Yong-Hong Hu

Sun Yat-Sen University, Shengcheng, Guangdong, China

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Publications (15)9.04 Total impact

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    ABSTRACT: To study the influence of preoperative chemoradiotherapy(CRT) on pulmonary function and postoperative pulmonary complications in esophageal cancer patients. Pulmonary function and postoperative pulmonary complications of 63 esophageal cancer patients undergoing preoperative CRT and operation in Cancer Center of Sun Yat-sen University between 2002 and 2013 were collected retrospectively. The influence of preoperative CRT on pulmonary functional indexes and postoperative pulmonary complications were analyzed. After preoperative CRT, DLco% decreased significantly(83.7±17.7 vs. 96.4±17.8, P<0.01), while no obvious changes in other indexes were found. Postoperative pulmonary complication rate was 34.9%(22/63), including 19 cases of pneumonia and 3 cases of acute pulmonary injury/acute respiratory distress syndrome. Differences in postoperative pulmonary complication rates were not statistically significant between patients with DLco% <80 and those with DLco% ≥80 patients(29.7% vs. 41.7%, P>0.05), and between patients with DLco% decline ≥15% and those with DLco% decline <15% patients(31.6% vs. 37.8%, P>0.05). Preoperative CRT can damage the diffusion function but not ventilation function of esophageal cancer patients, and does not increase the postoperative pulmonary complication rate.
    Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery 09/2013; 16(9):827-30.
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    ABSTRACT: Accurate individualized measurement of organ motion is the premise of defining internal margin (IM) for abdominal malignancies. This study was to assess the three-dimensional abdominal organ motion caused by respiration using four-dimensional computed tomography (4DCT), and to analyze the association between the movement of diaphragm and abdominal organs. The 4DCT scans of 13 patients with hepatocellular carcinoma were analyzed, five of whom had para-aortic lymph node metastases. The liver, kidneys, pancreas, spleen, and para-aortic lymph nodes were contoured in all 10 respiratory phases of 4DCT scans. The 3D movement of diaphragm and organs was calculated and the relationship between the movement of diaphragm and abdominal organs was analyzed. The average diaphragmatic movement was (10.3+/-4.0) mm with wide interpatient variations. Analysis of the center of the mass of abdominal organs revealed predominant cranio-caudal (CC) movement, with a mean of (10.1+/-3.9) mm for liver, (9.3+/-2.9) mm for left kidney, (9.6+/-4.1) mm for right kidney, (7.6+/-3.0) mm for pancreas, (10.6+/-3.3) mm for spleen, and (5.7+/-1.8) mm for para-aortic lymph nodes. The CC movement of the liver and the right kidney correlated well with the diaphragmatic movement, and no significant differences were observed. There was no significant correlation of the diaphragmatic movement to the CC movement of left kidney, pancreas and spleen. The movement of both kidneys was comparable, however, the movement of one kidney did not predict the movement of the contralateral one. The 4DCT scanning can accurately measure abdominal organ motion during whole respiration. The diaphragmatic mobility can approximate the CC movement of liver and right kidney, and the movement amplitude of para-aortic lymph nodes is much smaller than diaphragmatic mobility.
    Ai zheng = Aizheng = Chinese journal of cancer 10/2009; 28(9):989-93.
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    ABSTRACT: To determine the feasibility of using limited four-dimensional computed tomography (4DCT) images for treatment planning. The 4DCT scans of 16 patients with hepatocellular carcinoma (HCC) were analyzed. Gross tumor volumes (GTVs) were manually contoured on all 10 respiratory phases, and different internal clinical target volumes (ICTVs) were derived by encompassing volumes of the respective CTVs. Volume, position, and shape of ICTVs were calculated and compared. The ICTV(2 phases), ICTV(3 phases), ICTV(4 phases), and ICTV(6 phases) all showed excellent agreement with ICTV(10 phases), and the ICTV(2 phases) encompassed ICTV(10 phases) by 94.1+/-1.8% on average. The 3D shift between the centers of mass of the ICTVs was only 0.6mm. The surface distance between ICTV(10 phases) and ICTV(2 phases) was 1.7+/-0.8mm in the left-right (LR) and anteroposterior (AP) directions. Contouring two extreme phases at end-inhalation and end-exhalation is a reasonably safe and labor-saving method of deriving ITV for liver radiotherapy with low and medium tumor motion amplitude (1.6 cm). Whether the larger tumor movement affects the results is the subject of ongoing research.
