ABSTRACT
The aim of this study was to systematically review the efficacy and safety of iodine-125 brachytherapy combined with chemotherapy in patients with advanced lung cancer. PubMed, MEDLINE, EBSCO, FMJS and Web of Science were searched to obtain randomized controlled trials [RCTs], published in English and Chinese, until February 2016. The evaluating indicators were complete response [CR], partial response [PR], stable disease [SD], progressive disease [PD], overall response rate [ORR], disease control rate [DCR], one-year overall survival, two-year overall survival and adverse events. Revman 5.2 software was used for data syntheses and analyses. A total of 296 patients enrolled in 5 RCTs were ultimately included in this study based on our selection criteria, and 150 patients received chemotherapy alone, while another 146 patients received the combination therapy of iodine-125 brachytherapy and chemotherapy. The results showed that iodine-125 brachytherapy combined with chemotherapy was superior to chemotherapy alone in CR [risk ratio [RR] = 3.66, 95% confidence interval [CI]: 2.08 to 6.44, p<0.001], PR [RR = 1.47, 95% CI: 1.16 to 1.86, p=0.001], ORR [RR = 1.85, 95% CI: 1.54 to 2.22, p<0.001], DCR [RR = 1.19, 95% CI: 1.10 to 1.29, p<0.001], one-year overall survival [RR = 1.46, 95% CI: 1.12 to 1.92, p=0.006] and PD [RR = 0.20, 95% CI: 0.09 to 0.43, p<0.001]; meanwhile, there was no significant difference in two-year overall survival [RR = 1.30, 95% CI: 0.72 to 2.37, p=0.39]. In terms of adverse events, the combination therapy significantly increased the incidence of pneumothorax [RR = 4.93, 95% CI: 1.94 to 12.55, p=<0.001]; however, no significant differences were found in the incidence of other adverse events. This study indicated that the combination therapy of iodine-125 brachytherapy and chemotherapy could improve the therapeutic efficacy of advanced lung cancer without increasing the incidence of adverse events, except pneumothorax
Subject(s)
Humans , Brachytherapy , Iodine Radioisotopes , Treatment Outcome , Safety , Antineoplastic Agents , Review Literature as Topic , Randomized Controlled Trials as TopicABSTRACT
Objective To explore the expression of Ras-related protein 11(Rab11)in hypoxia, the effect of Rab11 on the invasion and migration of cervical cancer cell line SiHa and its possible mechanism. Methods SiHa cells were divided into 4 groups, the normoxic blank group (normal culture in normoxia), the hypoxic blank group (normal culture in hypoxia), the negative control group [transfection of negative control small interfering RNA(siRNA)in hypoxia], the Rab11-siRNA group (transfection of Rab11 siRNA in hypoxia). Western blot was used to examine the expression of Rab11, integrin α5, integrin β3, phosphorylated focal adhesion kinase(p-FAK), phosphorylated phosphatidylinositol 3 kinase(p-PI3K) protein, together with the expression of Ras correlative C3 creotoxin substrate 1(Rac1), which was critical in regulating cell invasion. The mRNA expression of Rab11 in the 4 groups was detected by realtime-qPCR. The cell invasion was detected by matrigel assay, while the cell migration was detected by transwell assay. Immunofluorescence was used to identify intracellular location of Rac1 in SiHa cell. Results (1) The expression of Rab11, intergrin α5, intergrin β3, p-FAK, p-PI3K and Rac1 in the normoxic blank group were 0.56±0.04, 0.33±0.03, 0.32±0.03, 0.36±0.03, 0.35±0.03 and 0.47±0.03, respectively. In the hypoxic blank group, they were 0.73±0.03, 0.74±0.03, 0.61±0.03, 0.62±0.03, 0.60±0.03 and 0.73±0.03, respectively. In the negative control group, their expressions were 0.72±0.03, 0.73±0.03, 0.59±0.03, 0.61±0.03, 0.59±0.03 and 0.72±0.03, respectively. While in the Rab11-siRNA group, they were 0.44±0.03, 0.30±0.03, 0.29±0.03, 0.30±0.03, 0.30±0.03 and 0.34±0.04, respectively. The expressions of Rab11, α5, β3, p-FAK, p-PI3K and Rac1 were significantly higher in the hypoxic blank group than in the normoxic blank group(P<0.05), and were significantly lower in the Rab11-siRNA group than in the hypoxic blank group and the negative control group(P<0.05). (2) The expressions of Rab11-mRNA were 1.000±0.000, 1.454±0.114, 1.442±0.101, 0.570± 0.046 in the normoxic blank group, the hypoxic blank group, the negative control group and the Rab11- siRNA group, respectively. It was significantly higher in the hypoxic blank group than in the normoxic blank group(P<0.05), and was significantly lower in the Rab11-siRNA group than in the hypoxic blank group and the negative control group(P<0.05). (3) By Matrigel, the invasion cell number in the normoxic blank group, the hypoxic blank group,the negative control group and the Rab11-siRNA group were 65±12, 106±16, 104± 17 and 50±11, respectively. The invasion capacity was significantly higher in the hypoxic blank group than in the normoxic blank group(P<0.05), and was significantly lower in the Rab11- siRNA group than in the hypoxic blank group and the negative control group(P<0.05). (4) By transwell assay, the migration cells in the normoxic blank group, the hypoxic blank group, the negative control group and the Rab11-siRNA group were 127±12, 169±15, 161±13 and 77±13, respectively. The capacity of invasion was significantly higher in the hypoxic blank group than in the normoxic blank group(P<0.05), and was significantly lower in the Rab11- siRNA group than in the hypoxic blank group and the negative control group(P<0.05). (5) The immunofluorescence showed that the red fluorescence intensity around nucleus was significantly increased in the normoxic blank group, the hypoxic blank group and the negative control group than in the Rab11- siRNA group. Conclusions Hypoxia could promote the invasion and migration of SiHa cells. In hypoxia, the down regulation of Rab11 expression could inhibit the invasion and migration of SiHa cells. This might be due to the decreased expression of the intergrin α5, intergrin β3, p-FAK, p-PI3K and Rac1 protein.
ABSTRACT
Objective To evaluate the value of percutaneous hyperthermia-chemotherapy (PHC)under CT guided in treating original and secondary hepatic and pulmonary malignant tumor.Methods Percutaneous hyperthermia and chemotherapy under CT guided was performed for 21 patient with original and secondary hepatic and pulmonary malignant tumor.Chemical drugs against tumors were warmed to 55～60℃ and injected into the tumors.Injected volume was according to:V=4/3 ?(r+0.5 cm) 3.Observation depends upon attenuation changes of CT scanning and biochemical index(AFP)The therapeutic effect was classified into Ⅰ～Ⅴgrade.Results The period of observation was 36 monthes,In 20 cases,survival period was 8～22 monthes,average survival period was 16 monthes.A patient had treated with PHC and transcatheter arterial embolization and was alive for 28 monthes.Total effective rate was 95.2%.Conclusion PHC under CT guidence is an effective method in treating hepatic and pulmonary malignant tumors.especially for unresected tumors.Cooperating transcatheter arterial embolization(TAE)can raise curative effect.