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Effect of CT-guided implantation of radioactive ~(125)I seeds on the residual foci of nasopharyngeal carcinoma after radiotherapy

Yueyun XIE ; Jingwu WU ; Hongzhi WANG ; Xiurong TIAN ; Zhongping BAO

Tumor.2009;(12):1170-1172. doi:10.3781/j.issn.1000-7431.2009.12.015

Objective:To evaluate the efficacy of computed tomography (CT)-guided implantation of radioactive ~(125)I seeds in the treatment of residual foci of nasopharyngeal carcinoma after radiotherapy.Methods:Twenty-five nasopharyngeal carcinoma patients who had residual foci after radiotherapy were implanted radioactive ~(125)I seeds from January 2007 to January 2008 in our hospital. Three-dimensional treatment planning system (TPS) was used to calculate the quantity and total dosage of ~(125)I seeds. The radioactive ~(125)I seeds were implanted into residual foci under CT guidance. The dosage distribution of radioactive ~(125)I seeds were verified after surgery. The nasopharyngeal endoscopy CT scans were performed at 3, 6, and 12 months after surgery and the short-term efficacy and adverse reaction were evaluated. Results:Out of the 25 patients, 20 patients had complete response (CR), 2 patients had partial response (PR), 2 patients had no change (NC), and 1 patient had progressive diseases (PD). The overall effective rate (CR+PR) was 88.0%. All patients had no serious postoperative complications. Conclusion:CT-guided implantation of radioactive ~(125)I seed was an effective and safe method in the treatment of the residual foci of nasopharyngeal carcinoma after radiotherapy.

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Clinical observation on every 3-week oxaliplatin plus 5-FU/CF regimen as postoperative adjuvant chemotherapy for colorectal cancer

Hao YU ; Teng WANG ; Dong HUA

Tumor.2009;(12):1167-1169. doi:10.3781/j.issn.1000-7431.2009.12.014

Objective:To investigate the clinical efficacy of every 3-week regimen of oxaliplatin (OXA) plus 5-fluorouracil (5-FU)/leucovorin(CF)as postoperative adjuvant chemotherapy for colorectal cancer.Methods:Ninety eight patients with stage Ⅱ to stage Ⅲ colorectal cancer received every 3-week OXA plus 5-FU/CF adjuvant chemotherapy for six cycles after resection surgery. All the patients received a complete reexamination every 3 months after the end of adjuvant chemotherapy. The disease-free survival period and 1- and 2-year disease-free survival rates were observed.Results:The total 2-year disease-free survival rate was 74.5%. It was 87.0% for stageⅡpatients and 63.5% for stage Ⅲ patients. The main adverse reaction included peripheral neurotoxicity, neutropenia and diarrhea at grades Ⅰ to Ⅱ. Grades Ⅲ to Ⅳ adverse reactions occurred rarely.Conclusion:The every 3-week OXA combined with 5-FU/CF adjuvant chemotherapy regimen had definite efficacy and good tolerance, which was a rational choice of postoperative adjuvant chemotherapy for colorectal cancer.

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Effect of glucocorticoids on the level of endogenous cortisol in patients with advanced gastrointestinal cancer

Naijian GE ; Yefa YANG ; Shuqun SHEN ; Jun LIANG ; Mengchao WU

Tumor.2009;(12):1163-1166. doi:10.3781/j.issn.1000-7431.2009.12.013

Objective:To observe the level of endogenous cortisol in patients with advanced gastrointestinal cancer, and to evaluate the effect of exogenous glucocorticoids treatment on patient's malignant symptoms and serum cortisol level. Methods:Thirty-one patients with advanced gastrointestinal cancer who were given 40 mg/d methylprednisolone for continuous 5 days. The patients included 8 patients with esophageal and cardial cancer, 12 patients with gastric cancer, and 11 patients with colorectal cancer. At the same time, 30 healthy adults were selected as control group. The cortisol radioactive immunoassay kit was used to determine the level of serum cortisol in the gastrointestinal cancer patients and controls. The life quality changes of gastrointestinal cancer patients were evaluated. Results:The serum cortisol level of 31 advanced gastrointestinal cancer patients was higher than that of healthy volunteers [(312.39±57.64)vs(144.64±52.20) μg/L,P<0.01]. The average serum cortisol levels in the patients with esophageal cancer, gastric cancer and colorectal cancer were higher than healthy controls (P<0.05). The serum cortisol level in gastric cancer patients was the highest among the three types of gastrointestinal cancers (P<0.01). After being treated with exogenous glucocorticoids, the five parameters such as appetite, spirit, sleeping, fatigue and pain in gastrointestinal cancer patients were improved significantly. During the course of exogenous glucocorticoid treatment, there were no serious complications. The serum cortisol levels after exogenous glucocorticoid treatment did not change significantly in the patients with esophageal cancer, gastric cancer and colorectal cancer (P>0.05). Conclusion:Endogenous serum cortisol levels of gastrointestinal cancer patients were significantly higher than those of healthy adults. Short-term treatment with medium dosage of exogenous glucocorticoids had little effect on the endogenous serum cortisol level.

