ABSTRACT
Objective To observe the effect of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) on the prevention and treatment of oral mucositis induced by concurrent chemoradiotherapy in patients with locally advanced nasopharyngeal carcinoma. Methods A total of 64 patients with locally advanced nasopharyngeal carcinoma from April 2015 to April 2017 in the Second Affiliated Hospital of Xi'an Jiaotong University were enrolled. The patients were randomly divided into the observation group (32 cases) and the control group (32 cases) according to the random number table method. Both groups were treated with intensity modulated radiotherapy (IMRT) and synchronized with TP regimen (docetaxel + cisplatin) chemotherapy for 2 cycles. Both groups were treated with mouthwash at the beginning of radiotherapy to prevent oral mucositis. The observation group was given rhGM-CSF mouthwash, and the control group was given compound borax mouthwash. The oral mucositis and the oral pain during the treatment and the end of the treatment were evaluated by using American Radiation Oncology Group (RTOG) grading criteria and visual analogue scoring method(VAS) grading criteria. The time of onset of oral mucositis and the total time of radiotherapy in both groups was also recorded. Results All the patients were treated with concurrent chemoradiotherapy. The total radiotherapy time in the observation group was less than that in the control group [(46.4±1.6) vs. (48.2±3.2) d, t= -2.720, P= 0.009]. The clinical total effective rate was 93.8 %(30/32) in the observation group and 96.9 %(31/32) in the control group respectively (χ2= 0.35, P =0.554).The occurrence of grade 1,2 and 3 oral mucositis in the observation group was(20.9±2.5), (29.3±2.4), and (34.5±1.8) d respectively, which was latter than that in the control group [(16.3 ±2.0), (24.2 ±2.2) and (31.0 ±2.2) d] respectively (t= 8.125, P= 0.000; t= 8.840, P= 0.000; t= 6.944, P= 0.001). During concurrent chemoradiotherapy,the incidence of grade 3 oral mucositis in the observation group was lower than that in the control group[31.2 %(10/32)vs.56.2 %(18/32);Z=-2.197,P=0.028].At the end of concurrent chemoradiotherapy, the total incidence of grade 2 and grade 3 oral mucositis in the observation group was lower than that in the control group [53.1 % (17/32) vs. 81.2 % (26/32); Z= -2.708, P= 0.007]. The incidence of moderate and severe oral pain caused by oral mucositis in the observation group was lower than that in the control group[46.9 %(15/32)and 6.2 %(2/32)vs.59.4 %(19/32)and 15.6 %(5/32),respectively;Z= -2.009, P= 0.045]. Conclusion rhGM-CSF mouthwash can delay the occurrence of oral mucositis, reduce the incidence of oral mucositis and oral pain to effectively prevent and treat oral mucositis induced by concurrent chemoradiotherapy in patients with locally advanced nasopharyngeal carcinoma, which is worthy of clinical application.
ABSTRACT
Objective To investigate the expression and significance of P-glycoprotein in triple negative breast cancer (TNBC).Methods One hundred and seventy-one cases of breast invasive ductal carcinoma in our hospital were retrospectively analyzed.According to the expression of ER,PR,Her2,we categorized those paitents into triple negative breast cancer group (58 cases) and non triple negative breast cancer group (113 cases).The different expression of P-glycoprotein was detected by immunohistochemieal technology in two groups.We analyzed the relationship between the expression of P-glycoprotein and clinical and pathological features in TNBC,and investigated the effect of P-gp on the rate of recurrence and metastasis in 3 years.Results (1) The expression of P-gp in TN BC was significantly higher than that of NTNBC (53.45％ vs 37.17％) (P ＜ 0.05).(2) The expression of P-gp in TNBC was associated with TNM stage,histological grade,lymph node status and vascular invasion (P ＜ 0.05),but not with age and size of the tumor (P ＞ 0.05).(3) The rate of recurrence and metastasis in positive expression of P-gp in TNBC was 58.06％,which was significantly higher than negative expression of P-gp in TNBC (44.44％),but no statistically significant was found(P ＞ 0.05).Survival analysis showed that P-glycoprotein expression had no relationshiop to 3-year cumulative survival rate (P =0.161 ＞ 0.05).Conclusions The positive expression of P-gp in TNBC is associated with drug resistance and metastasis,but has no obvious significance to recurrence and metastasis,so as to 3-year cumulative survival rate.
