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Objectives: Patients with early-stage distal rectal cancer, if treated with radical surgery, usually suffer a poor quality of life. Definitive radiotherapy or chemoradiotherapy may be another treatment option for them. The aim of this study was to evaluate the role of definitive external beam radiotherapy or chemoradiotherapy in treating distal rectal cancer with stage cT1-2N0. Methods: We performed a retrospective study of 231 distal rectal cancer patients who were staged as cT1-2N0 from March 2002 to March 2015. All patients were treated by definitive radiotherapy or chemoradiotherapy. Overall survival (OS), progression-free survival (PFS), and short-term efficacy were analyzed. Multivariate analysis was performed to explore clinical factors significantly associated with PFS, local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) for the whole group. Results: For the whole group, 135 patients (58.4%) achieved clinical complete response (cCR). The 5-year OS, PFS, and LRFS were 86.19%, 83.30%, and 92.50%, respectively. Patients with cCR acquired better survival than those with non-cCR. In multivariable analysis, it revealed that clinical stage, carcinoembryonic antigen (CEA level) and concurrent chemotherapy were independent predictors of PFS. Conclusion: Definitive radiotherapy or chemoradiotherapy may be feasible in some early-stage distal rectal cancer regarding its favorable efficacy.

Kai-yun You,1,* Hai-hua Peng,2,* Yan-hui Jiang,1,* Zhuo-fei Bi,1 Xing-sheng Qiu11Department of Radiation Oncology, SunYat-Sen Memorial Hospital, SunYat-Sen University; 2Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou 510075, People’s Republic of China*These authors contributed equally to this workBackground: Whether concurrent chemotherapy could bring about better oncological outcomes in elderly patients receiving definitive radiotherapy is still unknown. So, the purpose of this study was to find out whether it is essential for elderly patients to undergo concurrent chemotherapy.Methods: We performed a retrospective study of 246 elderly cervical cancer patients who were treated with definitive radiotherapy or chemo-radiation between August 2004 and August 2015. All patients were divided into two groups according to whether they were receiving concurrent chemotherapy or not. Overall survival (OS) and disease-free survival (DFS) were compared between the two groups. Recurrence patterns were also analyzed. Multivariate analysis was performed to explore clinical factors significantly associated with DFS, local recurrence-free survival, and distant metastasis-free survival (DMFS).Results: The 5-year OS in the radiotherapy and chemo-radiation groups were 72.89% and 82.25%, respectively. A significant difference was found between the two groups (P=0.016). The 5-year DFS in the radiotherapy and chemo-radiaton groups were 58.19% and 75.52%, respectively, also with a significant difference between the two groups (P=0.028). Further subgroup analysis showed that in patients with negative lymph nodes, there were no differences in both OS and DFS between patients who did and did not receive concurrent chemotherapy. However, in patients with positive lymph nodes, patients who received concurrent chemotherapy acquired better OS and DFS than those who did not. Multivariable analysis showed that concurrent chemotherapy was an independent predictor of DFS and DMFS.Conclusion: Concurrent chemotherapy could improve oncological outcomes in elderly cervical cancer patients with positive lymph nodes, but not in those with negative lymph nodes.Keywords: cervical cancer, chemotherapy, radiotherapy &nbsp

Background The optimal care for pT3N0 rectal cancer remains controversial. And whether tumor location can be used to guide the administration of adjuvant radiotherapy for pT3N0 rectal cancer is not fully confirmed. The current study was designed to identify the benefit of adjuvant radiotherapy for pT3N0 rectal cancer. Methods We performed a retrospective study of 265 pT3N0 rectal cancer patients who were treated by surgery and adjuvant therapy from Mar. 2005 to Sept. 2015. All patients were divided into two groups according to receiving adjuvant radiotherapy or not. Overall survival (OS), disease-free survival (DFS) were compare between patients who did and did not receive adjuvant radiotherapy. Multivariate analysis was performed to explore clinical factors significantly associated with DFS, local recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS). Results For patients with lower tumor, DFS in adjuvant chemo-radiotherapy group was higher than that in adjuvant chemotherapy group. Besides, the rates of local recurrence and distant metastasis were found lower in patients who did receive adjuvant radiotherapy than those who did not. For patients with upper tumor, the 5-year OS and DFS were similar between groups of adjuvant chemotherapy and adjuvant chemo-radiotherapy. Multivariable analysis indicated both the CEA and tumor location were independent predictors of LRFS. And adjuvant radiotherapy predicted the DFS, LRFS and DMFS in lower rectal cancer patients. Conclusion Tumor location can serve as an indication for the administration of adjuvant radiotherapy in pT3N0 rectal cancer patients.

