Objective:To compare the efficacy and safety of adjuvant radiotherapy versus surgery alone in patients with stage pT 2-3N 0M 0 esophageal squamous cell carcinoma after radical resection. Methods:The search was conducted through Web of Science, Emabse, PubMed, Cochrane Library, CNKI, Chongqing VIP, China Biomedical Literature Database, and Wanfang database, etc. The search time was ranged from the establishment of the database to December 2022. Searched studies were screened according to the inclusion and exclusion criteria. Review Manager 5.4 software was used for analysis.Results:Clinical data of 2 424 patients from 8 controlled clinical studies were finally included. Meta-analysis showed that postoperative adjuvant radiotherapy had higher 3-year and 5-year disease-free survival rates ( OR=2.33, 95%CI=1.71-3.17, P<0.001; OR=2.38, 95% CI=1.73-3.27, P<0.001) and 3-year and 5-year overall survival rates ( OR=1.89, 95% CI=1.37-2.60, P<0.01; OR=1.94,95% CI=1.50-2.49, P<0.001) than surgery alone. Meanwhile, the local recurrence rate ( OR=0.33, 95% CI=0.21-0.50, P<0.001) and distant metastasis rate ( OR=0.62, 95% CI=0.39-0.98, P=0.040) of postoperative adjuvant radiotherapy group were lower than those in the surgery alone group. The incidence of radiation esophagitis (1.4%-9.5%), radiation pneumonitis (2.1%) and anastomotic stenosis (5.3%) was reported. Conclusions:For patients with stage pT 2-3N 0M 0 squamous cell carcinoma after radical resection of esophageal cancer, adjuvant radiotherapy may improve 3-year and 5-year disease-free survival rates and 3-year and 5-year overall survival rates compared with surgery alone. In addition, adjuvant radiotherapy may reduce the local recurrence and distant metastasis rates. Therefore, postoperative adjuvant radiotherapy is an optional treatment for stage pT 2-3N 0M 0 esophageal squamous cell carcinoma.

Objective:To systematically evaluate the efficacy and safety between neoadjuvant chemoradiotherapy followed by surgery and immediate surgery in the treatment of resectable and borderline resectable pancreatic cancer.Methods:Literature review was performed from PubMed, Embase, Cochrane Library, Web of Science, CBM, Wanfang, CNKI and VIP from the inception date to February, 2020 using the key words including "pancreatic neoplasm, pancreatic cancer, surgery, preoperative chemoradiotherapy, neoadjuvant chemoradiotherapy" in both English and Chinese. The randomized controlled clinical trials (RCTs) of neoadjuvant chemoradiotherapy followed by surgery versus immediate surgery in the treatment of resectable and borderline resectable pancreatic cancer were searches. Literature screening, data extraction and estimation of the risk of bias were independently conducted by two researchers. The HR and 95% CI were used for estimating the overall survival time. The R 0 resection rate, overall incidence of postoperative complications, and mortality rate throughout treatment were assessed by the RR and 95% CI. The heterogeneity of the studies was analyzed using the I2 test. Results:A total of 4 RCTs were included. Among 400 patients, 197 cases were assigned into the neoadjuvant chemoradiotherapy combined with surgery group and 203 in the immediate surgery group. The results of Meta-analysis showed that patients in the neoadjuvant chemoradiotherapy followed by surgery group obtained longer overall survival ( HR=0.76, 95% CI: 0.60-0.97, P=0.03) and higher R 0 resection rate ( RR=1.72, 95% CI: 1.40-2.13, P<0.01). Besides, the overall incidence of postoperative complications ( RR=1.02, 95% CI: 0.73-1.43, P=0.90) and mortality rate throughout treatment ( RR=1.19, 95% CI: 0.48-2.93, P=0.71) did not significantly differ between two groups. Conclusions:During the treatment of resectable or borderline resectable pancreatic cancer, neoadjuvant chemoradiotherapy followed by surgery may bring more survival benefits than immediate surgery and does not increase the incidence of postoperative complications and mortality rate throughout treatment. Therefore, neoadjuvant chemoradiotherapy followed by surgery can be used as a recommended treatment for patients with resectable or borderline resectable pancreatic cancer.