    Radiotherapy and Oncology 07/2009; 92(2):255-9. · 4.52 Impact Factor
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    ABSTRACT: For early stage breast cancer with less than four metastatic axillary lymph nodes (ALN), indications for adjuvant radiotherapy are not well defined. This study was to investigate the risk factors for postmastectomy locoregional recurrence and survival in those patients. In total 217 patients undergoing mastectomy in Sun Yat-sen University Cancer Center between March 1998 and March 2002 were retrospectively reviewed. Seventy-one patients were at pT1 stage, and 146 cases at pT2 stage. Two hundred and two patients received adjuvant chemotherapy, 51 received radiotherapy (RT), and 116 received endocrine therapy whose estrogen receptors (ER) or progesterone receptors (PR) were positive. The median follow-up time for these patients was 69 months. The 5-year actuarial locoregional recurrence-free survival (LRFS), disease-free survival (DFS), and overall survival (OS) were 85.2%, 81.8%, and 90.2%, respectively. Treatment failure was found in 44 patients, among whom 21 cases were diagnosed as locoregional recurrence. The 5-year actuarial OS was significantly lowered in patients with locoregional recurrence than in those without (61.9% vs. 93.6%, P<0.0001). Age younger than 35 years, pT2 tumor, and the rate of metastatic ALN>or=30% were risk factors for poor LRFS, DFS, and OS. When a scoring system was established consisting of these three prognostic factors, the 5-year actuarial LRFS in patients with varied scores were significantly different (P=0.0072). In the subgroup of 159 patients who received adjuvant chemotherapy of not less than five cycles, 35 patients who received adjuvant RT achieved significantly better survival rates than those who did not. Age younger than 35 years, pT2 tumor, and the rate of metastatic ALN>or=30% are risk factors for locoregional recurrence and survival in patients with early stage breast cancer who have one to three positive ALN. Adjuvant RT is recommended for those patients.
    Ai zheng = Aizheng = Chinese journal of cancer 04/2009; 28(4):395-401.
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    ABSTRACT: To investigate the effects of neo-adjuvant chemoradiotherapy followed by surgery in treatment of advanced esophageal carcinoma. Forty-two consecutive patients with locally advanced esophageal carcinoma underwent chemotherapy and radiotherapy concurrently. The chemotherapy consisted of intravenous infusion of vinorelbine (25 mg/m(2) per day) on days 1, 8, 22, and 29 or 5-fluorouracil (2.4 g/m(2)) on days 1 - 3 and days 22 - 24, and cisplatin (75 mg/m(2)) on days 1 and 22. Radiotherapy was delivered 5 days a week for 4 weeks with the total dose of 40 Gy divided into a daily fraction of 2.0 Gy. After the completion of chemoradiotherapy, clinical restaging was performed. Esophagectomy and lymphadenectomy were performed 4 - 6 weeks after the chemoradiotherapy. Forty-one of the 42 patients finished the preoperative chemoradiotherapy. The clinical response rate of chemoradiotherapy was 83.3%. Forty cases received esophagectomy, with a radical operation rate of 97.5% and a pathological complete response rate of 23.8%. The overall 1, 3, and 5-year survival rates were 66.9%, 54.5%, and 44.9% respectively with a median survival time of 43.4 months. The 1, 3, and 5-year disease-free survival rates were 61.1%, 48.7%, and 39.5% respectively with a median disease-free survival time of 32.7 months. The toxic responses of the chemoradiotherapy, such as myelotoxicity, pulmonary toxicity, and esophagitis were at grade 1 or 2. No death occurred during chemoradiotherapy. The incidence rates of postoperative pulmonary infection and severe arrhythmia were 22.5% and 20.0% respectively. The postoperative mortality rate was 5.0%. The neoadjuvant chemoradiotherapy followed by surgery achieves a high clinical response rate and pathologic complete tumor regression rate, significantly downstages the esophageal cancer, and improves the survival. Although the toxicity of chemoradiotherapy is mild, the side-effects cannot be ignored still.
