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Low dose rate permanent seed brachytherapy: tracing its evolution and current status. PRECISION RADIATION ONCOLOGY 2020. [DOI: 10.1002/pro6.1096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Wang X, Hu X, Liu X, Peng L, Wang Z, Wang G, Wang G, Zhang Q, Han J. The efficacy of 99mTc-MIBI imaging in 125I seed implantation treatment of rabbit VX2 transplanted liver cancer. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2019; 12:2363-2367. [PMID: 31934063 PMCID: PMC6949617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 05/22/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE To evaluate the efficacy of 99mTc-MIBI imaging in the evaluation of 125I radioactive particle implantation for treatment of rabbit VX2 transplanted liver cancer. METHODS Twelve New Zealand white rabbit VX2 liver cancer models were successfully prepared by tumor cell suspension method and randomly divided into a control group and treatment group. The treatment group received 125I particle implantation according to the TPS plan, and the control group received the same number of hollow particle implantation. 99mTc-MIBI imaging was performed before and 7 d, 14 d, and 28 d after implantation. The target lesion (target, T) and normal liver tissue (nontarget, N) were determined by region of interest (ROI) technique. Radioactivity count was used to calculate the 99mTc-MIBI uptake ratio (target-to-nontarget ratio, T/N) between the target lesion and normal liver tissue, thereby obtaining early ratio (ER) and delayed ratio (DR), respectively. The retention index (RI) was calculated. The mice were sacrificed after 28 days for histopathologic observation. RESULTS The T/N ratio, ER, and DR showed no statistical changes following the implantation time in the control group. In the treatment group, ER and DR gradually decreased after implantation of 125I seeds (P < 0.05). There was no significant difference in RI during different observation times between the treatment group and the control group. Compared with the treatment group, RI exhibited no statistical difference between before and 7 d, 7~14 d, and 14~28 d after implantation (P > 0.05). CONCLUSION This method has value in evaluating the efficacy of 125I seed implantation treatment of rabbit VX2 transplanted liver cancer. The T/N ratio is independent of the tumor diameter, but is related to the blood perfusion and metabolic state of the tumor. Implantation of 125I particles into the rabbit transplanted liver cancer can effectively inhibit tumor growth, thus is a safe and effective method.
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Affiliation(s)
- Xufu Wang
- Department of Nuclear Medicine, The Affiliated Hospital of Qingdao UniversityQingdao 266003, Shandong, China
| | - Xiaokun Hu
- The Centre of Intervention, The Affiliated Hospital of Qingdao UniversityQingdao 266003, Shandong, China
| | - Xinfeng Liu
- Department of Nuclear Medicine, The Affiliated Hospital of Qingdao UniversityQingdao 266003, Shandong, China
| | - Lijing Peng
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao UniversityQingdao 266003, Shandong, China
| | - Zenghua Wang
- Department of Nuclear Medicine, The Affiliated Hospital of Qingdao UniversityQingdao 266003, Shandong, China
| | - Guoqiang Wang
- Department of Nuclear Medicine, The Affiliated Hospital of Qingdao UniversityQingdao 266003, Shandong, China
| | - Guoming Wang
- Department of Nuclear Medicine, The Affiliated Hospital of Qingdao UniversityQingdao 266003, Shandong, China
| | - Qin Zhang
- Department of Nuclear Medicine, The Affiliated Hospital of Qingdao UniversityQingdao 266003, Shandong, China
| | - Jiankui Han
- Department of Nuclear Medicine, Qilu Hospital of Shandong UniversityShandong, China
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Ma X, Yang PZ, Jiang PS, Huo PB, Cao Q, Chai PS, Wang PH. Effectiveness and safety of a robot-assisted 3D personalized template in 125I seed brachytherapy of thoracoabdominal tumors. J Contemp Brachytherapy 2018; 10:368-379. [PMID: 30237820 PMCID: PMC6142644 DOI: 10.5114/jcb.2018.77957] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 08/10/2018] [Indexed: 12/27/2022] Open
Abstract
PURPOSE This research aims to evaluate the effectiveness and safety of a robot-assisted 3D personalized template in 125I seed brachytherapy of thoracoabdominal tumors. MATERIAL AND METHODS Forty-three patients with different tumors were involved in this research between 2013 and 2015. They were all eligible to 125I seed implantation based on robot-assisted 3D personalized template. Meanwhile, 51 patients with similar tumors, which were treated with a conventional coplanar template, were involved for comparison. Follow-up was carried out after the surgery to evaluate the therapeutic efficacy, including overall survival (OS) of the patient and local control (LC) of the tumor. Complications were also summarized to evaluate the safety. Besides, statistical analysis was achieved to investigate possible factors associated with the result. RESULTS In the robot-assisted 3D personalized template-guided brachytherapy, the median target volume treated by the prescription dose (V100) was 95.3% (range, 92.4-109.8), and the median dose administered to 90% of the target volume (D90) was 126.1 Gy (range, 114.2-132.0), improved 5% and 8% compared with the conventional template-guided brachytherapy, respectively. The median OS was 30 months (95% CI: 19.4-40.6) and the rates of 2-year OS and LC were 58.1% and 86.0%, respectively. The median OS was prolonged 10 months and the 2-year OS and LC were improved 18.9% and 23.3% compared with the conventional template-guided brachytherapy, respectively. CONCLUSIONS Through analysis of the selected patients with thoracoabdominal tumors, the robot-assisted 3D personalized template in 125I seed brachytherapy was a more effective and safer method. It can achieve a more favorable OS and LC.
