Over 80% of the patients with prostate cancer (PCa) develop bone metastasis, which seriously affects the patients' quality of life and remains a major cause of morbidity. Radium-223 (Ra-223), a newly approved agent targeting bone metastasis of PCa, can improve the quality of life and prolong the overall survival of the PCa patients with bone metastasis. This article presents an overview of the clinical trials recently published on the management of bone metastasis of PCa with Ra-223.
Bone Neoplasms ; radiotherapy ; secondary ; Clinical Trials as Topic ; Humans ; Male ; Prostatic Neoplasms ; pathology ; Quality of Life ; Radioisotopes ; Radium ; therapeutic use

No abstract available.
Aged ; Biomarkers, Tumor/analysis ; Biopsy, Large-Core Needle ; Bone Neoplasms/chemistry/radiotherapy/*secondary ; Female ; Humans ; Immunohistochemistry ; Lung Neoplasms/chemistry/*pathology/surgery ; Pneumonectomy ; Positron-Emission Tomography ; Pulmonary Sclerosing Hemangioma/chemistry/radiotherapy/*secondary/surgery ; Tomography, X-Ray Computed ; Treatment Outcome

OBJECTIVETo explore the value of percutaneous vertebroplasty combined with interstitial implantation of ¹²⁵I seeds in the treatment of metastatic thoracolumbar tumors.

METHODSBased on the CT images before ¹²⁵I seed implantation, a computer-based treatment planning system (TPS) was used to determine the optimal seed distribution. Under CT guidance and local anaesthesia, ¹²⁵I seeds were implanted into 22 osseous metastatic lesions in 18 patients. Based on the CT images after the implantation, quality check was carried out with TPS. DSA (digital subtraction angiography)-guided vertebroplasty was performed under local anaesthesia, and bone cement was injected into the vertebrae through pedicle of vertebral arch.

RESULTSAll the 18 patients received percutaneous vertebroplasty combined with interstitial implantation of ¹²⁵I seeds. Every vertebra was injected with 2-6 ml bone cement, average 3.5 ml, and was injected with ¹²⁵I seeds 16-34 pills, average 26 pills. At 2-months follow-up, their numerical rating scale (NRS) pain scores were 7.12 ± 1.48 before and 2.26 ± 1.07 after treatment, with a significant difference (P < 0.05).

CONCLUSIONSPercutaneous vertebroplasty combined with interstitial implantation of ¹²⁵I seeds is a minimally invasive procedure with small wound and minor complications, and no need of external radiation therapy. It is effective in the alleviation of pain in metastatic thoracolumbar tumor patients, restrains the tumor growth, and improves the quality of life. It is a promising minimally invasive method in the treatment of metastatic thoracolumbar tumors.

Aged ; Angiography, Digital Subtraction ; Bone Cements ; therapeutic use ; Brachytherapy ; Breast Neoplasms ; pathology ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Iodine Radioisotopes ; therapeutic use ; Lumbar Vertebrae ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Pain Measurement ; Prostatic Neoplasms ; pathology ; Quality of Life ; Radiotherapy Planning, Computer-Assisted ; Spinal Neoplasms ; secondary ; therapy ; Thoracic Vertebrae ; Vertebroplasty ; methods

OBJECTIVETo review the outcomes and complications of 21 consecutive patients with soft tissue sarcomas of the adductor compartment treated in our hospital from July 2006 to March 2012.

METHODSMedical records of 21 patients who underwent resection of soft tissue sarcomas of the adductor compartment were reviewed. Eight of the patients had primary operation, other eight had secondary radical excision, and five were admitted for tumor recurrence after operation in local hospitals. Six cases used gracilis or sartorius muscle to fill the cavity after removal of adductor muscle group. Fifteen patients underwent adjuvant treatment including radiotherapy and/or chemotherapy.

RESULTSSeven patients (33.3%) developed wound complications. Five required further surgery and two received dressing changes. All the patients were followed up for 3 to 60 months. During the follow-up period, no tumor recurrence was found in all the patients, only one case had multiple bone and pulmonary metastases, and two cases died (one for pulmonary metastasis at 11 months after surgery, and the other died of heart disease at 36 months post operation).

CONCLUSIONSGood local control rate can be achieved in patients with soft tissue sarcomas of the adductor compartment by using adductor muscle group resection, but it carries a relatively high rate of wound complications requiring proper management.

