Biomedical subjects

Guo-liang Jiang

Publications and source records attributed to Guo-liang Jiang.

7 recordsLinked to original sources

PubMed2006

[Three-dimensional conformal radiotherapy combined with transcatheter arterial chemoembolization for hepatocellular carcinoma].

OBJECTIVE: To evaluate the response and tolerance in hepatocellular carcinoma (HCC) patients treated by three-dimensional conformal radiotherapy (3DCRT) combined with. transcatheter arterial chemoembolization (TACE). METHODS: Fourty-six HCC patients confirmed by cytology or histology were studied. All patients underwent TACE 1 to 3 courses. Then they received 3DCRT after an interval of about one month. 3DCRT was given with the field covering the tumor with a generous margin. 6 MV X-ray was used. The total dose was 30 - 54 Gy, in daily 2 Gy fractions. Immediate response was recorded according to the WHO criteria carried out by serial CT scan one month after 3DCRT. Irradiation toxicities were scored by the RTOG criteria. Acute liver toxicity was graded according to the common toxicity criteria (CTC) of National Cancer Institute. Late toxicity was focused on radiation-induced liver disease (RILD). RESULTS: Partial response was observed in 8 (17.4%) patients. Stable disease and progressive disease was observed in 35 (76.1%) patients and 3 (6.5%) patients, respectively. No complete response was observed at the time of the response evaluation. The overall survival rate at 1-, 2- and 3-year was 60.9%, 39.1% and 28.3%, respectively, with a median survival period of 16 months. The 1-, 2- and 3-year local progression-free rate was 73.9%, 56.5% and 39.1%, respectively. The 1-, 2- and 3-year distant metastasis rate was 15.2%, 21.7% and 34.8%. Univariate analysis showed that favorable prognostic predictors for survival were: T3 stage, CACA 2001 stage I, absence of portal thrombosis, Child-Pugh grade A and irradiation dose of >45 Gy. Irradiation dose and liver cirrhosis were identified by Cox-regression analysis as independent predictors for survival. Two patients experienced CTC grade 1 acute hepatic toxicity and three patients experienced grade 3 acute hepatic toxicity. Two patients developed RILD. Three patients experienced RTOG grade 1 acute gastrointestinal complication and one patient experienced acute gastrointestinal bleeding. Five patients experienced RTOG grade 1 leucopenia, and five patients experienced grade 2 leucopenia. CONCLUSION: 3DCRT combined with TACE is safe and effective for HCC. It is worthy of a further dose escalation study.

Adult↗

PubMed2005

Late course accelerated hyperfractionated radiotherapy plus concurrent chemotherapy for squamous cell carcinoma of the esophagus: a phase III randomized study.

PURPOSE: Late course accelerated hyperfractionated (LCAF) radiotherapy (RT) is as effective as standard chemoradiotherapy for nonsurgical management of locally advanced esophageal squamous cell carcinoma (SCC). We have evaluated further the efficacy of concurrent LCAF RT and chemotherapy. METHODS AND MATERIALS: In all, 111 eligible patients with esophageal SCC were randomized to receive LCAF alone (LCAF) or concurrent LCAF and chemotherapy (LCAT+CT) between March 1998 and July 2000. All patients received conventional fractionation irradiation of 1.8 Gy per day, to a dose of 41.4 Gy/23 fractions in 4-5 weeks, followed by accelerated hyperfractionated irradiation using reduced fields, 1.5 Gy/fractions twice a day, to a dose of 27 Gy in 18 days. Thus, the total dose was 68.4 Gy/41 fractions in 44 days. Fifty-four patients in the LCAF+CT arm had an additional four cycles of chemotherapy using cisplatin 25 mg/m(2) daily and fluorouracil (5-FU) 600 mg/m(2) daily on Days 1-3 every 4 weeks starting on the same day that LCAF was delivered. RESULTS: The median survival was 23.9 months (95% confidence [CI], 20.1-27.7) for the LCAF arm and 30.8 months (95% CI, 17.6-44.1) for the LCAF+CT arm, respectively. Survival rates at 1, 3, and 5 years of the LCAF arm were 77%, 39%, and 28%, respectively, while those of the LCAF+CT arm were 67%, 44%, and 40%, respectively (p = 0.310). Grades 3 and 4 acute toxicities occurred in 46% and 25% of the patients in the LCAF arm and the LCAF+CT arm, respectively; 6% of the patients in the combined arm had Grade 5 acute toxicities, whereas none was noted in the LCAF alone arm. CONCLUSIONS: Late course accelerated hyperfractionation was effective for locally advanced esophageal SCC. There was a trend toward better survival among patients who received intensified treatment with concurrent chemotherapy. Further randomized studies with a larger number of patients should be carried out, but additional measures must be taken to reduce the higher mortality rate due to chemotherapy-related acute toxicities.

