Objective:To evaluate the impact of postoperative radiotherapy (RT) and associated risk factors on the prognosis of patients undergoing postmastectomy breast reconstruction (PMBR) for breast cancer.Methods:A retrospective analysis was conducted on 1593 breast cancer patients who underwent PMBR at Tianjin Medical University Cancer Institute & Hospital between January 2010 and October 2023. Patients were divided into an RT group ( n = 351) and a non-RT group ( n =1242) based on whether postoperative radiotherapy was administered. The primary endpoints were overall survival (OS) and progression-free survival (PFS), and the secondary endpoint was the incidence of revision surgery. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were used for pairing. Continuous variables were compared between the two groups using the independent samples t-tests, while categorical variables were compared using chi-square tests, and survival analysis was performed using the Kaplan-Meier method. Cox proportional hazards model was used to analyze survival influencing factors, and include propensity factors with P<0.2 in univariate analysis into multivariate analysis. Results:In the RT group, there were 3 deaths (0.9%) and 21 cases of disease progression (6.0%); in the non-RT group, 7 patients died (0.56%) and 40 experienced disease progression (3.22%). The median OS was 20.1 months (range: 0.1-164.9), and the median PFS was 19.5 months (range: 0.1-160.9). Pregnancy-associated breast cancer and higher N stage were identified as significant risk factors for OS, while neoadjuvant therapy, absence of adjuvant chemotherapy or endocrine therapy, and higher T stage were significant risk factors affecting patients' PFS. Radiotherapy significantly reduced the survival risk for PMBR patients with pregnancy-associated breast cancer or those receiving neoadjuvant therapy ( P=0.019, 0.027). Compared with other reconstruction methods, implant-based reconstruction was associated with a lower incidence of postmastectomy revision surgery(10.5% vs. 17.0%, P<0.001). Even after radiotherapy, the revision surgery incidence for implant-based reconstruction remained lower than that of other methods (12.2% vs. 14.2%, P=0.591). Compared with other reconstruction types, expander-based reconstruction was associated with an increased incidence of revision surgery (31.9% vs. 10.9%, P<0.001). Conclusions:Postmastectomy radiotherapy can reduce survival risk in PMBR patients with pregnancy-associated breast cancer or who received neoadjuvant therapy, showing positive effects on OS and PFS in high-risk patients. Pregnancy, higher T/N stage, and specific treatment strategies are critical factors influencing the prognosis of PMBR patients. Implant-based reconstruction is associated with a lower incidence of revision surgery, which remains low even after RT, whereas expander-based reconstruction may increase the long-term risk of revision surgery.

Objective:To evaluate the impact of postoperative radiotherapy (RT) and associated risk factors on the prognosis of patients undergoing postmastectomy breast reconstruction (PMBR) for breast cancer.Methods:A retrospective analysis was conducted on 1593 breast cancer patients who underwent PMBR at Tianjin Medical University Cancer Institute & Hospital between January 2010 and October 2023. Patients were divided into an RT group ( n = 351) and a non-RT group ( n =1242) based on whether postoperative radiotherapy was administered. The primary endpoints were overall survival (OS) and progression-free survival (PFS), and the secondary endpoint was the incidence of revision surgery. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were used for pairing. Continuous variables were compared between the two groups using the independent samples t-tests, while categorical variables were compared using chi-square tests, and survival analysis was performed using the Kaplan-Meier method. Cox proportional hazards model was used to analyze survival influencing factors, and include propensity factors with P<0.2 in univariate analysis into multivariate analysis. Results:In the RT group, there were 3 deaths (0.9%) and 21 cases of disease progression (6.0%); in the non-RT group, 7 patients died (0.56%) and 40 experienced disease progression (3.22%). The median OS was 20.1 months (range: 0.1-164.9), and the median PFS was 19.5 months (range: 0.1-160.9). Pregnancy-associated breast cancer and higher N stage were identified as significant risk factors for OS, while neoadjuvant therapy, absence of adjuvant chemotherapy or endocrine therapy, and higher T stage were significant risk factors affecting patients' PFS. Radiotherapy significantly reduced the survival risk for PMBR patients with pregnancy-associated breast cancer or those receiving neoadjuvant therapy ( P=0.019, 0.027). Compared with other reconstruction methods, implant-based reconstruction was associated with a lower incidence of postmastectomy revision surgery(10.5% vs. 17.0%, P<0.001). Even after radiotherapy, the revision surgery incidence for implant-based reconstruction remained lower than that of other methods (12.2% vs. 14.2%, P=0.591). Compared with other reconstruction types, expander-based reconstruction was associated with an increased incidence of revision surgery (31.9% vs. 10.9%, P<0.001). Conclusions:Postmastectomy radiotherapy can reduce survival risk in PMBR patients with pregnancy-associated breast cancer or who received neoadjuvant therapy, showing positive effects on OS and PFS in high-risk patients. Pregnancy, higher T/N stage, and specific treatment strategies are critical factors influencing the prognosis of PMBR patients. Implant-based reconstruction is associated with a lower incidence of revision surgery, which remains low even after RT, whereas expander-based reconstruction may increase the long-term risk of revision surgery.