Adolescent ; Adult ; Aged ; Bone Neoplasms ; secondary ; Chemotherapy, Adjuvant ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; secondary ; Male ; Middle Aged ; Muscles ; surgery ; Postoperative Complications ; Radiotherapy, Adjuvant ; Sarcoma ; drug therapy ; radiotherapy ; secondary ; surgery ; Soft Tissue Neoplasms ; drug therapy ; radiotherapy ; surgery ; Survival Rate ; Thigh ; Young Adult

OBJECTIVETo investigate the clinical features and prognosis of bone metastases in colorectal cancer patients.

METHODSThe clinical data of 104 cases of colorectal cancer with bone metastasis were collected and retrospectively analyzed.

RESULTSAmong all the 104 patients included, 45 (43.3%) patients had multiple bone metastases, and 59 (56.7%) patients had single bone metastasis. Pelvis (46.1%) was the most common site, followed by thoracic vertebrae (41.3%), lumbar vertebrae (40.4%), sacral vertebrae (29.8%) and ribs (29.8%). One hundred and two patients (98.1%) were complicated with other organ metastases. The median time from colorectal cancer diagnosis to bone metastasis was 16 months, and the median time from bone metastasis to first skeletal-related events (SREs) was 1 month. The most common skeletal-related events (SREs) were the need for radiotherapy (44.2%), severe bone pain (15.4%) and pathologic fracture (9.6%). The median survival time of patients with bone metastases was 10.0 months, and 8.5 months for patients with SREs. ECOG score, systemic chemotherapy and bisphosphonate therapy were prognostic factors by univariate analysis (all P < 0.05). ECOG score and systemic chemotherapy were independent prognostic factors by Cox multivariate analysis.

CONCLUSIONSBone metastasis in colorectal cancer patients has a poor prognosis and the use of chemotherapy and bisphosphonates may have a benefit for their survival.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bone Density Conservation Agents ; therapeutic use ; Bone Neoplasms ; drug therapy ; radiotherapy ; secondary ; Colorectal Neoplasms ; drug therapy ; pathology ; radiotherapy ; surgery ; Diphosphonates ; therapeutic use ; Female ; Follow-Up Studies ; Fractures, Bone ; etiology ; Humans ; Lumbar Vertebrae ; pathology ; Male ; Middle Aged ; Pain ; etiology ; Pelvic Bones ; pathology ; Prognosis ; Retrospective Studies ; Ribs ; pathology ; Sacrum ; pathology ; Spinal Cord Compression ; etiology ; Spinal Neoplasms ; drug therapy ; radiotherapy ; secondary ; Thoracic Vertebrae ; pathology ; Young Adult

OBJECTIVETo explore the optimal management and analyze the prognostic factors for follicular thyroid carcinoma.

METHODSThe clinicopathological data of 119 patients with well-differentiated follicular thyroid carcinoma treated in our hospital from 1970 to 2008 were retrospectively reviewed. The overall survival (OS) rate was estimated by Kaplan-Meier method. Log rank and Cox regression analyses were used to identify the prognostic factors.

RESULTSThe 5- and 10-year OS rates were 81.1% and 66.7%, respectively. The 3- , 5- and 10-year cumulative distant metastasis rates were 27.4%, 29.6% and 35.9%, respectively. The age of ≥ 45 years old was one of the most important factors affecting survival rate (P < 0.05) and an independent factor for distant matastasis.

CONCLUSIONSFollicular thyroid carcinoma has some special features such as diffuse growth and vascular tumors thrombosis and with a relatively poor prognosis. The key measure to improve local control and prognosis is radical resection. Some aggressive management such as total thyroidectomy combined with (13)1I therapy and regular follow-up should be performed to improve the survival rate and to control postoperative distant metastasis for patients ≥ 45 years old.

Adenocarcinoma, Follicular ; pathology ; radiotherapy ; secondary ; surgery ; Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Bone Neoplasms ; secondary ; Child ; Female ; Follow-Up Studies ; Humans ; Iodine Radioisotopes ; therapeutic use ; Lung Neoplasms ; secondary ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Radiotherapy, Adjuvant ; Retrospective Studies ; Survival Rate ; Thyroid Neoplasms ; pathology ; radiotherapy ; surgery ; Thyroidectomy ; Young Adult

OBJECTIVETo compare the efficacy and side effects of induction chemotherapy with vinorelbine plus cisplatin (NP) or docetaxel plus cisplatin (TP) combined with concurrent chemoradiotherapy in treating locally advanced nasopharyngeal carcinoma (NPC).