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The understanding of cancer pain by medical doctors and its therapeutic status in Shanghai-a survey in 2007

Peng PENG ; Jiejun WANG ; Zhezhou HUANG ; Kai GU ; Chunfang WANG ; Yongmei XIANG ; Pingping BAO ; Yangming GONG ; Chunxiao WU ; Defeng XU ; Ying ZHENG

Tumor.2009;(12):1158-1162. doi:10.3781/j.issn.1000-7431.2009.12.012

Objective:To investigate the understanding of cancer pain by medical doctors and its therapeutic status in Shanghai. Methods:We recruited 1 982 medical physicians from 106 secondary and tertiary hospitals in Shanghai city from January to March in 2007. The understanding and the therapeutic status of cancer pain were investigated by conducting a questionnaire survey and the results were statistically analyzed.Rusults:There were 52.3% physicians who believed that they understand the treatment protocol of the Three-step Analgesic Ladder regimen. The rate increased by 21.6 percentage point compared with the results in 1999. The understanding degree of oncologists was significantly better than non-oncologists. There were 16.8% physicians giving the correct answers on the three main principles of the dosage titration in analgesic management. The correct rate of oncologists was significantly higher than that of non-oncologists. Opium with strong analgesic effect had become the first choice for severe cancer pain, and the use of pethidine (Dolantin) for severe cancer pain decreased significantly.The pain was significantly relieved in 74.8% patients. The pain-relieving rate increased by 25.4 percentage point compared with the results in 1999. There were 81.1% medical doctors confirming the effect of pain treatment and among them oncologists were more optimistic to therapeutic outcome than others. There were 93.3% physicians who agreed that it was necessary to carry out the standardized training of cancer pain treatment and the requirement of non-oncologists were much emergent. The over-strict controls by the hospitals and the regulations were the main obstacles for using analgesic drugs.Conclusion:The understanding of medical doctors and the diagnostic and therapeutic levels of cancer pain were improved significantly compared with those in 1999. But more training of cancer pain treatment are still required to publicize the standardized therapy and overcome the obstacles of using analgesic drug.

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Comparison of therapeutic efficacy between Ivor-Lewis esophagectomy and 2-incision esophagectomy via left thoracic-cervical pathway in the treatment of middle thoracic esophageal carcinoma

Xiaofeng ZHU ; Zhou WANG ; Qingfu CHEN ; Xiangyan LIU ; Yang YU ; Fanying LIU

Tumor.2009;(12):1153-1157. doi:10.3781/j.issn.1000-7431.2009.12.011

Objective:To retrospectively evaluate the therapeutic efficacy of two different surgical approaches, Ivor-Lewis esophagectomy and 2-incision esophagectomy via left thoracic-cervical pathway, in the treatment of middle thoracic esophageal squamous cell carcinoma. Methods:One hundred and two patients from 167 patients with middle thoracic esophageal squamous cell carcinoma received Ivor-Lewis esophagectomy and another 65 patients received 2-incision esophagectomy via left thoracic-cervical pathway. The local recurrence rate of tumor and survival rate were calculated by using Kaplan-Meier method. The difference in the survival rate between the two surgical methods was analyzed by using log-rank test. The prognostic risk factors were assessed by COX regression analysis. Results:Peri-operative complications occurred in 35 patients (21.0%), in which the incidences of recurrent laryngeal nerve (RLN) injury and anastomotic leakage were higher in the left thoracic-cervical group (P<0.05), and the incidence of intrathoracic gastric retention was higher in the Ivor-Lewis group, but the difference was not significant. The 3-year local recurrence rate was 37.3% in the Ivor-Lewis group, and 40.0% in the left thoracic-cervical group. The difference was not significant (P>0.05). The overall 5-year survival rate of the 167 patients was 34.6%. It was 36.0% in the Ivor-Lewis group and 32.3% in the left thoracic-cervical group, respectively (P>0.05). COX regression analysis revealed that pTNM staging was the independent prognostic factor [P=0.000, HR(hazard ratio)=2.69]. Conclusion:Both Ivor-Lewis esophagectomy and 2-incision esophagectomy via left thoracic-cervical pathway are feasible alternatives in the treatment of middle thoracic esophageal squmamous cell carcinoma. We should choose the rational operative method based on the patients'individual condition.

