions (72%). The most common regimen of CT, which was used in 66 institutions (51%), was a combination of cisplatin/carboplatin with paclitaxel. CT was considered an appropriate alternative option to RT/CCRT in patients with risk factors such as bulky tumors, lymph node metastasis, lymphovascular invasion, parametrial invasion, and stromal invasion. The risk of severe adverse events was considered to be lower for CT than for RT/CCRT in 109 institutions (84%). CONCLUSION: This survey revealed a variety of policies regarding adjuvant therapy among institutions. A clinical study to assess the efficacy or non-inferiority of adjuvant CT is warranted.
Chemoradiotherapy, Adjuvant ; Combined Modality Therapy ; Female ; Humans ; Japan/epidemiology ; Middle Aged ; Neoplasm Recurrence, Local/prevention & control ; *Practice Patterns, Physicians'/statistics & numerical data ; Risk Assessment ; Risk Factors ; Surveys and Questionnaires ; Uterine Cervical Neoplasms/radiotherapy/*therapy

In North Korea, the prevalence of hepatitis B is high due to natural factors, gaps in vaccination, and the lack of antiviral treatment. Aid projects are urgently needed, however impeded by North Korea's political and economical situation and isolation. The feasibility of a joint North Korean and German humanitarian hepatitis B prevention program was assessed. Part 1: Hepatitis B vaccination catch-up campaign. Part 2: Implementation of endoscopic ligation of esophageal varices (EVL) by trainings in Germany and North Korea. By vaccinating 7 million children between 2010 and 2012, the hepatitis B vaccination gap was closed. Coverage of 99.23% was reached. A total of 11 hepatitis B-induced liver cirrhosis patients (mean age 41.1 yr) with severe esophageal varices and previous bleedings were successfully treated by EVL without major complications. A clinical standard operating procedure, a feedback system and a follow-up plan were developed. The bi-modal preventive strategy was implemented successfully. Parts of the project can serve as an example for other low-income countries, however its general transferability is limited due to the special circumstances in North Korea.
Adult ; Combined Modality Therapy/methods/statistics & numerical data ; Democratic People's Republic of Korea/epidemiology ; Esophageal and Gastric Varices/*embryology/*surgery ; Esophagoscopy/statistics & numerical data ; Feasibility Studies ; Female ; Hepatitis B/*epidemiology/*prevention & control ; Hepatitis B Vaccines/*administration & dosage ; Humans ; Male ; Mass Vaccination/*statistics & numerical data ; Middle Aged ; Prevalence ; Retrospective Studies ; Risk Factors ; Secondary Prevention/methods/statistics & numerical data ; Treatment Outcome

OBJECTIVETo evaluate the effects of acute normovolemic hemodilution (ANH) combined with controlled hypotension on reducing heterogeneous transfusion and safety during liver tumorectomy.

METHODSThirty patients undergoing elective liver tumorectomy were randomly divided into 3 groups (10 each), namely ANH group (group A), ANH combined with controlled hypotension group (group B) and control group (group C). All the patients were anesthetized via endotracheal intubation. Before the operation, ANH was performed in groups A and B after anesthesia induction, and controlled hypotension was initiated in group B during tumorectomy. Blood transfusion and fluid infusion were carried out routinely in group C. Hb and Hct were measured before operation, after ANH, and immediately, 1 day and 7 days after the operation. The difference in intraoperative blood loss and heterogeneous blood transfusion volume in the 3 groups was observed.

RESULTSIn group A, heterogeneous blood transfusion was avoided in 6 cases and but given in the other cases for an average of 400 ml. In group C, every patient received heterogeneous blood transfusion (664.8-/+248.1 ml), but none of the patients received heterogeneous blood in group B. The difference in transfusion volume between the 3 groups was significant (P<0.01). Hemodynamics was basically stable during operation in the 3 groups.

CONCLUSIONANH combined with controlled hypotension is safe and effective for decreasing and even avoiding homologous blood transfusion in liver tumorectomy.

Adult ; Aged ; Blood Loss, Surgical ; prevention & control ; Blood Transfusion ; statistics & numerical data ; Combined Modality Therapy ; Female ; Hemodilution ; methods ; Hepatectomy ; methods ; Humans ; Hypotension, Controlled ; methods ; Isotonic Solutions ; Liver Neoplasms ; surgery ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Treatment Outcome

OBJECTIVETo analyze initial response rate of radiotherapy and chemotherapy for early nasal NK/T-cell lymphoma, and its prognostic factors.

