ObjectiveTo summarize the research progress and clinical efficacy of hepatic artery infusion chemotherapy in the treatment of colorectal cancer liver metastasis.MethodThe literatures of hepatic artery infusion chemotherapy for colorectal cancer liver metastasis were collected and reviewed.ResultsThe incidence of colorectal cancer liver metastasis was high, which affected the prognosis of patients. Surgical treatment was the preferred treatment for colorectal cancer liver metastasis. Hepatic arterial infusion chemotherapy could be used for preoperative neoadjuvant therapy and postoperative adjuvant therapy.ConclusionsHepatic arterial infusion chemotherapy is an effective local treatment for colorectal cancer liver metastasis and can be used as a supplement to surgical treatment. Compared with systemic chemotherapy, hepatic arterial infusion chemotherapy combined with systemic chemotherapy can improve the overall survival and disease-free survival, reduce the risk of intrahepatic recurrence, and improve the prognosis of patients.
This study aims to investigate the value of pre-treatment computed tomography (CT) texture analysis in predicting therapeutic response of liver metastasis from colorectal cancer after combined targeting chemotherapy. A total of 82 patients with colorectal cancer liver metastases who underwent chemotherapy combined with targeted therapy (cetuximab) between March 2011 and October 2017 comprised this retrospective study population. According to the RECIST1.1, the best curative effect evaluation of patients was recorded. Complete response (CR) and partial response (PR) were assigned to the response group, and the stable disease (SD) and progressive disease (PD) were assigned to the non-response group. The CT texture analysis was based on the Omini-Kinetics software, and the three-dimensional (3D) texture analysis was performed on the marked lesion on portal phase. The differences of texture parameters between the response group and the non-response group were compared. The receiver operating characteristic (ROC) curves were depicted on the parameters which with statistically difference, to characterize value in predicting the response to target-combined chemotherapy. The differences of Entropy, Energy, Variance, std. Deviation, Quantile95 and sumEntropy between the two groups in pre-treatment lesions were significant (P < 0.05). And lesions with higher Entropy, lower Energy, higher Variance, higher std Deviation and higher sumEntropy seemed to indicate a better therapeutic response. When sumEntropy > 0.867, good diagnostic efficiency could be obtained, with sensitivity of 60.5% and specificity of 79.5%, respectively. In conclusion, texture parameters derived from baseline CT images of colorectal cancer liver metastasis have the potential value acting as imaging biomarkers in predicting tumor response to combined target chemotherapy.
Tumor chemotherapy is a treatment method that employs chemotherapeutic drugs to eradicate cancer cells. These drugs are cytotoxic, meaning they can affect both tumor cells and normal cells. In recent years, there has been a gradual increase in chemotherapy-induced liver injury. Chemotherapy-induced parenchymal liver injury often manifests as diffuse lesions, although focal lesions can occasionally be observed. There is a diversity in the pathogenesis and pathological changes of chemotherapy-induced focal liver disease. Radiologically, there is often challenging in differentiating chemotherapy-induced focal liver disease from hepatic metastases. Therefore, early and accurate diagnosis of this condition poses a certain challenge in clinical practice. This article presents the radiological findings of a case of chemotherapy-induced focal liver disease induced by chemotherapy for gastric cancer, and summarizes the radiological features and differential diagnostic points of chemotherapy-induced focal liver disease, aiming to enhance the understanding of this type of lesion among radiologists and clinicians and reduce related missed diagnoses and misdiagnoses.
Objective To evaluate the effect of regiono-perfusional chemotherapy of pancreatic adenocarcinoma, and to seek the management of its complications. MethodsThirty-six patients with unresectable pancreatic adenocarcinoma received selectively intra-arterial catheterization and perfused with 5-Fu, ADM, DDP. Results Six patients had complete response, 15 partial response, and one underwent radical resection subsequently. Cmplications occurred in 14 patients with 2 patients died of complications.Conclusion Regiono-perfusional chemotherapy of pancreatic adenocarcinoma is effective, but the complications can not be neglected.
