1.Efficacy and safety of cisplatin combined with paclitaxel concurrent radiotherapy in patients with locally advanced cervical squamous cell carcinoma
Tao FENG ; Yuxin ZHANG ; Guanghao ZHENG ; Xiaojuan LV ; Dingding YAN ; Yue FENG ; Hanmei LOU
Journal of Gynecologic Oncology 2025;36(1):e10-
Objective:
This study aimed to compare outcomes and adverse events of patients with locally advanced cervical cancer (LACC) undergoing concurrent chemoradiotherapy (CCRT) with cisplatin single-agent chemotherapy vs. CCRT with cisplatin combined with paclitaxel dualagent therapy. The primary outcomes are overall survival (OS), progression-free survival (PFS), local recurrence (LR), distant metastasis (DM) and the occurrence of adverse events.
Methods:
This retrospective cohort study included patients with FIGO 2009 stage IB1-IVA cervical squamous cell carcinoma undergoing radical CCRT. Patients were divided into groups A and B, treatment outcomes were compared between the two groups after 1:1 proportional propensity score matching.
Results:
Medical records of 1,203 patients were reviewed and 572 patients were finally included for propensity score matching. After propensity score matching, 121 pairs of patients were selected for analysis. The OS, PFS, LR and DM rates were 78.5% and 83.5% (p=0.417), 73.3% and 78.5% (p=0.312), 6.6% and 2.5% (p=0.123), 19% and 15.7% (p=0.497) for groups A and B, respectively. Further subgroup analysis according to stage and lymph node metastatic status showed no difference in survival between the two groups. The incidence of grade 3–4 acute haematological toxicities was different between the two groups (p<0.05).
Conclusion
Cisplatin combined with paclitaxel CCRT couldn’t improve the survival rates of patients with LACC. However, the hematological toxicity of combination chemotherapy is more severe but controllable. Cisplatin single-agent therapy remains the first choice for CCRT. Further prospective studies are indicated to provide evidence for the efficacy of cisplatin plus paclitaxel in dual-agent concurrent therapy.
2.Efficacy and safety of cisplatin combined with paclitaxel concurrent radiotherapy in patients with locally advanced cervical squamous cell carcinoma
Tao FENG ; Yuxin ZHANG ; Guanghao ZHENG ; Xiaojuan LV ; Dingding YAN ; Yue FENG ; Hanmei LOU
Journal of Gynecologic Oncology 2025;36(1):e10-
Objective:
This study aimed to compare outcomes and adverse events of patients with locally advanced cervical cancer (LACC) undergoing concurrent chemoradiotherapy (CCRT) with cisplatin single-agent chemotherapy vs. CCRT with cisplatin combined with paclitaxel dualagent therapy. The primary outcomes are overall survival (OS), progression-free survival (PFS), local recurrence (LR), distant metastasis (DM) and the occurrence of adverse events.
Methods:
This retrospective cohort study included patients with FIGO 2009 stage IB1-IVA cervical squamous cell carcinoma undergoing radical CCRT. Patients were divided into groups A and B, treatment outcomes were compared between the two groups after 1:1 proportional propensity score matching.
Results:
Medical records of 1,203 patients were reviewed and 572 patients were finally included for propensity score matching. After propensity score matching, 121 pairs of patients were selected for analysis. The OS, PFS, LR and DM rates were 78.5% and 83.5% (p=0.417), 73.3% and 78.5% (p=0.312), 6.6% and 2.5% (p=0.123), 19% and 15.7% (p=0.497) for groups A and B, respectively. Further subgroup analysis according to stage and lymph node metastatic status showed no difference in survival between the two groups. The incidence of grade 3–4 acute haematological toxicities was different between the two groups (p<0.05).
Conclusion
Cisplatin combined with paclitaxel CCRT couldn’t improve the survival rates of patients with LACC. However, the hematological toxicity of combination chemotherapy is more severe but controllable. Cisplatin single-agent therapy remains the first choice for CCRT. Further prospective studies are indicated to provide evidence for the efficacy of cisplatin plus paclitaxel in dual-agent concurrent therapy.
3.Efficacy and safety of cisplatin combined with paclitaxel concurrent radiotherapy in patients with locally advanced cervical squamous cell carcinoma
Tao FENG ; Yuxin ZHANG ; Guanghao ZHENG ; Xiaojuan LV ; Dingding YAN ; Yue FENG ; Hanmei LOU
Journal of Gynecologic Oncology 2025;36(1):e10-
Objective:
This study aimed to compare outcomes and adverse events of patients with locally advanced cervical cancer (LACC) undergoing concurrent chemoradiotherapy (CCRT) with cisplatin single-agent chemotherapy vs. CCRT with cisplatin combined with paclitaxel dualagent therapy. The primary outcomes are overall survival (OS), progression-free survival (PFS), local recurrence (LR), distant metastasis (DM) and the occurrence of adverse events.