METHODSFrom January 2005 to December 2009, 146 patients with locally advanced nasopharyngeal carcinoma treated in our department were randomized into NP group (76 patients) or TP group (70 patients). Both groups received two cycles of induction chemotherapy and concurrent chemoradiotherapy. After three weeks of induction chemotherapy, the patients received concurrent chemoradiotherapy. The chemotherapy was recycled every three weeks. Two groups were treated with intensity-modulated radiation therapy.

RESULTSThe short-term efficacy of NP group was similar to that of TP group. The 3-year overall survival rates, disease-free-survival rates, locoregional relapse-free survival rates and distant metastasis-free survival rates in the NP and TP groups were 84.2% and 82.9%, 71.1% and 74.3%, 89.5% and 91.4%, 81.6% and 77.1%, respectively (P > 0.05). The occurrence rates of leucopenia, anemia and acute mucositis were significantly higher in the TP group than those in the NP group (P < 0.05). The gastrointestinal toxicity, dermatitis and liver toxicity were similar in the two groups.

CONCLUSIONSThe efficacy of NP regimen induction chemotherapy plus concurrent chemordiotherapy for advanced NPC is similar to that of TP regimen. The toxicity of the NP regimen is lower than that of NP regimen, tolerable, and with a good compliance.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bone Neoplasms ; secondary ; Carcinoma ; Chemoradiotherapy ; Cisplatin ; administration & dosage ; adverse effects ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Induction Chemotherapy ; Leukopenia ; chemically induced ; etiology ; Liver Neoplasms ; secondary ; Lung Neoplasms ; secondary ; Male ; Middle Aged ; Mucositis ; chemically induced ; etiology ; Nasopharyngeal Neoplasms ; pathology ; therapy ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Radiotherapy, Intensity-Modulated ; Remission Induction ; Survival Rate ; Taxoids ; administration & dosage ; adverse effects ; Vinblastine ; administration & dosage ; adverse effects ; analogs & derivatives ; Young Adult

BACKGROUNDSubjective assessment tools such as visual analog scales (VAS) or pain scores are commonly used to evaluate the intensity of chronic cancer-induced pain. However, their value is limited in some cases. We measured changes in VAS pain scores and salivary α-amylase (sAA) concentrations in cancer patients receiving radiotherapy for bone metastases to ascertain the correlation between these measures.

METHODSWe enrolled 30 patients with bone metastases attending a single institution from June 2010 to March 2011. All patients with cancer-induced bone pain received radiation therapy (RT) at the same dose (30 Gy) and fractionation (3 Gy/fraction, 5 days/week) for palliative pain relief. We assessed heart rate (HR), systolic and diastolic blood pressures (DBP/SBP) and VAS pain scores before (d0) and after five (d5) and ten fractions (d10) of irradiation. sAA and salivary cortisol (SC) concentrations were measured using a portable analyzer and automated chemiluminescence analyzer, respectively.

RESULTSRadiotherapy markedly decreased VAS scores from (82.93 ± 9.29) to (31.43 ± 16.73) mm (P < 0.001) and sAA concentrations from (109.40 ± 26.38) to (36.03 ± 19.40) U/ml (P <0.001). Moreover, there was a significant correlation between these two indices (P <0.01, r = 0.541). HR decreased by 6.5% after radiotherapy, but did not correlate with VAS scores (P >0.05). SC concentrations and BP did not change significantly during the study (P >0.05).

CONCLUSIONSThe significant correlation between sAA concentrations and VAS pain scores identified in these preliminary results suggests that this biomarker may be a valuable, noninvasive and sensitive index for the objective assessment of pain intensity in patients with cancer-induced bone pain.

Aged ; Bone Neoplasms ; enzymology ; radiotherapy ; secondary ; Female ; Humans ; Male ; Middle Aged ; Pain ; enzymology ; radiotherapy ; Pain Management ; Pain Measurement ; Salivary alpha-Amylases ; metabolism ; Treatment Outcome

OBJECTIVETo evaluate the efficacy and prognostic factors of personalized treatment for breast cancer patients who failed chemotherapy.

