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2007 2

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Improved local control without elective nodal radiotherapy in patients with unresectable NSCLC treated

YANG Kunyu, LIU Li, ZHANG Tao, WU Gang, CAO Fengjun, WANG Jianhua

《医学前沿（英文）》 2007年第1卷第4期页码 381-385 doi: 10.1007/s11684-007-0074-7

摘要： To investigate the influence of prophylactic elective nodal irradiation on the therapeutic results of definitive radiotherapy for patients with stage IIIA or stage IIIB unresectable non-small-cell lung cancer, 55 patients with clinically inoperable advanced non-small-cell lung cancer were studied. After four cycles of induction chemotherapy, the patients were divided into two groups at random. In one group, the elective nodal irradiation was included in clinical tumor volume (CTV) of definitive radiotherapy (ENI group); and in the other group, elective nodal irradiation was not included in CTV (non-ENI group). For the patients in the ENI group, the mean prescription dose for gross tumor volumes was 58.4 Gy, while for the patients in the non-ENI group, it was 65.8 Gy (<0.05). The responsive rates were 45.8% and 74.0% (<0.05), and the rate of the elective nodal failure (ENF) was 4.2% and 11.1%, respectively. Kaplan-Meier analysis showed that the mean local-progression-free survival time was 11.0 and 15.0 months, and one-year local-failure rates were 51.9% and 24.5% (<0.05). The median overall survival time was 13.0 and 15.0 months, respectively ( = 0.084). The one-year survival rates were 55.7% and 72.5%, and two-year survival rates were 0% and 19.9%. There was no significant difference in the occurrences of radiation-associated complications between the two groups. Our results showed that omitting elective nodal irradiation did not result in a high incidence of elective nodal failure. On the contrary, it decreased local failure by increasing prescription doses to the primary diseases and lymphadenopaphy, and thereby it may further prolong the patients survival.

关键词： significant difference irradiation unresectable non-small-cell induction chemotherapy influence

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An analysis of clinico-pathologic features of intraductal papillary mucinous neoplasm of the pancreas

LOU Wenhui, JIN Dayong, WANG Dansong, XU Xuefeng, KUANG Tiantao, QIN Xinyu

《医学前沿（英文）》 2007年第1卷第2期页码 173-176 doi: 10.1007/s11684-007-0032-4

摘要： The natural history and clinical manifestation of resected intraductal papillary mucinous neoplasm (IPMN) of the pancreas were elucidated, and based on this, a retrospective pancreatic database was reviewed to identify patients with IPMN who were surgically managed in our department from 1999 to June 2006. Pathologic rereview of each case was performed, and the clinico-pathologic features were examined. Student s test and analysis were used to identify factors associated with malignancy. Fifty-one patients were identified. There were 33 males and 18 females. One patient s pancreas was unresectable, two patients underwent a total pancreatectomy, 42 patients had a pancreatecoduodenectomy and five patients had distal pancreatectomy. Main-duct type carcinoma was identified in 24 patients; branch-duct type in 15 patients, and mixed type in 12 patients. Invasive carcinoma was present in 35 patients. Weight loss and jaundice occurred more commonly in the invasive group. The average serum CA19-9 level was significantly higher in the invasive group (1542μ 94.5μ). The average diameter of the pancreatic duct was also wider in the invasive group (8.7 mm 4.3 mm). Significant predictors of malignant IPMNs included weight loss, jaundice, a high level of serum CA19-9, a large pancreatic duct and main-duct type carcinoma.

关键词： diameter Pathologic rereview invasive unresectable intraductal papillary