Objective:To systematic review the clinical efficacy and safety of neoadjuvant chemotherapy and neoadjuvant concurrent chemoradiotherapy for resectable esophageal squamous cell carcinoma.Methods:Literature search was performed from Web of Science, Pubmed, Cochrane Library, Embase, CBM, Wanfang Data, CNKI and Chongqing VIP. The clinical controlled studies of neoadjuvant chemotherapy versus neoadjuvant concurrent chemoradiation in the treatment of resectable esophageal squamous cell carcinoma was searched. Relevant outcome indicators were analyzed by Revman 5.3 statistical software.Results:Nine studies were included, with a total of 1, 369 patients. Compared with the neoadjuvant chemoradiotherapy, the neoadjuvant chemotherapy had lower overall survival rates at 3 and 5 years( OR=0.68, 95% CI: 0.53-0.86, P<0.05; OR=0.51, 95% CI: 0.34-0.77, P<0.05) , lower pathological complete remission rate( OR=0.28, 95% CI: 0.18-0.45, P<0.05)and R0 resection rate( OR=0.39, 95% CI: 0.22-0.68, P<0.05), The total postoperative complication rate is similar( OR=1.07, 95% CI: 0.75-1.51, P>0.05). Conclusion:Neoadjuvant concurrent radiochemotherapy maybe superior to neoadjuvant chemotherapy among patients with resectable esophageal squamous cell carcinoma.

Objective: To systematically evaluate the efficacy and safety between neoadjuvant concurrent chemoradiotherapy followed by surgery and surgery alone in the treatment of resectable esophageal squamous cell carcinoma. Methods: Literature review was performed from Embase, PubMed, Web of Science, Cochrane Library, CBM, Wanfang Data, CNKI and Chongqing VIP. The randomized controlled clinical trials of concurrent chemoradiotherapy followed by surgery versus surgery alone in the treatment of resectable esophageal squamous cell carcinoma were retrieved. The meta-analysis of survival data, R₀ resection rate, incidences of postoperative complications and peritreatment mortality was conducted by using RevMan 5.3 software. Results: A total of 1450 patients from 11 controlled clinical trials were included in this meta-analysis. The results of the meta-analysis showed that concurrent chemoradiotherapy followed by surgery group had significantly higher 2-and 5-year overall survival rate (RR=1.14, 95%CI: 1.05-1.23, P=0.00) and progression-free survival rate (RR=1.56, 95%CI: 1.05-2.32, P=0.03). R₀ resection rate were also improved in concurrent chemoradiotherapy followed by surgery group (RR=1.10, 95%CI: 1.05-1.14, P=0.00). Compared with the surgery alone group, the incidence of arrhythmia in the concurrent chemoradiotherapy plus surgery group was significantly higher (RR=2.45, 95%CI: 1.37-4.38, P=0.00). However, there was no significant difference in the overall incidence of postoperative complications (RR=1.12, 95%CI: 0.79-1.59, P=0.51) and incidence of peritreatment mortality (RR=1.78, 95%CI: 0.90-3.52, P=0.10) between two groups. Conclusions Neoadjuvant concurrent chemoradiotherapy followed by surgery improves the survival and R₀ resection rate over surgery alone among patients with resectable esophageal squamous cell carcinoma, whereas it does not increase the risk of postoperative complications. Consequently, neoadjuvant concurrent chemoradiotherapy followed by surgery is an optimal treatment for patients with resectable esophageal squamous cell carcinoma.

