chemotherapy

摘要： Background and Aim: Primary testicular lymphoma (PTL) is a rare form of extranodal non-Hodgkin’s lymphoma. It represents for 1% - 2% of non-Hodgkin’s lymphoma, and mostly affects the elderly. We describe an interesting case of PTL managed by a combined multimodal approach with a review of the literature. Case Presentation: Patient aged 56 years, consulted for an increase in the volume of the right testicle without associated pain, all evolving in the context of a slight decline in general condition. Clinical examination revealed a large painless mass in the right scrotal bursa. A scrotal ultrasound showed a right intra-testicular mass. The patient had undergone inguinal orchiectomy. Pathological analysis showed diffuse large B-cell lymphoma of the testis. Whole-body 18-fluorodeoxyglucose positron emission tomography (18-FDG-PET-CT) showed no suspicious hypermetabolism. Lumbar puncture did not reveal malignant cells in the cerebrospinal fluid (CSF). The patient then received 6 cycles of chemotherapy according to the R-CHOP protocol (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone) and 2 cycles of intrathecal methotrexate. After chemotherapy, scrotal radiotherapy at a dose of 30 Gy was delivered. The evolution was marked by the death of the patient six months after the end of the scrotal radiotherapy following a diffuse lymph node relapse with a profound alteration of the general state. Conclusion: The treatment depends imperatively on the stage of the disease. The therapeutic approach is multimodal and combined based on orchiectomy, systemic and intrathecal treatment and scrotal radiotherapy. PTL is an aggressive malignant with a poor prognosis. Randomized trials are needed to define a better therapeutic strategy.

摘要： Primary breast lymphomas are rare. They are defined by the involvement of one or both breasts. This is the first site affected or mainly affected with the exception of ipsilateral axillary involvement. Due to the absence of specific clinical and radiological signs, the diagnosis is confirmed by histology. The most frequent entity remains diffuse large B-cell lymphomas. The place of surgery remains exclusive in establishing the initial diagnosis. Anthracycline-based chemotherapy with or without Rituximab remains the gold standard in the therapeutic arsenal. We present the case of a 42-year-old woman with no surgical history;nulliparous;followed in nephrology for chronic renal failure, received as an outpatient for a nodule in the left breast in a context of dyspnea. This is a nodule discovered incidentally during a routine examination. Clinical examination of the left breast found nipple retraction without ulceration;a mass 7 cm in diameter located in the left upper outer quadrant. Breast ultrasound and mammography suggest a suspected lesion of malignancy. After a percutaneous micro biopsy;the histological study confirms the diagnosis of a large B-cell lymphoma of the left breast. A TAP CT scan is performed as part of the extension assessment. Chemotherapy based on R-CHOP with local radiotherapy is decided in CPR.

摘要： Introduction: The objective of our study was to determine the prevalence of hematological toxicity during breast cancer chemotherapy. Patients and Methods: This was a cross-sectional descriptive study that took place in the cancerology and internal medicine department during the period from January 1, 2021 to December 31, 2021, i.e. a period of 1 year. Were included in our study: patients with and histological diagnosis, and having received at least two cycles of chemotherapy and having presented hematological toxicity: anemia and/or neutropenia. The variables studied were: Age, level of study, socioeconomic level, stage of extension, type of chemotherapy, type of toxicity: neutropenia and anemia. Bivariate analysis was done between anemia, neutropenia and type of chemotherapy. Results: The average age of the patients was 50.35 ± 13.6 years. The extremes were 27 years and 79 years old. The most represented age group was the age group from 37 to 46 years with 18 cases or 33.33%. The most represented level study in our study was the primary level 63%, followed by secondary level 26% and the upper or superior level 11%. Metastatic stage of location was represented in 16.6% of cases, the local stage was represented in 16.7% of cases. The most common chemotherapy used was FAC protocol in 50% of cases, followed by FAC + DOCETAXEL in 47% of cases, AC protocol was used in 3% of cases. The most represented grade of neutropenia was grade 3 in 53% of cases, followed by grade 2 in 27% of cases and grade 1 in 20%. Grade 1 anemia was the most represented in 70% of cases, followed respectively by grade 2 in 27%. The majority of patients had received more than 3 courses of chemotherapy in 83% of cases. Grade 3 neutropenia was observed mostly in the advanced stages, 15 cases at the locoregional stage. Grade 1 anemia was most common in patients who received more than 3 courses of chemotherapy. The FAC chemotherapy protocol was responsible for more grade 3 anemia in 14 cases. FAC-type chemotherapy was associated with grade 3 and 2 neutropenia in 8 cases and 4 cases, but the results were not significant. FAC + DOCEAXEL type chemotherapy was also responsible for grade 3 and 2 neutropenia in 8 cases and 4 cases P > 5% respectively. Conclusion: Hematological toxicity in the context of our limited resources is dominated by anemia and neutropenia. The knowledge of this hematological toxicity is necessary for the limitation of the delay of chemotherapy.