Objective:To assess the effectiveness of pelvic bone marrow (PBM)-sparing intensity-modulated radiation therapy (IMRT) in mit-igating acute hematologic toxicity (HT) in older patients with cervical cancer. Methods:A retrospective analysis of the data from 41 older pa-tients with cervical cancer who underwent postoperative concurrent chemoradiotherapy (CCRT) between January 2015 and December 2016 at Tianjin Medical University Cancer Institute & Hospital was conducted. The patients were grouped into PBM sparing and non-PBM sparing groups. The HT grades,white blood cells,absolute neutrophils,hemoglobin,and nadir platelet count were assessed. In addition,the volumes of PBM with various radiation doses (V10,V20,V30,and V40) were calculated. Regression models with multiple independent predictors were used to examine the association between dosimetric parameters and HT. Results:The PBM sparing group exhibited a significantly lower incidence of HT and RT breaks than the non-PBM-sparing group. Decreased V20 and V40 were significantly correlated with lower rates of grades ≥2 and ≥3 leukopenia,respectively. A partitioning analysis identified a cutoff value of 61％ for V20 of the whole pelvic bone to predict grade ≥2 leukopenia and 33.5％ for V40 to predict grade ≥3 leukopenia. Conclusions:PBM-sparing RT significantly reduced the in-cidence of acute HT and treatment breaks. Increased PBM V20 and V40 were associated with higher rates of grade ≥2 and grade ≥3 leuko-penia,respectively.

Objective:To assess the effectiveness of pelvic bone marrow (PBM)-sparing intensity-modulated radiation therapy (IMRT) in mit-igating acute hematologic toxicity (HT) in older patients with cervical cancer. Methods:A retrospective analysis of the data from 41 older pa-tients with cervical cancer who underwent postoperative concurrent chemoradiotherapy (CCRT) between January 2015 and December 2016 at Tianjin Medical University Cancer Institute & Hospital was conducted. The patients were grouped into PBM sparing and non-PBM sparing groups. The HT grades,white blood cells,absolute neutrophils,hemoglobin,and nadir platelet count were assessed. In addition,the volumes of PBM with various radiation doses (V10,V20,V30,and V40) were calculated. Regression models with multiple independent predictors were used to examine the association between dosimetric parameters and HT. Results:The PBM sparing group exhibited a significantly lower incidence of HT and RT breaks than the non-PBM-sparing group. Decreased V20 and V40 were significantly correlated with lower rates of grades ≥2 and ≥3 leukopenia,respectively. A partitioning analysis identified a cutoff value of 61％ for V20 of the whole pelvic bone to predict grade ≥2 leukopenia and 33.5％ for V40 to predict grade ≥3 leukopenia. Conclusions:PBM-sparing RT significantly reduced the in-cidence of acute HT and treatment breaks. Increased PBM V20 and V40 were associated with higher rates of grade ≥2 and grade ≥3 leuko-penia,respectively.