    Zhonghua yi xue za zhi 01/2009; 88(45):3182-5.
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    ABSTRACT: Although concurrent radiochemotherapy is popularly accepted as a standard treatment for advanced esophageal carcinoma, there is still great room to improve the clinical efficacy. This phase II clinical trial was to further verify the efficacy of sodium glyci-didazole (CM-Na), as a valid sensitizer, combined with concurrent radiochemotherapy on advanced esophageal carcinoma, and observe adverse events. A total of 37 patients with esophageal carcinoma received radiotherapy at a dose of 54-60 Gy to the gross tumor volume (GTV) and a course of PF regimen [continuous intravenous drip of cisplatin 20 mg x (m(2) x d) g(-1) and 5-fluorouracil (5-FU) 500 mg x (m(2) x d) g(-1) on Days 1-5] every 3 weeks. All patients were given intravenous drip of CM-Na 700 mg/m(2) at 1 h before irradiation or chemotherapy three times weekly. All patients completed the treatment. Three months after treatment, 16 (43.2%) patients achieved complete remission (CR) and 17 (46.0%) achieved partial remission (PR); the overall response rate was 89.2%. The 1-and 2-year survival rates were 78.6% and 48.7%. The median survival time was 23.2 months. The occurrence rate of grade III adverse events was 21.6%; no neurotoxicity was observed. Concurrent chemoradiotherapy combined with CM-Na could enhance the response rate and prolong survival of the patients with advanced esophageal carcinoma.
    Ai zheng = Aizheng = Chinese journal of cancer 07/2008; 27(6):622-6.
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    ABSTRACT: To define individualized internal target volume (ITV) for hepatocellular carcinoma using four-dimensional computed tomography (4DCT). Gross tumor volumes (GTVs) and clinical target volumes (CTVs) were contoured on all 10 respiratory phases of 4DCT scans in 10 patients with hepatocellular carcinoma. The 3D and 4D treatment plans were performed for each patient using two different planning target volumes (PTVs): (1) PTV(3D) was derived from a single CTV plus conventional margins; (2) PTV(4D) was derived from ITV(4D), which encompassed all 10 CTVs plus setup margins (SMs). The volumes of PTVs and dose distribution were compared between the two plans. The average PTV volume of the 4D plans (328.4+/-152.2cm(3)) was less than 3D plans (407.0+/-165.6cm(3)). The 4D plans spared more surrounding normal tissues than 3D plans, especially normal liver. Compared with 3D plans, the mean dose to normal liver (MDTNL) decreased from 22.7 to 20.3Gy. Without increasing the normal tissue complication probability (NTCP), the 4D plans allowed for increasing the calculated dose from 50.4+/-1.3 to 54.2+/-2.6Gy, an average increase of 7.5% (range 4.0-16.0%). The conventional 3D plans can result in geometric miss and include excess normal tissues. The 4DCT-based plans can reduce the target volumes to spare more normal tissues and allow dose escalation compared with 3D plans.