ABSTRACT
Objective To evaluate the feasibility of intra-operative ultrasound guide in breast conservative-surgery and its effect on positive margin rate and breast tissue volume.Methods Fifty-five cases of invasive breast cancer staged T1-2N0-1 were randomly assigned to palpation-guided group(control group) 26 cases and ultrasound-guided group(experiment group) 29 cases.Before and during operation,high-frequency ultrasound was used to guide the resection of breast cancer with 1 cm margin in experiment group.The resection margin positive rate deteced by tissue section frozen biopsy and resected breast tissue volume were compared between experiment and control group.Results The clinicopathologic features were accordant between two groups.The margin positive rate and near-margin positive rate in experiment group were 0 and 3.45％ respectively,slightly lower than that of control group 3.85％ and 15.38％,but with no statistical significance (P ＞ 0.05).The same situation occurred at the re-exision rate.The resected breast tissue volume in experiment group (32.40 ± 10.93) cm3 was lower than that of control group (55.11 ± 12.88) cm3,and with statistical significance (P ＜ 0.01).Conclusions Intra-operative ultrasound guide could reduce the margin positive rate and unnecessary resected brcast tissue volume in breast conservative-surgery,and improve cosmetic effect.
ABSTRACT
Objective To explore the optimal b value in MR DWI for breast.Methods Forty patients with palpable masses of breasts underwent MR and DWI at b = 1000, 800 and 600 s/mm2 before surgery according prospective planning. Visual assessment, signal to noise ratio (SNR) of DWI and the ADC values of benign and malignant lesions were compared among three b values using one-way ANOVA test.The diagnostic value of ADC were analyzed by ROC curves.Results Of the 40 patients, there were 26 patients with malignant lesions and 14 patients with benign lesions verified by histopathology.36 patients with 42 lesions were examined by DWI, and detectabilities at three b values were alike.Most DWI at b = 1000, 800 and 600 s/mm2 were of high quality, and images of grade A were 75.0% (30/40), 77.5% (31/40) and 77.5% (31/40), respectively.Mean SNR at b = 1000, 800 and 600 s/mm2 were 63 ± 22,82 ± 27 and 96 ± 29 respectively.Compared with one another, there was statistically significant difference (P <0.01).Mean ADC of benign lesions at different b values were (1.44 ± 0.28) × 10-3, (1.50 ± 0.32) × 10-3 and (1.52±0.29) × 10-3 mm2/s respectively. Compared with one another, there was no statistically significant difference (P = 0.725).Mean ADC of malignant lesions were (1.00 ± 0.25) × 10-3, (0.98 ± 0.19) × 10-3 and (1.07 ± 0.22) × 10-3 mm2/s respectively.Compared with one another, there was also no statistically significant difference (P = 0.358).The area under the ROC curves at b = 1000,800 and 600 s/mm2 were 0.879,0.885 and 0.865 respectively.Threshold value to distinguish benign and malignant lesions were 1.295 × 10-3,1.435×10-3 and 1.335×10-3 mm2/s respectively.Sensitivity of diagnosing breast cancer were 80.0%, 92.0% and 84.0%, and specificity were all 90.0% . Positive predictive values were 95.2%, 95.8% and 95.5% at b = 1000, 800 and 600 s/mm2.Conclusion Combining SNR and the value of ADC in diagnosing benign and malignant breast lesions, the study indicated that b = 800 s/mm2 was the optimal b value in breast DWI.