METHODSFrom January 1996 to December 2002, 116 patients with nasal NK/T-cell lymphoma were diagnosed pathologically. Immunophenotyping was performed in 50 cases. According to Ann Arbor staging classification, 95 patients were stage I(E) and 21 II(E). Of the 116 patients, 22 received radiotherapy alone, 6 chemotherapy alone and 88 combined modality therapy (CMT), including, 41 radiotherapy followed by chemotherapy, and 47 chemotherapy followed by radiotherapy.

RESULTSThe 5-year overall survival (OS) rate and disease free survival (DFS) rate for all patients was 74.1% and 61.5%, respectively. For stage I(E) and II(E) patients, the 5-year OS rate was 75.1% and 68% (P = 0.45), and DFS rate was 64.7% and 47.8%, respectively (P = 0.07). The 5 year OS rate and DFS rate were 86.5% and 71.5% for patients who achieved complete response (CR), and 18.4% and 17.2% for those who didn't, respectively (P = 0.000). Sixty-three patients were treated with radiotherapy alone or radiotherapy followed by chemotherapy, while 53 with chemotherapy followed by radiotherapy or chemotherapy alone. The CR rate for radiotherapy was 74.6% while for chemotherapy was 20.8% (P = 0.000). The 5-year OS rate and DFS rate were 76.8% and 65.4% for radiotherapy with or without chemotherapy, and 78.8% and 61.8% for chemotherapy followed by radiotherapy (P > 0.05). Multivariate analysis by COX regression showed that CR rate was the only independent prognostic factor.

CONCLUSIONThe CR rate of radiotherapy is much higher than that of conventional chemotherapy. Addition of chemotherapy to radiotherapy do not improve the survival of patients with early stage nasal NK/T-cell lymphoma. Radiotherapy is the primary treatment for stage I and II nasal NK/T-cell lymphoma.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Combined Modality Therapy ; Drug Therapy ; methods ; statistics & numerical data ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Lymphoma, Extranodal NK-T-Cell ; therapy ; Male ; Middle Aged ; Nasal Cavity ; Nose Neoplasms ; therapy ; Prognosis ; Proportional Hazards Models ; Radiotherapy ; methods ; statistics & numerical data ; Treatment Outcome ; Young Adult

Primary central nervous system germ cell tumors (CNS-GCTs) in children and adolescents have unique clinical features and methods of treatment compared with those in adults. There is little information about Chinese children and adolescents with CNS-GCTs. Therefore, in this study we retrospectively analyzed the clinical features and treatment outcome of Chinese children and adolescents with primary CNS-GCTs. Between January 2002 and December 2012, 57 untreated patients from a single institution were enrolled. They were diagnosed with CNS-GCTs after pathologic or clinical assessment. Of the 57 patients, 41 were males and 16 were females, with a median age of 12.8 years (range, 2.7 to 18.0 years) at diagnosis; 43 (75.4%) had non-germinomatous germ cell tumors (NGGCTs) and 14 (24.6%) had germinomas; 44 (77.2%) had localized disease and 13 (22.8%) had extensive lesions. Fifty-three patients completed the prescribed treatment, of which 18 underwent monotherapy of surgery, radiotherapy, or chemotherapy, and 35 underwent multimodality therapies that included radiotherapy combined with chemotherapy or surgery combined with chemotherapy and/or radiotherapy. PEB (cisplatin, etoposide, and bleomycin) protocol was the major chemotherapy regimen. The median follow-up time was 32.3 months (range, 1.2 to 139 months). Fourteen patients died of relapse or disease progression. The 3-year event-free survival (EFS) and overall survival rates for all patients were 72.2% and 73.8%, respectively. The 3-year EFS was 92.9% for germinomas and 64.8% for NGGCTs (P = 0.064). The 3-year EFS rates for patients with NGGCTs who underwent monotherapy and multimodality therapies were 50.6% and 73.5%, respectively (P = 0.042). Our results indicate that multimodality therapies including chemotherapy plus radiotherapy were better treatment option for children and adolescents with CNS-GCTs.
Adolescent ; Antineoplastic Agents ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bleomycin ; administration & dosage ; Central Nervous System Neoplasms ; therapy ; Child ; Child, Preschool ; Cisplatin ; administration & dosage ; Combined Modality Therapy ; statistics & numerical data ; Disease-Free Survival ; Etoposide ; administration & dosage ; Female ; Humans ; Male ; Neoplasm Recurrence, Local ; Neoplasms, Germ Cell and Embryonal ; therapy ; Retrospective Studies ; Survival Rate ; Treatment Outcome