    Radiotherapy and Oncology 10/2007; 84(3):272-8. · 4.52 Impact Factor
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    ABSTRACT: Accurate definition of target volume is difficult in three-dimensional conformal radiotherapy (3D CRT) for liver tumors because of the wide moving extent of tumors with respiration. This study was to define individualized internal target volume (ITV) using four-dimensional computed tomography (4D-CT), and compare planning target volumes (PTVs) and dose distribution of 3D planning with 4D planning for hepatocellular carcinoma (HCC). Seven primary HCC patients received 4D-CT scanning. Gross tumor volumes (GTVs) and clinical target volumes (CTVs) were contoured on all 10 respiratory phases of CT images. The 3D and 4D treatment plans were made for each patient using different PTVs, namely, PTV-3D derived from a single CTV plus conventional margins; PTV-4D derived from ITV-4D which encompassing all 10 CTVs plus setup margins (SM). The two plans were designed at the 20% respiratory phase CT images using 3D treatment planning system and compared with respect to PTVs, dose distribution to normal tissues, normal tissue complication probability. The prescription dose and design of irradiating fields were identical for both plans. The average PTV was (417.6+/-197.7) cm(3) in 3D plan and (331.9+/-183.1) cm(3) in 4D plan, decreased by 20.50% (12.60%-34.40%). PTV coverage and dose uniformity were similar in the 2 plans. 4D plans spared more normal liver, kidney, stomach, and small intestine than 3D plans, especially for the liver. The V30 and V40 of the liver were lower in 4D plans than in 3D plans (33.59% vs. 38.77%, 22.62% vs. 27.32%); the mean dose to normal liver was decreased from 24.13 Gy to 21.5 Gy; liver complication probability was decreased from 21.57% to 15.86%. Without increasing the normal tissue complication probability, the prescription dose was higher in 4D plans than in 3D plans [(54.86+/-2.79) Gy vs. (50.57+/-1.51) Gy], increased by 9.72% (4%-16%). The 3D plans have pitfalls of geometric miss or over coverage of target volume. The 4D plans can accurately definite target volume to spare more normal tissues and make dose escalation as compared with 3D CRT.
    Ai zheng = Aizheng = Chinese journal of cancer 02/2007; 26(1):1-8.
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    ABSTRACT: To evaluate the long-term effect of sodium glycididazole (CMNa) as a hypoxic radiosensitizer on the radiotherapy for nasopharyngeal carcinoma. Between May 1999 and May 2002, 211 patients with pathologically confirmed nasopharyngeal carcinoma were randomized into group-A treated by radiotherapy plus CMNa or group-B by radiotherapy alone. The staging was determined according to 92' Fuzhou staging systerm. The type, procession and dosage of radiotherapy were identical in both groups. The early adverse effect grade was assessed based on the CTC2.0 criteria and the late adverse effects were evaluated according to the RTOG/EORTC criteria. The median follow-up time was 52 months. All the data was analyzed by the SPSS 13.0 software. Characteristics and adverse events of these patients were compared between the two groups using t-test and the Wilcoxin rank sum test. Time-to-event curves were estimated using the Kaplan-Meier method. The prognostic parameters were analyzed using univariate analysis and the Cox multivariate regression analysis. The clinical data of the two groups were comparable. The 3-year survival was 88.4% in group-A, while 75.2% in group-B, with a statistically significant difference between two groups (P = 0.010). Univariate analysis showed that the 3-year survival was statistically correlated with N-staging ((N0-1, 86.9%, N2-3 73.8%, P < 0.001), T-staging (T1-2 85.6%, T3-4 79.3%, P = 0.014), TNM staging (P = 0.039), and whether using CMNa or not during rediotherapy (Group-A 88.4%, Group-B 75.2%, P = 0.010). The 5-year recurrence-free survival, 5-year metastasis-free survival and 5-year overall survival were 75.8%, 74.9% and 77.7% in Group-A, while 63.0%, 63.0% and 62.4% in Group-B with a statistically significant difference between two groups (0.013, 0.022 and 0.010, respectively). If stratified in the subgroups, the overall survival of stage III - IV patients was statistically different between group A and B (P = 0.009), however, not of stage I - II patients (P = 0.502). Cox multivariate regression analysis showed that the independent prognostic parameters for survival were N-stage (RR = 3.288) , T-stage (RR = 2.147) and use of CMNa during rediotherapy (RR = 0.407). However, there was no statistically significant difference between two groups in acute or late adverse effects on nervous system or heart, which suggested that use of CMNa during radiotherapy would not aggravate the toxicity caused by radiotherapy. Sodium glycididazole is well tolerable effective as a hypoxic radiosensitizer, which can improve the efficacy of radiotherapy and the long-term result of nasopharyngeal carcinom a patients, especially for the stage III - IV patients.
