Objective To investigate the efficacy of trastuzumab combined with neratinib on human epidermal growth factor receptor(HER)-2 positive metastatic breast cancer and its impact in the immune function and quality of life of patients.Methods Eighty-two patients with HER-2 positive metastatic breast cancer admitted to our hospital(from June 2022 to December 2023)were included and used as research objects.Patients were separated into the neratinib group and the combination group stochastically,with 41 cases in each group.The neratinib group was treated with neratinib maleate,and the combined group was treated with trastuzumab for injection on the basis of neratinib group for 6 courses of treatment.The clinical efficacy,quality of life scores(FACT-B),immune function indicators(CD4+,CD8+,CD4+/CD8+),tumor marker indicators[carbohydrate antigen(CA)125,CA153,carcinoembryonic antigen(CEA)]and adverse reactions were observed before treatment and after 6 courses of treatment between two groups.Results The overall clinical symptom relief rate was greatly higher in the combination group than that of the neratinib group(P＜0.05).Before treatment,there were no significant differences in quality of life,immune function and tumor markers between the two groups(P＞0.05).After treatment,FACT-B score,CD4+,CD4+/CD8+levels were higher in the two groups than before treatment(P＜0.05),while CD8+,CA125,CA153 and CEA levels were lower than before treatment(P＜0.05),and changes of indexes were more significant in the combination group than those in the nilatinib group(P＜0.05).During treatment,the incidence of adverse reactions was lower in the combination group than that in the nilatinib group(P＜0.05).Conclusion Trastuzumab combined with neratinib is effective and safe in the treatment of HER-2 positive metastatic breast cancer.

Objective To investigate the efficacy of trastuzumab combined with neratinib on human epidermal growth factor receptor(HER)-2 positive metastatic breast cancer and its impact in the immune function and quality of life of patients.Methods Eighty-two patients with HER-2 positive metastatic breast cancer admitted to our hospital(from June 2022 to December 2023)were included and used as research objects.Patients were separated into the neratinib group and the combination group stochastically,with 41 cases in each group.The neratinib group was treated with neratinib maleate,and the combined group was treated with trastuzumab for injection on the basis of neratinib group for 6 courses of treatment.The clinical efficacy,quality of life scores(FACT-B),immune function indicators(CD4+,CD8+,CD4+/CD8+),tumor marker indicators[carbohydrate antigen(CA)125,CA153,carcinoembryonic antigen(CEA)]and adverse reactions were observed before treatment and after 6 courses of treatment between two groups.Results The overall clinical symptom relief rate was greatly higher in the combination group than that of the neratinib group(P＜0.05).Before treatment,there were no significant differences in quality of life,immune function and tumor markers between the two groups(P＞0.05).After treatment,FACT-B score,CD4+,CD4+/CD8+levels were higher in the two groups than before treatment(P＜0.05),while CD8+,CA125,CA153 and CEA levels were lower than before treatment(P＜0.05),and changes of indexes were more significant in the combination group than those in the nilatinib group(P＜0.05).During treatment,the incidence of adverse reactions was lower in the combination group than that in the nilatinib group(P＜0.05).Conclusion Trastuzumab combined with neratinib is effective and safe in the treatment of HER-2 positive metastatic breast cancer.

