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Objective To assess the efficacy of docetaxel rechallenge on castration-resistant prostate cancer (mCRPC) patients and to analyze prognostic factors. Methods We retrospectively reviewed the medical history of 120 mCRPC patients treated with the first-line docetaxel chemotherapy effectively and progressed with docetaxel rechallenge. Coprimary end points were prostate specific antigen progression-free survival (PSA PFS) after the first sequence docetaxel chemotherapy, prostate specific antigen progression-free survival after docetaxel rechallenge (Rechallenge PSA PFS) and overall survival (OS). Univariable and multivariable Cox analyses were performed to determine prognostic factors associated with PSA PFS, Rechallenge PSA PFS and OS. Results At a median follow-up of 32.73 months, 30(25%) patients were still alive. The median PSA PFS, Rechallenge PSA PFS and OS were 13.89(7.67-39.00), 5.29(1.25-20.00) and 27.13(12.40-60.50) months, respectively. In multivariate analysis, treatment-free interval between the first sequence docetaxel chemotherapy and docetaxel rechallenge (> 6 months vs. ≤6 months) was independent predictor for PSA PFS. Response of docetaxel rechallenge (partial vs. no partial) was independent predictor for Rechallenge PSA PFS. mCRPC baseline serum-PSA and response of docetaxel rechallenge (partial vs. no partial) were independent predictors for OS. Conclusion These results further support the favorable profile of docetaxel rechallenge in mCRPC patients who were effectively treated with first-line docetaxel.

Objective To assess the efficacy of docetaxel plus ADT on mHSPC patients and analyze the prognostic factors. Methods We retrospectively reviewed the clinical data of 107 mHSPC patients treated with docetaxel plus ADT. Co-primary end points were PSA PFS and rPFS. Univariable and multivariable Cox analyses were performed to determine prognostic factors for PSA PFS and rPFS. Results The median follow-up time was 36 months, and 13 (12.1%) patients died. The median PSA PFS and rPFS were 34.000 (30.878-37.122) and 33.000 (30.031-35.969) months, respectively. Univariate analysis results showed that the serum PSA, PSA nadir at 7th month (≤0.2ng/dl vs. > 0.2ng/dl), number of chemotherapy cycles (≤6 vs. 7-12), ECOG PS (0-1 vs. 2) and visceral disease (yes vs. no) were independent predictors for PSA PFS and rPFS. Multivariate analysis results showed that PSA nadir at 7th month (≤0.2ng/dl vs. > 0.2ng/dl) and visceral disease (yes vs. no) were independent predictors for PSA PFS and rPFS. Conclusion The effect of docetaxel plus ADT on patients with mHSPC in China is favorable. PSA nadir at 7th month (≤0.2ng/dl vs. > 0.2ng/dl) and visceral disease (yes vs. no) are independent predictors for PSA PFS and rPFS.