Objective To systematically evaluate the efficacy and safety between neoadjuvant therapy followed by radical surgery and definite chemoradiotherapy in the treatment of Ⅰ B2-Ⅱ B cervical cancer.Methods A computerized search was performed in PubMed,Embase,Cochrane Library,Web of Science,CBM,Wanfang Data,CNKI and VIP to collect controlled clinical trials related to neoadjuvant therapy followed by radical surgery versus definite chemoradiotherapy in the treatment of ⅠB2-ⅡB cervical cancer.The meta-analysis of survival data and adverse events was performed by Review Manager 5.3 software.Results Nine controlled clinical trials involving 3 914 patients were included in this meta-analysis.There were no significant differences in overall survival (HR =0.83,P =0.31) and progression-free survival (HR=O.85,P=0.57) between two groups.Compared with patients receiving definite chemoradiotherapy,those in the neoadjuvant therapy group had a significantly lower risk of irradiation enteritis (RR=0.27,P=0.03),whereas no significant difference was observed in the risk of irradiation cystitis (RR=0.30,P=0.34) and grade ≥ 3 neutropenia (RR=0.77,P=0.46) between two groups.Conclusion In the treatment of locally advanced ⅠB2-Ⅱ B cervical cancer,two modalities show similar survival benefits.Although the neoadjuvant therapy group yields a lower incidence of irradiation enteritis,the incidence rates of irradiation cystitis and grade ≥3 neutropenia do not significantly differ between two groups.Neoadjuvant therapy followed by radical surgery is not superior to the standard therapeutic regime.

Objective To systematically evaluate the clinical efficacy and safety between high-dose (74 to 80 Gy) and conventional-dose (64.0 to 70.2 Gy) conventionally fractionated external beam radiotherapy for stage T1b-4No-1M0 prostate cancer in this meta-analysis.Methods A literature search was performed in PubMea,ambasa,aochrane Librara,aeb of Scienca,aBa,aanfang Data,aNKI and Chongqing VIP to collect clinical trials on high-dose versus conventional-dose conventionally fractionated external beam radiotherapy of prostate cancer from the inception to July 1,2018.The included literatures were evaluated by Cochrane quality evaluation criteria and subject to meta-analysis by using Review Manager 5.3 statistical software.Results A total of 7 randomized controlled clinical trials involving 4 132 patients were included in the meta-analysis.The meta-analysis showed that the high-dose and conventional-dose groups yielded similar 10-year overall survival (RR=1.01,95％CI:0.96 to 1.07,P=0.64) and 10-year prostate cancer-specific survival (RR=1.01,95％CI:0.98 to 1.03,P=0.47).The biochemical failure rate in the high-dose group was significantly lower than that in the conventional-dose group (RR =0.78,95％CI:0.70 to 0.86,P＜0.01).Compared with the conventional-dose groua,ahe incidence of late grade ≥ 2 gastrointestinal and genitourinary adverse reactions (RR=1.48,95％CI:1.31 to 1.67,P＜0.01;RR=1.35,95％CI:1.06 to 1.73,P=0.02) was significantly higher in the high-dose group.Conclusion High-dose conventionally fractionated external beam radiotherapy has advantages in reducing the biochemical failure rate of patients with stage T1b-4N0-1M0 prostate cancer.Nevertheless,whether it can improve overall survival and prostate cancer-specific survival remains to be validated.High-dose radiotherapy also induce a higher incidence rate of late grade ≥ 2 gastrointestinal and genitourinary adverse reactions compared with conventional-dose radiotherapy.

Objective: The role of additional docetaxel chemotherapy in the treatment of localised high-risk prostate cancer (PCa) remains a controversy. This meta-analysis aimed to investigate the effect of additional docetaxel chemotherapy on localised high-risk PCa. Methods: A computerized search was performed in Pubmed, Embase, Cochrane Library, Web of Science, CBM, CNKI, VIP and Wanfang Data to collect clinical controlled trails on localised high-risk PCa treated with docetaxel chemotherapy from the inception to April 2019. The Review Manager 5.3 software was used to perform meta-analysis of survival data and adverse events. Results: Six literatures were enrolled, including 3 187 patients. Compared with the standard treatment (local treatment combined with endocrine therapy) group, the progression-free survival (PFS) was prolonged in the standard treatment plus docetaxel group, and the difference was statistically significant. [hazard ratio(HR)=0.75, 95%CI 0.65-0.86, P<0.01]. Patients in the standard treatment plus docetaxel group had longer overall survival (OS) and biochemical recurrence-free survival (BRFS) in comparison with standard treatment group, but the difference was not statistically significant (HR=0.843, 95%CI 0.68-1.01, P=0.06; HR=0.86, 95%CI 0.69-1.07, P=0.17). In terms of safety, the incidence of adverse reactions was increased in the standard treatment plus docetaxel group, including the incidence of grade ≥3 neutropenia (RR=44.14, 95%CI 19.15-101.71, P<0.01), the incidence of grade ≥3 febrile neutropenia (RR=13.4, 95%CI 7.93-22.65, P<0.01) and the incidence of grade ≥3 diarrhea (RR=13.43, 95%CI 3.21-56.16, P<0.01). Conclusions Additional docetaxel chemotherapy could significantly improve the PFS in localised high-risk PCa patients. OS and BRFS were prolonged, but the difference was not statistically significant.

