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A prospective analysis of factors that influence weight loss in patients undergoing radiotherapy

Chinese Journal of Cancer 2014年第4期33卷 204-210页

作者： Jon Cacicedo Francisco Casquero Lorea Martinez-Indart Olga del Hoyo Alfonso Gomez de Iturriaga Arturo Navarro Pedro Bilbao department of Radiation oncology Cruces University Hospital department of Statistics and Epidemiology Cruces University Hospital department of Radiation oncology Catalan Institute of OncologyL'Hospitalet de Llobregat

Malnutrition occurs frequently in patients with ***,a variety of nutritional and tumorrelated factors must be taken into account in these *** this relationship,we aimed to prospectively evaluate the risk factors that influence weight loss in patients undergoing radiotherapy with oral nutritional supplementation and dietetic *** loss of 74 patients during radiotherapy and 1 month after treatment was *** such as age,gender,tumor location,tumor stage,Eastern Cooperative oncology Group performance status(ECOG PS)score,and the use of chemotherapy were analyzed to evaluate their influence on weight *** patients underwent oral nutritional supplementation and dietetic ***-six(65.7%)patients lost weight,with a mean weight loss of(4.73±3.91)kg,during *** 1 month after treatment,45(66.2%)patients lost weight,presenting a mean weight loss of(4.96±4.04)kg,corresponding to a(6.84±5.24)%net reduction from their baseline *** and neck cancer patients had a mean weight loss of(3.25±5.30)kg,whereas the remaining patients had a mean weight loss of(0.64±2.39)kg(P=0.028)during *** the multivariate analysis,the head and neck tumor location(P=0.005),use of chemotherapy(P=0.011),and ECOG PS score of 2-3(P=0.026)were considered independent risk *** status and parameters,such as tumor location(especially the head and neck),the use of chemotherapy,and the ECOG PS score,should be evaluated before radiotherapy because these factors can influence weight loss during radiotherapy and 1 month after treatment.

关键词：癌症患者放疗减肥头颈部肿瘤平均体重营养不良危险因素营养补充

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Comparison of linac-based fractionated stereotactic radiotherapy and tomotherapy treatment plans for intra-cranial tumors

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Chinese Physics C 2010年第11期34卷 1768-1774页

作者： Jang Bo Shim Suk Lee Sam Ju Cho Sang Hoon Lee Juree Kim Kwang Hwan Cho Chul Kee Min Hyun Do Huh Rena Lee Dae Sik Yang Young Je Park Won Seob Yoon Chul Yong Kim Soo Il Kwon department of Radiation oncology College of MedicineKorea University department of Medical Physics Kyonggi University department of Radiation oncology College of MedicineEulji University department of Radiation oncology Cheil General Hospital & Women's Healthcare CenterKwandong University College of Medicine department of Radiation oncology Soonchunhyang University Boocheon Hospital department of Radiation oncology Konyang University Hospital department of Radiation oncology Inha University Hospital department of Radiation oncology School of MedicineEwha Womans University

This study compares and analyzes stereotactic radiotherapy using tomotherapy and linac-based fractionated stereotactic radiotherapy in the treatment of intra-cranial tumors,according to some *** this study,linac-based fractionated stereotactic radiotherapy and tomotherapy treatment were administered to five patients diagnosed with intra-cranial cancer in which the dose of 18–20 Gy was applied on 3–5 separate *** tumor dosing was decided by evaluating the inhomogeneous index （II） and conformity index （CI）.Also,the radiation-sensitive tissue was evaluated using low dose factors V1,V2,V3,V4,V5,and V10,as well as the non-irradiation ratio volume （NIV）.The values of the II for each prescription dose in the linacbased non-coplanar radiotherapy plan and tomotherapy treatment plan were （0.125±0.113） and （0.090±0.180）,respectively,and the values of the CI were （0.899±0.149） and （0.917±0.114）,*** low dose areas,V1,V2,V3,V4,V5,and V10,in radiation-sensitive tissues in the linac-based non-coplanar radiotherapy plan fell into the ranges 0.3%–95.6%,0.1%–87.6%,0.1%–78.8%,38.8%–69.9%,26.6%–65.2%,and 4.2%–39.7%,respectively,and the tomotherapy treatment plan had ranges of 13.6%–100%,3.5%–100%,0.4%–94.9%,0.2%– 82.2%,0.1%–78.5%,and 0.3%–46.3%,*** the NIV for each organ,it is possible to obtain similar values except for the irradiation area of the brain *** percentages of NIV10%,NIV20%,and NIV30%for the brain stem in each patient were 15%–99.8%,33.4%–100%,and 39.8%–100%,respectively,in the fractionated stereotactic treatment plan and 44.2%–96.5%,77.7%–99.8%,and 87.8%–100%,respectively,in the tomotherapy treatment *** order to achieve higher-quality treatment of intra-cranial tumors,treatment plans should be tailored according to the isodose target volume,inhomogeneous index,conformity index,position of the tumor upon fractionated stereotactic radiosurgery,and radiation dosage for radiation-sensitive tissues.