ABSTRACT
Objective To study the effect and toxicity of COX-2 selective inhibitor, celecoxib, plus doxetaxel + epirubicin regimen for LABC as neoadjuvant chemotherapy. Methods 59 women with LABC staged ⅡB～ⅢB were allotted and randomly divided into 2 groups: the control group consisted of 29 patients and with the dosage: doxetaxel (75 mg/m2, d1), epirubicin(75 mg/m2, d1) every 3 weeks; the experiment group consisted of 30 patients and with the dosage: doxetaxel (75 mg/m2, d1), epirubicin(75 mg/m2, d1) and celeeoxib (40Omg, twice daily, d1～21) every 3 weeks. After 2 cycles, the efficacy and toxicity of each group were evaluated. Results The control group achieved an overall response rate (RR) of 72.41%(21/29), and consisted of clinical complete remission (cCR) 2 cases, partial remission (PR) 19 cases, stable disease (SD) 8 cases; the experiment group achieved a RR of 80.00 %(24/30), and consisted of eCR 3 cases, PR 21 cases, SD 6 cases. Both of the group had no pathological complete remission (pCR) and progressive disease (PD) case, and the difference of RR between 2 groups showed no statistical signifieance(χ2=0.469, P=0.493). There was no difference of the diameter of tumor between 2 groups before neoadjuvant ehemotherapy(t=0.569, P= 0.570), but showed statistieal significance after neoadjuvant chemotherapy (t=7.300, P=0.000). Incidence of myalgia and arthralgia of the experiment group was lower than that of control group and had statistical significance (P=0.013). Conclusion Doxetaxel plus epirubiein regimen is effective for LABC with tolerable toxicity. Celeeoxib can enhance the effect and reduce the incidence of myalgia and arthralgia.
ABSTRACT
OBJECTIVE: To investigate the effects of serum containing Scutellaria Barbata extract (ESB) on apoptosis rate and mitochondrial transmembrane potential (MTP) of liver cancer cell line H22 from mice in vitro. METHODS: H22 cells were cultured in vitro and divided into 5 groups: blank control group, low-dose ESB group, medium-dose ESB group, high-dose ESB group and fluorouracil (5-Fu) group. Methyl thiazolyl tetrazolium assay was utilized to determine the proliferation rates of H22 cells. Cellular morphology was observed under a transmission electron microscope (EM). The rhodamine 123 was used as a fluorescence probe to label the H22 cells, and the fluorescence intensities were observed with a laser scanning confocal microscope. The fluorescence intensity of H22 cells indicated the MTP of H22 cells. RESULTS: The inhibition of serum containing ESB on the proliferation of H22 cells in vitro was observed in a time-dependent manner. The typical morphological changes of apoptosis were observed after incubation with ESB-containing serum in high dose for 48h. The apoptosis rates of blank control group, 5-Fu group, low-dose ESB group, medium-dose ESB group and high-dose ESB group were (0.51+/-0.32)%, (11.26+/-2.97)%, (1.07+/-0.46)%, (3.15+/-1.12)%, (7.83+/-2.25)% respectively. ESB could reduce the MTP of H22 cells from mice as compared with the untreated group. The MTPs of the blank control group, 5-Fu group, and low-, medium- and high-dose ESB groups were (245.45+/-67.37), (127.42+/-41.35), (213.68+/-65.52), (186.34+/-56.37) and (142.65+/-39.44) respectively, which were negatively correlated with the apoptosis rates. CONCLUSION: ESB-containing serum effectively induces apoptosis, which may be related to the decrease of MTP in H22 cells.