treatment of LS-SCLC, two fractionation modes show similar short-term efficacy and survival benefits. However, hyperfractionated radiotherapy causes a higher incidence of radiation esophagitis than conventionally fractionated radiotherapy. Given that hyperfractionated radiotherapy is not superior to conventionally fractionated radiotherapy,conventionally fractionated radiotherapy is recommended for treating LS-SCLC.

Objective To investigate the effect of liver kinase B1(LKB1) on the radiosensitivity of subcutaneous xenograft tumor of lung cancer H460 cells in nude mice.Methods Human lung cancer H460 cells were implanted into female nude mice (BALB/c-nu) to establish a subcutaneous xenograft tumor model of lung cancer.A total of 24 female nude mice in which the model was successfully established were equally and randomly divided into four groups:pEGFP-Ctrl plasmid (empty vector plasmid) group, irradiation (IR)+pEGFP-Ctrl plasmid group, pEGFP-LKB1 plasmid (overexpressing LKB1) group, and IR+pEGFP-LKB1 plasmid group.The growth of xenograft tumors was observed and the tumor inhibition rate and enhancement factor (EF) were calculated.The expression of LKB1 in each group was measured by immunohistochemistry and Western blot to analyze the relationship between LKB1 and radiosensitivity.Results Compared with the pEGFP-Ctrl plasmid group, the IR+pEGFP-Ctrl plasmid group, pEGFP-LKB1 plasmid group, and IR+pEGFP-LKB1 plasmid group showed varying degrees of inhibition of tumor growth, particularly in the IR+pEGFP-LKB1 plasmid group, and the tumor inhibition rates were 31.30%, 14.78%, and 43.48%, respectively.The EF of LKB1 in the IR+pEGFP-LKB1 plasmid group was 1.18.The immunohistochemistry and Western blot showed that LKB1 could be effectively expressed in the pEGFP-LKB1 plasmid group and IR+pEGFP-LKB1 plasmid group, but not in the other two groups.Conclusions The subcutaneous xenograft tumor model of human lung cancer H460 cells has been successfully established in nude mice.LKB1 has a radiosensitizing effect on the subcutaneous xenograft tumor of lung cancer H460 cells in nude mice.

Objective To explore the prognostic factors of non-small-cell lung cancer (NSCLC) patients with brain metastasis. Methods 122 NSCLC patients with brain metastasis from Jan 2007 to Dec 2012 were incorporated, and followed with death as the end. The influence factors of prognosis were retrospective analyzed. Kaplan-Meier method was used for survival analysis, the Log-rank test for single factor analysis,and Cox regression model for multiple factors analysis. Results The single-factor and multi-factor analysis showed that the influence factors of prognosis were age, pathological type, number of intracranial metastasis, presence of extracranial metastasis, treatment, Karnofsky score, the original site control situation (P<0.05). Gender, the size of the original site had no influence for prognosis (P>0.05). The average survival times of patients with palliative symptomatic treatment, simple whole brain radiotherapy, whole brain radiotherapy local lesion plus the amount of radiation, whole brain radiotherapy local lesion plus the amount of radiation combined with chemotherapy were (2.14 ±0.19) months, (7.28 ±0.60) months, (16.90 ±1.35) months, (17.7±1.12) months, 1 year survival rates were 0, 8.5%, 71.0%, 93.3%. Survival analysis showed that there was statistical significance among the four groups (P= 0.000). Conclusion The age, pathological type, number of intracranial metastasis, presence of extracranial metastasis, treatment, Karnofsky score, the original site control situation are the prognosis factors in NSCLC patients with brain metastasis, therefore the treatment of these patients should be comprehensively analyzed.