Methods:
This retrospective cohort study included patients with FIGO 2009 stage IB1-IVA cervical squamous cell carcinoma undergoing radical CCRT. Patients were divided into groups A and B, treatment outcomes were compared between the two groups after 1:1 proportional propensity score matching.
Results:
Medical records of 1,203 patients were reviewed and 572 patients were finally included for propensity score matching. After propensity score matching, 121 pairs of patients were selected for analysis. The OS, PFS, LR and DM rates were 78.5% and 83.5% (p=0.417), 73.3% and 78.5% (p=0.312), 6.6% and 2.5% (p=0.123), 19% and 15.7% (p=0.497) for groups A and B, respectively. Further subgroup analysis according to stage and lymph node metastatic status showed no difference in survival between the two groups. The incidence of grade 3–4 acute haematological toxicities was different between the two groups (p<0.05).
Conclusion
Cisplatin combined with paclitaxel CCRT couldn’t improve the survival rates of patients with LACC. However, the hematological toxicity of combination chemotherapy is more severe but controllable. Cisplatin single-agent therapy remains the first choice for CCRT. Further prospective studies are indicated to provide evidence for the efficacy of cisplatin plus paclitaxel in dual-agent concurrent therapy.
4.Investigation of frontomaxillary facial angle in fetuses at 11+0 to 13+6 weeks with two- and three-dimensional ultrasound
Yunshu OUYANG ; Yixiu ZHANG ; Hua MENG ; Yuxin JIANG ; Qing DAI ; Zhonghui XU ; Meng YANG ; Yan YUAN ; Haiya LOU ; Peng LI ; Xiao YANG
Chinese Journal of Medical Imaging Technology 2009;25(10):1837-1840
Objective To investigate the role of two-dimensional ultrasound (2DUS) and three-dimensional ultrasonography (3DUS) in the measurement of fetal frontomaxillay facial (FMF) angle. Methods FMF angle in fetuses at 11~(+0) to 13~(+6) weeks were measured with 2DUS and 3DUS respectively. The difference between measurements and reproducibility were compared, and the relationship between FMF angle measured with 3DUS and crown-rump length (CRL) was assessed.Results FMF angle was obtained in 37 fetuses. Assessable fetuses increased with increased CRL, while the values of FMF angle decreased. Qualified 3D volumes were obtained from 30/37 (81.08%) fetuses, while qualified 2D measurements were available in 18/37 (48.65%) fetuses. For the same fetus, the difference between two measurements with 3DUS was significantly less than that with 2DUS (1.68°±1.01° vs 2.78°±1.95°, P<0.01). For the 11 fetuses assessed with both methods, the values of FMF angle obtained with two methods were not significant different. There was significant negative correlation between FMF angle and fetal CRL (r=-0.540,P<0.01).Conclusion FMF angle in fetuses at 11~(+0) to 13~(+6) weeks can be achieved rapidly and accurately with 3DUS.
5.Fetal discrepancy during first trimester in dichorionic twins
Yixiu ZHANG ; Hua MENG ; Yunshu OUYANG ; Yuxin JIANG ; Qing DAI ; Zhonghui XU ; Meng YANG ; Yan YUAN ; Jia LU ; Haiya LOU ; Peng LI ; Xiao YANG
Chinese Journal of Ultrasonography 2012;21(3):228-230
Objective To investigate the incidence and distribution of fetal discrepancy during the first trimester in dichorionic twins.Methods This was a prospective analysis of dichorionic twin pregnancies that underwent 11+0~ 13+6 week scan at a tertiary hospital from Sep 2008 to Oct 2010.Differences in crown-rump length (CRL),nuchal translucency ( NT),heart rate ( HR).deepest vertical pockets of amniotic fluid (DVP) for every pair of twin fetuses were calculated and expressed as absolute value and percentage of discordance.Results A total of 66 dichorionic twin pregnancies were included.The average CRL was significantly different between the larger fetus and the smaller one,which were (65.28 ±8.54)mm and (62.34 ± 8.49) mm respectively ( P < 0.001).The average NT was significantly different between two fetuses,which were ( 1.56 ± 0.35) mm and (1.28 ± 0.30) mm respectively. HR and DVP were also statistically different between two fetuses ( P <0.001).Conclusions The growth of two fetuses in normal dichorionic twins is not uniform during the first trimester.
