ObjectiveTo investigate the impact of postoperative application of Pseudomonas aeruginosa injection on recurrence free survival (RFS) and overall survival (OS) in patients with abnormal serum calcitonin levels following surgery for medullary thyroid carcinoma (MTC). MethodsA retrospective collection of data was conducted for 214 patients with abnormal serum calcitonin levels following MTC surgery at West China Hospital of Sichuan University from January 2015 to April 2024. Propensity score matching (1∶2) was utilized to match patients’ data to reduce confounding bias, comparing RFS and OS between patients who used (Pseudomonas group) and did not use (control group) Pseudomonas aeruginosa injection. ResultsAfter propensity score matching, 72 patients with abnormal postoperative calcitonin levels were included, with 24 in the Pseudomonas group and 48 in the control group. The median follow-up time for the 72 patients was 66 months (11–168 months). The 1-year RFS rates for the Pseudomonas group and the control group were 100% and 75.0%, respectively, and the 2-year RFS rates were 87.5% and 56.3%, respectively. The RFS in the Pseudomonas group was superior to that in the control group (χ2=4.791, P=0.029). The 5-year OS rates for the Pseudomonas group and the control group were 90.9% and 93.5%, respectively, with no significant difference between the two groups (χ2=0.469, P=0.491). The Cox proportional hazards regression model indicated that the median RFS was extended in the Pseudomonas group [25 months vs. 21 months, RR=0.350, 95%CI (0.135, 0.900), P=0.029], but there was no significant impact on OS [66 months vs. 69 months, RR=2.22, 95%CI (0.229, 21.444), P=0.503]. ConclusionPostoperative use of Pseudomonas aeruginosa injection in MTC patients with abnormal serum calcitonin level shows significant improvement in RFS, but no significant change in OS.
【摘要】 目的 探討替吉奧膠囊聯合奧沙利鉑治療晚期胃癌的近期療效和毒性反應。 方法 2010年1-7月，16例晚期胃癌患者根據體表面積來確定初始劑量，體表面積lt;1.25 m2，替吉奧膠囊40 mg/次，2次/d；體表面積1.25~1.5 m2，替吉奧膠囊50 mg/次，2次/d；體表面積gt;1.5 m2，替吉奧膠囊60 mg/次，2次/d，早、晚飯后分別口服1次，連續服用28 d，停藥14 d。奧沙利鉑注射液130 mg/m2加入5%葡萄糖注射液500 mL避光緩慢靜gt;2 h，第1、21天重復，連用2周期。按RECIST 1.1標準評價客觀療效和不良反應。 結果 16例患者中PR 9例（56.3%），SD3例（18.8%），PD 4例（25%），總有效率為69.0%。不良反應主要是血液學毒性、胃腸道反應及外周神經毒性，且均在Ⅰ~Ⅱ。 結論 替吉奧膠囊聯合奧沙利鉑方案治療晚期胃癌的近期療效較好，不良反應可以耐受，值得進一步研究應用。【Abstract】 Objective To explore the early efficacy of Oxaliplatin combined with S1 capsule on advanced gastric cancer and observe the toxicity. Methods A total of 16 patients with advanced gastric cancer from January to July 2010 were treated with chemotherapy: oxaliplatin 130 mg/m2 mixed with 5% glucose injection 500 mL in the first day and repeated in the 21st day; Po after breakfast and dinner: S1 capsule with an initial dose according to the body surface area. Body surface lt;1.25 m2, 40 mg once, twice per day; body surface:1.25-1.5 m2,50 mg once, twice per day; body surface gt;1.5 m2, 60 mg once, twice per day. The medication lasted for 28 days, withdrew for 14 days. All of the patients underwent the treatment for two cycles. Efficacy and toxicities were evaluated according to the RECIST 1.1 standard. Results Of the 16 patients, partial remission (PR) was in nine (56.3%), stable disease was in three (18.8%) (SD), and progression disease was in four (PD). The total response rate was 69.0%. The major toxicities included leucopenia, nausea, vomiting and neurosensory abnormity. Conclusion Oxaliplatin combined with S1 capsule is effective on advanced gastric cancer, and the adverse effects are tolerable.
ObjectiveTo investigate the clinical manifestations, imaging manifestations, etiology, histological origin, pathological characteristics, diagnosis and differential diagnosis, selection of treatment methods, and prognosis of primary diffuse large B cell lymphoma of livers (PDLBCLL), so as to improve understanding and reasonable diagnosis and treatment of this kind of disease.MethodThe clinicopathologic data of a case of PDLBCLL diagnosed in the West China Hospital of Sichuan University in June 2019 were analyzed retrospectively.ResultsIt was very difficult to diagnose PDLBCLL preoperatively and to distinguish PDLBCLL from primary liver cancer and other liver space occupying lesions. It was also easy to ignore the possibility of invasion of liver by lymphopoietic tissue tumor, which was often diagnosed by postoperative pathological diagnosis or puncture biopsy, and after the elimination of hematological diseases by various examinations. This patient was admitted to the hospital as a space occupying in right liver. Preoperative imaging examination considered that may be a tumor. After MDT discussion, considering that the nature of the tumor should be confirmed by surgical resection, and then go to the Department of Oncology. Irregular right hemihepatectomy + cholecystectomy + hilar lymphadenectomy + diaphragmatic repair was performed after MDT discussion. The diagnosis of PDLBCLL was confirmed by postoperative pathological examination. The operation duration was about 230 min, and the intraoperative blood loss was about 200 mL. The patient recovered well without complications and was discharged on the 10th day after operation. The patient was followed up for 9 months. The liver and kidney function, electrolytes and abdominal Doppler ultrasound examination were regularly reviewed every month. No obvious abnormality was found in these results.ConclusionsAt present, there is no unified treatment principle, most of them will undergo surgery, chemotherapy, radiotherapy or combined treatment. Due to its unknown etiology and unclear mechanism, clinicians can only implement individualized treatment according to the characteristics of patients’ conditions.
目的 觀察替吉奧膠囊聯合奧沙利鉑治療晚期結直腸癌的近期療效和毒性反應。 方法 2011年5月－12月，將30例晚期結直腸癌患者根據體表面積來確定初始劑量，體表面積＜1.25 m2者，替吉奧膠囊40 mg/次，2次/d；體表面積1.25～1.50 m2者，替吉奧膠囊50 mg/次，2次/d；體表面積＞1.50 m2者，替吉奧膠囊60 mg/次，2次/d。早飯后和晚飯后分別口服1次，第1～4天服用奧沙利鉑注射液 130 mg/ m2，靜脈滴注，第1、21天重復，此為1個月周期。連用2周期后，按美國國立癌癥研究所擬定的藥物不良反應的分級評價標準3.0版本評價不良反應，按實體瘤治療療效評價標準評價療效。 結果 30例患者中，完全緩解1例（3.3%），部分緩解7例（23.3%），穩定12例（40%），進展10例（33.3%），疾病控制率為66.6%。不良反應主要是血液學毒性、胃腸道反應、皮膚色素沉著及外周神經毒性；1例Ⅳ度骨髓抑制，3例3度貧血，2例3度腹瀉，2例3度皮膚色素沉著，2例3度惡心、嘔吐，其余且均在Ⅰ～Ⅱ度骨髓抑制。 結論 替吉奧膠囊聯合奧沙利鉑方案治療晚期結直腸癌可獲得較高的疾病控制率，不良反應可控。