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Affiliation(s)
- Xiaodong Ma
- School of Mechanical Engineering, Tianjin University, Tianjin
| | | | | | - Prof. Bin Huo
- Department of Oncology, the Second Hospital of Tianjin Medical University, Tianjin, China
| | - Qiang Cao
- Department of Oncology, the Second Hospital of Tianjin Medical University, Tianjin, China
| | - Prof. Shude Chai
- Department of Oncology, the Second Hospital of Tianjin Medical University, Tianjin, China
| | - Prof. Haitao Wang
- Department of Oncology, the Second Hospital of Tianjin Medical University, Tianjin, China
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Feng H, Hu Y, Jin P, Meng X, Chen Y, Zhang H. Intensity-modulated radiotherapy combined with iodine-125 seed implantation in non-central recurrence of cervical cancer: A case report and literature review. Oncol Lett 2017; 14:4085-4091. [PMID: 28959365 PMCID: PMC5607647 DOI: 10.3892/ol.2017.6680] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 03/03/2017] [Indexed: 12/22/2022] Open
Abstract
Recurrent cervical cancer is a clinically complex disease that is difficult to treat. There are numerous treatment options, but the results achieved by each are poor. External-beam radiation therapy of the pelvic lymph drainage area, in combination with intracavitary afterloading or the interstitial implantation of a radiation source (i.e., brachytherapy), are the current standard radiotherapy regimens used in high-risk clinical targets. However, there are few reports concerning the use of iodine-125 (125I) seed implantation brachytherapy in recurrent cervical cancer, and the effects of treatment and adverse reactions have not yet been systematically evaluated. In the present study one such case is reported, in which the patient was successfully treated with intensity-modulated radiotherapy (IMRT) in combination with 125I seed implantation. The patient, a 47-year-old woman, was initially diagnosed with International Federation of Gynecology and Obstetrics stage IB1 cervical cancer, and received a radical hysterectomy, left lateral adnexectomy and pelvic lymph node dissection. A follow-up examination 23 months later revealed vaginal invasion and a solitary lump in the cervical stump with a maximum diameter of 38 mm. The patient was subsequently diagnosed with recurrent cervical cancer and was treated with six cycles of docetaxel and nedaplatin chemotherapy, alongside IMRT and interstitial 125I seed implantation. At the point of manuscript submission, the patient's progression-free survival time was 33 months and long-term adverse reactions were acceptable. The response of this patient indicates that 125I seed implantation could be used as a complementary treatment for recurrent cervical cancer and may also prove to be a reliable means for the comprehensive treatment of primary cervical cancer, as the patient had characteristics similar to primary cervical cancer, although this hypothesis could not be confirmed in the present study.
