Background::This study assessed the effect of standardized efficacy markers on prognosis in patients with newly diagnosed multiple myeloma (MM) during the induction phase of treatment with bortezomib, cyclophosphamide, and dexamethasone (BCD).Methods::We retrospectively analyzed clinical data in 197 newly diagnosed MM patients treated with BCD as front-line regimen at Peking Union Medical College Hospital from January 1, 2013 to December 31, 2018.Results::There were 107 patients with International Staging System (ISS) III and 51 with paraprotein of light chain. Of these, 77 completed nine cycles of the BCD regimen. As the number of treatment cycles increased, the proportions of serum and urine immunofixation electrophoresis (IFE) tests elevated from 40.39% to 62.22% and 16.75% to 37.78%, respectively. More than 90% of intact immunoglobulin chain MM patients were evaluated for blood M protein per cycle, but that of urinary M protein was less than 60%. The detection rate of urinary M protein in light chain MM was more than 70% per cycle. Patients with a very good partial response (VGPR) had longer progression-free survival (PFS) than those with uncertain VGPR (32 vs. 26 months, p = 0.0336). Of the 141 patients who completed at least four cycles without undergoing autologous hematopoietic stem cell transplantation, those who were regularly assessed at every other cycle showed more favorable PFS than those who visited irregularly (27 vs. 22 months, p = 0.059). Conclusion::Urinary M protein detection rate is significantly lower than that in serum, leading to an overestimation of efficacy, premature reduction of treatment intensity, and shortened PFS. Precise response assessments are critical to treatment decisions and clinical diagnoses.

Background::This study assessed the effect of standardized efficacy markers on prognosis in patients with newly diagnosed multiple myeloma (MM) during the induction phase of treatment with bortezomib, cyclophosphamide, and dexamethasone (BCD).Methods::We retrospectively analyzed clinical data in 197 newly diagnosed MM patients treated with BCD as front-line regimen at Peking Union Medical College Hospital from January 1, 2013 to December 31, 2018.Results::There were 107 patients with International Staging System (ISS) III and 51 with paraprotein of light chain. Of these, 77 completed nine cycles of the BCD regimen. As the number of treatment cycles increased, the proportions of serum and urine immunofixation electrophoresis (IFE) tests elevated from 40.39% to 62.22% and 16.75% to 37.78%, respectively. More than 90% of intact immunoglobulin chain MM patients were evaluated for blood M protein per cycle, but that of urinary M protein was less than 60%. The detection rate of urinary M protein in light chain MM was more than 70% per cycle. Patients with a very good partial response (VGPR) had longer progression-free survival (PFS) than those with uncertain VGPR (32 vs. 26 months, p = 0.0336). Of the 141 patients who completed at least four cycles without undergoing autologous hematopoietic stem cell transplantation, those who were regularly assessed at every other cycle showed more favorable PFS than those who visited irregularly (27 vs. 22 months, p = 0.059). Conclusion::Urinary M protein detection rate is significantly lower than that in serum, leading to an overestimation of efficacy, premature reduction of treatment intensity, and shortened PFS. Precise response assessments are critical to treatment decisions and clinical diagnoses.

Objective To analyze the endoscopic observation of gastroduodenal ulcer radioactive injury induced by pancreatic cancer radiotherapy, and to preliminary investigate the risk factors of radiation-induced ulcer after radiotherapy in patients with pancreatic cancer. Methods A total of 112 patients with pancreatic cancer who accepted gastroscopy before and after radiotherapy at Air Force General Hospital were collected. Self-comparative study of gastroscopic findings was performed on these patients. Single factor analysis and the logistic regression analysis model were used to analyze whether the clinical factors were likely to affect the radiation-induced ulcer or not. Results The total incidence of radiation-induced ulcer was 42.0 % (47/112) in 112 patients. The history of ulcer and grade 2 or more acute gastrointestinal symptoms (P= 0.036, P= 0.030) were the independent risk factors of radiation-induced ulcer. The rest clinical factors had no influence on the radiation-induced ulcer (all P>0.05). Conclusion In the radiotherapy of pancreatic cancer, patients who has the history of ulcer or grade 2 or more acute gastrointestinal symptoms should be alert to the occurrence of radiation-induced ulcer.

Objective To describe the endoscopic observation of pancreatic cancer radiotherapy induced gastro-duodenal radioactive injury, and investigate the influence of radiation-induced ulceration by concurrent chemoradio-therapy with S-1 (Tegafur Gimeracil Oteracil Potassium Capsule) and gemcitabine. Methods Self-comparative study of endoscopic performance were performed on patients received endoscopy before and after pancreatic cancer Chemoradiotherapy with S-1 or gemcitabine or radiotherapy only, from February 2010 to May 2015. Pearson chi-square test was used to analyze whether Concurrent Chemoradiotherapy groups and radiotherapy group are different in radiation-induced ulceration occurrence rate. Results The incidence of radiation-induced ulceration of radiother-apy group, S-1 group and gemcitabine group are 44.1 % (26/59), 50.0 % (10/20) and 46.7 % (7/15), respectively. Radiation-induced ulceration incidence was no statistical difference among the three groups. Conclusion From the angle of safety, patients can according to their self-condition for choosing S-1 or gemcitabine chemotherapy. Wether the concurrent chemoradiotherapy treatment was adopted or not, the occurrence rate of radiation-induced ulceration has no significant difference.