ABSTRACT
OBJECTIVE@#To analyze the impact of β-tubulin-III (TUBB3), thymidylate synthase (TS) and excision repair cross complementation group 1 (ERCC1) mRNA expression on chemoresponse and clinical outcome of patients with advanced gastric cancer treated with TXT/CDDP/FU (DCF) regimen chemotherapy.@*METHODS@#The study population consisted of 48 patients with advanced gastric cancer. All patients were treated with DCF regimen palliative chemotherapy. The mRNA expressions of TUBB3, TS and ERCC1 of primary tumors were examined by multiplex branched-DNA liquid chip technology.@*RESULTS@#The patients with low TUBB3 mRNA expression had higher response rate to chemotherapy than patients with high TUBB3 expression (P=0.011). There were no significant differences between response rate and TS or ERCC1 expression pattern. Median overall survival (OS) and median time to progression (TTP) were significantly longer in patients with low TUBB3 mRNA expression (P=0.002, P<0.001). TS or ERCC1 expression was not correlated with TTP and OS. In the combined analysis including TUBB3, TS and ERCC1, the patients with 0 or 1 high expression gene had better response rate, TTP and OS than the remaining patients (all P<0.001). Multivariate analysis revealed that ECOG (Eastern Cooperative Oncology Group)≥2 (HR=2.42, P=0.009) and TUBB3 (HR=2.34, P=0.036) mRNA expression significantly impacted on OS.@*CONCLUSION@#High TUBB3 mRNA expression is correlated with resistance to DCF regimen chemotherapy. TUBB3 might be a predictive and prognostic factor in patients with advanced gastric cancer treated with TXT-based chemotherapy. The combined evaluation of TUBB3, TS and ERCC1 expression can promote the individual treatment in advanced gastric cancer.
Subject(s)
Humans , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Biomarkers, Tumor , Metabolism , DNA-Binding Proteins , Genetics , Metabolism , Drug Resistance, Neoplasm , Endonucleases , Genetics , Metabolism , RNA, Messenger , Genetics , Metabolism , Stomach Neoplasms , Drug Therapy , Genetics , Thymidylate Synthase , Genetics , Metabolism , Treatment Outcome , Tubulin , Genetics , MetabolismABSTRACT
Object To evaluate the efficacy and toxicity of L-asparaginase based regimen for extranodal nasal type NK/T cell lymphoma (ENKTL).Methods 36 patients were treated with L-asparaginase based regimen from February 2008 to November 2011. 20 stage Ⅰ /Ⅱ patients were administered with VLD regimen based chemo-radiotherapy. 4 of 16 stage Ⅲ/Ⅳ patients received modified SMILE regimen chemotherapy, followed by involved field radiation therapy (IFRT), while others received modified SMILE regimen chemotherapy alone.Results Among 36 patients,35 were eligible for treatment response evaluation.The overall response rate (RR) was 68.6％ (24/35) with complete response (CR) rate of 54.3％ (19/35).After the median follow-up of 13.5 (range 3-31) months,for all patients,the 1-year overall survival (OS) rate was 82 ％,and the rate of progression-free survival (PFS) at 1 year was 65 ％.The patients who attained response with treatment showed better 1-year OS (93 ％) and PFS (80 ％) as compared with patients without response (35 ％; 33 ％),and the differences were statistically significant (x2=13.909,P =0.000; x2=8.216,P =0.004).The major adverse event was myelosuppression. No chemotherapy-related mortality occurred. Conclusion L-asparaginase based regimen is obviously effective and well tolerant for ENKTL. The large prospective clinical trials of L-asparaginase based regimen in the first-line treatment for ENKTL are worth for further investigation.
ABSTRACT
OBJECTIVE@#To analyze the clinical characteristics of primary gastric lymphoma (PGL) and to improve its diagnosis and treatment.@*METHODS@#The clinical manifestations, diagnosis, treatments and history of 50 PGL patients, who were hospitalized from September 2005 to September 2009, were reviewed and analyzed.@*RESULTS@#The main manifestation of PGL was epigastric pain with infrequent systemic symptoms, such as stomach ache, abdominal discomfort, vomit, black stool, loss of appetite, fever, feeble, and skinny. Pathological examination indicated that only 1 patient had T cell lymphoma while the rest 49 had B cell lymphoma. Fourteen had mucosa-associated lymphoid tissue lymphoma (MALT), 35 had diffuse large B cell lymphoma (DLBCL), and 2 had both DLBCL and MALT (DLBCML). All the 50 patients received chemotherapy, and 12 underwent surgical treatment besides chemotherapy. Fourteen out of the 49 patients with B cell lymphoma received rituximab together with chemotherapy, and 35 received chemotherapy alone. The 2-year survival rate in the patients receiving rituximab together with chemotherapy was higher than that in the patients receiving chemotherapy alone (85.7% vs 77.1%, P< 0.05). The 2-year survival rate in patients of clinical stage I-II was higher than that in patients of clinical stage III-IV (90.9% vs 71.4%, P< 0.05).@*CONCLUSION@#The main clinical manifestation of PGL patients is non-specific gastrointestinal symptoms, among which abdominal pain is most common. The clinical examination mainly relies on pathological examinations, and the most common pathological type of primary gastric lymphoma is DLBCL. The main treatment is chemotherapy, and the prognosis is related to the clinical stage and the use of rituximab. After the treatment, the 2-year survival rate in the 50 patients reaches 80.0%.