    Zhonghua zhong liu za zhi [Chinese journal of oncology] 01/2007; 28(12):932-7.
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    ABSTRACT: Barium swallow is widely used to observe the treatment response of esophageal squamous cell carcinoma (ESCC) and as a routine examination for long-term follow-up in China because of its convenience and inexpensiveness. This study was to observe esophageal tumor regression by barium swallow during radiotherapy, analyze the correlations of tumor regression speed to short-term response and long-term survival, and evaluate the clinical value of barium swallow during radiotherapy for ESCC. Clinical data from 94 patients with ESCC, treated with radiotherapy (39 patients) or chemoradiotherapy (55 patients) from Jan. 2001 to Jun. 2003 at Cancer Center of Sun Yat-sen University, were retrospectively reviewed. Of the 94 patients, 18 (19.1%) were at stage II, 36 (36.3%) at stage III, and 42 (44.6%) at stage IV. Barium swallow was performed at the radiation dose of 40 Gy and the radiation end, and the X-ray appearance was classified according to Zhengzhou Meeting criteria. The patients were divided into 3 groups according to their tumor regression speed: Group A had rapid regression, with the X-ray appearance classified as grade I or II at 40 Gy, Group B had slow regression, with the X-ray appearance classified as grade III or IV at 40 Gy, but as grade I or II at the radiation end, Group C had obvious residual tumors, with the X-ray appearance kept being classified as grade III or IV till radiation end. The correlations of tumor regression speed to short-term response and long-term survival were analyzed. The complete response (CR) rates were 100.0% in Group A, 65.2% in Group B, and 28.3% in Group C (P<0.001), the 3-year survival rates were 44.0%, 24.2%, and 17.3%, respectively (P<0.001). Multivariate Cox regression analysis showed that short-term response and M stage were independent prognostic factors. The 3-year survival rates of CR patients were 44.0% in Group A, 32.6% in Group B, and 42.2% in Group C (P=0.814). The locoregional failure rates were 50% in Group A, 88% in Group B, and 81% in Group C, and the occurrence rates of severe radiation-related complications were 19%, 0%, and 6%, respectively. Barium swallow during radiotherapy for ESCC could be used to judge tumor regression speed, which is closely related to short-term response. Short-term response is an important prognostic factor of ESCC.
    Ai zheng = Aizheng = Chinese journal of cancer 07/2006; 25(6):723-7.
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    ABSTRACT: Concurrent chemoradiotherapy is recommended as standard treatment for unresectable esophageal carcinoma now. This study was to analyze the prognostic factors of unresectable esophageal carcinoma after concurrent chemoradiotherapy. A total of 132 unresectable esophageal carcinoma patients received concurrent chemoradiotherapy from Jan. 1996 to Dec. 2003 in our hospital. All patients received chemotherapy at the beginning of radiotherapy, and when the radiation dose escalated to 40 Gy. Total dose of irradiation was 60-70 Gy. Gender, age, disease course, focus location, swallow embarrassment, weight loss, Karnofsky's performance status (KPS) score, family history, hemoglobin (HB) before therapy, X-ray type, pathologic grade, focus length, TNM stage, irradiation method and technology, irradiation dose, radiotherapy interval, short-term effect, esophagus perforation, esophagus haemorrhage, and retreatment methods were used as analysis factors for Cox regression univariate and multivariate analyses. Univariate analysis showed that diseases course, focus location, weight loss, M stage, short-term effect, esophagus perforation, esophagus haemorrhage, and retreatment methods were prognostic factors of these patients. Multivariate analysis showed that M stage [P=0.014, odds ratio (OR)=2.515], short-term effect (P < 0.001, OR=2.181), esophagus perforation (P=0.022, OR=3.266), and retreatment methods (P=0.026, OR=1.142) were independent prognostic factors. The main prognostic factors of the patients with unresectable esophageal carcinoma treated with concurrent chemoradiotherapy are M stage, short-term effect, esophagus perforation, and retreatment methods.