Adult↗

PubMed2005

[Prognostic factor of primary liver cancer treated by hypofractionated three-dimensional conformal radiotherapy].

OBJECTIVE: To evaluate the toxicity and efficacy of primary liver cancer (PLC) treated by hypofractionated three-dimensional conformal radiotherapy (3DCRT) and investigate the prognostic factors. METHODS: Between April 1999 and August 2003, 128 PLC patients received hypofractionated 3DCRT. According to UICC/AJCC staging system, there were 83 T3 patients, 45 T4, with none of them having lymph node metastasis. The mean value of gross tumor volume (GTV) was (458.92 +/- 429.8) cm(3) (6.2-2097 cm(3)). Thirty-four patients had portal vein tumor thrombosis (PVTT). 108 patients had Child-Pugh Grade A liver cirrhosis and 20 Child-Pugh Grade B liver cirrhosis. All patients received a total dose of (53.6 +/- 6.6) Gy/4-8 Gy per fraction/3 fractions per week. Forty-eight of these patients received 3DCRT combined with transarterial chemoembolization (TACE). RESULTS: Seven patients died within 3 months after the treatment were dismissed from the series. The response rate (CR + PR) was 55% (67/121). The overall 1-, 2-, and 3-year survival rate was 65.0%, 43.3%, and 33.1%, respectively. T stage (P = 0.001), GTV (P = 0.0001), PVTT (P = 0.0001) and Child-Pugh Grade (P = 0.0001) had significant impact on the overall survival. However, only GTV and Child-Pugh Grade were independent significant prognostic factors by Cox-regression analysis, (P = 0.044 and P = 0.015). CONCLUSION: T stage, GTV, PVTT and Child-Pugh Grade have significant impact on the overall survival in primary liver cancer patients treated by three-dimensional conformal radiotherapy. But only GTV and Child-Pugh Grade are independent prognostic factors.

Adult↗

PubMed2004

[Study of prognostic factors in patients with stage I non-small cell lung cancer].

OBJECTIVE: To analyze the prognostic factors in patients with stage I non-small cell lung cancer (NSCLC). METHODS: Fifty-eight patients with stage I NSCLC treated from 1991 to 1995 were retrospectively reviewed. The clinical features, histopathology and prognostic factors were analyzed by SPSS10.0 statistic software. The expression of c-myc, MDM2, c-erbB-2, EGFR, p53, p14(ARF), p16(INK4), p21(WAF1) and nm23 was detected by immunohistochemical assay. The overall survival rate, local-regional control rate and distant metastasis rate were observed. RESULTS: The overall survival rate, local-regional recurrent rate and distant metastasis rate were 71.1%, 11.1% and 33.5%, respectively. In univariate analysis, tumor cell differentiation was an independent prognostic factor (P = 0.028); overexpression of c-myc or c-erbB-2 had significantly poor overall survival and high distant metastasis rate (P < 0.05). The total oncogene immunoreactive score (IRS) and comprehensive IRS were associated with poor overall survival. In multivariate analysis, tumor cell differentiation and comprehensive IRS were independent prognostic factors for overall survival. Among the high-risk group of patients, those who had received chemotherapy seemed to have a higher overall survival rate and a lower distant metastasis rate in this study, but the difference was not statistically significant. CONCLUSION: For stage I NSCLC patients, tumor cell differentiation and comprehensive IRS are independent prognostic factors for overall survival. Adjuvant chemotherapy might somehow improve the survival for the patients with high-risk factors.

Adult↗

PubMed2004

[Treatment of 40 patients with primary tracheal carcinoma].