摘要： The incidence of esophagogastric junction(EGJ)adenocarcinoma is increasing in developed nations due to the rising prevalence of obesity and gastroesophageal reflux disease.Due to the peculiar location in a histological transition zone between the esophagus and the stomach,the management of EGJ tumors is controversial.Two main surgical approaches exist:total gastrectomy with distal esophagectomy or esophagectomy by either transhiatal or transthoracic approach.These operations differ significantly in the extent of lymphadenectomy.In addition,patients with locally advanced disease can receive either preoperative chemoradiation or perioperative chemotherapy.This evidence-based review analyzes current evidence regarding the management of EGJ tumors in order to help defining the best surgical and systemic treatment of these patients.

摘要： BACKGROUND Lung cancer is one of the deadliest cancers in the world with the highest incidence and mortality rate among all cancers.Non-small cell lung cancer(NSCLC)accounts for approximately 80%of primary lung cancer.However,efficacy and safety of the current regimens for NSCLC is unsatisfactory.Therefore,there has been an increasing urgency for development of potential therapeutic therapies for NSCLC.AIM To investigate the therapeutic outcomes and safety of continuous intravenous infusion of recombinant human endostatin(Rh-endostain)using an infusion pump in retreated advanced NSCLC.METHODS Patients with retreated advanced NSCLC who were admitted to Zhejiang Provincial People's Hospital from October 2017 to April 2019 were recruited.These patients received continuous intravenous infusion of Rh-endostain using an infusion pump.Objective response rate(ORR),clinical benefit rate(CBR),median progression-free survival(mPFS),and incidences of adverse events(AEs)were analyzed after treatment.RESULTS A total of 45 patients with retreated advanced NSCLC were included,and all of them were evaluated.In these patients,ORR was 22.2%,CBR was 84.4%,and mPFS was 5.3 mo.The following AEs were observed,decreased hemoglobin(34 cases,75.6%),nausea/vomiting(32 cases,71.1%),elevated transaminase(24 cases,53.3%),leukopenia(16 cases,35.6%),thrombocytopenia(14 cases,31.1%),and constipation(1 case,3.4%).None of the patients had leukopenia,nausea/vomiting,and constipation of grade III and above.CONCLUSION The patients showed improved adherence to 5-d continuous intravenous infusion of Rh-endostain using an infusion pump.Favorable efficacy and safety of this treatment regimen were achieved in retreated advanced NSCLC.

摘要： BACKGROUND Mixed neuroendocrine-nonneuroendocrine neoplasm(MiNEN)is a rare tumor that occurs in the gastrointestinal tract and pancreas,usually composed of adenocarcinoma and neuroendocrine carcinoma.MiNEN occurring in ampulla is even rarer.We report 4 cases of MiNEN in ampulla,combined with literature review to summarize the clinical features and treatment of the disease,in order to improve the understanding of the disease.CASE SUMMARY A retrospective analysis was performed in 4 cases of MiNEN of the ampulla diagnosed by pathology from 2014 to 2021.The 4 patients were all male,aged 67-81 years(average 72.25 years).Among them,2 patients had jaundice,1 patient had abdominal pain,and 1 patient had jaundice with abdominal pain as the first symptom.All 4 patients underwent enhanced CT or MRI,which all indicated that the tumors were located in the ampulla.Two patients underwent duodenoscopy,and a biopsy revealed ampullary adenocarcinoma.All 4 patients underwent radical pancreaticoduodenectomy.Four cases were followed up:One patient developed severe complications after the operation,his condition deteriorated,and he survived for 1 mo.In the other 3 patients,tumor recurrence was observed during follow-up,and 2 of them survived for 29 mo and 22 mo respectively.One case survived and is still being followed up.CONCLUSION MiNEN of the ampulla are extremely rare,lacking typical clinical symptoms and imaging features,and are usually diagnosed after postoperative histopathological and immunohistochemical examinations.The main treatment is radical surgical resection,which can be combined with chemotherapy.The best method of diagnosis and treatment needs further research.

