AIM： To evaluate the prevalent topical therapeutic modalities available for the treatment of acute radiation proctitis compared to formalin. METHODS： A total of 120 rats were used. Four groups （n = 30） were analyz...AIM： To evaluate the prevalent topical therapeutic modalities available for the treatment of acute radiation proctitis compared to formalin. METHODS： A total of 120 rats were used. Four groups （n = 30） were analyzed with one group for each of the following applied therapy modalities： control, mesalazine, formalin, betamethasone, and misoprostol. A single fraction of 17.5 Gy was delivered to each rat. The rats in control group rats were given saline, and the rats in the other three groups received appropriate enemas twice a day beginning on the first day after the irradiation until the day of euthanasia. On d 5, 10, and 15, ten rats from each group were euthanized and a pathologist who was unaware of treatment assignment examined the rectums using a scoring system. RESULTS： The histopathologic scores for surface epithelium, glands （crypts） and lamina propria stroma of the rectums reached their maximum level on d 10. The control and formalin groups had the highest and mesalazine had the lowest, respectively on d 10. On the 15^th d, mesalazine, betamethasone, and misoprostol had the lowest scores of betamethasone. CONCLUSION： Mesalazine, betamethasone, and misoprostol are the best topical agents for radiation proctitis and formalin has an inflammatory effect and should not be used.展开更多
AIM To evaluate the efficacy and tolerability of neoadjuvant hyperfractionated accelerated radiotherapy(HART)and concurrent chemotherapy in patients with locally advanced infraperitoneal rectal cancer.METHODS A total ...AIM To evaluate the efficacy and tolerability of neoadjuvant hyperfractionated accelerated radiotherapy(HART)and concurrent chemotherapy in patients with locally advanced infraperitoneal rectal cancer.METHODS A total of 30 patients with histopathologically confirmed T2-3/N0+infraperitoneal adenocarcinoma of rectum cancer patients received preoperative 42 Gy/1.5 Gy/18 days/bid radiotherapy and continuous infusion of 5-fluorouracil(325 mg/m^2).All patients were operated 4-8 wk after neoadjuvant concomitant therapy.RESULTS In the early phase of treatment,6 patients had gradeⅢ-Ⅳgastrointestinal toxicity,2 patients had gradeⅢ-Ⅳhematologic toxicity,and 1 patient had gradeⅤtoxicity due to postoperative sepsis during chemotherapy.Only 1 patient had radiotherapy-related late side effects,i.e.,gradeⅣtenesmus.Complete pathological response was achieved in 6 patients(21%),while near-complete pathological response was obtained in 9(31%).After a median follow-up period of 60 mo,the local tumor control rate was 96.6%.In 13 patients,distant metastasis occurred.Disease-free survival rates at 2 and 5 years were 63.3%and 53%,and corresponding overall survival rates were 70%and 53.1%,respectively.CONCLUSION Although it has excellent local control and complete pathological response rates,neoadjuvant HART concurrent chemotherapy appears to not be a feasible treatment regimen in locally advanced rectal cancer,having high perioperative complication and intolerable side effects.Effects of reduced 5-fluorouracil dose or omission of chemotherapy with the aim of reducing toxicity may be examined in further studies.展开更多
Phyllode tumor （PT） is extremely rare tumor of the breast. Distant metastasis occurs in 10-20% of patients with malignant phyllode tumor. The most common sites of metastases are the lungs and bones. Although theoret...Phyllode tumor （PT） is extremely rare tumor of the breast. Distant metastasis occurs in 10-20% of patients with malignant phyllode tumor. The most common sites of metastases are the lungs and bones. Although theoretically any organ may have metastasis, an isolated duodenum metastasis has not been documented as yet in the English-language literature. We report herein a case with a isolated duodenal metastasis from PT of breast in a 31 year-old-woman who underwent right mastectomy 4 years before because of the recurrent malignant PT. She presented to our hospital with massive upper gastrointestinal bleeding. Clinical evaluation revealed a huge mass originated from duodenum. Urgent laparotomy and pancreaticoduodenectomy were carried out in order to remove the bleeding duodenal mass. The pathologic examination of the resected specimen showed a malignant spindle cell tumor consistent with metastatic malignant PT. Our case of gastrointestinal bleeding due to an isolated duodenal metastasis as a result of hematogenous spread from malignant phyllode tumor of breast is unique in the English literature and pancreaticoduodenectomy is a curative treatment for patients with isolated duodenal involvement.展开更多