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Affiliation(s)
- Hu Feng
- Department of Radiotherapy, Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China
| | - Yuanyuan Hu
- Department of Radiotherapy, Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China
| | - Peng Jin
- Department of Radiotherapy, Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China
| | - Xiangkuan Meng
- Department of Radiotherapy, Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China
| | - Yubing Chen
- Department of Radiotherapy, Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China
| | - Hongmei Zhang
- Scientific Research Center, China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
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Zhao J, Shi L, Ji M, Wu J, Wu C. The combination of systemic chemotherapy and local treatment may improve the survival of patients with unresectable metastatic colorectal cancer. Mol Clin Oncol 2017; 6:856-860. [PMID: 28588777 PMCID: PMC5451863 DOI: 10.3892/mco.2017.1247] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 03/08/2017] [Indexed: 01/16/2023] Open
Abstract
With the development of systemic chemotherapy, the survival time of patients with advanced colorectal cancer (CRC) has increased. In addition, local treatments, such as microwave ablation and radioactive seed implantation, have been shown to be effective. However, the number of studies reporting on the effect of systemic chemotherapy combined with local treatments is limited. The present study was conducted to determine the effect of local treatment combined with systemic chemotherapy in patients with initial unresectable metastatic CRC (mCRC). Clinicopathological and follow-up data from 273 patients with initial unresectable mCRC between April, 2007 and October, 2013 were retrospectively analyzed. A total of 51 patients received minimally invasive treatments combined with systemic chemotherapy and 39 patients achieved tumor-free survival (TFS). The median TFS time was 9 months (range, 2–45 months); the median overall survival (OS) time was 40 months (range, 12–108 months). In patients who did not achieve TFS, the OS was 37 months. Thus, patients who achieved TFS exhibited a significantly longer OS compared with those who did not achieve TFS (P=0.049). The results of the univariate analysis demonstrated that certain characteristics, such as the number of lesions and maximum tumor diameter, were associated with the achievement of TFS. The patients assessed herein achieved TFS in response to local treatments combined with systemic chemotherapy. Furthermore, the achieved TFS provided an OS benefit.
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Affiliation(s)
- Jiemin Zhao
- Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu 213000, P.R. China
| | - Liangrong Shi
- Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu 213000, P.R. China
| | - Mei Ji
- Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu 213000, P.R. China
| | - Jun Wu
- Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu 213000, P.R. China
| | - Changping Wu
- Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu 213000, P.R. China
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Tan Q, Qin Q, Yang W, Lian B, Mo Q, Wei C. Combination of 125I brachytherapy and chemotherapy for unresectable recurrent breast cancer: A retrospective control study. Medicine (Baltimore) 2016; 95:e5302. [PMID: 27858906 PMCID: PMC5591154 DOI: 10.1097/md.0000000000005302] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Recurrent breast cancer remains an incurable malignancy and cannot be removed by surgery in the majority of cases. This study aimed to explore the feasibility and efficacy of the combination of I brachytherapy and chemotherapy for the treatment of unresectable recurrent breast cancer. Patients with unresectable recurrent breast cancer treated between January 2011 and December 2014 with a combination of I brachytherapy and capecitabine or gemcitabine were evaluated and outcomes were compared with those of women treated with capecitabine or gemcitabine in conventional dose as a monotherapy. Of 61 patients evaluated, 28 received the combination treatment and 33 received capecitabine or gemcitabine monotherapy. The combination of I brachytherapy and chemotherapy resulted in a significant improvement in progression-free survival versus capecitabine or gemcitabine monotherapy (median, 17.8 vs 11.4 months; hazard ratio [HR], 0.44; 95% confidence interval [CI], 0.23-0.84; P = 0.013). The objective response rate (ORR) was significantly higher with the combination (82.1%) than with monotherapy (54.5%; P = 0.022), and the rate of pain relief was higher in the combination arm (100% vs 73.6%; P = 0.038). There was no significant improvement for overall survival (median, 30.1 vs 27.2 months; HR, 0.82; 95% CI, 0.47-1.44; P = 0.496). There were no serious complications detected during the follow-up period, any grade toxicities were comparable between treatment arms. In conclusion, the combination of I brachytherapy and second-line chemotherapy is superior to chemotherapy alone and is an effective and safe therapy for unresectable recurrent breast cancer. However, further investigation and much larger scale randomized controlled trials with long-term follow-up are needed.
