Traditional Chinese medicine (TCM) has some unique advantages in the prevention and treatment of cancer. Due to different ideas and mechanism of between TCM and biomedicine in the prevention and treatment of cancer, the clinial effect evaluation approches of biomedicine could not be used as a beneficial method to scientifically evaluate the effects of TCM. From three angles, this article analyzes the key issues regardsing the evaluation methods of TCM as an adjuvant therapy of cancer. It draws lessons from the idea of quality-adjusted survival (QAS), proposes Two-in-One (TIO) method to evaluate the effects of TCM as adjuvant therapy of cancer, which reflects the combined value of the individual patient dynamic information and provides methodological support for the effect evaluation of TCM.
Objective To review the clinical evidence of Pingxiao Capsule for tumor adjuvant treatment so as to provide some decision-making references for clinical practice. Methods We electronically searched CBM, CNKI, VIP, WanFang Data and MEDLINE (from inception to Feb, 2013) to collect the randomized controlled trials (RCTs) and non-randomized controlled trials (non-RCTs) about Pingxiao Capsule for tumor adjuvant treatment. Then, the included studies were summarized and evaluated according to the classification of diseases. Results 1 097 potential relevant articles were searched. We included 41 RCTs and 15 non-RCTs. The results showed that Pingxiao Capsule used as an adjuvant therapy in treating tumor improved the efficacy and reduced the side effects of radiation and chemotherapy, and also improved the quality of survival. Conclusion Current evidence showed that the effectiveness and safety of Pingxiao Capsule combined with radiation or chemotherapy in the tumor treatment is superior to radiation monotherapy or chemotherapy monotherapy. But due to the limited quality of the included studies, the results needed to be further verified by high-quality studies.
Objective To assess the effectiveness of adjuvant chemotherapy with complete resection for non-small cell lung cancer. Methods We searched MEDLINE （1966 ～ 2005 ）, EMBASE （1984-2005 ）, The Cochrane Library （Issue 2,2005 ）, CBMdisc （1979-2005 ）, CNKI （1994-2005 ）, VIP （1989-2005 ）, CMCC （1994-2005 ） and Wanfang Database with key words of non-small cell lung cancer or NSCLC and adjuvant chemotherapy, to identify randomized control trials （RCTs） of platinum-based adjuvant chemotherapy plus complete resection versus complete resection alone for non-small cell lung cancer patients. Two reviewers evaluated the quality of literature independently. Then we conducted meta-analysis using RevMan 4.2.7 software. Results We identified 9 RCTs and did not carry out pool analysis for the difference of chemotherapy regimens between the studies. The results of three studies showed that 5 years＇ mortality of adjuvant chemotherapy group was lower than that of surgery group alone. The results of the other 6 studies showed there was no statistical difference in 5 years＇ mortality between the adjuvant chemotherapy plus surgery and surgery alone groups. Conclusions The effectiveness of some adjuvant chemotherapy regimens with complete resection in patients with non-small cell lung cancer has been improved. But the number of each chemotherapy regimen RCT is too small and with poor quality. So more multi-center RCTs with a larger sample size and high quality are needed.
目的:探讨妊娠相关性宫颈癌的早期诊断、治疗和预后。方法:结合文献回顾分析我院2000年至2007年收治的13例妊娠相关性宫颈癌的诊治经过和预后。结果:妊娠相关性宫颈癌分化程度低，癌灶体积大，早期盆腔淋巴结转移率高，产褥期宫颈癌预后差。结论:宫颈细胞学检查应列为首次产检常规项目；妊娠期宫颈原位癌在密切随诊前提下可暂不予处理，待分娩后6~8周活检确认病变性质后，再采取相应治疗措施；新辅助化疗同样可为晚期别的妊娠相关性宫颈癌争取手术时机。
Objective To assess the clinical efficacy of neoadjuvant chemotherapy （NAC） for breast invasive ductal carcinoma with MR diffusion weighted imaging. Methods Thirty patients with breast invasive ductal carcinoma underwent conventional MRI scanning and diffusion weighted imaging examination before and after preoperative neoadj-uvant chemotherapy. Two experienced radiologists independently analyzed and measured the maximum lesion diameter and apparent diffusion coefficient （ADC） values before and after treatment，respectively. Statistical analysis was performed for testing the tumor maximum diameter and ADC values change by using the paired t-test. Results After NAC treatment，the maximum tumor diameter of invasive ductal breast carcinoma sharply reduced〔（4.33±0.83） cm vs. （2.04±0.64） cm，P＜0.001〕. When b value was 1 000，the mean ADC values of breast massess were significantly changed after NAC treatment〔（1.89±0.15） ×10-3mm2/s vs. （1.14±0.31） ×10-3mm2/s， P＜0.05〕. Conclusion MR diffusion weighted imaging can non-invasively and accurately assess the NAC efficacy， which are helpful for making surgical strategies.