Major depressive disorder (MDD) is a common affective disorder.With its unique characteristics and advantages,traditional Chinese medicine (TCM) has played an important role in the treatment of MDD.Recent researches have revealed that the neuroinflammation-induced neurogenesis reduction were the key pathology of MDD.This analysis indicated that salvia was frequently used for treatment of MDD from the prescriptions reported in literatures.Salvianolic acid (SalB),one of main active compounds of salvia,had showed anti-inflammation and neuroprotection effects in previous studies.In this review,we summarized the antidepressant effects of SalB through regulating microglial activation,inhibiting neuroinflammation and promoting neurogenesis.According to the theory of removing blood stasis for promoting tissue regeneration,it was suggested that the novel antidepressant strategies for antiinflammatory and neuroprotective activities were through microglia-modulating pathway with TCM.

Primary breast lymphoma is a rare form of extranodal lymphoma with distinct characteristics.It comprises diverse histologic subtypes with diffuse large B-cell lymphoma (DLBCL) as the most common one.In this review,the primary breast DLBCL was focused and the definition,staging,the role of systemic chemotherapy,local adjuvant radiotherapy and rituximab in treatment of primary breast DLBCL were described.

Objective To evaluate clinical risk factors that can predict brain metastasis after complete resection of small cell lung cancer (SCLC) and to assess the role of prophylactic cranial irradiation (PCI) in such kind of patients.Methods Eighty-eight patients with completely resected stage Ⅰ - Ⅲ SCLC from Jan.2000 to Dec.2009 in our hospital were retrospectively analyzed.Kaplan-Meier was used to compare the differences in the incidence of metastasis free survival in different groups.Logistic model was used to assess the independent risk factors for brain metastasis.Results The follow-up rate is 100％,and 37 patients were followed up for more than three years.None of the 3 patients who received PCI developed brain metastasis,while for patients without receiving PCI,24％ developed brain metastases.The incidence of brain metastasis for stage Ⅰ,Ⅱ and Ⅲ SCLC after surgery were 4％,26％ and 29％ ( x2 =7.57,P =0.023),respectively.The median survival time and the 3-year survival rate were 18 months and 25％ for patients who developed brain metastasis,and 48 months and 59％ for those without brain metastasis ( x2 =10.63,P =0.001 ).Both univariate and multivariate analyses showed that pre-treatment disease stage wasindependent risk factor for brain metastasis ( x2 =7.57,8.52 ; P =0.023,0.004 ).Age,sex,tumor location,pathological type,induction chemotherapy,and postoperative chemotherapy/radiotherapy were not significantly correlated with the incidence of brain metastasis ( x2 =0.03,0.00,0.00,2.58,0.01,1.23,0.84;P =0.869,0.998,0.992,0.109,0.936,0.266,0.361,respectively).Conclusions Pre-treatment disease stage was independent risk factor for brain metastasis in SCLC.PCI may be important for stage Ⅱ -Ⅲ SCLC but not for stage Ⅰ disease.<英文关键词>=Carcinoma,small cell lung/surgery; Neoplasm metastasis,brain/prophylactic irradiation; Factors analysis

Objective To investigate the prognostic factors and the clinical outcome of locally recurrent rectal cancer after radical resection. Methods From April 2000 to April 2004, 105 patients with locally recurrent rectal cancer after radical resection were re-treated in Tianjin cancer hospital. Thirty-four patients were re-treated with surgery combined with adjuvant chemoradiotherapy (group 1), 35 with surgery alone (group 2), and 36 with chemoradiotherapy (group 3). The impact of 17 clinicopathological factors and treatment modalities on the survival was analyzed. Results The follow-up rate was 95. 2%. The median survival time was 23 months. The 1-, 3-and 5-year survival rates of patients with locally recurrent rectal cancer were 63% ,34% and 19%, respectively. The 1-, 3-and 5-year survival rates were 79%, 55% and 32% in group 1 ; 68%, 40% and 14% in group 2; and 64%, 36% and 11% in group 3; respectively (χ~2 =7. 96,P =0. 019). The univariate analysis showed that the degree of differentiation, depth of tumor invasion, number of metastatic lymph nodes, initial TNM stage, recurrent location, time to recurrence, and surgery combined with adjuvant therapy were significant prognostic factors, with the last 4 being the independent prognostic factors. Conclusions Surgery combined with chemoradiotherapy may improve the survival of patients with locally recurrent rectal cancer.