Background: Large skeletal defects due to postosteomyelitis are uncommon, and they present a challenging reconstructive problem. The aim of our study was to summarize our experience performing a distraction osteogenesis technique using an intramedullary nail and a monolateral external fixator in the reconstruction of massive postosteomyelitis skeletal defects of the femur. Methods: Between January 1998 and October 2004, 17 patients with massive postosteomyelitis skeletal defects of the femur (11 men and 6 women), underwent the reconstruction procedure. After osteotomy of diaphysis of the femur, we inserted an intramedullary nail into the femur, and we placed a monolateral external fixator with half-pins lateral to the nail. Lengthening was started on the seventh postoperative day at a rate of 1 mm/d. Once we achieved solid bone union, we removed the monolateral external fixator; the intramedullary nail remained for bone consolidation until reconstruction was complete. We assessed the outcomes clinically and radiographically at a mean of 70.3 months postoperatively. Results: At follow-up (mean 70.3, range 14.0-96.0 mo), all the skeletal defects were filled, bone union at docking sites was achieved without bone graft and leg length discrepancies were less than 2.5 cm in all patients. The mean gain in length was 12.9 (range 10.2-18.4) cm. According to Paley and Maar's evaluation criteria, we graded the bone results as excellent for 10 patients, good for 5, fair for 1 and poor for 1. We graded the functional results as excellent for 12 patients, good for 4 and fair for 1. The mean external fixator index was 18.1 d/cm; the consolidation index was 35.7 d/cm. Ten patients experienced pin infection, and 1 patient experienced a recurrence of deep infection. There were no neurologic or vascular injuries. Conclusion: Our study demonstrates that a distraction osteogenesis technique using an intramedullary nail and a monolateral external fixator is a reliable method for the reconstruction of massive postosteomyelitis skeletal defects. Contexte : Les lacunes osseuses majeures consecutives a une osteomyelite sont rares et causent des problemes de reconstruction difficiles. Notre etude visait a resumer notre experience d'une technique d'osteogenese par distraction utilisant un clou intramedullaire et un fixateur externe monolateral pour reconstruire des lacunes osseuses massives du femur consecutives a une osteomyelite. Methodes : Entre janvier 1998 et octobre 2004, 17 patients ayant des lacunes osseuses massives du femur consecutives a une osteomyelite (11 hommes et 6 femmes) ont subi une intervention de reconstruction. Apres une osteotomie de la diaphyse du femur, nous avons introduit un clou intramedullaire dans le femur et mis en place un fixateur externe monolateral avec des demi-broches posees lateralement au clou. On a commence l'allongement le septieme jour apres l'intervention a raison de 1 mm/j. Apres la fusion solide de l'os, nous avons enleve le fixateur externe monolateral. Le clou intramedullaire est demeure en place pour la consolidation de l'os jusqu'a ce que la reconstruction soit terminee. Nous avons evalue les resultats par des examens cliniques et radiographiques 70,3 mois en moyenne apres l'intervention. Resultats : Au suivi (moyenne de 70,3, intervalle de 14,0 a 96,0 mois), toutes les lacunes osseuses etaient comblees, la fusion de l'os au site d'amarrage s'etait produite sans greffe osseuse et la difference au niveau de la longueur des jambes etait inferieure a 2,5 cm chez tous les patients. L'allongement moyen s'est etabli a 12,9 (intervalle de 10,2 a 18,4) cm. Selon les criteres d'evaluation de Paley et Maar, nous avons juge les resultats osseux excellents chez 10 patients, bons chez 5, moyens chez 1 et mediocres chez 1 autre. Nous avons juge les resultats fonctionnels excellents chez 12 patients, bons chez 4 et moyens chez 1. L'indice moyen du fixateur externe etait de 18,1 j/cm, l'indice de consolidation s'est etabli a 35,7 j/cm. Dix patients ont eu une infection aux broches et un patient a ete atteint d'une infection profonde repetitive. Il n'y a pas eu de traumatisme neurologique ou vasculaire. Conclusion : Notre etude demontre qu'une technique d'osteogenese par distraction utilisant un clou intramedulaire et un fixateur externe monolateral constitue une methode fiable de reconstruction de lacunes osseuses massives consecutives a une osteomyelite., Hematogeneous osteomyelitis is rarely seen in the femur; however, it may lead to poor outcomes owing to delayed or inappropriate treatments, especially in developing countries. Some severe chronic osteomyelitis may [...]

The present study tested whether myrtol improves post-traumatic knee osteoarthritis (PTKO) by regulating the reactive oxygen species (ROS), transforming growth factor β1 (TGF-β1) and apoptosis in a mouse model. PTKO model mice were administered with 150, 300 or 450 mg/kg myrtol for 8 weeks. ELISA analysis was used to measure tumor necrosis factor-α, interleukin-6, malondialdehyde, superoxide dismutase, reactive oxygen species and TGF-β1 levels. Caspase-3 and Bax protein expressions were analyzed using western blot analysis. In the current study, treatment with myrtol improved the tissue damage and osteoarthritis score, while it also reversed the subchondral bone thickness, subchondral bone density, trabecular bone volume/relative trabecular bone volume ratio and trabecular bone spacing in PTKO mice. The activity of tumor necrosis factor α, interleukin-6, TGF-β1, malondialdehyde, superoxide dismutase and ROS were effectively inhibited, and the protein expression of caspase-3 and Bax were clearly suppressed by treatment with myrtol in a mouse model of PTKO. In conclusion, the results demonstrated that myrtol treatment improved PTKO through the suppression of inflammation, oxidative stress, ROS, TGF-β1 and Bax/caspase-3 in mice, and myrtol may be a potential agent for clinical therapy. [ABSTRACT FROM AUTHOR]