ObjectiveTo evaluate the efficacy and toxicity of TEC and CEF regimen in preoperative chemotherapy for patients with breast cancer. MethodsA total of one hundred breast cancer patients undergoing preoperative chemotherapy were divided into TEC group (n=50) and CEF group (n=50) by the pairgroup method and received surgical therapy after three courses of chemotherapy. The efficacy and toxicity of preoperative chemotherapy of patients in two groups were analyzed. ResultsFour patients with stage ⅢB breast cancer quit from CEF group after two courses of treatment because of the worse satisfaction. Clinical complete remission (cCR) was 7 cases, clinic partial remission (cPR) was 34 cases, stable disease (SD) was 9 cases, therefore, the remission rate (RR) was 82.0% (41/50), and reduction rate of tumor was 64.0% (32/50) in TEC group. cCR was 2 cases, cPR was 32 cases, SD was 12 cases, thus the RR was 680% (34/50), and reduction rate of tumor was 40.0% (20/50) in CEF group. The clinical efficacy and reduction rate of tumor of patients in TEC group were significantly superior than those in CEF group (Plt;0.05). The negative conversion ratio of lymph nodes were 54.1% (20/37) and 57.1% (20/35) in TEC group and CEF group, which was not statistically different (Plt;0.05). The occurrence of hair loss and leukopenia of patients in TEC group were significantly higher than those in CEF group (Plt;0.05), while the differences in thrombocytopenia, low concentration of hemoglobin, nausea, vomiting, diarrhea, cardiac toxicity, and neurotoxicity were not significant (Pgt;0.05). ConclusionTEC regimen is better than CEF regimen in the efficacy and safety of neo-adjuant therapy for patients with breast cancer, and well tolerated.
Objective To investigate the effect of radiotherapy after neoadjuvant chemotherapy and modified radical surgery on breast cancer specific survival (BCSS) of patients with stage cT1–2N1M0 breast cancer. Methods A total of 917 cT1–2N1M0 stage breast cancer patients treated with neoadjuvant chemotherapy and modified radical surgery from 2010 to 2017 were extracted from the The Surveillance, Epidemiology, and End Results (SEER) database. Of them 720 matched patients were divided into radiotherapy group (n=360) and non-radiotherapy group (n=360) by using propensity score matching (PSM). Cox proportional hazard regression model was used to explore the factors affecting BCSS. Results Patients were all interviewed for a median follow-up of 65 months, and the 5-year BCSS was 91.9% in the radiotherapy group and 93.2% in the non-radiotherapy group, there was no significant difference between the 2 groups (χ2=0.292, P=0.589). The results were the same in patients with no axillary lymph node metastasis, one axillary lymphnode metastasis, two axillary lymph node metastasis and 3 axillary lymph node metastasis group (χ2=0.139, P=0.709; χ2=0.578, P=0.447; χ2=2.617, P=0.106; χ2=0.062, P=0.803). The result of Cox proportional hazard regression analysis showed that, after controlling for Grade grade, time from diagnosis to treatment, efficacy of neoadjuvant chemotherapy, number of positive axillary lymph nodes, molecular typing, and tumor diameter at first diagnosis, radiotherapy had no statistically significant effect on BCSS [HR=1.048, 95%CI (0.704, 1.561), P=0.817]. Conclusions The effect of radiotherapy on the BCSS of patients with stage cT1–2N1M0 breast cancer who have received neoadjuvant chemotherapy and modified radical surgery with 0 to 3 axillary lymph nodes metastases is limited, but whether to undergo radiotherapy should still be determined according to the comprehensive risk of individual tumor patients.