文摘AIM： To evaluate the prevalent topical therapeutic modalities available for the treatment of acute radiation proctitis compared to formalin. METHODS： A total of 120 rats were used. Four groups （n = 30） were analyzed with one group for each of the following applied therapy modalities： control, mesalazine, formalin, betamethasone, and misoprostol. A single fraction of 17.5 Gy was delivered to each rat. The rats in control group rats were given saline, and the rats in the other three groups received appropriate enemas twice a day beginning on the first day after the irradiation until the day of euthanasia. On d 5, 10, and 15, ten rats from each group were euthanized and a pathologist who was unaware of treatment assignment examined the rectums using a scoring system. RESULTS： The histopathologic scores for surface epithelium, glands （crypts） and lamina propria stroma of the rectums reached their maximum level on d 10. The control and formalin groups had the highest and mesalazine had the lowest, respectively on d 10. On the 15^th d, mesalazine, betamethasone, and misoprostol had the lowest scores of betamethasone. CONCLUSION： Mesalazine, betamethasone, and misoprostol are the best topical agents for radiation proctitis and formalin has an inflammatory effect and should not be used.
文摘AIM To evaluate the efficacy and tolerability of neoadjuvant hyperfractionated accelerated radiotherapy(HART)and concurrent chemotherapy in patients with locally advanced infraperitoneal rectal cancer.METHODS A total of 30 patients with histopathologically confirmed T2-3/N0+infraperitoneal adenocarcinoma of rectum cancer patients received preoperative 42 Gy/1.5 Gy/18 days/bid radiotherapy and continuous infusion of 5-fluorouracil(325 mg/m^2).All patients were operated 4-8 wk after neoadjuvant concomitant therapy.RESULTS In the early phase of treatment,6 patients had gradeⅢ-Ⅳgastrointestinal toxicity,2 patients had gradeⅢ-Ⅳhematologic toxicity,and 1 patient had gradeⅤtoxicity due to postoperative sepsis during chemotherapy.Only 1 patient had radiotherapy-related late side effects,i.e.,gradeⅣtenesmus.Complete pathological response was achieved in 6 patients(21%),while near-complete pathological response was obtained in 9(31%).After a median follow-up period of 60 mo,the local tumor control rate was 96.6%.In 13 patients,distant metastasis occurred.Disease-free survival rates at 2 and 5 years were 63.3%and 53%,and corresponding overall survival rates were 70%and 53.1%,respectively.CONCLUSION Although it has excellent local control and complete pathological response rates,neoadjuvant HART concurrent chemotherapy appears to not be a feasible treatment regimen in locally advanced rectal cancer,having high perioperative complication and intolerable side effects.Effects of reduced 5-fluorouracil dose or omission of chemotherapy with the aim of reducing toxicity may be examined in further studies.
文摘Phyllode tumor （PT） is extremely rare tumor of the breast. Distant metastasis occurs in 10-20% of patients with malignant phyllode tumor. The most common sites of metastases are the lungs and bones. Although theoretically any organ may have metastasis, an isolated duodenum metastasis has not been documented as yet in the English-language literature. We report herein a case with a isolated duodenal metastasis from PT of breast in a 31 year-old-woman who underwent right mastectomy 4 years before because of the recurrent malignant PT. She presented to our hospital with massive upper gastrointestinal bleeding. Clinical evaluation revealed a huge mass originated from duodenum. Urgent laparotomy and pancreaticoduodenectomy were carried out in order to remove the bleeding duodenal mass. The pathologic examination of the resected specimen showed a malignant spindle cell tumor consistent with metastatic malignant PT. Our case of gastrointestinal bleeding due to an isolated duodenal metastasis as a result of hematogenous spread from malignant phyllode tumor of breast is unique in the English literature and pancreaticoduodenectomy is a curative treatment for patients with isolated duodenal involvement.