摘要： Tuberculosis infections is a serious illness and can be life threatening for patients with hematologic malignancies. We are reporting the observations of two children aged 7 and 5 years undergoing anticancer treatment for hematological malignancies. The symptoms were, in the first case, cough, purulent sputum and signs of tuberculosis impregnation, for the second case, cervical adenopathies (PDA) with inflammatory signs. The evolution under antituberculosis treatment was favorable for both patients, with a 5-year follow-up for the first patient and one year for the second case. The tuberculosis did not affect chemotherapy. The goal of our work is to specify the etio-pathogenic mechanisms, the clinical, therapeutic and evolutionary particularities of this rare association.

摘要： Objective:The present study was designed to evaluate the effects of adjuvant chemotherapy(CT)vs.radiotherapy(RT,alone or combined with CT)on the prognosis of patients with high-risk,early-stage(stage I and stage II)endometrioid endometrial carcinoma.Methods:This single-center retrospective clinical study was conducted in Union Hospital,Tongji Medical College,Huazhong University of Science and Technology between 2010 and 2019.

摘要： BACKGROUND Leukemia is a broad term for blood cell cancer.Leukemia is divided into acute or chronic,depending on cell differentiation.Leukemia patients are prone to adverse reactions during chemotherapy,such as anxiety,depression,and even suicide,affecting prognosis.As a nursing model developed by three well-known cognitive psychologists,empathetic nursing with mindfulness cognitive therapy(ENMCT)can effectively reduce anxiety and depression and improve the quality of life in patients with chronic disease.AIM To explore the effect of ENMCT on cancer-induced fatigue,hope level,and negative emotions in patients with long-term leukemia chemotherapy.METHODS A total of 103 patients with long-term leukemia chemotherapy diagnosed and treated in our hospital from July 2017 to October 2019 were enrolled and randomly assigned to observation and control groups using the random number table approach.Fifty-one patients in the control group received routine nursing,while 52 patients in the observation group received empathic nursing with mindfulness cognitive therapy.After three months of nursing care,cancerinduced fatigue was measured with the Piper Fatigue Scale(PFS),hope level with the Herth Hope Index(HHI),and negative emotion with the Hamilton Anxiety Scale(HAMA)/Hamilton Depression Scale(HAMD).Self-management(Chinese Strategies Used by People to Promote Health)was also recorded.RESULTS The observation group’s total scores in behavior,cognition,emotion,feeling,and PFS were lower than the control group after the intervention(P<0.05).Keeping close contact with others,the attitude of taking positive actions,the attitude toward reality and future,and the total HHI score were higher in the observation group than the control group(P<0.05).The observation group’s HAMA and HAMD scores were lower than the control group(P<0.05).The observation group’s positive attitude,self-decision,and self-relief scores were greater than the control group(P<0.05).CONCLUSION Empathetic nursing with cognitive mindfulness therapy is beneficial in improving cancer-related fatigue,negative emotions,expectation level,and self-management ability in patients with longterm leukemia chemotherapy.

摘要： Cell autophagy and apoptosis processes are of interest in drug development and contribute to the chemotherapy outcomes of patients receiving cancer treatment. The functional roles of cyclic nucleotides in cells include maintenance of metabolic homeostasis. cGMP and steroid compounds participate in apoptotic and autophagic events, and modulate the function of multi-drug resistance proteins. Endogenous steroid and cyclic nucleotide ratios change with ageing and this may initiate detrimental changes in cell function. This study uses a computational chemistry approach to investigate molecular similarity within chemotherapeutic and steroid compound structures. Modulators of autophagy/apoptosis and endogenous steroid structures all demonstrate molecular similarity to the structure of cGMP. Relative molecular similarity within these structures facilitates additive and synergistic treatment effects. Endogenous steroids are natural modulators of autophagy and apoptosis;concentration changes consequently have the potential to impact cancer risks.

