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Objective To evaluate the efficacy and safety of recombinant adenovirus-p53(rAdp53) injection combined with radiotherapy and hyperthermia in the treatment of unresectable advanced soft tissue sarcoma.Methods In this retrospective study, we evaluated 76 patients with unresectable advanced primary or recurrent soft tissue sarcoma treated in our hospital from November 2005 to November 2012.These patients received radiotherapy and hyperthermia with rAdp53(p53 group, n=41) or without rAdp53(control group, n=35).rAdp53((1-2)×1012viral particles each time, once a week, 8 times on average) was injected into the tumor or infused into the pelvic cavity.Radiotherapy (2 Gy each time, 5 times a week) was performed for the planning target volume at 56.3±5.3 Gy in the p53 group and 58.1±4.2 Gy in the control group, with no significant difference between the two groups (P>0.05).Superficial or deep thermotherapy was employed 8 times on average (twice a week).Clinical features, response rate, time to progression (TTP), overall survival (OS), and adverse events were compared between the two groups (P>0.05).The Kaplan-Meier method was used to calculate OS;the log-rank test was used for survival difference analysis and univariate prognostic analysis;the chi-square test was used for comparison of categorical data.Results At 2 months after treatment, the p53 group had significantly increased response rate (partial response+ complete response+ stable disease)(85% vs.54%, P=0.003) and local control rate (49% vs.23%, P=0.020) as well as prolonged TTP (12 months vs.5 months, P=0.010) and OS (48 months vs.31 months, P=0.049), as compared with the control group.No adverse events caused by radiotherapy and hyperthermia except transient fever were seen in the two groups.Conclusions Concurrent radiotherapy and hyperthermia combined with rAdp53 injection is effective and safe for patients with advanced soft tissue sarcoma.
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Objective To analyze the dosimetfic benefits, clinical effect and side-respond of whole breast using intensity modulated radiotherapy for early breast cancer after conservative surgery. Methods From Oct.2004 to Aug. 2005,103 patients received the whole breast intensity modulated radiation therapy (IMRT). A dosimetric comparison of IMRT with conventional radiotherapy (CR) was performed on each patient. The cosmetic results, clinical effect and side-respond were observed. Results The average volume proportion of 95% and 107% prescribed dose was 95.8% ± 4.90% and 84.0% ± 20.7% (t = 9.60, P < 0.01) with IMRT and CR in clinical target volume, respectively. The V20 (lung volume of aceepted> 20 Gy/all lung volume × 100%) of the ipsilateral lung were 15.70% ± 4.64% and 23. 11% ± 7.88% (t = - 13.3, P < 0.01). The V30of the heart were 4.44% ±3.93% and 15.55% ± 10.89%(t = - 11.3, P< 0.01) with IMRT and CR respectively for sixty-three left side breast cancer patients. The 1- and 2-year excellent rate of good cosmetic outcome was both 100%. The 1-, 2- and 3-year local control rate was 99% ,99% and 98% ,respectively. The 1-, 2- and 3-year disease-free survival rate was 99% ,99% and 96% ,respectively. The Grade 1 and 2 acute radiation skin reaction rate was 95.1% and 4.9%, respectively. Conclusion Compared with conventional radiotherapy, IMRT improves dose distribution of CTV and reduce the dose of normal tissue around CTV;but with better clinical effects and lower side-respond for early breast cancer patients after breast conservative surgery.
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Objective To evaluate the effect of tumor infiltrating lymphocyte(TIL) on prognosis of rectal cancer treated with preoperative radiotherapy. Methods From Jan. 1999 to Oct. 2007,107 patients with rectal cancer were treated with preoperative radiotherapy of 30 Gy/10f/12 days. The relationships a-mong TIL,pathologic regression and prognosis were analyzed. Results Before radiotherapy,TIL in rectal cancer was 75 patients (70.1%) in grade 1,16 (15.0%) in grade 2 and 16 (15.0%) in grade 3; While after radiotherapy,it changed to 19 (17.7 %) in grade 1,43 (40.2%) in grade 2,35 (32.7 %) in grade 3 and 10 (9.3%) in grade 4. After radiotherapy,pathologic regression was 36 (33.6%) in grade 1,57 (53.3%) in grade 2 and 14 (13.1%) in grade 3. Univariate analysis showed that TIL both before and after radiotherapy was the significant prognostic factor for local pathologic regression (X2= 36.80, P < 0.01; X<'2>= 14.00, P<0.01). Kaplan Meier survival analysis showed that TIL and pathologic regression after radiother-apy were significant associated with the survival(X2=24.00, P < 0.01; X2=12.17, P<0.01 ). Logistic re-gression showed that TIL after radiotherapy had a significant effect on local pathologic regression(X2=8.05, P<0.01). Conclusions For rectal cancer treated with preoperative radiotherapy,TIL before and after ra-diotherapy is significantly related with local pathologic regression, and TIL after radiotherapy is a prognostic factor.