METHODSSeventy-two patients with breast cancer who failed chemotherapy were treated at the Tumor Hospital of Harbin Medical University from January 2001 to January 2012. Among them, 42 cases received 5.6 cycles (range, 4-8 cycles) of postoperative adjuvant chemotherapy, and 30 cases received 12.2 cycles (range, 6-22 cycles), both postoperative adjuvant and salvage chemotherapy. All of the 72 patients of stage IV were given personalized treatment. Under guidance of the principle that multidisciplinary treatment improves control rate but does not or less damage the normal tissues and host immune function, precise radiotherapy combined with Chinese herbal medicine (CHM), biological agent and others were chosen for the patients.

RESULTSThe median survival time was 20 months. Univariate analysis showed that non-invasive ductal carcinoma, less metastasized organs, without brain, liver and lung metastasis, Karnofsky performance scores ≥ 80, not combined with chemotherapy, and multiple courses of Chinese herbal medicine and biolojical agent treatment had significant impact on survival (P < 0.05). Multivariate analysis showed that no brain metastasis, non-invasive ductal carcinoma, and Chinese herbal medicine and biological agent treatment ≥ 7 courses and not combined with chemotherapy had obvious significance (P < 0.05). The rate of grade 3 and 4 treatment-related hematological toxicity was 8.3% (6/72) and 5.6% (4/72), respectively. All the patients with grade 4 hematological toxicity were the cases of grade 3 at hospital admission. No grade 3 and 4 acute radiation damages of the lung and liver were noticed.

CONCLUSIONChinese herbal medicine combined with biological agents and others prolongs survival time in breast cancer patients who failed chemotherapy, and provides an alternative treatment modality for them.

Adult ; Aged ; Aromatase Inhibitors ; therapeutic use ; Bone Density Conservation Agents ; therapeutic use ; Bone Neoplasms ; drug therapy ; secondary ; Brain Neoplasms ; drug therapy ; secondary ; Breast Neoplasms ; drug therapy ; pathology ; radiotherapy ; surgery ; Carcinoma, Ductal, Breast ; drug therapy ; pathology ; radiotherapy ; secondary ; surgery ; Chemotherapy, Adjuvant ; Diphosphonates ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Imidazoles ; therapeutic use ; Lung Neoplasms ; drug therapy ; secondary ; Medicine, Chinese Traditional ; Middle Aged ; Neoplasm Staging ; Nitriles ; therapeutic use ; Radiotherapy, Adjuvant ; Radiotherapy, Conformal ; methods ; Remission Induction ; Retrospective Studies ; Survival Rate ; Treatment Failure ; Triazoles ; therapeutic use

Systemic chemotherapy is the basic palliative treatment for metastatic nasopharyngeal carcinoma (NPC); however, it is not known whether locoregional radiotherapy targeting the primary tumor and regional lymph nodes affects the survival of patients with metastatic NPC. Therefore, we aimed to retrospectively evaluate the benefits of locoregional radiotherapy. A total of 408 patients with metastatic NPC were included in this study. The mortality risks of the patients undergoing supportive treatment and those undergoing chemotherapy were compared with that of patients undergoing locoregional radiotherapy delivered alone or in combination with chemotherapy. Univariate and multivariate analyses were conducted. The contributions of independent factors were assessed after adjustment for covariates with significant prognostic associations (P < 0.05). Both locoregional radiotherapy and systemic chemotherapy were identified as significant independent prognostic factors of overall survival (OS). The mortality risk was similar in the group undergoing locoregional radiotherapy alone and the group undergoing systemic chemotherapy alone [multi-adjusted hazard ratio (HR) = 0.9, P = 0.529]; this risk was 60% lower than that of the group undergoing supportive treatment (HR = 0.4, P = 0.004) and 130% higher than that of the group undergoing both systemic chemotherapy and locoregional radiotherapy (HR = 2.3, P < 0.001). In conclusion, locoregional radiotherapy, particularly when combined with systemic chemotherapy, is associated with improved survival of patients with metastatic NPC.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bone Neoplasms ; drug therapy ; radiotherapy ; secondary ; surgery ; Chemoradiotherapy ; Chemotherapy, Adjuvant ; Cisplatin ; administration & dosage ; Deoxycytidine ; administration & dosage ; analogs & derivatives ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms ; drug therapy ; radiotherapy ; secondary ; surgery ; Lung Neoplasms ; drug therapy ; radiotherapy ; secondary ; surgery ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; drug therapy ; pathology ; radiotherapy ; Neoplasm Staging ; Paclitaxel ; administration & dosage ; Palliative Care ; Radiotherapy, Intensity-Modulated ; Retrospective Studies ; Survival Rate ; Young Adult