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عضویت

جستجوی مقالات مرتبط با کلیدواژه « Concurrent chemoradiotherapy » در نشریات گروه « پزشکی »

  • Kien Do, Tu Do, Tai Nguyen, Duc Le, Linh Phan, Chu Nguyen

    Extranodal natural killer (NK)/T-cell lymphoma, nasal type is a rare, aggressive, and poor prognostic subtype. The concurrent chemoradiotherapy followed by chemotherapy showed a relatively high response rate and the toxicity due to the treatment is acceptable. The study attempted to report the clinicopathological features, the survival outcome, and response rates of stages I-II, nasal type ENKTL patients treated with CCRT followed by adjuvant VIPD chemotherapy in Vietnam.

    Materials and Methods

    The current study was conducted on 31 stage I or II NK/T cell lymphoma, nasal-type patients received by CCRT, followed by adjuvant VIPD chemotherapy. Information on patient demographics, disease stage, clinical symptoms, tumor, and paraclinical characteristics were collected. The primary endpoints of this study were OS and response rates.

    Results

    After CCRT, 26 out of 31 (83.9%) patients had stable disease or response. Overall response rate (ORR) was observed in 80.6% of patients with a complete response rate of 67.7%. Low-risk PINK patients had a higher response rate than the intermediate- risk group(p=0.038). Mean disease-free survival was 44.3±4.5 months (95% CI, 35.4-53.1 months). Mean overall survival was 46.8±4.5 months (95% CI, 37.99-55.8 months). The intermediate-risk PINK patients had a significantly lower OS rate than low-risk patients.

    Conclusion

    Concurrent chemoradiotherapy followed by adjuvant VIPD chemotherapy showed a high response rate and survival benefit in stages I-II, nasal type, and extranodal natural killer (NK)/T-cell lymphoma Vietnamese patients.

    Keywords: NK, T-Cell, Lymphoma, Concurrent Chemoradiotherapy, VIPD, Prognosis}
  • Juanni Wang*, Chunyan Wei, Wei Liu, Baofeng Wang, Qiang Han
    Background

    Breast cancer is a common term for a malignant tumor that arises from the epithelial component of the breast. Concurrent chemoradiotherapy’s efficacy and safety are controversial, considering the impact on patients' quality of life.

    Objectives

    The aim of this study was investigating the efficacy and safety of concurrent chemoradiotherapy with docetaxel in locally advanced breast cancer who have received a modified radical mastectomy.

    Methods

    A cohort of 110 female patients with locally advanced breast cancer were included in the present study and divided by chemoradiotherapy mode into a concurrent chemoradiotherapy group (n=58) and a sequential chemoradiotherapy group (n=52). Docetaxel was administered concurrently during radiotherapy in the concurrent group, whereas the sequential group underwent adjuvant radiotherapy 1-3 weeks after chemotherapy. Then, the two groups were compared with respect to clinical efficacy, levels of tumor markers across vascular endothelial growth factor (VEGF) and Carcinoembryonic antigen (CEA), adverse reactions, and the 3-year overall survival (OS) rate.

    Results

    The results showed that the mean age, operation, evaluation of Post treatment VEGF (pg / mg) and Post treatment CEA (/g / L), effectiveness of treatment in two sequential and concurrent treatment groups was not significant The results showed that the amount of Prior treatment VGEF (pg / mg) and Post treatment VGEF (pg / mg) in the two groups were statistically significant difference. Which shows the positive effect of this treatment before and after the intervention. Comparison of survival time in the two groups did not show a significant difference.

    Conclusion

    The chemotherapy protocol with a combination of cyclophosphamide, fluorouracil and epirubicin with concurrent docetaxel presented higher efficacy and prolonged the overall survival in locally advanced breast cancer patients who had undergone a radical mastectomy, while it did not significantly increase the toxicity.