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Lung cancer in young patients aged from 15 to 44 years:incidence trend, current status and survival analysis from 2002 to 2005

Rui WANG ; Chunxiao WU ; Jie ZHANG ; Pingping BAO ; Haiquan CHEN

Tumor.2009;(12):1146-1152. doi:10.3781/j.issn.1000-7431.2009.12.010

Objective:To analyze the incidence trend, current status and survival period of young patients with lung cancer aged from 15 to 44 years in Shanghai between 2002 to 2005. Methods:All the data were collected from the database of registration and ma-nagement system of diagnosed cancer cases in Shanghai city organized by Shanghai Municipal Center for Disease Control & Prevention. The incidence trend was analyzed by using APC(annual percent change)model. The survival period and median survival time were calculated by using SPSS 12.0 software and life table method. The univariate and multivariate analyses were analyzed by using Kaplan-Meier and COX regression model, respectively.Results:A total of 972 young patients with lung cancer who aged from 15 to 44 years were diagnosed in Shanghai between 2002 and 2005, accounting for 3.09% of the whole percentage of adenocarcinoma in young patients was higher than that in whole lung cancer population at the same period, while the TNM stage was not significantly different between male and female young patients. Multivariate analysis demonstrated that gender, pathological classification and TNM stage were independent prognostic factors for young patients with lung cancer. Conclusion:The lung cancer had different characteristics in young patients compared with that in whole lung cancer population in Shanghai city. It was necessary to further investigate the biologic behavior of lung cancer in young patients.

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Multiple factor analysis on the prognosis of colorectal cancer patients with liver metastases

Nihong LU ; Wenling WANG ; Xiaoping WEN

Tumor.2009;(12):1140-1145. doi:10.3781/j.issn.1000-7431.2009.12.009

Objective:To investigate the clinicopathological factors affecting the prognosis of colorectal cancer patients with liver metastasis and how to select therapeutic method. Methods:The clinical records of 146 colorectal cancer patients with liver metastases who were admitted in Cancer Hospital of Guizhou Province from March 1997 to March 2007 were collected and made a retrospective analysis. The survival rate of the 146 patients was calculated by using life table method. Kaplan-Meier method and log-rank test were used for univariate analysis on clinicopathological features and therapeutic modalities. The multivariate analysis was performed by using COX regression model. The prognostic index (PI) of patients was calculated based on the result of multivariate analysis. The patients were classified into different risk groups according to PI value and the survival rate was compared between the different groups. Rusults:The overall 1-, 3-, and 5-year survival rates were 62.0%, 15.5%and 6.2%, respectively. Univariate analysis revealed that the following factors were related with the prognosis of colorectal cancer patients with liver metastasis. They included pathological classification, histological grade, serum CEA(carcinoembryonic antigen)level, primary tumor resection, local lymph node metastasis, number and size of liver metastases, distribution and initiation time of liver metastases, extrahepatic invasion, with or without surgery and che-motherapy for liver metastasis, and chemotherapeutic regimen selection. Multivariate analysis showed that the serum CEA level, extrahepatic metastasis, number and size of liver metastases, primary tumor resection, and chemotherapeutic regimen were independent prognostic factors for colorectal patients with liver metastasis.Conclusion:The therapeutic modality had an obvious effect on the prognosis of colorectal cancer with liver metastasis. Active treatment for primary tumor and metastatic lesions increased the survival rate of patients. Serum CEA levels, with or without extrahepatic metastases, and the number and size of liver metastases were prognostic factors. PI value could be used to predict the prognosis of colorectal cancer patients with liver metastasis.