    Ai zheng = Aizheng = Chinese journal of cancer 07/2005; 24(6):731-4.
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    ABSTRACT: Although concurrent radiochemotherapy is recommended as the standard treatment for advanced esophageal carcinoma, the local failure still reaches up to 44%-54%. This study aimed to explore maximum tolerance dose (MTD) of sodium glycididazole(CM-Na) in the combined planning as the recommended dose for phase II study. Twenty-two patients with pathologically confirmed esophageal squamous carcinoma of stage III-IV were recruited according to the inclusion criteria. All patients were divided into 4 groups (at least 3 patients in a group) by turn as the dose of CM-Na escalated from 400 to 600, 700, and 800 mg x (m(2) x d)(-1) by Fibonacci's method, and treated according to the plan. All patients underwent the same concurrent radiochemotherapy. Conventional radiotherapy was performed with total dose of 60 Gy within 6 weeks. CM-Na was given 1 h before radiotherapy at Monday, Wednesday, and Friday every week, combined with 2 circles of continuous 5-day chemotherapy of 500 mg x (m(2) x d)(-1) of 5-fluoruracil (5-FU) and 20 mg x (m(2) x d)(-1) of cisplatin (DDP) at the first and the fifth week. Low-grade gastrointestinal adverse reactions were observed in the 4 groups during the period of chemotherapy, but no adverse reactions of nervous system, kidney, or heart were observed. Severe adverse reactions occurred in 800 mg x (m(2) x d) (-1) group, included 3 cases of grade III radioactive esophagitis, 2 cases of grade IV aminopherase risen, and 1 case of grade III thrombocytopenia. All the 19 patients in the rest 3 groups suffered grade I-II thrombocytopenia. The rates of complete remission and partial remission were 27% (6/22) and 68% (15/22) at the end of treating, and 46% (10/22) and 54% (12/22) 1 month after treating. Liver disfunction is the main dose-limited toxicity of the treatment schemeu 700 mg x (m(2) x d) (-1) of CM-Na is recommended to phase II clinical study.
    Ai zheng = Aizheng = Chinese journal of cancer 06/2005; 24(5):582-6.
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    ABSTRACT: Concurrent chemoradiotherapy is the standard treatment for unresectable esophageal carcinoma. Local failure and recurrence are main reasons of treatment failure. This study was to discuss the factors related with local failure and recurrence of unresectable esophageal carcinoma after concurrent chemoradiotherapy. Records of 132 patients with esophageal carcinoma, treated with concurrent chemotherapy in our hospital from Jan. 1996 to Dec. 2003, were reviewed. The patients received the first cycle of chemotherapy at the beginning of radiotherapy, and the second cycle of chemotherapy when radiation dose escalated to 40 Gy. Local failure-related factors were analyzed by binary logistic regression. To the terminal of follow-up, of the 132 patients, 54 had local failure or in-fields recurrence, 20 had in-fields recurrence and lymph nodes or distant metastasis, 5 had out-fields recurrence. Logistic regression analysis showed that short-term effect and irradiation dose were correlated with local failure and recurrence. Local failure and recurrence rate was lower in patients with complete remission (CR) than in patients with partial remission (PR) after chemoradiotherapy (44.9% vs. 79.6%, P < 0.001); and the mean time to recurrence was longer in CR patients than in PR patients (12.9 months vs. 6.1 months, P=0.002). When irradiated with 50-60 Gy,60.1-69.9 Gy, >/=70 Gy of x-ray, the local failure rates of the patients were 69%, 61%, and 52% (P=0.027), respectively, the mean time to recurrence were 5.3, 9.1, and 10.3 months, respectively. Radiation dose and short-term effect may influence local control of unresectable esophageal carcinoma.