关键词： fractionated stereotactic radiotherapy tomotherapy treatment plan virtual organ delineation

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Facial nerve paralysis in children

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World Journal of Clinical Cases 2015年第12期3卷 973-979页

作者： Andrea Ciorba Virginia Corazzi Veronica Conz Chiara Bianchini Claudia Aimoni ent and Audiology department University Hospital of Ferrara

Facial nerve palsy is a condition with several implications, particularly when occurring in childhood. It represents a serious clinical problem as it causes significant concerns in doctors because of its etiology, its treatment options and its outcome, as well as in little patients and their parents, because of functional and aesthetic outcomes. There are several described causes of facial nerve paralysis in children, as it can be congenital(due to delivery traumas and genetic or malformative diseases) or acquired(due to infective,inflammatory, neoplastic, traumatic or iatrogenic causes). Nonetheless, in approximately 40%-75% of the cases, the cause of unilateral facial paralysis still remains idiopathic. A careful diagnostic workout and differential diagnosis are particularly recommended in case of pediatric facial nerve palsy, in order to establish the most appropriate treatment, as the therapeutic approach differs in relation to the etiology.

关键词： Facial paralysis Seventh cranial nerve Children Bell’s palsy Therapy

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Molecular classifications of gastric cancers: Novel insights and possible future applications

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World Journal of Gastrointestinal oncology 2017年第5期9卷 194-208页

作者： Silvio Ken Garattini Debora Basile Monica Cattaneo Valentina Fanotto Elena Ongaro Marta Bonotto Francesca V Negri Rosa Berenato Paola Ermacora Giovanni Gerardo Cardellino Mariella Giovannoni Nicoletta Pella Mario Scartozzi Lorenzo Antonuzzo Nicola Silvestris Gianpiero Fasola Giuseppe Aprile department of oncology University and General Hospital Medical oncology University Hospital Medical oncology National Cancer InstituteIRCCS department of oncology University Hospital

Despite some notable advances in the systemic management of gastric cancer(GC), the prognosis of patients with advanced disease remains overall poor and their chance of cure is anecdotic. In a molecularly selected population, a median overall survival of 13.8 mo has been reached with the use of human epidermal growth factor 2(HER2) inhibitors in combination with chemotherapy, which has soon after become the standard of care for patients with HER2-overexpressing GC. Moreover, oncologists have recognized the clinical utility of conceiving cancers as a collection of different molecularlydriven entities rather than a single disease. Several molecular drivers have been identified as having crucial roles in other tumors and new molecular classifications have been recently proposed for gastric cancer as well. Not only these classifications allow the identification of different tumor subtypes with unique features, but also they serve as springboard for the development of different therapeutic strategies. Hopefully, the application of standard systemic chemotherapy, specifictargeted agents, immunotherapy or even surgery in specific cancer subgroups will help maximizing treatment outcomes and will avoid treating patients with minimal chance to respond, therefore diluting the average benefit. In this review, we aim at elucidating the aspects of GC molecular subtypes, and the possible future applications of such molecular analyses.

关键词： Molecular biology Immunotherapy Gastric cancer Classification Targeted therapy

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Endoscopic full-thickness resection: current status

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World Journal of Gastroenterology 2015年第31期21卷 9273-9285页

作者： Arthur Schmidt Benjamin Meier Karel Caca department of Gastroenterology and oncology

Conventional endoscopic resection techniques such as endoscopic mucosal resection or endoscopic submucosal dissection are powerful tools for treatment of gastrointestinal neoplasms. However,those techniques are restricted to superficial layers of the gastrointestinal wall. Endoscopic full-thickness resection(EFTR) is an evolving technique,which is just about to enter clinical routine. It is not only a powerful tool for diagnostic tissue acquisition but also has the potential to spare surgical therapy in selected patients. This review will give an overview about current EFTR techniques and devices.