Background: Whether concurrent chemotherapy could bring about better oncological outcomes in elderly patients receiving definitive radiotherapy is still unknown. So, the purpose of this study was to find out whether it is essential for elderly patients to undergo concurrent chemotherapy. Methods: We performed a retrospective study of 246 elderly cervical cancer patients who were treated with definitive radiotherapy or chemo-radiation between August 2004 and August 2015. All patients were divided into two groups according to whether they were receiving concurrent chemotherapy or not. Overall survival (OS) and disease-free survival (DFS) were compared between the two groups. Recurrence patterns were also analyzed. Multivariate analysis was performed to explore clinical factors significantly associated with DFS, local recurrence-free survival, and distant metastasis-free survival (DMFS). Results: The 5-year OS in the radiotherapy and chemo-radiation groups were 72.89% and 82.25%, respectively. A significant difference was found between the two groups (P=0.016). The 5-year DFS in the radiotherapy and chemo-radiaton groups were 58.19% and 75.52%, respectively, also with a significant difference between the two groups (P=0.028). Further subgroup analysis showed that in patients with negative lymph nodes, there were no differences in both OS and DFS between patients who did and did not receive concurrent chemotherapy. However, in patients with positive lymph nodes, patients who received concurrent chemotherapy acquired better OS and DFS than those who did not. Multivariable analysis showed that concurrent chemotherapy was an independent predictor of DFS and DMFS. Conclusion: Concurrent chemotherapy could improve oncological outcomes in elderly cervical cancer patients with positive lymph nodes, but not in those with negative lymph nodes.

ObjectivesThe optimal interval between surgery and adjuvant treatment has not yet been found in cervical cancer. And whether patients with different FIGO stage should choose different interval is unknown. The purpose of this study was to evaluate whether interval has a different effect on oncologic outcome for patients with different tumor stages.MethodsWe performed a retrospective study of 226 cervical cancer patients who were treated by surgery and adjuvant therapy from May 2005 to August 2015. All patients were divided into 2 groups according to the interval of 5 weeks. Overall survival (OS) and disease-free survival (DFS) were compared between patients with interval shorter and longer than 5 weeks in the whole group and subgroups. Recurrence patterns were also analyzed. Multivariate analysis was performed to explore clinical factors significantly associated with DFS, local recurrence-free survival and distant metastasis-free survival for patients with stage IB2–IIA.ResultsFor patients with stage IA2–IB1, the 5-year OS and DFS were similar between groups of short and long interval with also the comparable results of local and distant failure. For patients with IB2–IIA, both the OS and DFS in the short-interval group were higher than that in the long-interval group. Besides, the rates of local recurrence were found higher in the group of long interval compared with short interval. Multivariable analysis indicated that time interval was an independent predictor of DFS and local recurrence-free survival for patients with stage IB2–IIA.ConclusionsIn cervical cancer patients, time interval between surgery and adjuvant therapy may have different effects on the prognosis in different FIGO stages.

Background Locoregionally advanced nasopharyngeal carcinoma has high risk of distant metastasis and mortality. Induction chemotherapy is commonly administrated in clinical practice, but the efficacy was quite controversial in and out of randomized controlled trials. We thus conducted this pairwise meta-analysis. Materials and Methods Trials that randomized patients to receive radiotherapy or concurrent chemoradiotherapy with or without induction chemotherapy were identified via searches of PubMed, MEDLINE, and ClinicalTrials.gov. Results A total of ten trials (2,627 patients) were included. The pooled hazard ratios (HRs) based on fixed effect model were 0.68 (95% confidence interval [CI] 0.56–0.80, p Conclusion This pairwise meta-analysis confirms the benefit in OS, PFS, and locoregional and distant controls associated with the addition of induction chemotherapy in nasopharyngeal carcinoma. Implications for Practice According to the results of this meta-analysis of ten trials, induction chemotherapy can prolong overall survival and progression-free survival and improve locoregional and distant controls for nasopharyngeal carcinoma.

