AIM: In this retrospective study of unresectable hepatocellular carcinoma (HCC), we have investigated the efficacy of CT-derived parameters, laboratory measurements, clinical assessment and associated transarterial em...AIM: In this retrospective study of unresectable hepatocellular carcinoma (HCC), we have investigated the efficacy of CT-derived parameters, laboratory measurements, clinical assessment and associated transarterial embolization (TAE) as predictors of post-radiotherapy survival time. METHODS: Sixty-six patients diagnosed with unresectable HCC that had undergone radiotherapy at two medical university hospitals in Taipei were enrolled in the study. Using multivariant analysis, pre-treatment parameters including tumor number and CT confirmation of PVT and ascites were compared. Multivariant analysis was also used for comparison of the mean pretreatment values for laboratory measurements, including alpha-fetoprotein, direct/total bilirubin and GOT/GPT levels, and clinical history of chronic hepatitis across the three survival-time categories. The x2 was used to test the significance of the relationship between survival time and TAE procedure. The P values for the above tests were deemed statistically significant where P<0.05. RESULTS: Portal vein thrombosis (P= 0.032) and ascites (P><0.05) were negative predictors of post-radiation survival time. Low-grade liver cirrhosis (A or B), lower tumor volume and low levels of AFT, GOT/GPT, and total bilirubin were predictors of longer post-radiation survival time (P<0.05). CONCLUSION: The CT and clinical and laboratory assessment provide a reference for, and enable estimation of, probable survival times in HCC patients after radiotherapy. Tumor volume, severity of liver cirrhosis, status with respect to portal vein thrombosis and ascites and AFT, GOT/GPT and total bilirubin values were significant predictors of survival in this study.展开更多
Aim:The aim of this study was to evaluate the impact of MRI performed three months after treatment on further follow-up interventions and outcome in patients with uterine cervical carcinoma treated with definitive che...Aim:The aim of this study was to evaluate the impact of MRI performed three months after treatment on further follow-up interventions and outcome in patients with uterine cervical carcinoma treated with definitive chemoradiotherapy.Methods:Sixty consecutive women diagnosed with uterine cervical cancer FIGO 2009 stage IB1-IVA during 2011-2012 treated with definitive chemoradiotherapy/radiotherapy with curative intent at the Department of Gynaecological Oncology at Karolinska University Hospital were retrospectively included.A review of MRI reports and medical records with focus on follow-up interventions associated to imaging was performed.Results:On follow-up MRI three months post treatment,29/60 women had complete remission(mrCR),24/60 women had partial remission(mrPR)and 7/60 had progressive disease(mrPD).In patients with mrCR,no additional procedures were performed.The group with mrPR had 27 additional MRIs,3 PET/CT examinations and 9 biopsy procedures,none leading to diagnosis of residual tumour.Locoregional control rate was 96%after 6.5 months(median).No patient had cervical relapse only;2/53 had cervical relapse in combination with non-regional lymph nodes and distant relapse.There was no statistically significant difference in overall survival between patients with mrCR and mrPR(HR=2.2,P=0.21).Conclusion:Patients with residual changes on MRI at three months post treatment have a low risk for locoregional recurrence.If this is not recognised,follow-up MRI results in unnecessary additional procedures with low impact on treatment outcome.Further studies are needed regarding the most appropriate imaging modality and timing of post-treatment evaluation.展开更多
文摘AIM: In this retrospective study of unresectable hepatocellular carcinoma (HCC), we have investigated the efficacy of CT-derived parameters, laboratory measurements, clinical assessment and associated transarterial embolization (TAE) as predictors of post-radiotherapy survival time. METHODS: Sixty-six patients diagnosed with unresectable HCC that had undergone radiotherapy at two medical university hospitals in Taipei were enrolled in the study. Using multivariant analysis, pre-treatment parameters including tumor number and CT confirmation of PVT and ascites were compared. Multivariant analysis was also used for comparison of the mean pretreatment values for laboratory measurements, including alpha-fetoprotein, direct/total bilirubin and GOT/GPT levels, and clinical history of chronic hepatitis across the three survival-time categories. The x2 was used to test the significance of the relationship between survival time and TAE procedure. The P values for the above tests were deemed statistically significant where P<0.05. RESULTS: Portal vein thrombosis (P= 0.032) and ascites (P><0.05) were negative predictors of post-radiation survival time. Low-grade liver cirrhosis (A or B), lower tumor volume and low levels of AFT, GOT/GPT, and total bilirubin were predictors of longer post-radiation survival time (P<0.05). CONCLUSION: The CT and clinical and laboratory assessment provide a reference for, and enable estimation of, probable survival times in HCC patients after radiotherapy. Tumor volume, severity of liver cirrhosis, status with respect to portal vein thrombosis and ascites and AFT, GOT/GPT and total bilirubin values were significant predictors of survival in this study.
文摘Aim:The aim of this study was to evaluate the impact of MRI performed three months after treatment on further follow-up interventions and outcome in patients with uterine cervical carcinoma treated with definitive chemoradiotherapy.Methods:Sixty consecutive women diagnosed with uterine cervical cancer FIGO 2009 stage IB1-IVA during 2011-2012 treated with definitive chemoradiotherapy/radiotherapy with curative intent at the Department of Gynaecological Oncology at Karolinska University Hospital were retrospectively included.A review of MRI reports and medical records with focus on follow-up interventions associated to imaging was performed.Results:On follow-up MRI three months post treatment,29/60 women had complete remission(mrCR),24/60 women had partial remission(mrPR)and 7/60 had progressive disease(mrPD).In patients with mrCR,no additional procedures were performed.The group with mrPR had 27 additional MRIs,3 PET/CT examinations and 9 biopsy procedures,none leading to diagnosis of residual tumour.Locoregional control rate was 96%after 6.5 months(median).No patient had cervical relapse only;2/53 had cervical relapse in combination with non-regional lymph nodes and distant relapse.There was no statistically significant difference in overall survival between patients with mrCR and mrPR(HR=2.2,P=0.21).Conclusion:Patients with residual changes on MRI at three months post treatment have a low risk for locoregional recurrence.If this is not recognised,follow-up MRI results in unnecessary additional procedures with low impact on treatment outcome.Further studies are needed regarding the most appropriate imaging modality and timing of post-treatment evaluation.