关键词： Endoscopic full-thickness resection Over-the-scope

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Notes for developing a molecular test for the full characterization of circulating tumor cells

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Chinese Journal of Cancer Research 2015年第5期27卷 471-478页

作者： Elisabetta Rossi Antonella Facchinetti Rita Zamarchi department of Surgery Oncology and GastroenterologyOncology SectionUniversity of Padova IOV-IRCCS

The proved association between the circulating tumor cell （CTC） levels and the patients＇ survival parameters has been growing interest to investigate the molecular profile of these neoplastic cells among which hide out precursors capable of initiating a new distant metastatic lesion. The full characterization of the tumor cells in peripheral blood of cancer patients is expected to be of help for understanding and （prospectively） for counteracting the metastatic process. The major hitch that is hampering the successful gaining of this result is the lack of a consensus onto standard operating procedures （SOPs） for performing what we generally define as the ＂liquid biopsy＂. Here we review the more recent acquisitions in the analysis of CTCs and tumor related nucleic acids, looking to the main open questions that are hampering their definitive employ in the routine clinical practice.

关键词： Circulating tumor cells (CTCs) single-cell analysis liquid biopsy

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Pancreatic adenosquamous carcinoma and intraductal papillary mucinous neoplasm in a CDKN2A germline mutation carrier

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World Journal of Gastrointestinal oncology 2017年第9期9卷 390-396页

作者： Fernando Martínez de Juan María Reolid Escribano Carmen Martínez Lapiedra Fernanda Maia de Alcantara María Caballero Soto Ana Calatrava Fons Isidro Machado Gastroenterology and Digestive Endoscopy department Valencian Institute of Oncology Digestive Surgery department Valencian Institute of Oncology Pathology department Valencian Institute of Oncology

A 69-year-old woman from a kindred with familial atypical multiple mole melanoma and carrier of a germline mutation in CDKN2A, presented with abdominal pain caused by a solid-cystic pancreatic mass. The patient had an abdominal computed tomography three years before in which there was no evidence of pancreatic lesion. The endoscopic ultrasound guided fine needle aspiration showed adenocarcinoma with squamous component. After surgical resection the final diagnosis was adenosquamous pancreatic carcinoma(ASPC) arising in an intraductal papillar mucinous neoplasm(IPMN). Adenosquamous carcinomas are uncommon in the pancreas and have rarely been described in association with IPMNs. It has worse prognosis than the ordinary pancreatic ductal adenocarcinoma and some distinct features. We review the clinical, imaging, pathologic and molecular aspects of ASPC. Differential diagnosis with contamination, squamous metaplasia and pancreatic metastases from a distant squamous carcinoma is discussed. Besides, the case is an accelerated model of the adenoma(IPMN)-carcinoma sequence probably due to the CDKN2A ger-mline mutation. Somatic CDKN2A mutations are commonevents in the early steps of sporadic pancreatic cancer, but germline mutation carriers have a significantly higher risk of pancreatic carcinoma.

关键词： Intraductal papillary mucinous neoplasia Melanoma-pancreatic cancer syndrome Adenosquamous carcinoma Pancreatic carcinoma CDKN2A

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The 2002 AJCC TNM classification is a better predictor of primary small cell esophageal carcinoma outcome than the VALSG staging system

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Chinese Journal of Cancer 2013年第6期32卷 342-352页

作者： Sheng-Ye Wang Wei-Ming Mao Xiang-Hui Du Ya-Ping Xu Su-Zhan Zhang department of Radiation oncology Zhejiang Cancer Hospital department of oncology Τhe Second Affiliated Hospital Zhejiang University

Small cell carcinoma of the esophagus (SCCE) is a rare and aggressive malignant tumor with a poor prognosis. The optimal disease staging system and treatment approaches have not yet been defined. This study aimed to evaluate the prediction of different staging systems for prognosis and treatment options of SCCE. We retrospectively accessed the clinicopathologic characteristics, treatment strategy, and prognosis of 76 patients diagnosed with primary SCCE between 2001 and 2011. The 1-, 2-, 3-, and 5-year overall survival rates were 58%, 31%, 19%, and 13%, respectively. Univariate analysis showed that the 2002 American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) classification (P=0.002), Veterans Administration Lung Study Group (VALSG) stage (P=0.001), predisposing factors (Pent prognostic factor for survival. The value of the area under the receiver operator characteristic (ROC) curve (AUC) of the 2002 AJCC TNM staging system was larger than that of VALSG staging system with regard to predicting overall survival (0.774 vs. 0.620). None of the single treatment regimens showed any benefit for survival by Cox regression analysis. Thus, the 2002 AJCC TMN staging system improved the prediction of SCCE prognosis; however, the optimal treatment regimen for SCCE remains unclear.

