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Objective To observe the clinical effect of gifitinib combined with hydroxylcamptothecin pericardial perfusion in the treatment of patients with advanced non-small cell lung cancer(NSCLC) with pericardial effusion. Methods From January 2016 to September 2017,eighty-four cases of late NSCLC with pericardial effusion treated in the People′s Hospital of Jiaozhou were randomly divided into two groups according to the digital table,with 42 cases in each group.The control group was treated with gefitinib,and the observation group was treated with hydroxylcampto-thecin on the basis of the control group.The curative effect was evaluated after two courses of treatment in the two groups,and the clinical efficacy and adverse reactions were observed.Results The effective rates of the control group and the observation group were 47.6% (20/42) and 66.7% (28/42),respectively.The effective rate of the observa-tion group was significantly higher than that of the control group(χ2 =4.525,P<0.05).The effective rate of pericar-dial effusion was 33.3% (14/42) in the control group and 69.1% (29/42) in the observation group,the difference between the two groups was statistically significant( χ2 =10.720,P <0.05).There was no ststistically significant difference in the incidence rate of adverse reactions between the two groups during treatment(P<0.05).Conclusion Combination of gefitinib and hydroxylcamptothecin pericardial perfusion in the treatment of NSCLC with pericardial effusion has good tolerance and good safety for the patients.
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BACKGROUND@#Epidermal growth factor receptor (EGFR) mutation non-small cell lung cancer (NSCLC) is an important subtype of lung cancer. The incidence of malignant pericardial effusion (MPCE) in EGFR-mutant NSCLC patients is high. However, there are few researches on the treatmentof this type of patients.@*METHODS@#We collected data on clinical characteristics and treatment of advanced NSCLC patients who harboring EGFR mutants and MPCE between January 2010 and December 2016. The treatments were divided into three groups: oral gefitinib combined with pericardial perfusion of hydroxycamptotheci (HCPT) group (gefitinib/HCPT); intravenous chemotherapy combined with pericardial perfusion of HCPT group (chemotherapy/HCPT) and gefitinib monotherapy group. And we retrospectively analyzed patients' outcomes in three groups.@*RESULTS@#In 273 advanced NSCLC patients with EGFR mutations, 29 cases had pericardial effusion, among which 6 patients with small amount of pericardial effusion were excluded, and 23 patients were analyzed. Median pericardium progression free survival (PFS) was 247 days. PFS for gefitinib/HCPT group (460 days) was superior to PFS for chemotherapy/HCPT group (94 days, P=0.008) and gefitinib monotherapy group (131 days, P=0.032). As for the efficacy of primary pulmonary lesions, the efficacy in gefitinib/ HCPT group was superior to chemotherapy/HCPT group [objective response rate (ORR): 33.3% vs 12.5%; disease control rate (DCR): 86.7% vs 62.5%]. There is no difference of ORR and DCR between gefitinib/HCPT group and gefitinib monotherapy group. No obvious adverse reaction was observed in all three groups.@*CONCLUSIONS@#First-line gefitinib therapy combined with pericardial perfusion of HCPT can improve pericardium PFS for advanced NSCLC patients who harboring EGFR mutants andmalignantpericardial effusion. This finding should be confirmed further through multicenter, prospective clinical trials with large sample size.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Carcinoma, Non-Small-Cell Lung , Drug Therapy , Metabolism , Pathology , Disease-Free Survival , ErbB Receptors , Metabolism , Gefitinib , Lung Neoplasms , Drug Therapy , Metabolism , Pathology , Perfusion , Pericardial Effusion , Pericardium , Quinazolines , Therapeutic Uses , Retrospective Studies , Treatment OutcomeABSTRACT
Background and purpose:The antitumor drugs produce a marked effect through the induction of apoptosis. The resistance to chemotherapy has been found to be associated with abnormal expression of genes related to apoptosis. We designed this experiment to investigate the role of survivin gene in the resistance to chemotherapy. Methods:After being treated with Hydroxycamptothecine (OPT,21.96mmol/L), the apoptosis in gastric cancer cell line BGC-823 cells were evaluated by either flow cytometry(FCM) or the terminal deoxynucleotidy transfer mediated dUTP-biotin nick end labeling(TUNEL). The expression of Survivin was detected by reverse transcription-Polymerase chain reaction(RT-PCR) and immunohistochemistry.Results:Compared to control group, the OPT can induced apoptosis in BGC-823[(12.68?0.17)% vs (3.35?0.13)% by FCM,(16.00?1.23)% vs (2.78? 0.84)% by TUNEL[, OPT could upregulate survivin expression in BGC-823 cells (1.489?0.041)% vs (0.756?0.037)% in terms of level of mRNA,(0.928?0.046) vs (0.303?0.032) in terms of protein expression).Conclusions:The survivin gene may be associated to the resistance to chemotherapy through the induction of gene expression.
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0.05).The median time to progression (mTTP) was 7.8 months in HCPTOX group and 7.9 months in FOLFOX4 group, respectively. The median survival time (MST) was 13.1 months in HCPTOX group and 13.3 months in FOLFOX4 group, respectively. The toxicities were well tolerated.The incidence of grade Ⅲ+Ⅳ nausea and vomiting was significantly lower in HCPTOX group than in FOLFOX4 group (?2=4.538,P0.05). Conclusion:Both of the two regimens were feasible, well tolerated and effective in treatment of metastatic colorectal cancer.HCPTOX regimen might be safer than FOLFOX4 regimen,especially in elderly patients or patients with ECOG PS of 1 to 2.