摘要： To evaluate the efficacy and safety of gemcitabine in combination with carboplatin at standard rate or fixed dose rate infusion in patients with advanced non-small-cell lung cancer(NSCLC). Patients and methods：In this prospective study，patients with chemonaive advanced NSCLC were randomized to receive gemcitabine at a standard rate(gemcitabine 1200 mg/m2 over 30 min，the standard arm)or a fixed dose rate(gemcitabine 1200 mg/m2 over 120 min，the FDR arm)on days 1 and 8 every three week cycle. In both treatment arms，carboplatin at AUC of 5 was administered over 4 hours following gemcitabine on day 1 of each cycle. Results：From November 2003 to June 2005，a total of 42 patients，in which 7(17％)patients had stage IIIB disease and 35(83％)had stage IV disease，were enrolled into this study. All patients were included in efficacy and toxicity assessment. No patient had a complete response. Seven(33％)patients in the standard arm and 10(48％)in the FDR arm had a partial response. The median time to progression and median overall survival time in the standard arm was 5.4 months(95％ CI，3.8-7.0 months)and 11.5 months(95％ CI，8.2-14.8 months)respectively，while in the FDR arm was 6.5(95％ CI，4.4-8.6 months)months，12.0 months(95％ CI，11.3-12.7 months)respectively. The most frequently reported grade 3 or 4 hematological toxicities were thrombocytopenia(38％ patients in the standard arm and 43％ in the FDR arm)and neutropenia(24％ in the standard arm and 33％ in the FDR arm). Although hematological toxicity occurred in a little higher percent of patients in the FDR arm than in the standard arm，there were no discernible differences by statistical analysis in both treatment arms(P>0.05). And significant nonhematologic toxicities were infrequent and tolerable in both arms. No significant difference existed also(P>0.05). Conclusion：In this phase II study，gemcitabine in combination with carboplatin either at standard rate or fixed dose rate infusion was clinically effective and well tolerated in patients with advanced NSCLC.

摘要： To evaluate the efficacy and safety of gemcitabine in combination with carboplatin at standard rate or fixed dose rate infusion in patients with advanced non-small-cell lung cancer(NSCLC). Patients and methods：In this prospective study，patients with chemonaive advanced NSCLC were randomized to receive gemcitabine at a standard rate(gemcitabine 1200 mg/m2 over 30 min，the standard arm)or a fixed dose rate(gemcitabine 1200 mg/m2 over 120 min，the FDR arm)on days 1 and 8 every three week cycle. In both treatment arms，carboplatin at AUC of 5 was administered over 4 hours following gemcitabine on day 1 of each cycle. Results：From November 2003 to June 2005，a total of 42 patients，in which 7(17％)patients had stage IIIB disease and 35(83％)had stage IV disease，were enrolled into this study. All patients were included in efficacy and toxicity assessment. No patient had a complete response. Seven(33％)patients in the standard arm and 10(48％)in the FDR arm had a partial response. The median time to progression and median overall survival time in the standard arm was 5.4 months(95％ CI，3.8-7.0 months)and 11.5 months(95％ CI，8.2-14.8 months)respectively，while in the FDR arm was 6.5(95％ CI，4.4-8.6 months)months，12.0 months(95％ CI，11.3-12.7 months)respectively. The most frequently reported grade 3 or 4 hematological toxicities were thrombocytopenia(38％ patients in the standard arm and 43％ in the FDR arm)and neutropenia(24％ in the standard arm and 33％ in the FDR arm). Although hematological toxicity occurred in a little higher percent of patients in the FDR arm than in the standard arm，there were no discernible differences by statistical analysis in both treatment arms(P>0.05). And significant nonhematologic toxicities were infrequent and tolerable in both arms. No significant difference existed also(P>0.05). Conclusion：In this phase II study，gemcitabine in combination with carboplatin either at standard rate or fixed dose rate infusion was clinically effective and well tolerated in patients with advanced NSCLC.

摘要： To evaluate the efficacy and safety of gemcitabine in combination with carboplatin at standard rate or fixed dose rate infusion in patients with advanced non-small-cell lung cancer(NSCLC). Patients and methods：In this prospective study，patients with chemonaive advanced NSCLC were randomized to receive gemcitabine at a standard rate(gemcitabine 1200 mg/m2 over 30 min，the standard arm)or a fixed dose rate(gemcitabine 1200 mg/m2 over 120 min，the FDR arm)on days 1 and 8 every three week cycle. In both treatment arms，carboplatin at AUC of 5 was administered over 4 hours following gemcitabine on day 1 of each cycle. Results：From November 2003 to June 2005，a total of 42 patients，in which 7(17％)patients had stage IIIB disease and 35(83％)had stage IV disease，were enrolled into this study. All patients were included in efficacy and toxicity assessment. No patient had a complete response. Seven(33％)patients in the standard arm and 10(48％)in the FDR arm had a partial response. The median time to progression and median overall survival time in the standard arm was 5.4 months(95％ CI，3.8-7.0 months)and 11.5 months(95％ CI，8.2-14.8 months)respectively，while in the FDR arm was 6.5(95％ CI，4.4-8.6 months)months，12.0 months(95％ CI，11.3-12.7 months)respectively. The most frequently reported grade 3 or 4 hematological toxicities were thrombocytopenia(38％ patients in the standard arm and 43％ in the FDR arm)and neutropenia(24％ in the standard arm and 33％ in the FDR arm). Although hematological toxicity occurred in a little higher percent of patients in the FDR arm than in the standard arm，there were no discernible differences by statistical analysis in both treatment arms(P>0.05). And significant nonhematologic toxicities were infrequent and tolerable in both arms. No significant difference existed also(P>0.05). Conclusion：In this phase II study，gemcitabine in combination with carboplatin either at standard rate or fixed dose rate infusion was clinically effective and well tolerated in patients with advanced NSCLC.