ObjectiveTo evaluate the effects of CTX, EADM, VCR, and Pred (CHOP) as preoperative regional intra-arterial infusion chemotherapy in primary gastric malignant lymphoma (PGML). MethodsForty-one patients with PGML underwent preoperative regionalarterial infusion chemotherapy. The regimen consisting of CTX 600 mg/m2, EADM 50 mg/m2, VCR 1.4 mg/m2, and Pred 60 mg/m2, was administrated 14－21 d before operation. Another 33 patients with similar PGML during the same period underwent surgery directly. The response of the tumor and chemotherapy toxicity were observed, together with the survival of the cases. ResultsAmong the 33 patients undergoing surgery directly, 24 cases (72.7%) had curative resection, the 5-year survival rate was 58.3% (14/24). All 41 patients of the neoadjuvant chemotherapy group completed the planned regimen of chemotherapy and surgery successfully. The most common related adverse effects were grade Ⅰ-Ⅱ gastrointestinal discomfort (22 cases) and bone marrow suppression (14 cases). Thirtyseven cases (90.2%) underwent curative resection, the 5year survival rate was 67.7% (21/31). There was no significant difference between two groups in 5year survival rate (χ2=0.517， P＝0.471), while with significant difference in curative resection rate (P＝0.041). ConclusionsNeoadjuvant intra-arterial infusion chemotherapy (CHOP) has been wellrated; it appears to have improved the resectable rate of the PGML patients studied.
Objective To explore the tumor shrinking model, the accurate image evaluation of the residual tumor, and the selection criteria for breast-conserving surgery after neoadjuvant chemotherapy. Methods To review literature on the clinical, imaging, and pathologic study of breast cancer after neoadjuvant chemotherapy. Results The possibility of breast-conserving for patients with large primary tumor is enhanced with neoadjuvant chemotherapy. The tumor shrinking mode after neoadjuvant chemotherapy and its correlation factors are still unclear. MRI is the most accurate image evaluation of the residual tumor at present. M.D.Anderson prognostic index and the American National Cancer Institute selection criteria for breast-conserving surgery after neoadjuvant chemotherapy are helpful for selection of surgical type. Conclusion Tumor shrinking mode and its accurate image evaluation is a key to the selection of breast-conserving surgery and the control of local recurrence after neoadjuvant chemotherapy, and is the research direction in future.
Objective To explore application of preoperative examination in the colorectal cancer patients. Methods The preoperative examination data of patients diagnosed definitely as colorectal cancer at West China Hospital of Sichuan University from November 2006 to June 2007 was retrospectively study, and the application situation and relationship among all preoperative examination in the colorectal cancer patients were analyzed. Results According to the inclusion criteria, 438 colorectal cancer patients were included which involved 260 males and 178 females. Preoperative examinations included two to sixteen items, with an average of 10.61 items. According to correlation analysis, positive correlation existed among lung function and blood type ( r =0.161, P =0.001), tumor marker ( r =0.118, P =0.014), chest X-ray ( r =0.113, P =0.018), routine electrocardiogram ( r =0.198, P =0.000) , while lung function and immune and stress reaction exhibit a negative correlation ( r =-0.106, P = 0.027) with preoperative examinations. At the same time, immune and stress reaction had positive correlation to CT examinations of abdomen ( r =0.151, P =0.001) as well as endorectal ultrasound ( r =0.330, P =0.000). Using univariate analysis, the influence of tumor location ( P =0.012) and operative method ( P =0.004) on the number of examination items was significant. Conclusion Preoperative examination of colorectal tumor surgery mainly includes routine examination, neoplasm-related examination and important organs function detection. And three levels of preoperative menu can be set up in early stage. Establishment of normalization preoperative combined examination may be helpful to consummate preoperative evaluation and improve medical quality.