BackgroundGlioblastoma multiforme (GBM) is the most aggressive primary brain tumor with high relapse rate. In this study, we aimed to determine if dose-escalated (DE) radiotherapy improved tumor control and survival in GBM patients.MethodsWe conducted a retrospective analysis of 49 and 23 newly-diagnosed histology-proven GBM patients, treated with DE radiotherapy delivered in 70 Gy (2.33 Gy per fraction) and conventional doses (60 Gy), respectively, between 2007 and 2013. Clinical target volumes for 70 and 60 Gy were defined by 0.5 and 2.0 cm expansion of magnetic resonance imaging T1-gadolinium-enhanced tumor/surgical cavity, respectively. Bilateral subventricular zones (SVZ) were contoured on a co-registered pre-treatment magnetic resonance imaging and planning computed tomography dataset as a 5 mm wide structure along the lateral margins of the lateral ventricles. Survival outcomes of both cohorts were compared using log-rank test. Radiation dose to SVZ in the DE cohort was evaluated.ResultsMedian follow-up was 13.6 and 15.1 months for the DE- and conventionally-treated cohorts, respectively. Median overall survival (OS) of patients who received DE radiotherapy was 15.2 months (95% confidence interval [CI] =11.0–18.6), while median OS of the latter cohort was 18.4 months (95% CI =12.5–31.4, P=0.253). Univariate analyses of clinical and dosimetric parameters among the DE cohort demonstrated a trend of longer progression-free survival, but not OS, with incremental radiation doses to the ipsilateral SVZ (hazard ratio [HR] =0.95, 95% CI =0.90–1.00, P=0.052) and proportion of ipsilateral SVZ receiving 50 Gy (HR =0.98, 95% CI =0.97–1.00, P=0.017).ConclusionDE radiotherapy did not improve survival in patients with GBM. Incorporation of ipsilateral SVZ as a radiotherapy target volume for patients with GBM requires prospective validation.

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Purpose: To determine the clinical efficacy of epirubicin plus docetaxel or paclitaxel in the management of breast cancer. Methods: This study was a randomized controlled trial that recruited 78 patients with breast cancer treated in The First People’s Hospital of Anqing between December 2018 and March 2021. The participants were randomized to receive either epirubicin plus docetaxel (control group) or epirubicin plus paclitaxel (study group), with 39 cases in each group. Clinical outcomes, adverse events, quality of life, and prognosis of the two groups were compared. Results: Epirubicin plus paclitaxel produced greater efficacy than epirubicin plus docetaxel (p < 0.05). The combination also exhibited a higher safety profile versus epirubicin with docetaxel, as evidenced by lower incidences of nausea and vomiting, intestinal discomfort, muscle pain, and dyspnea reactions (p < 0.05). Epirubicin with paclitaxel resulted in greater improvement in quality of life in patients than epirubicin plus docetaxel (p < 0.05) as well as provided more benefits in terms of survival and recurrence control than epirubicin plus docetaxel (p < 0.05). Conclusion: Epirubicin/paclitaxel combination alleviates clinical symptoms, reduces adverse events, enhances patient prognosis, lowers the risk of postoperative recurrence, and provides superior quality of life when compared to epirubicin/docetaxel combination in breast cancer patients. Nonetheless, large-scale and better-randomized clinical trials are required to validate the findings of this study.

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