Objective:To study the radiation dose rate and effective dose in ambient environment due to 125I seed implantation in the treatment of the patients suffering abdominal and pelvic tumors, so as to provide reference for occupational protection of different groups. Methods:Within 24 hours after operation, the radiation dose rate to 42 patients with abdominal and pelvic tumor with 125I seed implantation was monitored by using pocket dosimeter. The relationships between the total activity in the implanted particles and the measured dose rate, as well as between the implanted depth and the dose rate under the standard activity, were obtained by curve fitting. According to the formula, the relationship between the dose rate and the warning time was calculated. Results:The dose rates at 30 cm, 50 cm and 100 cm of vertical particle implantation site were (6.92±2.87), (4.10±1.62) and (1.30±0.48) μSv/h, respectively ( χ2=73.71, P<0.05). The dose rates on the left and right sides were (0.378±0.156) and (0.384±0.153) μSv/h at 30 cm, (0.170±0.089) and (0.17±0.086) μSv/h at 50 cm, (0.039 ±0.014) and (0.043±0.017) μSv/h at 100 cm, respectively ( χ2=76.19, 76.33, P<0.05). There was a linear relationship between the dose rate at the vertical particle implantation site and the total activity in the implanted particles, and between the dose rate and the implantation depth under the standard activity. The relationship between the warning time and the dose rate to adults in the same bed, co-workers, minors in the same bed and pregnant women were as follows: t ( d)=-106.616+ 83.779ln D( t), t ( d)=26.556+ 85.933ln D ( t), t( d)=3.088+ 85.017ln D( t). Conclusions:After 125I seed implantation, the radiation dose in the ambient environment is low, ensuring the radiation safety; and the measured dose rate decreases with the decrease in the total activity in the implanted particle and the increase in the implantation depth; at the same time, the warning time for different groups is calculated according to the measured dose rate or the total activity in the implanted particle and the depth of the implanted particle, so as to carry out individualized protection.

Objective To investigate the safety and effectiveness of radioactive 125I seed implantation in treating recurrent cervical lymphatic metastases after radiotherapy. Methods During the period from Aug. 2011 to July 2012, 17 patients with recurrent cervical lymphatic metastases who had received radiotherapy before were admitted to authors’ hospital. The clinical data were retrospectively analyzed. A total of 23 metastatic lymph nodes were detected in the 17 patients. Brachytherapy treatment planning system (TPS) was used to formulate the number, activity and distribution of radioactive 125I seeds. The radioactive activity was 0.3 - 0.8 mCi (1.30 × 107- 2.96 × 107 Bq), and the matched peripheral dose (MPD) was 60 - 120 Gy. Guided by ultrasound and CT radioactive 125I seeds were implanted under local anesthesia. CT scanning was performed within 24 hours after the procedure. Postoperative D90 was (81.4 ± 2.1) Gy. CT examination was employed every two months to determine the tumor size and to record the complications. Results All patients were followed up for 6 months. The 6-month local control rate was 65.2%. The control rates (CR+PR) for<4 cm (n=10) and>4 cm (n=13) lymph nodes were 90%and 46%respectively, the difference between the two was statistically significant (P = 0.038). No significant difference existed between the control rate (CR + PR) and the un-control rate (SD + PD) for each lymph node group at cervical Ⅰ, Ⅱ, Ⅲ and Ⅴ grade Ⅱ was seen in 8 cases and grade Ⅰ in 7 cases. No severe complications occurred. Conclusion For the treatment of recurrent cervical lymphatic metastases after radiotherapy, radioactive 125I seed implantation is effective and mini-invasive with fewer complications. This technique is more suitable for < 4 cm solitary metastatic lymph node with clear border.

Objective To study the effective dose and precaution time of the irradiation of the close contact from the radiators who underwent implantation of radioactive 125Ⅰ seeds so as to guide scientifically people how to avoid radiation damage.Methods Twenty patients with different types of cancer underwent implantation of radioactive 125Ⅰ seeds with the median value of implantation depth of 2.16 cm.Within 24hs after the operations the dose rates 30 cm and 100 cm from the skin were measured with pocket-size radiometer so as to imitate the situations of the close contacts.The effective doses and precaution times of different persons were calculated according to relevant formula.Results The dose rate a person received at the same time points (1,54,78,and 109 d,respectively) decreased along with the increase of the distance from the skin (t =5.962,5.961,5.961,5.962,P ＜ 0.05).and the dose rate a person received at the same distance from the skin decreased along with the extension of time (30 cm:t =6.236,6.236,6.235,P＜0.05;100 cm:t=7.310,7.315,7.314,P＜0.05).At different time points,the dose rates at 30 cm distance point were all significant higher than those at the 100 cm point (P ＜0.05).The adult living together,minors and pregnant women sharing the room,colleagues,adults who slept together with the patients began to reach the 50％ dose constraint values 0,54,78 and 109 days after the operation.Conclusions After their precaution time,it's safe to contact with the patients for the groups;otherwise,it's necessary to take some protect works within the precaution time.