// Lu-Ning Zhang 1,2,* , Xing-Sheng Qiu 3,* , Pu-Yun OuYang 2,* , Yao Xiao 2 , Xiao-Wen Lan 2 , Wuguo Deng 2 , Fang-Yun Xie 2 and Xi-Cheng Wang 1 1 Department of Oncology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China 2 Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China 3 Department of Radiation Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China * Co-first authors Correspondence to: Xi-Cheng Wang, email: // Fang-Yun Xie, email: // Wuguo Deng, email: // Keywords : age; concurrent chemoradiotherapy; distant metastasis; mortality; nasopharyngeal carcinoma Received : August 10, 2016 Accepted : September 29, 2016 Published : October 09, 2016 Abstract Background: Effect of age at diagnosis on treatment failure and mortality was rarely evaluated in nasopharyngeal carcinoma. Methods: We analyzed 1252 patients staged III-IVb and underwent concurrent chemoradiotherapy. Age was categorized as 20 to 49 years ( n =804), 50 to 59 years ( n =282) and 60 years or older ( n =166). Distant metastasis-free survival (DMFS), cancer-specific survival (CSS), overall survival (OS) and locoregional relapse-free survival (LRFS) were assessed by age group. Results: The 4-years DMFS decreased with age group (86.7% [20-49 years], 86.7% [50-59 years], 77.1% [≥60 years]; P =0.014); likewise, 4-years CSS were 91.0%, 87.4% and 74.2% ( P

Increasing evidence indicates that stimulating hippocampal neurogenesis could provide novel avenues for the treatment of depression, and recent studies have shown thatin vitroneurogenesis is enhanced by hypoxia. The aim of this study was to investigate the potential regulatory capacity of an intermittent hypobaric hypoxia (IH) regimen on hippocampal neurogenesis and its possible antidepressant-like effect. Here, we show that IH promotes the proliferation of endogenous neuroprogenitors leading to more newborn neurons in hippocampus in adult rats. Importantly, IH produces antidepressant-like effects in multiple animal models screening for antidepressant activity, including the forced swimming test, chronic mild stress paradigm, and novelty-suppressed feeding test. Hippocampal x-ray irradiation blocked both the neurogenic and behavioral effects of IH, indicating that IH likely produces antidepressant-like effects via promoting neurogenesis in adult hippocampus. Furthermore, IH stably enhanced the expression of BDNF in hippocampus; both the antidepressant-like effect and the enhancement of cell proliferation induced by IH were totally blocked by pharmacological and biological inhibition of BDNF–TrkB (tyrosine receptor kinase B) signaling, suggesting that the neurogenic and antidepressant-like effects of IH may involve BDNF signaling. These observations might contribute to both a better understanding of physiological responses to IH and to developing IH as a novel therapeutic approach for depression.

To evaluate the therapeutic effect of of whole brain irradiation (WBI) in the treatment of brain metastases of non-small-cell lung carcinoma and analyze the factors affecting the patients' survival.Ninety-three cases of brain metastases of non-small-cell lung carcinoma receiving radiotherapy between January 1998 and February 2004 were retrospectively reviewed. Of these patients, 68 were treated with three-dimensional conformal hypofractionated radiotherapy (3D-CRT) following WBI, while the other 25 underwent 3D-CRT alone. Kaplan-Meier method was used to analyze the survival rate and local control rate, and Cox proportional hazards model employed for determining prognostic factors influencing the patients' survival.The overall median actuarial survival of the patients was 14 months in the 3D-CRT+WBI group with 1- and 2-year actuarial survival rates of 50% and 27%, respectively, showing no significant difference from 3D-CRT group, which had a median survival of 11 months and 1- and 2-year survival rates of 45% and 15% (P=0.502, log-rank test). Actuarial 1-year local control rate in 3D-CRT+WBI group was 90% as compared to 70% in 3D-CRT group (P=0.028, log-rank test). In multivariate analyses, active extracranial disease (P=0.002) and Karnofsky Performance Scale score (P=0.034) were identified as the independent prognostic factors for the patients' survival.WBI prior to 3D-CRT does not benefit the patients with brain metastases of non-small cell lung carcinoma for their survival, but may help improve the local control rate.

To observe the preventive effect of rats' serum containing Buyang Huanwu Decoction (BYHWD) on cultured cardiomyocyte apoptosis of neonatal rat induced by means of 24 hrs hypoxia and 4 hrs reoxygenation, and to investigate its mechanism concerned with nitric oxide (NO).Myocyte apoptosis was detected by flow cytometry and ELISA with Annexin V-PI double labeled method. The lactate dehydrogenase (LDH) releasing level was measured with ultraviolet spectrophotometer. The NO concentration was determined by modified Yu method and the concentration of thiobarbituric acid response substance (TBARS) was tested by Ohkawa method.BYHWD contained rats' serum could significantly prevent cardiomyocyte from apoptosis induced by hypoxia and reoxygenation. After hypoxia-reoxygenation, the NO, LDH and TBARS levels in the supernatant of cultured liquid treated with BYHWD were significantly lower than those in non-treated cultured liquid, the effect of BYHWD was dose-dependent.BYHWD can prevent cardiomyocytes from apoptosis induced by hypoxia and reoxygenation, its mechanism might be related with oxygen free radical and NO scavenging produced during the hypoxia-reoxygenation process.