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adjuvant therapy for orbital non-rhabdomyosarcoma soft tissue sarcoma:comparison of long-term outcome between radiotherapy and chemotherapy

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International Journal of Ophthalmology(English edition) 2023年第3期16卷 402-410页

作者： Xiao-Feng Li Rui-Qi Ma Xue Wu Lu Gan Zhi-Yu Peng Jiang Qian Department of Ophthalmology Eye and ENT Hospital of Fudan UniversityShanghai 200031China Laboratory of Myopia Chinese Academy of Medical SciencesShanghai 200031China NHC Key Laboratory of Myopia Fudan UniversityShanghai 200031China Department of Ophthalmology West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina

AIM:To illustrate clinicopathological features of orbital non-rhabdomyosarcoma soft tissue sarcoma(NRSTS),and to compare the treatment outcome between postoperative radiotherapy(RT) and chemotherapy in a retrospective analysis nearly 20y.METHODS:A retrospective cohort study of 56 patients with orbital NRSTS were reviewed,34 of whom received postoperative RT,and 22 received postoperative chemotherapy.The clinicopathological features,local recurrence,metastases,and survival data were recorded.Survival analysis was performed using the Kaplan-Meier method.RESULTS:During follow-up(111.8mo,ranged 8-233mo) for 56 patients,19 patients of them developed local recurrence,and 7 patients developed distant metastases.Fifteen patients died during follow-up period.Overall survival rates considering the whole study group was 78.57% at 5y,and 72.16% at 10y after the initial diagnosis.Compared with chemotherapy,RT was associated with lower risk of local recurrence [hazard ratio for RT vs chemotherapy,0.263,95% confidence interval(CI),0.095-0.728,P=0.0015];with lower risk of distant metastasis(hazard ratio for RT vs chemotherapy,0.073,95%CI,0.015-0.364,P=0.0014);and with lower risk of death from disease(hazard ratio for RT vs chemotherapy,0.066,95%CI,0.022-0.200,Padjuvant therapy compared to chemotherapy possibly.

关键词： orbital tumor non-rhabdomyosarcoma soft tissue sarcoma oncological outcome adjuvant radiotherapy adjuvant chemotherapy

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Refining the American Urological Association and American Society for Radiation Oncology guideline for adjuvant radiotherapy after radical prostatectomy using the pathologic Gleason score

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Asian Journal of Andrology 2017年第1期19卷 20-25页

作者： Wan Song Young Suk Kwon Seong Soo Jeon Isaac Yi Kim Section of Urologic Oncology Rutgers Cancer Institute of New Jersey Rutgers The State University of New Jersey New Brunswick NJ 08903 USA Department of Urology Samsung Medical Center Sungkyunkwan University School of Medicine Seoul South Korea.

Recently, it has been suggested that the guideline for adjuvant radiotherapy （ART） following radical prostatectomy （RP） sponsored by the American Urological Association and American Society for Radiation Oncology （AUA/ASTRO） may result in a significant overtreatment. Thus, the objective of the present study was to refine the AUA/ASTRO guideline for ART in patients at risk for biochemical recurrence （BCR） after RP. To this end, we reviewed our prospectively maintained database and selected 193 patients who met the AUA/ASTRO ART criteria. With a median follow-up of 24.0 months, BCR rate was 17.6% （34/193）. When stratified by the Gleason score, BCR rate in men with Gleason score 6 was 6.8%. There was no significant association between BCR-free survival and surgical margin （P= 0.690） and pathologic stage （P= 0.353） in patients with the Gleason score 6. However, in patients with positive surgical margins （PSMs）/pathologic stage ≥T3, there was a significant difference in BCR-free survival according to Gleason score （≤7 vs8-10, P= 0.047）. Multivariate Cox regression analysis demonstrated that pathologic stage ≥T3 （HR = 2.106; P = 0.018）, PSMs （HR = 2.411; P = 0.003）, and pathologic Gleason score 8-10 （HR = 4.715; P 〈 0.001） were independent predictors of BCR after RP. Therefore, in addition to pathologic stage 〉T3 and PSMs, Gleason score 8-10 predicts 8CR after RP. In patients with Gleason score 6, observation rather than ART may be more appropriate regardless of stage and surgical margin status.

关键词： adjuvant radiotherapy biochemical recurrence radical prostatectomy

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Current concepts in the surgical treatment of skeletal metastases

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World Journal of Orthopedics 2020年第7期11卷 319-327页

作者： Jessica Ehne Panagiotis Tsagozis Department of Orthopedic Surgery Karolinska University HospitalSolna 17176Sweden

Symptomatic metastatic bone disease affects a large proportion of patients with malignant tumours and significantly impairs patients’quality of life.There are still controversies regarding both surgical indications and methods,mainly because of the relatively few high-quality studies in this field.Generally,prosthetic reconstruction has been shown to result in fewer implant failures and should be preferred in patients with a good prognosis.Survival estimation tools should be used as part of preoperative planning.adjuvant treatment,which relies on radiotherapy and inhibition of osteoclast function may also offer symptomatic relief and prevent implant failure.In this review we discuss the epidemiology,indications for surgery,preoperative planning,surgical techniques and adjuvant treatment of metastatic bone disease.