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Affiliation(s)
| | | | - Weiping Yang
- Department of Ultrasound Diagnosis, The Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | | | | | - Changyuan Wei
- Department of Breast Surgery
- Correspondence: Changyuan Wei, Department of Breast Surgery, The Affiliated Tumor Hospital of Guangxi Medical University, 71 Hedi Road, Nanning 530021, China (e-mail: )
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Huo X, Wang H, Yang J, Li X, Yan W, Huo B, Zheng G, Chai S, Wang J, Guan Z, Yu Z. Effectiveness and safety of CT-guided 125I seed brachytherapy for postoperative locoregional recurrence in patients with non–small cell lung cancer. Brachytherapy 2016; 15:370-380. [DOI: 10.1016/j.brachy.2016.02.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 01/22/2016] [Accepted: 02/02/2016] [Indexed: 10/22/2022]
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Shi L, Li X, Pei H, Zhao J, Qiang W, Wang J, Xu B, Chen L, Wu J, Ji M, Lu Q, Li Z, Wang H, Jiang J, Wu C. Phase II study of computed tomography-guided (125)I-seed implantation plus chemotherapy for locally recurrent rectal cancer. Radiother Oncol 2015; 118:375-81. [PMID: 26522058 DOI: 10.1016/j.radonc.2015.10.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 10/23/2015] [Accepted: 10/25/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND PURPOSE This trial evaluated the efficacy and safety of CT guided (125)I-seed implantation (CTII) plus chemotherapy with fluorouracil, leucovorin, and irinotecan (FOLFIRI) compared with FOLFIRI alone as second-line treatment for locally recurrent rectal cancer (LRRC). MATERIAL AND METHODS Patients with LRRC who received one prior chemotherapy regimen were enrolled and divided randomly assigned to FOLFORI alone (Arm A) and FOLFORI plus CTII (Arm B). The primary endpoint was local control time (LCT). Overall survival (OS) and treatment related adverse events (TRAEs) were also observed. RESULTS Fifty-seven patients were enrolled from October 2008 and December 2014. Twenty-seven were assigned into Arm A and 30 into Arm B. The overall response rate of locally recurrent tumor was improved to 100% in Arm B versus 29.6% in Arm A (P<0.001). A significant longer LCT was observed in Arm A (P<0.001); median LCT was 12 months in Arm B versus 4 months in Arm A. A borderline significant improvement in OS was also observed in Arm B (P=0.0464); median OS was 25 months in Arm B versus 19 months in Arm A. For patients without distant metastases, median OS was 37 months in Arm B versus 21 months in Arm A (P=0.0101). For patients with (neo)adjuvant radiotherapy (ART), a longer LCT and OS were also found in Arm B (P<0.001 and P=0.0217, respectively). TRAEs were not serious generally. There was no statistically significant difference in treatment related toxicity between Arm A and B both for all patients and patients receiving ART. CONCLUSIONS CTII plus FOLFIRI improves the LCT with tolerable toxicities as a second-line treatment in patients with local recurrent rectal cancer, and is helpful to prolong the OS, particularly in patients without distant metastases or with a history of radiotherapy.
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Affiliation(s)
- Liangrong Shi
- Department of Oncology, The Third Affiliated Hospital of Soochow University, China; Department of Biological Treatment, The Third Affiliated Hospital of Soochow University, China; Jiangsu Engineering Research Center for Tumor Immunotherapy, China
| | - Xiaodong Li
- Department of Oncology, The Third Affiliated Hospital of Soochow University, China; Department of Biological Treatment, The Third Affiliated Hospital of Soochow University, China; Jiangsu Engineering Research Center for Tumor Immunotherapy, China
| | - Honglei Pei
- Department of Radiation Oncology, The Third Affiliated Hospital of Soochow University, China.
| | - Jiemin Zhao
- Department of Oncology, The Third Affiliated Hospital of Soochow University, China
| | - Weiguang Qiang
- Department of Oncology, The Third Affiliated Hospital of Soochow University, China
| | - Jin Wang
- Department of Radiation Oncology, The Third Affiliated Hospital of Soochow University, China
| | - Bin Xu
- Department of Biological Treatment, The Third Affiliated Hospital of Soochow University, China; Jiangsu Engineering Research Center for Tumor Immunotherapy, China
| | - Lujun Chen
- Department of Biological Treatment, The Third Affiliated Hospital of Soochow University, China; Jiangsu Engineering Research Center for Tumor Immunotherapy, China
| | - Jun Wu
- Department of Oncology, The Third Affiliated Hospital of Soochow University, China
| | - Mei Ji
- Department of Oncology, The Third Affiliated Hospital of Soochow University, China
| | - Qicheng Lu
- Department of Gastrointestinal Surgery, The Third Affiliated Hospital of Soochow University, China
| | - Zhong Li
- Department of Gastrointestinal Surgery, The Third Affiliated Hospital of Soochow University, China
| | - Haitao Wang
- Department of Gastrointestinal Surgery, The Third Affiliated Hospital of Soochow University, China
| | - Jingting Jiang
- Department of Biological Treatment, The Third Affiliated Hospital of Soochow University, China; Jiangsu Engineering Research Center for Tumor Immunotherapy, China.
| | - Changping Wu
- Department of Oncology, The Third Affiliated Hospital of Soochow University, China; Department of Biological Treatment, The Third Affiliated Hospital of Soochow University, China; Jiangsu Engineering Research Center for Tumor Immunotherapy, China.