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Regional differences of methylation of metallothionein-3 gene in tissues of esophageal cancer

Haijun WANG ; Liandi LIAO ; Ziqiang TIAN ; Liyan XU ; Zhongying SHEN

Tumor.2009;(12):1137-1139. doi:10.3781/j.issn.1000-7431.2009.12.008

Objective:To investigate the methylation of CpG island of metallothionein-3 (MT-3) gene in esophageal cancer tissues and normal tissues in middle and south area of Hebei Province and Chaoshan area of Guangdong Province and compared the results with those in low risk area of esophageal cancer. Methods:The blood samples from 10 normal volunteers, 10 embryonic esophageal tissues, 20 esophageal mucosa tissues from normal subjects in low risk area as well as 30 fresh surgical specimens of esophageal cancer and 30 normal marginal tissues in the high risk middle-south Hebei Province and Chaoshan area were collected. Methylation-specific polymerase chain reaction (MSP) was used to detect the methylation status of the CpG island of MT-3 gene in these samples. Its relationship with clinicopatho-logical features was analyzed. Results:There were 20 (33.3%) cases with MT-3 methylation in the marginal tissues of esophageal cancer from high-risk area, which was higher than that in the normal mucosa from low-risk area (P=0.013). And there were 49 (81.7%) cases with MT-3 methylation in esophageal cancer tissues, which was higher than that in normal marginal tissues (P<0.001). But there was no significant difference in the methylation degree between middle-south of Hebei Province and Chaoshan area (P=0.739). Conclusion:MT-3 methylation widely exists in esophageal mucosa and carcinoma tissues. Acquired stimulus may be the main cause of these methylations.

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Efficacy of stereotactic radiotherapy combined with chemotherapy for local recurrent non-small-cell lung cancer after radiotherapy

Zhao DONG ; Qi LI ; Qingliang QIN ; Yong GAO

Tumor.2009;(12):1133-1136. doi:10.3781/j.issn.1000-7431.2009.12.007

Objective:To study the efficacy of stereotactic radiotherapy (SRT) combined with gemcitabine plus cisplatin (GP)-based chemotherapy on local recurrent non-small-cell lung cancer (NSCLC) after radiotherapy. Methods:Thirty-eight patients with local recurrent NSCLC were treated with SRT(3.00-4.85 Gy per fraction, five times every week, totally 8-12 fractions, total course of 2-3 weeks). Before SRT the patients were given two cycles of GP-based chemotherapy (gemcitabine 1 000 mg/m~2 d 1 and d 8;cisplatin 30 mg/m~2 d 1-3) and at the end of SRT they were given 4 cycles of GP-based chemotherapy. Results:Of the 38 patients,7 patients had complete response, and 23 patients achieved partial response. The overall immediate response rate was 78.95% (30/38). The 6-month and 12-month total survival rates were 71.05% and 10.53%,respectively. The median survival time was 7.8 months. Conclusion:SRT combined with GP-based chemotherapy had better short-term efficacy and the patients were tolerable. No severe short-term radiation-induced injury was observed. The long-term radiation-induced injury and long-term efficacy need further investigation.

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Expression of mitofusin-2 in non-small-cell lung cancer and its clinical significance

Huanran DING ; Guangjian JIANG ; Xiaobing MA ; Lijuan MIAO ; Qingan XIA ; Gang ZHAO ; Liren MA

Tumor.2009;(12):1129-1132. doi:10.3781/j.issn.1000-7431.2009.12.006

Objective:To investigate the expressions of Mfn2(mitofusin 2) in non-small-cell lung cancer (NSCLC) tissues and non-cancerous lung tissues,and analyze its relationship with clinicopathological characteristics of lung carcinomas.Methods:The expressions of Mfn2 mRNA and protein in 92 cases of NSCLC tissues and 27 cases of non-cancerous lung tissues were detected by in situ hybridization and immunohistochemical methods. Results:The positive rates of Mfn2 mRNA and protein in pulmonary squamous cell carcinoma were higher than those in adenocarcinoma (83.33% and 89.58% vs 56.82% and 65.91%), respectively. The positive rates of Mfn2 mRNA and protein in NSCLC were higher than those in the non-cancerous lung tissues (25.93% and 29.63%) . The difference was statistically significant among the three groups (P<0.001 and P<0.01). The expressions of Mfn2 mRNA and protein in well-differentiated (93.75% and 100%) and moderately-differentiated NSCLC (91.67% and 91.67%) were higher than those in poor-diffe-rentiated NSCLC (21.43% and 42.86%). The difference was significant (P<0.001). The expressions of Mfn2 mRNA and protein had no correlation with the gender, age, tumor size, TNM stage and lymph node metastasis (P>0.05). The expression of Mfn2 mRNA was consistent with that of Mfn2 protein in NSCLC.Conclusion:Mfn2 was involved in the initiation and progression of lung cancer, and the expression of Mfn2 was related to the histological types of lung cancer and its differentiation degree.

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