关键词： Pathological fracture Bone cancer adjuvant radiotherapy Survival analysis Fracture fixations Fixation devices Orthopaedic

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The role of radiation for pancreatic adenocarcinoma

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Journal of Pancreatology 2020年第2期3卷 72-80页

作者： Gamboa Adriana C. Lee Rachel M. Maithel Shishir K. Division of Surgical Oncology Winship Cancer InstituteDepartment of SurgeryEmory UniversityAtlantaUSA

Pancreatic cancer is an aggressive malignancy with a high recurrence rate even after curative-intent resection.Improvements in survival have not been achieved in the last 25 years thus highlighting the need for effective multimodal treatment strategies.The role of radiation therapy for pancreatic cancer remains ill-defined due to historical lack of a standard definition of resectability,and the use of antiquated radiation delivery techniques and chemotherapy regimens.Current level I data regarding neoadjuvant chemoradiotherapy for resectable and borderline resectable pancreatic adenocarcinoma(PDAC)are limited to 2 randomized controlled trials and several retrospective studies and suggest that it may lead to an increased likelihood of a margin-negative resection and certainly allows for improved patient selection for pancreaticoduodenectomy when compared to upfront surgery.In the adjuvant setting,data are similarly lacking but suggest that chemoradiotherapy may be beneficial for patients at high risk of locoregional recurrence.Here we review existing data regarding the role of radiation in PDAC.

关键词： adjuvant radiotherapy Neoadjuvant radiotherapy Pancreatic ductal adenocarcinoma Role of radiation for pancreas cancer

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adjuvant therapy for gastric cancer:What have we learned since INT0116?

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World Journal of Gastroenterology 2015年第13期21卷 3850-3859页

作者： Alexandre A Jácome Ajith K Sankarankutty José Sebastiao dos Santos Department of Medical Oncology Hospital Mater DeiBelo Horizonte 30190-131Minas GeraisBrazil Department of Surgery and Anatomy University of Sao Paulo at Ribeirao PretoSchool of MedicineRibeirao Preto14049-900Sao PauloBrazil

Gastric cancer is one of the main cancer-related causes of death worldwide. The curative treatment of gastric cancer consists of tumor resection and lymphadenectomy. However, surgical treatment alone is associated with high recurrence rates. adjuvant treatment strategies have been studied over the last decades, but there have been controversial results from the initial studies. The pivotal INT0116 study demonstrated that the use of adjuvant chemoradiotherapy with 5-fluorouracil increases relapse-free and overall survival, and it has been adopted across the Western world. The high toxicity of radiochemotherapy and suboptimal surgical treatment employed, with fewer than 10% of the patients submitted to D2 lymphadenectomy, were the main study limitations. Since its publication, other adjuvant treatment modalities have been studied, and radiochemotherapy is being refined to improve its efficacy and safety. A multimodal approach has been demonstrated to significantly increase relapsefree and overall survival, and it can be offered in the form of perioperative chemotherapy, adjuvant chemoradiotherapy or adjuvant chemotherapy, regardless of the extent of lymphadenectomy. The objective of the present review is to report the major advances obtained in the last decades in the adjuvant treatment of gastric cancer as well as the perspectives of treatment based on recent knowledge of the molecular biology of the disease.

关键词： Stomach neoplasms adjuvant radiotherapy adjuvant chemotherapy Histology Genes erbB-2

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Benefit of adjuvant chemoradiotherapy in patients with pathologically lymph node-positive and locally advanced gastric cancer

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Oncology and Translational Medicine 2020年第2期6卷 72-80页

作者： Shanhui Zhang Fei Zhou Donghai Liang Hongying Lv Hongsheng Yu Qingdao University Qingdao 266000China Department of Oncology Affiliated Hospital of Qingdao UniversityQingdao 266000China

Objective This study aimed to compare the effectiveness of adjuvant chemoradiotherapy(CRT)and adjuvant chemotherapy(ChT)for T3–4/N+gastric cancer(GC)following D2/R0 dissection,and identify the specific subgroups that could benefit from adjuvant CRT.Methods All eligible patients were divided into the CRT group and ChT group.We assessed the survival outcomes and patterns of recurrence for each group,and determined the prognostic factors for survival by performing Cox proportional risk regression analyses.Results A total of 192 gastric cancer patients were included in the study.The estimated 3-year and 5-year disease-free survival(DFS)probabilities in the CRT and ChT groups were 52.9%vs.36.7%(P=0.024)and 41.2%vs.31.1%(P=0.148),respectively,and the estimated 3-year and 5-year overall survival(OS)probabilities were 82.4%vs.70.0%(P=0.044)and 52.0%vs.35.6%(P=0.022).Patients in the CRT group had a lower risk of locoregional recurrence than those in the ChT group(20.6%vs.34.4%;P=0.031).The subset analyses revealed that patients with stage N1–2 disease were more likely to benefit from adjuvant CRT than from adjuvant ChT(DFS:53.1%vs.36.4%;P=0.039;OS:53.1%vs.38.6%;P=0.036).Conclusion For locally advanced gastric cancer patients with LN+,adjuvant CRT showed superior survival benefits compared with adjuvant ChT alone.Patients with N1–2 achieved better survival from adjuvant CRT.

关键词： locally advanced gastric cancer adjuvant chemoradiotherapy adjuvant radiotherapy lymph node-positive survival and prognosis

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