6.Measurement and assessment of fetal tricuspid waveform in first-trimester
Yan YUAN ; Hua MENG ; Yuxin JIANG ; Qing DAI ; Zhonghui XU ; Meng YANG ; Yunshu OUYANG ; Yixiu ZHANG ; Jia LU ; Peng LI ; Haiya LOU
Chinese Journal of Ultrasonography 2011;20(7):602-604
Objective To investigate the clinical value and method of fetal tricuspid regurgitation in the first trimester.Methods Fetuses were performed ultrasonography at 11 to 14 gestational weeks,measuring crown rump length,nuchal translucency and acquiring tricuspid waveform.All the fetuses were followed up until 6 months after birth,including prenatal ultrasound examination,maternal serum biochemistry and karyotype test.Results A total of 262 fetuses were performed ultrasonography in the first trimester,the tricuspid waveform were acquired successfully in 249 (95%).Nine cases with tricuspid regurgitation were detected,including 3 cases of trisomy 21,3 cases with complex heart defects,one case with omphalocele,two resulted in intrauterine death and one case of normal chromosome and phenotype.Conclusions Tricuspid waveform is relatively easier to examine and assessment.Tricuspid regurgitation is a useful first-trimester ultrasound marker for the detection of chromosomal abnormalities,cardiac defects,and adverse pregnancy outcome.
7.Value of prenatal ultrasonography in diagnosis of fetal biliary cystic malformation
Yixiu ZHANG ; Hua MENG ; Yunshu OUYANG ; Yuxin JIANG ; Qing DAI ; Zhonghui XU ; Meng YANG ; Yan YUAN ; Peng LI ; Haiya LOU ; Xiao YANG
Chinese Journal of Ultrasonography 2010;19(5):427-430
Objective To investigate the diagnositic value of ultrasonography in fetuses with cystic biliary malformation. Methods Three cases of cystic biliary malformation diagnosed in our hospital by prenatal ultrasound were followed up until surgery after birth. Results In all three cases.an anechoic cystic lesion was detected in the right upper abdomen at 16,26,34 weeks' gestation respectively, which were diagnosed as biliary cystic malformation by prenatal ultrasound. Two cases were confirmed as choledochal cyst by surgery, one case as biliary atresia. The maximum diameter during pregnancy of choledochal cyst were 3. 9 cm and 4.2 cm respectively, which increased steadily as gestational age advanced, with normal gallbladder in continuity with the choledochal cyst. But the largest diameter of the cyst in congenital biliary atresia was 1.7 cm and remained unchanged throughout the remaining pregnancy, the gallbladder could not be detected or an irregular small gallbladder was shown. Excision of the cyst and Roux-en-Y hepaticojejunostomy were successfully performed in all three cases. Postoperative course were uneventful. Conclusions Cyst diameter, change in size, gallbladder ultrasound pattern may allow to make a prenatal differential diagnosis of biliary tree cystic malformation. Small and stable cyst with an undetected gallbladder or small gallbladder is more suggestive of biliary atresia than choledochal cyst. Precise imaging may facilitate prenatal counseling and perinatal management. The outcomes had improved with earlier operations.
8.Prenatal ultrasound diagnosis of fetal hand malformations
Jia LU ; Hua MENG ; Yuxin JIANG ; Qing DAI ; Meng YANG ; Yixiu ZHANG ; Xinyan LIU ; Dingrong ZHONG ; Zhonghui XU ; Yunshu OUYANG ; Yan YUAN ; Haiya LOU ; Peng LI ; Xiao YANG
Chinese Journal of Ultrasonography 2009;18(11):966-969
Objective To determine the diagnostic value of two and three dimensional ultrasound in detecting fetal hand malformations. Methods In the retrospectively analysis,the severe fetal hand malformations detected by prenatal ultrasound during the recent three years in our hospital were classified according to the prenatal sonographic characteristics,family history,karyotype analysis and autopsy results,etc.Results Fourteen fetuses with hand-anomaly were detected during the 16-28th week of gestation,both hands were affected in 10 cases,with the same morphology bilaterally in 8 cases.Thirteen cases had other abnormal sonographic findings.They were detected and classified into three categories,Wrist deformity (9 cases),three fetuses were associated with total absence of radius and radial clubhand,and six fetuses had palmar deviated hands,with various etiologies including familial hereditary arthrogryposis multiplex congenita,distal type 1 (AMCD1),amniotic band syndrome,body stalk anomaly,trisomy18 and micromelia.Hand (figer) hypoplasia or aphasia (3 cases),one hand was absent in one fetus without associated anomaly,absence of five fingers with ipsilateral multicystic dysplastic kidney in the second fetus,and the third fetus had split hand/foot malformation (SHFM).Overlapping fingers (4 cases),three of them were trisomy18,and two fetuses had both wrist deformity and overlapping fingers.Conclusions Prenatal two and three dimensional ultrasound play an important role in detecting and diagnosing severe type of fetal hand malformations.
