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Objective The clinical effect and prognosis of greenlight photoselective laser vaporization combined with intraoperative submucosa multi-point injection of gemcitabin for the treatment of non muscle-invasive bladder tumors(NMIBC).Methods Selected 105 cases of NMIBC Confirmed by pathology from Mar.2012 to Nov.2013 in Guangzhou General Hosptial of Guangzhou Military Command of PLA urology.Put the patients into three groups randomly.Greenlight photoselective laser vaporization for bladder tumors (PVBT) combined with intraoperative submucosal injection of gemcitabine (PVBT group) 38 cases,Transurethral resection of bladder tumor(TURBT) combined with intraoperative submucosal injection of gemcitabine 25 cases (TURBT group),TURBT combined with immediate postoperative bladder perfusion chemotherapy (Control group)42 cases.Maintain the bladder perfusion chemotherapy after surgery,follow-up of 2 years.To compare and analysis the effect and the prognosis of three ways of operation method,And evaluate the quality of life of three groups of patients after treatment.Results The operation of 105 cases were successful,a total of 31 cases of recurrence,included PVBT group 7 cases (18.4％),TURBT group 6 cases (24％),contrlol group 18 cases (42.9％).Tumor progression of time were 12、10、6 month for the first time.The body function,psychological function,social function and material life of four dimensions scores have no obvious difference Three groups (P ＞ 0.05).Conclusions PVBT combined with intraoperative submucosal multi-point injection of gemcitabine is a kind of simple operation,and reduce the complications and the recurrence of the operation,especially suitable for the lateral wall of superficial tumor and intolerance to TURBT surgery for high-risk patients.It is a new better method of expansion clinical application.
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OBJECTIVE:To systematically review the efficacy and safety of gemcitabine combined with docetaxel in the treat-ment of non-small cell lung cancer(NSCLC),and provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed,Cochrane Library,Elsevier,CJFD,Wangfang Database and VIP,randomized controlled trials(RCT)about the ef-ficacy and safety of gemcitabine combined with docetaxel(test group)versus the 3rd generation chemotherapeutic agents combined with cisplatin(control group)in the treatment of NSCLC were collected. Meta-analysis was performed by using Rev Man 5.3 soft-ware after quality evaluation by modified Jadad scale. RESULTS:Totally 9 RCTs were included,involving 1 986 patients. Results of Meta-analysis showed,there were no significant differences in the total effective rate [RR=0.93,95%CI(0.83,1.05),P=0.27], 1-year survival rate [RR=0.97,95%CI(0.87,1.09),P=0.64],the incidences of liver dysfunction [RR=0.35,95%CI(0.06,2.18), P=0.26] and leukopenia [RR=0.80,95%CI(0.57,1.10),P=0.17] and decreased rate of hemoglobin [RR=0.65,95%CI(0.25, 1.69),P=0.38] in 2 groups;the incidences of liver dysfunction [RR=0.09,95%CI(0.02,0.38),P=0.001] and neurotoxicity in test group were significantly lower than control group,while the incidence of lung injury [RR=8.71,95%CI(2.04,37.12),P=0.003] was significantly higher than control group,the differences were statistically significant. CONCLUSIONS:Gemcitabine com-bined with docetaxel shows similar efficacy to the 3rd generation chemotherapeutic agents combined with cisplatin in the treatment of NSCLC,less effect on renal function and nerve while high on pulmonary toxicity.
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Anticancer drugs kill tumor cells and increase host anti-tumor immunity. Interestingly, gemcitabin (Gem) and 5-fluorouracil (5-FU), widely used anticancer drugs, lead to IL-1beta secretion releasing cathepsin B which activates Nlrp3 inflammasome in myeloid derived suppressor cells (MDSCs). MDSC derived IL-1beta enhance secretion of IL-17 by CD4+ T cells. This mechanism limits the antitumor efficacy of the drugs and promotes tumor growth.