关键词：系统预测 TNM 食管癌细胞原发性治疗方案分类病理特征

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Prolonged acute hepatitis A mimicking autoimmune hepatitis

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World Journal of Gastroenterology 2005年第24期11卷 3791-3793页

作者： Rintaro Mikata Osamu Yokosuka Fumio Imazeki Kenichi Fukai Tatsuo Kanda Hiromitsu Saisho department of Medicine and Clinical oncology

AIM: We report a case with a prolonged course of hepatitis A, with alanine aminotransferase (ALT) higher than 500 IU/L for more than 2 mo. METHODS: A middle-aged woman had an elevated IgG level of more than 2 000 mg/dL, positive anti-nudear antibodies (ANA) and anti-smooth muscle antibodies (ASMA), but no evidence of persistent hepatitis A virus (HAV) infection. Liver biopsy findings were compatible with prolonged acute hepatitis, although acute onset of autoimmune hepatitis could not be ruled out. RESULTS: It was assumed that she developed a course of hepatitis similar to autoimmune hepatitis triggered by HAV infection. Ursodeoxycholic acid (UDCA) treatment was initiated and a favorable outcome was obtained. CONCLUSION: We describe a case of a middle-aged woman who showed a prolonged course of acute hepatitis A mimicking autoimmune hepatitis. Treatment with UDCA proved to be effective.

关键词： Prolonged IgG Hepatitis A Autoimmune hepatitis

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Combination chemotherapy with paclitaxel,cisplatin and fluorouracil for patients with advanced and metastatic gastric or esophagogastric junction adenocarcinoma:a multicenter prospective study

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Chinese Journal of Cancer Research 2012年第4期24卷 291-298页

作者： Xiao-Dong Zhang Yong-Qian Shu Jun Liang Feng-Chun Zhang Xue-Zhen Ma Jian-Jin Huang Li Chen Gen-Ming Shi Wei-Guo Cao Cheng-Ye Guo Lin Shen Mao-Lin Jin Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education) Department of Gastrointestinal Medical OncologyPeking University Cancer Hospital & Institute department of Medical oncology Jiangsu Province Hospital department of Medical oncology the Affiliated Hospital of Medical CollegeQingdao University department of Medical oncology Suzhou Kowloon HospitalShanghai Jiaotong University School of Medicine department of Medical oncology Qingdao Central Hospital department of Medical oncology Second Affiliated HospitalZhejiang University department of Medical oncology Shandong Tumor Hospital department of Medical oncology the First Affiliated Hospital of College of MedicineZhejiang University department of Medical oncology Ruijin Hospital ShanghaiShanghai Jiaotong University School of Medicine department of Medical oncology Qingdao Municipal Hospital

Objective： To evaluate the efficacy and toxicity of the combination regimen of paclitaxel, cisplatin and 5-FU （PCF） as first-line or second-line therapy in patients with advanced gastric and esophagogastric junction （EGJ） adenocarcinoma in China. Methods： The patients were treated with paclitaxel 150 mg/m2 on dl; fractionated cisplatin 15 mg/m2 and continuous infusion 5-FU 600 mg/（mLd） intravenously on d 1-d5 of a 21-d cycle until disease progression or unacceptable toxicities. Results： Seventy-five patients have been enrolled, among which, 41 received PCF regimen as the first-line therapy （group A） and 34 received the regimen as the second-line therapy （group B） with the median age of 59 years old and Karnofsky performance status （KPS） score 〉80. Toxicities were analyzed in all 75 patients. Seventy-one patients were evaluable for efficacy. The median overall survival （mOS） was 12.0 months （95% CI： 7.9-16.2 months） in group A and 7.3 months （95% CI： 4.3-10.3 months） in group B, respectively. The median progression-free survival （mPFS） was 5.7 months （95% CI： 4.1-7.2 months） and 5.0 months （95% CI： 3.1-6.9 months）, respectively. The response rate （CR^PR） was 40% （16/40; 95% CI： 24.9-56.7%） in group A and 22.6% （7/31; 95% CI： 9.6-41.1%） in group B. Major grade 3 or 4 adverse events include neutropenia （41.3 %）, febrile neutropenia （9.3 %）, nausea/anorexia （10.7%）, and vomiting （5.3 %）. There was no treatment-related death. Conclusions： The combination chemotherapy with PCF is active and tolerable as first-line and second- line therapy in Chinese patients with advanced gastric and EGJ adenocarcinoma. The response and survival of PCF are same as those of DCF, but the tolerance is much better.

关键词： Advanced gastric cancer esophagogastric junction (EGJ) adenocarcinoma paclitaxel

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