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1Success of photodynamic therapy in palliating patients with nonresectable cholangiocarcinoma: A systematic review and meta-analysis显示文摘AIM To perform a systematic review and meta-analysis on clinical outcomes of photodynamic therapy(PDT) in non-resectable cholangiocarcinoma. METHODS Included studies compared outcomes with photodynamic therapy and biliary stenting(PDT group) vs biliary stenting only(BS group) in palliation of non-resectable cholangiocarcinoma. Articles were searched in MEDLINE, PubM ed, and EMBASE. Pooled proportions were calculated using fixed and random effects model. Heterogeneity among studies was assessed using the I2 statistic.RESULTS Ten studies(n = 402) that met inclusion criteria were included in this analysis. The P for χ2 heterogeneity for all the pooled accuracy estimates was > 0.10. Pooled odds ratio for successful biliary drainage(decrease in bilirubin level > 50% within 7days after stenting)in PDT vs BS group was 4.39(95%CI: 2.35-8.19).Survival period in PDT and BS groups were 413.04d(95%CI: 349.54-476.54) and 183.41(95%CI:136.81-230.02) respectively. The change in Karnofsky performance scores after intervention in PDT and BS groups were +6.99(95%CI: 4.15-9.82) and-3.93(95%CI:-8.63-0.77) respectively. Odds ratio for postintervention cholangitis in PDT vs BS group was 0.57(95%CI: 0.35-0.94). In PDT group, 10.51%(95%CI:6.94-14.72) had photosensitivity reactions that were self-limiting. Subgroup analysis of prospective studies showed similar results, except the incidence of cholangitis was comparable in both groups. CONCLUSION In palliation of unresectable cholangiocarcinoma, PDT seems to be significantly superior to BS alone. PDT should be used as an adjunct to biliary stenting in these patients.Harsha Moole Harsha Tathireddy Sirish Dharmapuri Vishnu Moole Raghuveer Boddireddy Pratyusha Yedama Sowmya Dharmapuri Achuta Uppu Naveen Bondalapati Abhiram Duvvuri 2017World Journal of Gastroenterology2017,23,7:38
2Secondary mucosa-associated lymphoid tissue (MALT) lymphoma of the colon显示文摘Shagufta Shaheen Achuta K. Guddati 2013Medical Oncology2013,,2:1
3Secondary mucosa-associated lymphoid tissue (MALT) lymphoma of the colon显示文摘Shagufta Shaheen Achuta K. Guddati 2013Medical Oncology2013,,2:1
4Progression from low-grade dysplasia to malignancy in patients with Barrett's esophagus diagnosed by two or more pathologists显示文摘AIM To evaluate annual incidence of low grade dysplasia(LGD) progression to high grade dysplasia(HGD) and/or esophageal adenocarcinoma(EAC) when diagnosis was made by two or more expert pathologists.METHODS Studies evaluating the progression of LGD to HGD or EAC were included. The diagnosis of LGD must be made by consensus of two or more expert gastrointestinal pathologists. Articles were searched in Medline, Pubmed, and Embase. Pooled proportions were calculated using fixed and random effects model. Heterogeneity among studies was assessed using the I2 statistic. RESULTS Initial search identified 721 reference articles, of which 53 were selected and reviewed. Twelve studies(n = 971) that met the inclusion criteria were included in this analysis. Among the total original LGD diagnoses in the included studies, only 37.49% reached the consensus LGD diagnosis after review by two or more expert pathologists. Total follow up period was 1532 patient-years. In the pooled consensus LGD patients, the annual incidence rate(AIR) of progression to HGD and or EAC was 10.35%(95%CI: 7.56-13.13) and progression to EAC was 5.18%(95%CI: 3.43-6.92). Among the patients down staged from original LGD diagnosis to No-dysplasia Barrett's esophagus, the AIR of progression to HGD and EAC was 0.65%(95%CI: 0.49-0.80). Among the patients down staged to Indefinite for dysplasia, the AIR of progression to HGD and EAC was 1.42%(95%CI: 1.19-1.65). In patients with consensus HGD diagnosis, the AIR of progression to EAC was 28.63%(95%CI: 13.98-43.27). CONCLUSION When LGD is diagnosed by consensus agreement of two or more expert pathologists, its progression towards malignancy seems to be at least three times the current estimates, however it could be up to 20 times the current estimates. Biopsies of all Barrett's esophagus patients with LGD should be reviewed by two expert gastroenterology pathologists. Follow-up strict surveillance programs should be in place for these patients.Harsha Moole Jaymon Patel Zohair Ahmed Abhiram Duvvuri Sreekar Vennelaganti Vishnu Moole Sowmya Dharmapuri Raghuveer Boddireddy Pratyusha Yedama Naveen Bondalapati Achuta Uppu Prashanth Vennelaganti Srinivas Puli 2016World Journal of Gastroenterology2016,22,39:0
5Brain metastasis as exclusion criteria in extensive-stage small cell lung cancer trials:a trend over decades显示文摘Aim:To investigate the frequencies and trends of brain metastases(BMs)as exclusion criteria in extensive-stage small cell lung cancer(ES-SCLC)trials.Methods:We conducted a comprehensive search to identify prospective clinical trials in patients with ES-SCLC.PubMed searches were conducted with the key words“small cell lung cancer”and“extensive”.The online archives of 20 oncology journals were also searched.Recent review articles in ES-SCLC were also investigated for additional articles.Eligible studies must have enrolled primarily ES-SCLC and been published in English.Studies involving brain/chest radiation and brain metastasis-specific trials were excluded.Studies were categorized into allowed/undefined,conditional,or complete exclusion of BM.Results:In total,491 published studies were identified by PubMed(240),journal websites(198),and review articles(53).Early publication year(1970-1999)and first-line/maintenance setting were associated with higher incidence of complete exclusion of cases with BMs(P<0.0001 and 0.0233,respectively).Incidence of complete exclusion was 27%in the 1990s,and then decreased to 12%in the 2000s and 8%in the 2010s.Conclusion:A significant number of ES-SCLC trials continues to exclude patients with BM.Future studies need to ease eligibility regarding BM according to ASCO/Friends recommendations.Takefumi Komiya Gerard Chaaya Leigh Deshotels Emily Powell Achuta Kumar Guddati 2020Journal of Cancer Metastasis and Treatment2020,6,1:0
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