OBJECTIVE: To study the efficacy of treatment in 40 patients with primary tracheal carcinoma. METHODS: From 1970 to 2001, 40 patients with primary tracheal carcinoma treated in our hospital were retrospectively reviewed. Twenty-eight were male and 12 were female with median age of 47 years. The median interval from onset of symptoms to diagnosis was 10 months (1 - 60 months). Fifteen patients had adenoid cystic carcinoma, 14 squamous cell carcinoma, 8 adenocarcinoma, 2 small-cell carcinoma and 1 mucoepidermoid carcinoma. Thirty-two patients received operation plus adjuvant radiotherapy, 6 received radiotherapy alone and 2 received operation alone. RESULTS: The median survival time for all patients was 40 months. The 1-, 5-, and 10-year survival rate was 86%, 59% and 29%, respectively. The 1-, 5-, and 10-year local control rate was 84%, 60% and 50%, respectively. Distant metastasis rate in 1, 5, and 10 years was 17%, 51% and 84%, respectively. CONCLUSION: Surgical resection plus adjuvant radiotherapy is a reasonable mode of treatment. Despite late local recurrence after initial treatment, its intrinsic feature, excellent long-term palliation can be achieved after treatment.

Adult↗

PubMed2004

[Comparative study on prognostic factors in young and old lung cancer patients under chemo-radiotherapy].

OBJECTIVE: To investigate the differences in prognostic factors between the young and old lung cancer patients treated by chemo-radiotherapy. METHODS: The clinical data were collected from 70 young patients (< 40 years old, the study group) and 82 randomly selected old patients (> or = 40 years old, the control group) treated by chemo-radiotherapy. Survival analysis was done by the Kaplan-Meier method, univariate analysis by Log rank test and multivariate analysis by Cox proportional hazard model, respectively. RESULTS: Median survival time was 10 months in the study group and 12 months in the control group. The 2-year survival rate was 11.1% versus 23.1% and the 5-year survival was 3.1% versus 5.4%, respectively. Univariate analyses demonstrated that symptom duration time, mis-diagnosis duration time, clinical stage, chemo-radiation regimen, radiation dose, DDP dose, weight loss and Karnofsky performance status were associated with the prognosis of the study group, and symptom duration time, clinical stage, radiation dose, DDP dose, weight loss and Karnofsky performance status were associated with that of the control group. Multivariate analyses showed that clinical stage, weight loss and Karnofsky performance status were independent prognostic factors for both groups, but DDP dose only for the study group. CONCLUSION: The overall survival was similar in young and old patient groups; There was some difference in prognostic factors between the two groups; DDP dose was an independent prognostic factor for young lung cancer patients which might bear dose-response relationship.

Adenocarcinoma↗

PubMed2003

[Clinico-pathologic and prognostic studies on lung adenocarcinoma patients under 40 years of age].

OBJECTIVE: To study whether the clinico-pathologic characteristics and survival of young lung cancer patients < 40 years of age differ from those of lung cancer patients >or= 40 years of age. METHODS: Retrospective analysis was carried out to compare the clinico-pathologic features and survival of 129 young patients (young group) with those of 140 randomly selected older ones (elderly group). RESULTS: The young group, when compared with the older group, had more female (P = 0.037), longer mean duration of symptoms (4.7 m vs 2.5 m, P < 0.001), higher misdiagnostic rate (65.1% vs 24.3%, P < 0.001) with longer mean duration of misdiagnosis for the misdiagnosed patients (5.6 m vs 2.5 m, P < 0.001), more adenocarcinoma (54.3% vs 42.1%, P < 0.001), higher pathologic grade (69.5% vs 36.0%, P < 0.001), more advanced-stage diseases at diagnosis (74.4% vs 45.7%, P < 0.001), more patients receiving combined-modality treatment (94.6% vs 62.1%, P < 0.001) and more distant failures as initial relapse (64.7% vs 50.6%, P = 0.02). The median survivals and 5-year survival rates were better in patients with stage I-II disease in the young group than the older group (54 m vs 33 m and 46.2% vs 25.0%, P = 0.0495), even though the overall median survivals and 5-year survival rates were similar in either group (11 m vs 14 m and 8.3% vs 11.9%, P = 0.2889). There was no difference in family or smoking history (P = 0.227 and 0.171). CONCLUSION: Younger patients with lung cancer present difference in clinico-pathologic features from the older ones, but the survivals of the two groups are similar. To define younger lung cancer as "the younger type of lung cancer" may have a practical clinical significance.

Adenocarcinoma↗