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Objective:To investigate the effects of Adp53 and F56 on the growth and lung metastasis of breast cancer.Methods:The BICR-H1 cells were inoculated into the mammary fatty pad of BALB/C nude mice and NOD/SCID mice to establish breast cancer model.Then the nude mice with xenograft tumor were randomized into group Adp53+F56,Adp53,F56 and control.The NOD/SCID mice with xenograft tumor were randomized into group Adp53+F56,Adp53,F56,Adlacz and control.They were theated for 3 weeks according to the plan,diversity of the volume and histopathology of xenograft tumor of nude mice was observed and the expressions of p53 and VEGF gene,and microvessel density(MVD)were detected by immunohistochemistry.Lung metastasis of breast cancer in NOD/SCID mice was observed.Results:(1)Intratumoral injections of Adp53,F56,and their combination resulted in an inhibition on the growth of xenograft tumor of BICR-H1 cells.The ultimate relative growth volumes of groups Adp53+F56,Adp53,F56 and control were 2.47,4.37,4.69 and 12.49 respectively.(2)After treatment,P53 positive rate of group Adp53+F56,Adp53 increased 9.4%,6.3% than before respectively,but compared with control group,the difference is not significant(P=0.693);VEGF protein of group Adp53+F56,Adp53 and F56 decreased 21.9%,9.4% and 3.1% than before respectively,but compared with control group,the difference was not significant(P=0.284).Necrosis and decrease of vessel in the tumor and morphological change of endothelium were observed under light microscope in the groups Adp53+F56,Adp53 and F56.MVD estimated by FⅧ-RA staining of group Adp53+F56,Adp53 and F56 were 14.50?2.54,16.28?3.44 and 18.06?7.66,compared with control group(24.93?6.53),the difference is significant(P=0.000).(3)The average number of lung metastasis of NOD/SCID mice in group Adp53+F56,Adp53 and F56 were 1.143?0.378,2.750?0.886 and 3.375?0.518 respectively,lower than Adlacz group(5.000?0.816)and control group(5.670?0.817)obviously(P=0.000).Conclusion:Adp53 combined with F56 can greatly inhibit growth and matastasis of breast cancer in vivo.The mechanism of anti-tumor effects of Adp53 and F56 may be related to the anti-angiogenesis effect on malignant tumor through inhibiting the expression and activity of VEGF.
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Objective To evaluate the effect of radiochemotherapy for unresectable extra-hepatic bile duct cancinoma. Methods Form June 1993 to August 2003, 28 unresectable extra-hepatic bile duct carcinoma treated by radiochemotherapy were analyzed. There were 13 gallbladder carcinoma and 15 bile duct carcinoma. The radiotherapy regimen consisted of conventional radiation therapy group(15 patients,with a median dose of 45Gy, range 30-60Gy) and three-dimensional conformal radiation therapy group(13 patients, with a median dose of 55Gy , range 50-70Gy). Among these patients, 12 patients were treated by radiotherapy alone( RT), 16 patients treated by radiochemotherapy(CRT), with a chemotherapy regimen consisting of 5-Fu 500mg twice weekly or 5-Fu 500mg + DDP 30mg once weekly for 3-6 cycles. Results The CR+PR, SD and PD rate was 14%, 64%, and 21%, respectively. The overall 1-,2-year survival rate was 38% and 15%, with a median survival time of 9.4 months. The 1-year survival of gallbladder cancer and extra-hepatic bile duct cancer was 46% and 27%;of 3DCRT and conventional radiotherapy was 42% and 33%;of those radiation dose less than 50Gy and more than 50Gy was 29% and 45%;of RT alone and radiochemotherapy was 37% and 31%, respectively. There was significance difference in overall survival between those RT dose less than 50Gy and more than 50Gy,(P=0.023). Grade 1-2 and Grade 3 acute gastrointestinal toxicity was 57% and 18%, respectively. Only 25% patients suffered grade 1-2 hematology toxicity. Conclusion Radiochemotherapy shows moderate effect for unresectable extra-hepatic bile duct cancer with acceptable side effects.
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Objective To evaluate the effect of concomitantdifferent regimens chemotherapy and radiotherapy for inoperable stage Ⅲ non small cell lung cancer (NSCLC). Methods From September 1995 to December 1998, 62 patients with inoperable stage Ⅲ NSCLC were randomized into two groups. Twenty nine patients received paclitaxel 30 mg and cisplatin 30 mg weekly for 5～6 weeks (paclitaxel group), and 33 patients received etoposide (Vp 16) 100 mg and cisplatin 30 mg weekly for 5～6 weeks (VP 16 group). All patients received concomitant radiotherapy as well. Radiotherapy was given with conventional fraction in 2Gy per fraction and five fractions per week. The total tumor doses were 60～70 Gy. Treatment fields covered clinical tumor and lymph node involved. Results The overall response (CR+PR) rate in paclitaxel group was 82.8% with a complete response (CR) rate of 10.3%. The overall response rate in the VP 16 group was 54.6% with a CR rate of 18%. The difference of overall response rate between the two groups was statistically significant (P0.05). The major toxic effects of chemotherapy were gastrointestinal tract reaction and myelosuppression. Conclusions Concomitant chemotherapy of paclitaxel plus cisplatin and radiotherapy for inoperable stage Ⅲ NSCLC is acceptable, and its efficacy is superior to cisplatin plus etoposide combined with radiotherapy.