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Li D.,Chinese PLA General Hospital | Wang L.,Chinese PLA General Hospital | Zhu H.,Peking University | Dou L.,Chinese PLA General Hospital | And 10 more authors.
PLoS ONE | Year: 2015

Hematopoietic stem cell transplantation (HSCT) and consolidation chemotherapy have been used to treat intermediate-risk acute myeloid leukemia (AML) patients in first complete remission (CR1). However, it is still unclear which treatments are most effective for these patients. The aim of our study was to analyze the relapse-free survival (RFS) and overall survival (OS) benefit of allogeneic HSCT (alloHSCT) for intermediate-risk AML patients in CR1. A meta-analysis of prospective trials comparing alloHSCT to non-alloHSCT (autologous HSCT [autoHSCT] and/or chemotherapy) was undertaken. We systematically searched PubMed, Embase, and the Cochrane Library though October 2014, using keywords and relative MeSH or Emtree terms, allogeneic; acut and eukem/aml/leukaem/leucem/leucaem; and nonlympho or yelo. A total of 7053 articles were accessed. The primary outcomes were RFS and OS, while the secondary outcomes were treatment-related mortality (TRM) and relapse rate (RR). Hazard ratios (HR) and 95% confidence intervals (CI) were calculated for each outcome. The primary outcomes were RFS and OS, while the secondary outcomes were TRM and RR. We included 9 prospective controlled studies including 1950 adult patients. Patients with intermediate-risk AML in CR1 who received either alloHSCT or non-alloHSCT were considered eligible. AlloHSCT was found to be associated with significantly better RFS, OS, and RR than non-alloHSCT (HR, 0.684 [95% CI: 0.48, 0.95]; HR, 0.76 [95% CI: 0.61, 0.95]; and HR, 0.58 [95% CI: 0.45, 0.75], respectively). TRM was significantly higher following alloHSCT than non-alloHSCT (HR, 3.09 [95% CI: 1.38, 6.92]). However, subgroup analysis showed no OS benefit for alloHSCT over autoHSCT (HR, 0.99 [95% CI: 0.70, 1.39]). In conclusion, alloHSCT is associated with more favorable RFS, OS, and RR benefits (but not TRM outcomes) than nonalloHSCT generally, but does not have an OS advantage over autoHSCT specifically, in patients with intermediate-risk AML in CR1.

Jun Q.,Tumor Diagnosis and Treatment Center | Jundong Z.,Tumor Diagnosis and Treatment Center | Zhihong Z.,Tumor Diagnosis and Treatment Center
Cancer Research and Clinic | Year: 2015

Biological therapy for cancer has became a highpoint in recent years. It has been widely applied in clinical field. Management of their unique toxicities becomes more and more important. Cytokine release syndrome (CRS) is a potentially life-threatening toxicity. This review discusses the mechanisms that cause CRS, and new developments in the prevention and treatment of CRS.

Lu D.-H.,Tumor Diagnosis and Treatment Center | Fei Z.-L.,Tumor Diagnosis and Treatment Center | Zhou J.-P.,Tumor Diagnosis and Treatment Center | Hu Z.-T.,Tumor Diagnosis and Treatment Center | Hao W.-S.,Tumor Diagnosis and Treatment Center
Journal of Medical Imaging and Radiation Oncology | Year: 2015

Introduction We investigated the therapeutic effects of three-dimensional conformal radiotherapy combined with transcatheter arterial chemoembolisation (TACE) for hepatocellular carcinoma (HCC) with portal vein tumour thrombosis (PVTT). Methods Sixty-three HCC patients with PVTT were divided into two groups. Group A (30 patients) was treated with three-dimensional conformal radiotherapy followed by 2-3 series of TACE, while group B (33 patients) was only treated with TACE. Results The 1- and 2-year survival rates of group A were 62.40% and 20.81%, respectively, with a mean survival time of 13.0 months. The 1- and 2-year survival rates of group B were 56.49% and 18.83%, respectively, with a mean survival time of 9.0 months. There were significant differences between the two groups (log-rank chi-square value = 3.950, P = 0.047). Conclusion Three-dimensional conformal radiotherapy combined with TACE can significantly improve clinical outcomes in patients with HCC and PVTT compared with TACE alone. © 2014 The Royal Australian and New Zealand College of Radiologists.

Lu D.,Tumor Diagnosis and Treatment Center | Tang J.,Tumor Diagnosis and Treatment Center | Zhou J.,Tumor Diagnosis and Treatment Center | Fei Z.,Tumor Diagnosis and Treatment Center | And 2 more authors.
Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology | Year: 2015

OBJECTIVE: To study the influence of the sequence of three-dimensional conformal radiotherapy (3DCRT) and transcatheter arterial chemoembolization (TACE) on the efficacy and toxicity of treatment in patients with hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT).METHODS: A total of 65 patients who were diagnosed with primary HCC with PVTT were enrolled in the study from November 2008 to March 2012 and were randomly divided into the following two groups:group A,32 patients treated with 3DCRT followed by TACE; group B,33 patients treated with TACE followed by 3DCRT.RESULTS: The total efficacy rates of groups A and B were 68.8% and 69.7% (x² =0.232, P < 0.793). The survival rates,effective percentage of PVTT and AFP remission rates were not significantly different between group A and group B.The exacerbation rate of liver function was significantly higher for group B than for group A (P < 0.05). No serious complication was found in the follow-up period for either group.CONCLUSION: The combination of 3DCRT and TACE is a relatively effective local treatment for patients with primary HCC and PVTT.Compared with TACE followed by 3DCRT, 3DCRT followed by TACE may have a negative influence on liver function.

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