9.Prenatal sonographic diagnosis of hemivertebra
Yunshu OUYANG ; Yixiu ZHANG ; Hua MENG ; Yuxin JIANG ; Qing DAI ; Meng YANG ; Yan YUAN ; Zhonghui XU ; Jia LU ; Haiya LOU ; Peng LI ; Xiao YANG ; Dingrong ZHONG ; Xinyan LIU
Chinese Journal of Ultrasonography 2011;20(1):58-61
Objective To investigate the diagnostic value of prenatal ultrasonography in the fetal hemivertebra. Methods The ultrasonographic findings of three fetuses with hemivertebra diagnosed in our hospital were reviewed and compared with those of postnatal ultrasonography,other image modalities,and autopsy. Results In all fetuses,a distortion of the spine was observed where only one half of the vertebra could be identified. The parents opted for termination of the pregnancy in one case and the deformity was confirmed by autopsy. The other two fetuses were delivered and in one fetus the diagnosis was confirmed by radiological assessment. Conclusions Hemivertebra can be diagnosed accurately by second-trimester ultrasonography. The prognosis is mostly favorable when no other anomalies are associated. Meticulous examination may disclose the lesion and help decide the fate of pregnancy.
10.Role and potential mechanisms of tumor necrosis factor alpha-inducible protein 8-like molecule 1 in acute liver injury in mice
Yongsheng CHANG ; Xueqin TIAN ; Yuxin ZHAO ; Miaomiao SONG ; Han WANG ; Yunwei LOU ; Tingmin CHANG
Journal of Xinxiang Medical College 2024;41(8):712-717
Objective To investigate the role and potential mechanisms of tumor necrosis factor alpha-inducible protein 8-like molecule 1(TNFAIP8L1)in acute liver injury in mice.Methods The second generation of C57BL/6J male wild-type(WT)mice and the C57BL/6J female TNFAIP8L1+/-mice and WT mice were selected to further self-breed the third generation of male TNFAIP8L1-/-mice and the third generation of WT male mice.Five normal third-generation male WT mice and five normal third-generation male TNFAIP8L1-/-mice were selected.The serum alanine aminotransferase(ALT)levels of the two types of normal mice were measured and compared.The infiltration of inflammatory cells and cell necrosis in the liver tissues of the two types of normal mice were observed after hematoxylin & eosin(HE)staining.Flow cytometry was used to detect the percentages of neutrophils(Neu),eosinophils(EOS),dendritic cells(DC),bone marrow-derived macrophages(BMDMs),and bone marrow-derived mononuclear cell(BMNCs)in the liver myeloid cell subsets of the two types of normal mice.Another 5 third-generation male WT mice and 4 third-generation male TNFAIP8L1-/-mice were selected to induce acute liver injury mouse models using lipopolysaccharide(LPS)/D-galactosamine(D-Gal).After 24 hours,the serum ALT levels of the two types of acute liver injury mice were detected and compared,the infiltration of inflammatory cells and cell necrosis in the liver tissues of the two types of acute liver injury mice were observed,and the percentages of Neu,EOS,DC,BMDMs and BMNCs in the liver myeloid cell subsets of the two types of acute liver injury mice were measured by using the above methods.Results There was no significant difference in the percentages of Neu,EOS,DC,BMDMs and BMNCs,and serum ALT levels in the livermyeloid cell subsets of normal WT mice and TNFAIP8L1-/-mice(P>0.05).HE staining results of liver tissues in normal WT mice and TNFAIP8L1/mice showed that hepatic lobules were structurally complete and clear,hepatocytes were morphologically normal and arranged neatly,and there was no obvious inflammatory cell infiltration or cell necrosis.Twenty-four hours after acute liver injury,the percentages of Neu and BMNCs in the liver myeloid cell subsets and the serum ALT levels in the liver tissues of TNFAIP8L1-/-mice were significantly higher than those of WT mice(P<0.05);there was no significant difference in the percentages of EOS,DC and BMDMs in the liver myeloid cell subsets of mice between the two groups(P>0.05).In the liver tissues of WT mice with acute liver injury,hepatic lobules were structurally blurred,hepatocytes were swollen with scattered vacuolated steatosis,and a small amount of inflammatory cells were infiltrated.In the liver tissues of TNFAIP8L1/mice with acute liver injury,hepatic lobules were structurally non-existent,and hepatocytes were severely damaged and extensively necrotic,with a large amount of inflammatory cell infiltration.Conclusion The deficiency of the TNFAIP8L1 gene in mice does not affect the development of liver myeloid cells and the homeostasis of the liver.TNFAIP8L1 plays an inhibitory role in the occurrence and development of acute liver injury.TNFAIP8L1 gene deficiency aggravates LPS/D-Gal-induced acute liver injury,possibly by increasing Neu and BMNCs infiltration and recruiting other types of immune cells to infiltrate liver tissues,thereby exacerbating liver cell necrosis.