    Keywords: Breast cancer, Concurrent chemoradiotherapy, Docetaxel, Modified radical mastectomy}
  • Seyed Amir Aledavood, Soodabe Shahid Sales, Kazem Anvari, Mohammad Naser Forghani, Bahram Memar, Ali Emadi Torghabeh*
    Background
    Preoperative concurrent chemoradiotherapy may improve surgical results and patient survival rates in gastric adenocarcinomas. We aimed to assess tumor resectability and pathologic response rates in patients with locally advanced proximal gastric and esophagogastric junction adenocarcinomas by preoperative CRT and toxicity evaluation of treatment.
    Methods
    The patients with proximal gastric or esophagogastric junction adenocarcinoma who had locally advanced disease on basis of endoscopic and imaging findings were candidates for preoperative concurrent chemoradiotherapy. Eligible patients underwent radiotherapy 45-50.4/1.8-2 Grays, five days in week concurrent with chemotherapy by 5-fluorouracil and leucovorin or capecitabine. 4 - 6 weeks after completion of this treatment, non-metastatic patients underwent surgery and all resected specimens evaluated for completeness of resection and pathologic response rate of tumor to preoperative treatment. The patients were followed for postoperative complications in a short time.
    Results
    35 out of 41 enrolled patients completed preoperative treatment without any mortality and significant toxicity. Ultimately, 22 patients underwent surgery. From these, 2 (9%) had unresectable tumors, 2 (9%) underwent incomplete resection and 18 (82%) completely resected. In pathologic evaluations, 52% showed complete and partial pathologic responses and 48% showed no pathologic response to preoperative treatments. Male gender was significantly associated with tumor pathologic response (P value = 0.034). Postoperative complications were seen in only two patients.
    Conclusions
    Preoperative concurrent chemoradiotherapy with 5 fluorouracil and leucovorin or capecitabine followed by surgery is a tolerable and safe treatment in patients with locally advanced proximal gastric and EGJ adenocarcinomas. It resulted in promising high rates of tumor resectability and pathologic response.
    Keywords: Concurrent Chemoradiotherapy, Esophagogastric Junction Adenocarcinoma, Locally Advanced, Preoperative, Proximal Gastric Adenocarcinoma}
  • مهدی سیلانیان طوسی، سید امیر آل داوود، کاظم انوری، غلامحسین نوفرستی، سمیرا محتشمی
    زمینه و هدف
    جراحی و رادیوتراپی درمان های اصلی موضعی برای کارسینومای مری می باشند. نتایج رادیوتراپی تنها رضایت بخش نبوده است. هدف از این مطالعه ارزیابی نتایج درمان به روش کمورادیوتراپی قطعی در بیماران مبتلا به کارسینومای سلول سنگفرشی مری بود.
    روش بررسی
    این مطالعه هم گروهی تاریخی آینده نگر روی 190 بیمار غیر متاستاتیک مبتلا به کارسینومای مری که بین بهار 1379 تا بهار 1383 با هدف درمان قطعی به روش کمورادیوتراپی (Gy 64-55، Cisplatin با دوز mg/m2 100-80 روز اول و 5FU با دوز mg/m2 1000-750 انفوزیون 24 ساعت به مدت 4روز) در مرکز تحقیقات سرطان دانشگاه علوم پزشکی مشهد تحت درمان قرار گرفته بودند، انجام شد. حداقل یک دوره شیمی درمانی هم زمان با رادیوتراپی تجویز شده بود.
    یافته ها
    بیماران شامل 99 مرد و 91 زن با میانه سنی 65 سال (بین 84 -25) بودند. میانه دوز تجویز شده Gy 60 (بین 64-55) و میانه دوره های تجویز شده شیمی درمانی 4 (بین 8-1) بود. با میانه پیگیری 12 ماه (بین 60-3) میزان بقاء یک، دو و سه ساله به ترتیب 8/67درصد، 7/48درصد و 3/36درصد به دست آمد. کاهش علائم در 84درصد بیماران با دیسفاژی مشاهده شد. 109 بیمار با میانه پیگیری 14 ماه (بین 3 تا 60) عاری از عود باقی ماندند که در این میان 34 نفر بیش از 24 ماه پیگیری شده بودند. 81 مورد (6/42درصد) شکست درمان (34 مورد شکست موضعی ناحیه ای، 14 مورد متاستاز دوردست و 33 مورد متاستاز دوردست همراه با شکست موضعی ناحیه ای) در طی پیگیری مشخص شد.
    نتیجه گیری
    گرچه کمورادیوتراپی قطعی در گروهی از بیماران مبتلا به کارسینومای سلول سنگفرشی مری باعث بقاء طولانی مدت و حتی درمان قطعی می شود، اما هنوز عود موضعی ناحیه ای و متاستاز علت عمده شکست درمان می باشد.
    کلید واژگان: کارسینوم مری, شیمی درمانی, رادیوتراپی, کمورادیوتراپی هم زمان}
    Mahdi Seilanian Toosi, Seyed-Amir Aledavood, Kazem Anvari, Gholamhosain Nowferesti, Samira Mohtashami
    Background and Objective
    Surgery and /or radiotherapy are major local treatments for esophageal carcinoma. The results of radiotherapy alone have been unsatisfactory. The purpose of this study was to evaluate the treatment outcome of definitive chemoradiotherapy for patients with esophageal SCC.
    Materials and Methods
    This prospective histological descriptive study was done on 190 nonmetastatic esophageal SCC patients which received definitive chemoradiotherapy (55-64 Gy, Cisplatin 80-100 mg/m2 day 1-5FU 750-1000 mg/m2, 24h infusion days 1-4) with curative intent in cancer research center, Mashhad University of Medical Sciences between Jan 2000-Jan 2004. At least one course of chemotherapy was prescribed concurrently with radiotherapy.
    Results
    There were 99 male and 91female patients with the median age of 65 (range, 25-87). The median radiation dose prescribed was 60 Gy (range, 55-64) and median chemotherapy courses was 4 (range, 1-8). With a median follow-up time of 12 months (range, 3-60), one, two and three-year survival rates were 67.8%, 48.7% and 36.3% respectively and median survival was 22 months. Reduction of symptoms was shown in 84% of patients with dysphagia. 109 patients remained disease free with a median follow-up of 14 months (range, 3-60), among which 34 were followed more than 24 months. We found 81 cases (42.6%) with treatment failure during the follow-up (34 locoregional failure, 14 distant metastases, 33 distant metastases accompanied with locoreginal failure).
    Conclusion
    Although definitive chemoradiotherapy can result in long term disease free survival and even cure in a subset of patients with SCC of esophagus, locoregional failure and distant metastasis has remained the main causes of treatment failure.
    Keywords: Esophageal carcinoma, Chemotherapy, Radiotherapy, Concurrent chemoradiotherapy}
نکته
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