    Ai zheng = Aizheng = Chinese journal of cancer 04/2005; 24(4):498-501.
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    ABSTRACT: Recently, neoadjuvant therapy has become the focus of interest in an effort to prolong survival and reduce recurrence rates in patients with oesophageal cancer. This study was designed to evaluate the tolerance and the short-term outcome of chemoradiotherapy followed by surgery for patients with locally advanced esophageal squamous carcinoma, to observe effects of chemoradiotherapy on tumor resection rate, incidence of complications after surgery, and perioperative mortality. From January 2000 to September 2003, Thirty-four consecutive patients with locally advanced esophageal squamous carcinoma were entered into this phase II study. The clinical pre-treatment staging of the tumors were determined by chest CT scan, abdomial CT Scan, EUS, and bronchoscopy examination. Chemotherapy and radiotherapy were performed concurrently. The chemotherapy consisted of Vinorelbine (or 5-Fluorouracil) and Cisplatin. 5-Fluorouracil at 2.4 g/m(2) was administered in continuous infusion for days 1-3 and days 22-25. Vinorelbine at 25 mg/m(2) per day was administered in bolus infusion on d1, d8, d22 and d29. Cisplatin at 75 mg/m(2) was administered by intravenously infusion on d1 and d22. A total radiotherapy dose of 40 Gy was delivered in 20 daily fractions of 2.0 Gy each (given 5 d/wk for 4 weeks). After completion of chemoradiotherapy, clinical restaging was performed. Esophagectomy and lymphadenectomies were performed 3-5 weeks after chemoradiotherapy. Thirty-three patients completed the planned chemoradiotherapy, and 32 patients underwent surgery. The toxicities of chemoradiotherapy such as myelotoxicity, pulmonary toxicity, esophagitis were grade I or II. No death was resulted from chemoradiotherapy. The clinical response rate of chemoradiotherapy was 85.3%, the pathological complete response rate was 25%, the resectability rate was 100%. Postoperative pulmonary infection occurred in 8 patients (22.9%), anastomotic leak in 3 patients (9.4%). Two patients (6.3%) died perioperatively because of ARDS and anastomotic leak complicated with heart failure. The short-term results of this study suggest that the strategy of chemoradiotherapy followed by surgery is safe,although it caused considerable toxicity and increased operation-related complications rate and perioperative mortality rate compared with surgery alone at the same period. Preoperative chemoradiotherapy is able to significantly reduce the tumor stage, and achieve substantially high clinical response rate and pathological complete response rate.
    Ai zheng = Aizheng = Chinese journal of cancer 11/2004; 23(11 Suppl):1473-6.
  • Xiu-Shen Wang, Meng-Zhong Liu, Yong-Hong Hu
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    ABSTRACT: With the development of multidisciplinary treatment for cancer, great changes have taken place in the therapeutic strategy of breast cancer. However, radiotherapy as a method of local management, still plays an important role in the combined treatment of breast cancer. The recurrence in the chest wall ranks the first, accounting for 44-69% of the total local-regional relapse, therefore, the chest wall is commonly regarded as the most important target of radiotherapy after mastectomy. The traditional irradiation techniques cannot reach an ideal dose distribution due to the irregular shape of the chest wall. Electron arc therapy, by using the electron characteristics of dose distribution, combining the shape of thorax and the depth of target volume, make the dose distribution of target volume more reasonable, decreases the dose of heart or lung and has more clinical benefit than traditional techniques. On the other hand, it had been demonstrated by some clinical research that irradiation with electron arc could provide a high rate of local control and generally acceptable acute and long-term toxicity, comparing with the traditional irradiation techniques.
    Ai zheng = Aizheng = Chinese journal of cancer 04/2004; 23(3):358-60.