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Background@#In China, secondary cytoreductive surgery (SCR) has been widely used in ovarian cancer (OC) over the past two decades. Although Gynecologic Oncology Group-0213 trial did not show its overall survival benefit in first relapsed patients, the questions on patient selection and effect of subsequent targeting therapy are still open. The preliminary data from our pre-SOC1 phase II study showed that selected patients with second relapse who never received SCR at recurrence may still benefit from surgery. Moreover, poly(ADP-ribose) polymerase inhibitors (PARPi) maintenance now has been a standard care for platinum sensitive relapsed OC. To our knowledge, no published or ongoing trial is trying to answer the question if patient can benefit from a potentially complete resection combined with PARPi maintenance in OC patients with secondary recurrence. @*Methods@#SOC-3 is a multi-center, open, randomized, controlled, phase II trial of SCR followed by chemotherapy and niraparib maintenance vs chemotherapy and niraparib maintenance in patients with platinum-sensitive second relapsed OC who never received SCR at recurrence. To guarantee surgical quality, if the sites had no experience of participating in any OC-related surgical trials, the number of recurrent lesions evaluated by central-reviewed positron emission tomography–computed tomography image shouldn't be more than 3. Eligible patients are randomly assigned in a 1:1 ratio to receive either SCR followed by 6 cyclesof platinum-based chemotherapy and niraparib maintenance or 6 cycles of platinum-based chemotherapy and niraparib maintenance alone. Patients who undergo at least 4 cycles of chemotherapy and must be, in the opinion of the investigator, without disease progression, will be assigned niraparib maintenance. Major inclusion criteria are secondary relapsed OC with a platinum-free interval of no less than 6 months and a possibly complete resection. Major exclusion criteria are borderline tumors and non-epithelial ovarian malignancies, received debulking surgery at recurrence and impossible to complete resection. The sample size is 96 patients. Primary endpoint is 12-month non-progression rate.
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Objective To observe the clinical efficacy of recombinant human endostatin (endostar)combined with intravenous chemotherapy and intraperitoneal hyperthermic perfusion chemotherapy for advanced ovarian cancer (AOC).Methods Sixty-one patients with AOC were divided into treatment group (31 cases) and control group (30 cases) by table of random digit.The treatment group was given endostar +TP project (paclitaxel intravenous chemotherapy + cisplatin intraperitoneal hyperthermic perfusion chemotherapy).The control group was given endostar + TP project (paclitaxel and cisplatin intravenous chemotherapy).The recurrence rate,survival rate,improvement of quality of life (QOL) and drug side effects were observed in two groups.Results The improvement rate of QOL in treatment group was significantly higher than that in control group [64.5％(20/31) vs.33.3％(10/30),x2 =5.931,P=0.015].The 1-year and 2-year recurrence rate in treatment group were significantly lower than those in control group [17.2％(5/29)vs.41.4％(12/29),34.5％(10/29) vs.62.1％(18/29),P=0.043 and 0.036].The 1-year and 2-year survival rate in treatment group were significantly higher than those in control group [93.1％(27/29) vs.72.4％(21/29),79.3％ (23/29) vs.51.7％ (15/29),P =0.037 and 0.027].The incidence of nausea and vomiting in treatment group was significantly lower than that in control group [67.7％ (21/31) vs.93.3％ (28/30),P =0.012],there was no significant differences in bone marrow suppression,hair loss and liver and renal injury incidence between two groups (P ＞0.05).Conclusion Endostar combined with intravenous chemotherapy and intraperitoneal hyperthermic perfusion chemotherapy for AOC is safe and effective,and can improve patients' QOL,reduce the rate of recurrence and prolong survival time.
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To investigate the reliability and feasibility of human papillomavirus (HPV) DNA test in cervical scraping smears with polymerase chain reaction (PCR), 131 cases of cervical scraping specimens were collected, and the positive rates and accuracy of HPV infection were determined in normal subjects and cervical cancer patients. GP5+/GP6+ and E7 primer pairs designed for detecting HPV L1 and HPV type 16 E7 were tested in this study. Our results showed that positive rates of HPV DNA in normal population and cervical cancer patients were 32.99 % and 73.53 % respectively and there was significant difference between them (P＜0. 001). In normal subjects, detection rates of HPV DNA with GP5+/GP6+ and E7 primer pairs were 27.84 % and 16.49 % respectively, with statistically significant difference between them (P＞0.05). However the detection rates in cervical cancer patients were 38.24 % and 67.65 % for the two markers, with a significant difference found between them (P＜0.05). It is concluded that HPV DNA test with PCR for cervical scraping smears was feasible. GP5+/GP6+ primer pairs may be a useful probe to screen HPV infection in normal population, but they are not sensitive enough in cervical cancer patients. It is suggested that high risk type HPV DNA test was very useful in population with high risk of cervical cancer.
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Objective To explore the evidence of the hypophysis,pituitary gland danger advertises for the elephant and the reasonable treatment measure.Methods The clinical characteristics,misdiagnosis reason of the dangerous evidence in 35 hypophysis were retrospeceively analyzed.Results Only 11 cases were finally diagnosed in one year after onset of illness(31.8%).The misdiagnosis rate amounted to 68.2%.With the alimentary canal symptom the leader hair was 91.4%,32 cases.Do not adjust for the menses the next in order,anemia etc.3 cases had the central myelin sheath in the bridge of tapetum fuses,4 cases had organ dysfunction,4 cases dieds.Conclusion To sufferer who infurs big issue of blood in postpartum history on the appearence of the alimentary canal symptom,low serum natrium,hypoglycemia or hypotensions the evidence of the hypophysis,pituitary gland danger possibility should be watched out,on time proceed the relevant check,treatment as early as possible,can reduce the misdiagnosis rate and death rate.
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The relationship of connexin43 (Cx43) and bystander effect in ovarian tumor cells in herpes simplex virus thymidine kinase/ganciclovir (HSV-TK/GCV) gene therapy in vitro was explored and the effect of all-trans retinoic acid (RA) on the expression of Cx43 and bystander effect investigated. The Cx43 expression was detected by flowcytometry, Western blot, and immunofluorescence in two ovarian tumor cell lines OVCAR3, CaOV3 before and after RA treatment. Bystander effect was determined by the cells growth inhibitory rate with methyl thiazolyl tetrazolium. Following exposure to ganciclovir, there was much greater bystander killing in OVCAR3 than that in CaOV3 (P<0.05). The expression of Cx43 was detected in OVCAR3 by flowcytometry and Western blot, but it could not be detected in CaOV3. The expression of Cx43 in both cell lines could be induced by RA. Immunofluoresence staining showed that Cx43 protein of OVCAR3 was located on membrane surface, whereas CaOV3 in cytoplasm. RA could not change the location of Cx43 protein in both cell lines. There is relationship between Cx43 expression and HSV-TK/GCV bystander effect. HSV-TK/GCV bystander effect can be enhanced by RA in ovarian cancer.