摘要： To evaluate the efficacy and safety of gemcitabine in combination with carboplatin at standard rate or fixed dose rate infusion in patients with advanced non-small-cell lung cancer(NSCLC). Patients and methods：In this prospective study，patients with chemonaive advanced NSCLC were randomized to receive gemcitabine at a standard rate(gemcitabine 1200 mg/m2 over 30 min，the standard arm)or a fixed dose rate(gemcitabine 1200 mg/m2 over 120 min，the FDR arm)on days 1 and 8 every three week cycle. In both treatment arms，carboplatin at AUC of 5 was administered over 4 hours following gemcitabine on day 1 of each cycle. Results：From November 2003 to June 2005，a total of 42 patients，in which 7(17％)patients had stage IIIB disease and 35(83％)had stage IV disease，were enrolled into this study. All patients were included in efficacy and toxicity assessment. No patient had a complete response. Seven(33％)patients in the standard arm and 10(48％)in the FDR arm had a partial response. The median time to progression and median overall survival time in the standard arm was 5.4 months(95％ CI，3.8-7.0 months)and 11.5 months(95％ CI，8.2-14.8 months)respectively，while in the FDR arm was 6.5(95％ CI，4.4-8.6 months)months，12.0 months(95％ CI，11.3-12.7 months)respectively. The most frequently reported grade 3 or 4 hematological toxicities were thrombocytopenia(38％ patients in the standard arm and 43％ in the FDR arm)and neutropenia(24％ in the standard arm and 33％ in the FDR arm). Although hematological toxicity occurred in a little higher percent of patients in the FDR arm than in the standard arm，there were no discernible differences by statistical analysis in both treatment arms(P>0.05). And significant nonhematologic toxicities were infrequent and tolerable in both arms. No significant difference existed also(P>0.05). Conclusion：In this phase II study，gemcitabine in combination with carboplatin either at standard rate or fixed dose rate infusion was clinically effective and well tolerated in patients with advanced NSCLC.

摘要： To evaluate the efficacy and safety of gemcitabine in combination with carboplatin at standard rate or fixed dose rate infusion in patients with advanced non-small-cell lung cancer(NSCLC). Patients and methods：In this prospective study，patients with chemonaive advanced NSCLC were randomized to receive gemcitabine at a standard rate(gemcitabine 1200 mg/m2 over 30 min，the standard arm)or a fixed dose rate(gemcitabine 1200 mg/m2 over 120 min，the FDR arm)on days 1 and 8 every three week cycle. In both treatment arms，carboplatin at AUC of 5 was administered over 4 hours following gemcitabine on day 1 of each cycle. Results：From November 2003 to June 2005，a total of 42 patients，in which 7(17％)patients had stage IIIB disease and 35(83％)had stage IV disease，were enrolled into this study. All patients were included in efficacy and toxicity assessment. No patient had a complete response. Seven(33％)patients in the standard arm and 10(48％)in the FDR arm had a partial response. The median time to progression and median overall survival time in the standard arm was 5.4 months(95％ CI，3.8-7.0 months)and 11.5 months(95％ CI，8.2-14.8 months)respectively，while in the FDR arm was 6.5(95％ CI，4.4-8.6 months)months，12.0 months(95％ CI，11.3-12.7 months)respectively. The most frequently reported grade 3 or 4 hematological toxicities were thrombocytopenia(38％ patients in the standard arm and 43％ in the FDR arm)and neutropenia(24％ in the standard arm and 33％ in the FDR arm). Although hematological toxicity occurred in a little higher percent of patients in the FDR arm than in the standard arm，there were no discernible differences by statistical analysis in both treatment arms(P>0.05). And significant nonhematologic toxicities were infrequent and tolerable in both arms. No significant difference existed also(P>0.05). Conclusion：In this phase II study，gemcitabine in combination with carboplatin either at standard rate or fixed dose rate infusion was clinically effective and well tolerated in patients with advanced NSCLC.