ABSTRACT
OBJECTIVE: To study the assistant effect of Scutellaria barbata extract (ESB) in 5-fluorouracil (5-FU) chemotherapy. METHODS: A mouse model of transplanted hepatoma H22 was used in this study to evaluate the synergic and attenuating effects of ESB in chemotherapy. Tumor inhibition rate, life span of mice and the toxicity of chemotherapy were observed. The body weight, tumor weight, thymus index and spleen index in H22-bearing mice were also measured. The phagocytotic function of macrophages was studied by observing phagocytization of peritoneal macrophages. RESULTS: The increase of body weight in 5-FU plus ESB groups was higher than that in 5-FU group, and the side effects such as anorexia, abdominal distention and athrepsy were relieved. Compared with untreated group, prolonged lifetime in 5-FU plus high-dose ESB group and 5-FU plus low-dose ESB group was improved. Life prolongation rates in 5-FU plus high-dose ESB group and 5-FU plus low-dose ESB group were 61.46% and 23.59% respectively. High-dose ESB, 5-FU, 5-FU plus low-dose ESB and 5-FU plus high-dose ESB could inhibit the tumor growth, and the tumor inhibition rates were 36.98%, 42.26%, 52.45% and 65.28%, respectively. Thymus index and spleen index were increased significantly in 5-FU plus low-dose ESB group and 5-FU plus high-dose ESB group. White blood cell (WBC) count was decreased obviously in 5-FU group, while the count of WBC was increased in 5-FU plus low-dose ESB group and 5-FU plus high-dose ESB group. The phagocytotic function of macrophages was also increased in 5-FU plus low-dose ESB group and 5-FU plus high-dose ESB group. CONCLUSION: ESB can enhance the effect of chemotherapy, relieve the side effects and improve immune function of mice in chemotherapy. These results suggest that ESB, as a biochemical modulator to enhance the therapeutic effects, is useful in cancer chemotherapy.
ABSTRACT
Objective We studied the expression of VEGF and its receptor,FLK－ 1,in neuroblastoma and its relation to clinical features.Methods With the help of antigen repairing,immunohistochemical analysis using antibody against VEGF,FLK－ 1 was carried out on speciments of 52 cases of neuroblastoma.Results There were 36 cases of VEGF and 34 cases of FLK－ 1 positive expression,the expression of them were nearly consistent.The positive rate of VEGF and FLK－ 1 were higher in metastatic tumors(28/34,26/34)than in non－ metastastic tumors and had statistical significance(respectively P<0.01,P<0.05).The expression of VEGF in UH tumors was higher than in FH tumors,and statistical value is significant(P<0.05).Conclusion VEGF is a vital angiogenic factor,and may play an improtant role in the progression and metastasis of neuroblastoma.Its expression and function correlates well to FLK－ 1,and may aid in predicting patients at risk of metastasis.
ABSTRACT
Purpose:To evaluate the effect of late accelerated hyperfractionated radiotherapy (LCAHFR) combined with chemotherapy on advanced esophageal cancer.Methods:176 cases of advanced esophageal cancer were treated from March 1994 to March 1997.Patient were divided into 2 groups, including radiotherapy alone group (80 cases) receiving conventional irradiation to a total of 64～70 Gy and combined treatment group (96 cases) which received LCAHFR groups plus chemotherapy with PF regimen. Combined treatment group patients were treated with conventional fractionated radiotherapy during the firs two thirds of the treatment to a dose about 40 Gy/20 F/4 weeks. This was followed by accelerated hyper fractioned radiotherapy using reduced fields, twice daily at 1.5 Gy per fraction to a dose about 24～30 Gy.All cases of the combined treatment group were treated with PF(DDP 20 mg iv drip on days 1 to 5,and 5 FU 750 mg iv drip on days 1 to 5,Every 28 days as one cycle).All patients were followed for ≥ 5 years.Results:The short term results of LCAHFR combined with chemotherapy was better than that of radiotherapy alone. The difference between these two groups was statistically significant( P 0.05).The one , three and five year survival rate were 69.8%,51.1%,29.2% in combined group and 46.3%,21.3%,11.3% in simple irradiation alone group. The survival rates in the combined group were much better than those in simple radiotherapy group( P