Objective To assess the efficacy and toxicity of the maintenance radiotherapy for epithelial ovarian cancer. Methods We searched MEDLINE (1950 to 2009), EMbase (1966 to 2009), The Cochrane Library (Issue 1, 2009), CBMdisc (1978 to 2009), CNKI (1979 to 2009), VIP (1989 to 2009) and relevant internet websites to identify randomized controlled trials (RCTs) of maintenance radiotherapy for epithelial ovarian cancer. The quality of the included trials was assessed by Cochrane Systematic Review Handbook. Meta-analyses were conducted by RevMan 5.0 and SPSS 10.0 software. Results A total of 5 RCTs involving 529 patients were identified. The result of meta-analyses showed that the whole-abdominal radiation increased the 5-year progression-free survival (PFS) at RR1.76 and 95%CI 1.13 to 2.73, while it showed no effect on the 5-year overall survival (OS) at RR1.30 and 95%CI 0.96 to 1.76. The main adverse reactions of maintenance radiotherapy for epithelial ovarian cancer included diarrhea and abdominal pains, whose severity was related to radiation dose. Conclusion The whole-abdominal radiation can increase the 5-year PFS while its effect on the 5-year OS needs to be further studied.
目的 研究磷脂酰肌醇3-激酶（PI3K）和磷酸化蛋白激酶B（p-Akt）在人膀胱尿路上皮癌组织中的表达特征及临床意义。 方法 2005年6月－2010年7月，采用免疫组织化学法检测40例膀胱尿路上皮癌组织及10例正常膀胱组织PI3K与p-Akt的表达，并对结果进行统计学分析。 结果 PI3K和p-Akt在正常膀胱黏膜组织阳性表达率均低于膀胱尿路上皮癌组织中，差异均有统计学意义（P＜0.05）。同一标本中PI3K和p-Akt的表达不具有相关性（r=0.051，P=0.747）。 结论 PI3K、p-Akt在膀胱尿路上皮癌中高表达，两者在膀胱尿路上皮癌中共同促其发展，但其在膀胱尿路上皮癌的预后和进展中的作用尚不明确。
ObjectiveTo evaluate the efficacy and toxicity of gemcitabine, paclitaxel plus cisplatin (GTP) chemotherapy for advanced urothelial carcinoma in China. MethodsTen patients with advanced urothelial carcinoma who underwent GTP chemotherapy regimens were collected from February to July 2014 in our hospital. According to solid tumor curative effect evaluation standard 1.1, we evaluated the clinical effcacy and collected the adverse reactions. ResultsTen patients with advanced urothelial carcinoma accepted first-line chemotherapy using GTP chemotherapy regimens. There was 1 case of complete remission, 4 cases of partial response, 3 stable cases, and 2 progressive cases. Adverse reactions of degree Ⅲ were mainly of hematology toxicity, including 5 cases of leukocytes and neutrophils reduction, and 1 case of anemia. The remaining adverse reactions included gastrointestinal reaction, hair loss, and abnormal renal function. ConclusionGTP chemotherapy regimen is a promising treatment for advanced urothelial carcinoma.
Objective To assess the impact of adjuvant chemotherapy (ACH) on the survival of patients with pT3 urothelial carcinoma of the bladder (UCB) after radical cystectomy (RC). Methods We retrospectively analyzed the clinical and follow-up data of 223 UCB patients who underwent RC between January 2005 and June 2015. None of the patients received neoadjuvant chemotherapy. Of all the patients, 75 (33.6%) were diagnosed as pT3 cancer (including 32 pT3a and 43 pT3b patients). The follow-up data were up to June 2015. Kaplan-Meier method with log-rank test was used to estimate and compare overall survival (OS) and cancer-specific survival (CSS) between groups. Multivariate Cox proportional hazard models were used to identify predictors of OS and CSS. Results The short-term total effective rate of gemcitabine and cisplatin assisted chemotherapy in the treatment of pT3 UCB was 60.0%. Five-year OS rate (47.9%vs. 43.3%) and CSS rate (57.4%vs. 57.6%) were similar in the pT3a and pT3b groups (P=0.682 and 0.796, respectively). In pT3 patients, adjuvant chemotherapy was an independent predictor for OS (P=0.032). On multivariate analysis, according to the pT3 sub-stage, ACH was significantly associated with improved OS [hazard ratio (HR) =0.37; 95% confidence interval (CI) (0.15, 0.68),P=0.006] and CSS [HR=0.34, 95%CI (0.12, 0.86),P=0.022] in the pT3b group only. Conclusion Because pT3b cancer is characterized by macroscopic peri-vesical tissue invasion, patients may obtain an OS benefit from the administration of adjuvant chemotherapy.
ObjectiveTo systematically review the risk factors for intravesical recurrence (IVR) after radical nephroureterectomy (RNU) of upper tract urothelial carcinoma (UTUC).MethodsPubMed, EMbase, The Cochrane Library, CBM, CNKI, VIP and WanFang Data databases were electronically searched to collect case-control studies about the risk factors for IVR after RNU of UTUC from inception to August 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then meta-analysis was performed by RevMan 5.3 software.ResultsA total of 23 studies involving 8 614 patients were included. The results of meta-analysis showed that the history of bladder cancer (HR=1.77, 95%CI 1.42 to 2.22, P<0.001), tumor stage (≥T2) (HR=1.41, 95%CI 1.09 to 1.82,P=0.009), ureteral tumor (HR=1.34, 95%CI 1.20 to 1.49, P<0.000 01), tumor multifocality (HR=1.51, 95%CI 1.34 to 1.69,P<0.001), lymphovascular invasion (HR=1.43, 95%CI 1.20 to 1.70,P<0.000 1), laparoscopic surgery (HR=1.52, 95%CI 1.08 to 2.15,P=0.02), positive surgical margins (HR=1.87, 95%CI 1.17 to 2.99, P=0.009), and preoperative ureteroscopy (HR=1.46, 95%CI 1.21 to 1.75, P<0.001) were the risk factors for IVR after RNU.ConclusionsCurrent evidence shows that the risk factors for IVR after RNU include history bladder cancer, tumor stage (≥T2), ureteral tumor, etc. Due to the limited quality of the included studies, more high quality studies are required to verify the above conclusion.