体部放疗过程中基本皮肤反应不可避免，大概10次左右，每个人出现的或早或晚，或轻或重，可以应用放疗皮肤保护剂提前预防 当出现皮肤发黑，瘙痒感，需要避免搔抓、日光暴晒，穿纯棉衣物，用纯棉毛巾清洗，不要用肥皂等碱性洗涤品，放疗结束会逐渐好转。 当出现皮肤破溃，破溃面积逐渐扩大，局部渗液，局部疼痛明显影响休息这些状况的时候就需要及时找医生及时处理（尤其门诊放疗患者） 更多>

本阶段重点招募：胸腹部：纵隔淋巴瘤、后腹膜淋巴瘤、不需要化疗的惰性淋巴瘤、早期NK/T淋巴瘤、腮腺MALT淋巴瘤、肺尖癌、I-IIA期肺癌、初治基因突变非小细胞肺癌寡转移、原发性早期肝癌、后腹膜寡转移性肿瘤；头颈部及脊柱肿瘤：颅底脊索瘤和软骨肉瘤、垂体侵袭性腺瘤、间变性脑膜瘤、鼻腔鼻窦肿瘤、颅咽管瘤、头颈部腺样囊腺癌、骶尾部脊索瘤 更多>

广泛期小细胞肺癌的一线治疗策略是目前的研究热点之一。本项目团队首次探讨免疫治疗时代下血清学炎性指数和营养指数与广泛期小细胞肺癌一线接受化疗联合免疫治疗的预后相关性。研究结果表明：治疗前血小板淋巴细胞比（PLR）是广泛期小细胞肺癌一线接受化疗和免疫治疗的独立预后因素，同时PLR预后价值在瑞金医院广泛期小细胞肺癌人群中也得到进一步证实。因此，课题组认为，免疫治疗时代下，血小板淋巴细胞比（PLR）是广泛期小细胞肺癌的独立预后因素。对于高PLR患者人群，在全身化疗联合免疫一线治疗后，可进一步行胸部巩固放疗来提高患者的预后，这需要前瞻性的临床研究来进一步证实。本课题组首次探讨免疫治疗时代下血清学炎性指数和 更多>

乳腺原发性鳞状细胞癌(primary squamous cell carcinoma,PSCC)是一种罕见类型的乳腺化生癌。乳腺鳞状细胞癌比较少见,多发于中年女性乳腺部位。占所有乳腺癌的0.5%～2%,主要见于35～80岁,平均年龄为50～58岁。本研究回顾了SEER数据库和瑞金医院乳腺中心就诊的原发性乳腺鳞状细胞癌患者。共有515例来源SEER数据库和28例来至瑞金医院的乳腺原发性鳞状细胞癌患者纳入分析。研究结果提示：PSCC接受保乳术联合术后辅助放疗的预后显著优于单纯保乳术组 (CSS, p=0.034; OS,p=0.0004), 单纯改良根治手术组 (CSS, p=0.0001 更多>

食管癌是全球常见恶性消化道肿瘤之一。据国际癌症研究机构报告显示：2018年全球食管癌新发病例数为572，034人，死亡例数为508，585人，位居全球恶性肿瘤发病率第7位，死亡率第6位。我国是食管癌高发区，据全球癌症统计报告数据显示，我国食管癌发病率和死亡率均居世界首位。大约有1/3食管癌患者在确诊时属于局部晚期，手术切除具有一定的难度，而非手术治疗的疗效极差，需要行综合治疗，术前新辅助治疗是目前的研究热点。目前新辅助治疗的模式，主要有术前放疗、术前化疗和术前放化疗。术前同步放化疗是目前为止循证证据最多、应用最成熟的新辅助治疗模式。术前行同步放化疗，可以达到局部和远地兼顾、放化疗互相增敏的 更多>

应用竞争模型分析胃食管交接肿瘤术后辅助放化疗后复发风险分析Wei-Xiang Qi Jiayi Chen Shengguang Zhao1.Department of oncology, Rui Jin Hospital affiliated medicine school of Shanghai Jiao Tong University目的: Gastric cancer (GC) ranks the fifth most diagnosed malignant tumor (1,000,000 new cases) and the third cause of cancer-related mortality (783,000 deaths) worldwide. Surgical resection with regional lymph node dissection is considered as the only curative treatment for patients with GC. Adjuvant chemoradiotherapy (CRT) have been extensively investigated for the treatment of GC patients after curative surgery in order to improve survival. The impact of pre-treatment factors on long-term survival and treatment failure of patients who had undergone a curative resection of gastric or GE junction adenocarcinoma remains undetermined. The present study aims to identify pre-treatment factors relevant to overall survival (OS), distant metastasis (DM) and Local-regional recurrence (LRR) in surgically resected gastric and gastroesophageal (GE) junction adenocarcinoma after adjuvant chemoradiotherapy (CRT). 方法: This is a secondary analysis of the NCT00052910 phase III study which randomized patients with gastroesophageal adenocarcinoma into adjuvant chemoradiotherapy with epirubicin, cisplatin, and fluorouracil versus adjuvant chemoradiotherapy with fluorouracil (FU) and leucovorin (LV) after curative resection. Univariate analysis of pre-treatment factors affecting overall survival was conducted by using Cox regression analysis. Factors with p<0.05 in the univariate analysis were then included in the multivariate analysis. The cumulative incidence rates of DM and LRR were calculated using the Fine and Gray’s competing risk analysis. LRR and death events were treated as a competing risk to calculate the cumulative incidence of DM, while DM and death events were treated as a competing risk when calculating the cumulative incidence of LRR. The effect of categorical variables on the cumulative incidence rate was examined by Gray’s test. A two-tailed P-value <0.05 was considered statistically significant. 结果: A total of 546 patients from the phase III trial were included in the analysis. Median follow up was 6.5 year. Patients≤60 years comprised 53.8% while non-Hispanic race comprised 81.5%. 97.6% of the study patients have a performance score of 0-1. Male gender comprised 67.9% and 30.2% patients were diagnosed with Gastroesophageal junction (GE junction) adenocarcinoma. Median number of lymph node examined was 16 (range: 0-73). The following factors were prognostic predictors for OS in univariate analysis: No. of LN metastasis, histologic grade, gastroesophageal (GE) junction adenocarcinoma, T stage, N stage and M stage. Multivariate Cox regression analysis incorporating these six factors showed that GE junction (p=0.016), No. of LN metastasis (p=0.038), T4 stage (p=0.005) and N3 stage (p=0.049) predicted worse OS, while only pathological T3/4 stage was significantly correlated with distant metastasis (DM) and local regional recurrence (LRR) development in univariate and multivariate competing risk analyses. The 5-year cumulative incidence rates of DM were 0% for T1 stage, 10% for T2 stage, 27%for T3 stage and 14%for T4 stage, respectively. and the 5-year cumulative incidence rates of LRR were 5% for T1 stage, 14% for T2 stage, 27%for T3 stage and 40%for T4 stage； 结论: Pathological T stage is the most important predictive factor for overall survival and treatment failure among resected gastric and GE junction adenocarcinoma patients after adjuvant CRT within a clinical trial. Lymph node metastasis and GE junction adenocarcinoma are also independent predictors for OS in this patient population. 更多>