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Cathepsin B , Cathepsins , Fluorouracil , Interleukin-17 , T-LymphocytesABSTRACT
Objective To evaluate and compare the efficacy and toxicity of gemcitabin(GEM) plus cisplantin and GEM on the chemotherapy of elderly patients advanced non-small-cell lung cancer (NSCLC).Methods 85 elderly patients with stage 3 to 4 NSCLC were randomized into gemcitabine plus cisplatin (group GP) and GEM (group GEM).In group GP,patients received GEM on day 1 and day 8 at dose 1.0 g/m2,add cisplatin on day 2 to day 4 at dose 75 mg/m2. In group GEM, patients would received single GEM at dose 1.25 g/m2.The the therapy circle was 3 weeks and undertaken least 2 circles before the treatment efficacy and survival would be evaluated according RECIST. Results In GP group the response rate was 48.84 ％(21/43),In GEM group the response rate was 35.71％(15/42),the difference of response rate between two groups was not statistically significant(x2=1.708,P=0.424).The median survival were 11 months to Gp group and 9 months to GEM group. The 1 year survival rates of GP group were 39.53 ％ and of GEM group were 26.19 ％. The survival time between two groups was not statistically significant(t=1.377,P=0.172).The same toxicity in both groups was defected, Nausea and vomiting occurred were more serious in GP group than that in GEM group (x2=9.796, P=0.002). Conclusion GP and GEM are both effective for treatment of elderly advanced NSCLC.There are no significantly differences on efficacy and toxicity in 2 groups. Side effects on alimentary system are obviously less in GEM group than that in GP group.
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Background and purpose:The greastest diameter of cervical cancer with stage Ⅰ_(b2) disease was more than 4 cm in diameter. surgery as the fi rst priority was diffi cult in these patients, bleeding was the most frequent adverse effect. This article studied the effect of the cervical cancer with stage Ⅰ_(b2) disease underwent neoadjuvant chemotherapy with gemcitabin plus cisplatinum(DDP). Methods:23 cases (A groups) stage Ⅰ_(b2) cervical cancer were treated with gemcitabin 1.5 g/m2 iv infusion at d1, plus cisplatinum(DDP) 20 mg/m2 iv infusion at d1-3. The interval between the two cycles was two weeks.19 cases (B groups) were treated with cisplatinum(DDP) 20 mg/m2 iv infusion at d1-3,plus VCR 1.5 g/m2 iv infusion at d1, and BLM 10 mg/m2 im at d1-3, The interval between the two cycles was three weeks. The assessment for clinical effect and side effect were conducted for the patients with completion of at least two cycles of chemotherapy. Results:42 cases were enrolled in this trial. There was signifi cant(P=0.004) difference between the two groups with the shrinkage of the greatest diameter after neoadjuvant chemotherapy. The main toxicities were myelosuppression. There was signifi cant (P
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Background and purpose:Chemotherapy including anthracyclin and taxanes is one of the effective regimens for patients with advanced breast cancer, but 20%-30% patients do not achieve a satisfactory curative effect .At present, there is no unified standard second-line chemotherapy regimen for these patients. We studied the efficacy and toxicity of gemcitabin plus capecitabine in the treatment of the patients with advanced breast cancer who had failed in response to the treatment of anthracyclin and taxanes chemotherapy. Methods:Gemcitabin 1 000 mg/m2 iv infusion at d1,8 and capecitabine 950 mg/m2 po tid at d1-14.The interval between the two cycles was 3 weeks. The assessment for clinical effect and side effect was conducted for the patients with completion of 2 cycles of chemotherapy at least.Results:30 female patients were enrolled in this trial ,overall response rate was 46.7%,with 6.7% complete response (2/30)and 40% partial response (12/30). Stable disease was seen in 42.3%(13/30),and disease progression in 10% (3/30).Median time to progression was 9 months, and median overall survival was 12.5 months. The main toxicities were myelosuppression and hand-foot syndrome.Conclusions:Gemcitabin plus capecitabine is effective for the patients with advanced breast cancer who failed in the treatment of anthracyclin and taxanes chemotherapy, and its side effect is tolerable.