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BACKGROUND@#The patients with advanced lung adenocarcinoma should select targeted drugs based on the type of tumor epidermal growth factor receptor (EGFR) gene mutation. However, it is difficult to collect tumor tissue of advanced lung adenocarcinoma, and some experts agree that peripheral blood can be used as a substitute for tumor tissue as a test specimen. This paper aimed to investigate the clinical value of ddPCR and super-amplification refractory mutation system (ARMS) in detecting EGFR gene mutation in peripheral blood of patients with advanced lung adenocarcinoma.@*METHODS@#A total of 119 patients diagnosed in Beijing Chest Hospital Affiliated to Capital Medical University from February 2016 to February 2019 were collected, and the sensitivity and specificity of plasma ctDNA EGFR gene mutation detected by ddPCR and super-arms were compared. Some patients with positive EGFR gene mutations received oral treatment with first-line EGFR tyrosine kinase inhibitors (EGFR-TKI). The patients were divided into subgroups according to the test results. In group 1, both ddPCR and super-arms showed positive EGFR gene mutation results, with 21 cases. In group 2, ddPCR and super-arms detection of EGFR gene mutation were all negative, with 16 cases. In group 3, the ddPCR test was positive and the super-arms test was negative, with 5 cases. In group 4, the ddPCR test result was negative while the super-arms test result was positive. Since the number of patients in group 4 was 0, no statistics were included. Objective response rate (ORR) and disease control rate (DCR) were used to evaluate the short-term outcome, and progression-free survival (PFS) was compared with survival analysis to evaluate the long-term outcome.@*RESULTS@#EGFR mutations were detected in 58 (48.7%) of 119 patients with advanced lung adenocarcinoma. The coincidence rate between ddPCR and EGFR gene mutation in tumor tissues was 82.4% (Kappa=0.647, P0.05). Survival analysis showed that the PFS of the three groups was compared. The difference was not statistically significant (χ²=2.221, P=0.329).@*CONCLUSIONS@#ddPCR, as a high sensitivity and specificity liquid gene detection method, can be used as a reliable method to detect the mutation of plasma ctDNA EGFR gene in patients with advanced lung adenocarcinoma. The results of plasma genetic testing can also be used as the basis for predicting the efficacy of EGFR-TKIs in patients.
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Objective To evaluate the safety and feasibility of three-dimensional conformal radiation therapy combined with tegafur in treating locally recurrent rectal cancer. Methods A total of 32 patients with locally recurrent rectal cancer were treated with chemoradiotherapy ( CRT) . Radiotherapy was delivered to a total of 45 Gy in 25 fractions followed by a boost of 18 Gy in 10 fractions using three dimensional radiotherapy planning. Tegafur was given orally[80 mg·(m2)-1·d-1] on days 1-5, 8-12, 15-19, 22-26, 29-33, 36-40, and 43-47 during radiotherapy. Results Most of the adverse effects were mild. Grade 3-4 toxic effects occurred in 12. 5% of patients. Thirty-one patients completed full course of CRT, while one patient discontinued chemotherapy due to Grade 4 thrombocytopenia. There were 3 cases (9. 4%) with complete response, 21 cases (65. 6%) with partial response, and the overall response rate was 75. 0%. Overall pain response (complete and partial pain relief) was achieved in 96. 9% of patients. The 1- and 2-year overall survival rate was 71. 0% and 56. 5%, respectively. Conclusion 3D-CRT combined with tegafur for locally recurrent rectal cancer is feasible with high patient compliance and tolerable toxicities.