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Zhang WF, Jin WD, Li B, Wang MC, Li XG, Mao WY, Luo KY. Effect of brachytherapy on NF-κB and VEGF in gastric carcinoma xenografts. Oncol Rep 2014; 32:635-40. [PMID: 24926530 DOI: 10.3892/or.2014.3255] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 03/28/2014] [Indexed: 11/06/2022] Open
Abstract
Iodine-125 (125I) seed irradiation can be used as an important supplementary treatment for unresectable advanced gastric cancer. However, the radiobiological mechanism underlying brachytherapy remains unclear. Therefore, we investigated the influence of continuous and low-energy 125I irradiation on the cell cycle distribution, apoptosis, expression of NF-κB and VEGF and tumor growth in a human gastric cancer xenograft model. To create an animal model of gastric cancer, SGC-7901 cells were surgically implanted into mice. The 60 mice bearing SGC-7901 gastric cancer xenografts were randomly separated into 2 groups. Sham seeds (0 mCi) were implanted into the control group (n=30); 125I seeds (0.6 mCi) were implanted into the treatment group (n=30). At 28 days after irradiation, apoptosis was detected by flow cytometry. fluorescence micrograph detected intense VEGF and NF-κB immunofluorescence in the tumor samples, and changes in NF-κB and VEGF mRNA and protein expression were assessed by real-time PCR and western blot analysis, respectively. The tumor volume and weight were measured 0-28 days after 125I seed implantation. 125I seed irradiation induced significant apoptosis and G2/M phase arrest. Reduction in the intensities of VEGF and NF-κB immunofluorescence in tumor vessels was observed after treatment. NF-κB and VEGF mRNA and protein expression levels were substantially lower in the implantation treatment group than in the control group. Consequently, 125I seed implantation inhibited cancer growth and reduced cancer volume. The present study revealed that 125I seed irradiation significantly induced apoptosis and cell cycle arrest in the human gastric cancer xenografts. 125I-induced changes in NF-κB and VEGF expression are suggested as potential mechanisms underlying effective brachytherapy.
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Affiliation(s)
- Wan-Fu Zhang
- Department of General Surgery, The Second People's Hospital of Yunnan Province, Kunming, Yunnan 650500, P.R. China
| | - Wen-Di Jin
- Department of General Surgery, The Second People's Hospital of Yunnan Province, Kunming, Yunnan 650500, P.R. China
| | - Bo Li
- Department of General Surgery, The Second People's Hospital of Yunnan Province, Kunming, Yunnan 650500, P.R. China
| | - Ming-Chun Wang
- Department of General Surgery, The Second People's Hospital of Yunnan Province, Kunming, Yunnan 650500, P.R. China
| | - Xiao-Gang Li
- Department of General Surgery, The Second People's Hospital of Yunnan Province, Kunming, Yunnan 650500, P.R. China
| | - Wen-Yuan Mao
- Department of General Surgery, The Second People's Hospital of Yunnan Province, Kunming, Yunnan 650500, P.R. China
| | - Kai-Yuan Luo
- Department of General Surgery, The Second People's Hospital of Yunnan Province, Kunming, Yunnan 650500, P.R. China
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Ho C, Tong DKH, Tsang JS, Law SYK. Post-esophagectomy gastric conduit cancers: treatment experiences and literature review. Dis Esophagus 2013; 27:141-5. [PMID: 23551754 DOI: 10.1111/dote.12070] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Esophagectomy remains the mainstay of treatment for esophageal cancer. The stomach is the commonest organ used to restore intestinal continuity after esophagectomy. Metachronous gastric cancer in the gastric conduit after esophagectomy is rare; the etiology remains unclear. Possible risk factors include Helicobacter pylori infection, biliary or pancreatic reflux and prior radiotherapy. Prognosis of these patients remains poor. Treatment of this particular entity poses unique challenges to the surgeon and oncologist. Early diagnosis by endoscopy may allow endoscopic excision such as endoscopic mucosal resection or endoscopic submucosal dissection. In more advanced cancers, surgery is difficult, reconstruction is complicated, and further radiation may not be feasible because of previous neoadjuvant therapy. In this report, four patients who developed gastric conduit cancers are presented. They were treated with either surgery alone or combined with chemoradiotherapy. All four patients were still alive after at least 21 months, with three patients currently still alive (21-48 months). The literature is also reviewed, in particular addressing the incidence, possible underlying causes, prognosis and options of treatment for this specific clinical scenario.
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Affiliation(s)
- C Ho
- Department of Surgery, Kwong Wah Hospital
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