Metastatic renal cell carcinoma accounts for 20%-30% of newly diagnosed renal cell carcinoma and its prognosis is poor. It is not sensitive to radiotherapy or chemotherapy, and traditional cytokine therapy has limited efficacy in patient with metastatic renal cell carcinoma. In recent years, with the emergence of targeted drugs and immune checkpoint inhibitors, the survival of patients with metastatic renal cancer has been greatly improved. This article reviews treatment and research progress of metastatic renal cell carcinoma. It mainly introduces the medical treatment, including cytokine therapy, targeted therapy and emerging immunotherapy, and further analyzes the value of cytoreductive nephrectomy in the context of targeted therapy. The purpose of this article is to provide evidence for reasonable choices of treatment regimens in order to better guide clinical treatment.
High-grade gliomas are the most common malignant primary central nervous system tumors with poor prognosis. The operation based on the principle of maximum safe resection of tumors, combined with radiation therapy and chemotherapy, is the primary treatment method. This treatment only delays the progression of high-grade gliomas, and almost all patients eventually develop disease progression or relapse. With the development of molecular biology, immunology, and genomics, people have a deeper understanding of the pathogenesis of gliomas. Targeted therapy, immunotherapy, and other comprehensive treatments are expected to become potential treatments for high-grade gliomas. This article reviews the current status of medical treatment of primary and recurrent high-grade gliomas, and the research progress of high-grade gliomas in targeted therapy and immunotherapy.
ObjectiveTo observe the effectiveness and safety of pseudomonas aeruginosa preparation in treating refractory seroma after breast cancer surgery.MethodsA total of 76 patients with refractory seroma after breast cancer surgery who underwent surgery from October 2018 to August 2019 in our hospital were selected. The subjects were randomly divided into two groups. The patients in the control group (n=36) adopted negative pressure drainage connected with indwelling needle in the lower position of the seroma chamber; on the basis, patients in the experimental group (n=400) were injected with pseudomonas aeruginosa preparation into the seroma chamber. The drainage time, total drainage volume, recurrence rate, and incidence of complications of the two groups were compared.ResultsThere were 4 cases in the experimental group and 3 cases in the control group were lost followed-up, so only 69 cases enrolled in data analysis. The drainage time, total drainage volume, and the recurrence rate of the experimental group were all shorter or less than those of the control group (P<0.05). But there was no significant difference in the incidence of complications between the experimental group and the control group (P>0.05), such as fever, inflamed skin, and infection of incision.ConclusionPseudomonas aeruginosa preparation is an effective treatment for refractory seroma after breast cancer surgery, which can shorten the drainage time and promote wound healing.
ObjectiveTo explore the proper time to initiation of adjuvant chemotherapy after radical resection for gastric cancer. MethodsWe searched electronically in PubMed, Embase, China National Knowledge Infrastructure, Wangfang database, and Chongqing VIP database for all relevant studies published before May 1st, 2018. The references included in eligible trials were also searched. All eligible studies were assessed and evaluated by two investigators working independently. The Meta-analysis was conducted using Stata 14 software. ResultsOur literature search included a total of 10 studies. There were 9 studies reporting overall survival (OS), in which 3 studies used a 4-week cutoff for delay from surgery to adjuvant chemotherapy, 4 shared a 6-week cutoff, and 2 studies shared an 8-week cutoff. There were 4 studies reporting disease-free survival (DFS). Initiating adjuvant chemotherapy beyond 4 weeks after surgery was significantly associated with worse OS [hazard ratio (HR)=0.42, 95% confidence interval (CI) (0.27, 0.65), P<0.001]. No significant benefit was found by starting adjuvant chemotherapy within 6 weeks or 8 weeks after surgery [HR=0.91, 95%CI (0.66, 1.26), P=0.577; HR=1.02, 95%CI (0.91, 1.14), P=0.744; respectively]. Four trials reporting DFS did not share a same cutoff delay from surgery to adjuvant chemotherapy, thus it was impossible to conduct a combined Meta-analysis. ConclusionThe initiation of adjuvant chemotherapy within 4 weeks after radical resection for gastric cancer may obtain better OS.