ObjectiveTo observe the clinical efficacy of half-dose photodynamic therapy (PDT) in the treatment of acute central serous chorioretinopathy (CSC) by enhanced deep imaging-OCT (EDI-OCT).MethodsA retrospective case study. From September 2015 to November 2018, 100 patients with acute CSC who received half-dose PDT in Hangzhou Branch of the Eye Optometry Hospital of Wenzhou Medical University were included in the study. Among 100 patients, 69 patients were males and 31 patients were females; the average age was 49.63±7.97 years; the average duration of disease was 2.19±0.71 months. All patients underwent BCVA, EDI-OCT, FFA, ICGA and other examinations. BCVA was used on the international standard visual acuity chart and converted to logMAR visual acuity records. Before treatment, the average logMAR BCVA was 0.29±0.19, the average macular foveal retinal thickness (CMT) was 370.59±134.98 μm, and the average macular subfoveal choroidal thickness (SFCT) was 366.93±86.95 μm. All patients were treated with half-dose PDT. We compared the changes of BCVA, CMT, SFCT, and subretinal fluid (SRF) of the eye before treatment and 2 weeks after treatment and 1, 3, and 6 months. Pearson correlation analysis method was used to analyze the correlation between BCVA and baseline BCVA, CMT, SFCT after 6 months of treatment.ResultsSix months after treatment, SRF was completely absorbed in 98 eyes, with an effective rate of 98.0%. Compared with before treatment, 2 weeks and 1, 3, and 6 months after treatment, the BCVA of the eye significantly increased (F=66.493, P＜0.001), and CMT and SFCT significantly decreased (F=134.625, 30.394; P＜0.001,＜0.001). The results of Pearson correlation analysis showed that BCVA was positively correlated with baseline BCVA 6 months after treatment (r=0.529, P＜0.001), and there was no significant correlation with CMT and SFCT. There were no serious complications related to treatment during the follow-up period.ConclusionsHalf-dose PDT can effectively increase BCVA in a short period of time for acute CSC. EDI-OCT can observe that CMT, SFCT and SRF absorption are significantly reduced after treatment.
To evaluate the effect of intraperitoneal hyperthermo-chemotherapy (IPHC) on immunologic function of patients with gastrointestinal malignant tumor (GMT). The authors determined the serum T-lymphocyte subsets (T-LS) and interleukin-2 receptor (sIL-2R) of 32 patients with GMT after IPHC, and compared the two indexes with 20 healthy control group. Results: Before IPHC the serum CD＋3, CD＋4, CD＋8 and CD＋4/CD＋8 were higher and sIL-2R were lower than control group, after IPHC, CD＋3, CD＋4, CD＋8 and CD＋4/CD＋8 increased obviously (Ｐ＜0.01) and the serum sIL-2R decreased significantly (Ｐ＜0.01). Conclusion: The IPHC can improve the patients immunologic function.
Abstract: Objective To summarize the method and effective result of thoracoscopic intrapleural perfusion hyperthermochemotherapy(TIPHC) for treating malignant pleural effusion caused by lung cancer. Methods Fiftyeight patients with malignant pleural effusion caused by lung cancer were randomly divided into therapeutic group(30 cases) and control group(28 cases) between February 1999 and March 2005. Pleural biopsy and TIPHC under general ansthesia with unilateral ventilation were performed in the therapeutic group, and intrapleural injection of cisplatin was administered in control group after drainage of pleural effusion. The effect on malignant pleural effusion， the change for the concentration of carcinoembryonic antigen(CEA)， cytokeratin-19 fragments (CYFRA21-1)， neuronspecific enolase (NSE) and the side effect were compared before and after the treatment. Results The therapeutic group achieved total response rate of 100.0%, but only 53.6% in control group, with significant difference(χ 2=3.863, Plt;0.05). Furthermore, the concentration of CEA， CYFRA21-1， NSE in therapeutic group dramatically descended than control group(t=2.562,Plt;0.05). But there was no significant difference in side effect (Pgt;0.05). The pathological diagnosis of all the patients were determined in the therapeutic group. Conclusion TIPHC has the advantage of both diagnosis and treatment of malignant pleural effusions. It is safe and effective, and also able to determine the diagnosis. Furthermore, it offers the superiority of small wound， best visualization and convenient pleural biopsy.
ObjectiveTo study the latest progress of neoadjuvant chemotherapy in breast cancer. MethodsLiteratures of neoadjuvant chemotherapy in breast cancer, involving with theoretical basis, clinical significance, indications, drugs, predictors, and its relationship of breastconserving surgery, sentinel lymph node biopsy were reviewed. ResultsNeoadjuvant chemotherapy could reduce the clinical stage, increase opportunity of breast-conserving surgery, learn the sensitivity of drugs, prevent distant metastases, but the impact of the sentinel lymph node biopsy was still in dispute. ConclusionNeoadjuvant chemotherapy is an important part of a systemic treatment for breast cancer, but how to select sensitive drugs, develop individualized treatment programs and forecast the outcome needs further study.
