Drug resistance factors in postoperative gemcitabine chemotherapy after radical resection of pancreatic cancer / 中华消化外科杂志

Objective:To investigate the drug resistance factors in postoperative gemci-tabine chemotherapy after radical resection of pancreatic cancer.Methods:The retrospective case-control study was constructed. The clinicopathological data of 255 patients with pancreatic cancer who were firstly admitted to the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Xi ′an Jiaotong University from January 2018 to June 2021 were collected. There were 140 males and 115 females, aged (59±10)years. All patients underwent radical resection of pancreatic cancer and received postoperative gemcitabine-based adjuvant chemotherapy. Observation indicators: (1) follow-up; (2) postoperative chemotherapy; (3) drug resistance and changing of regimen; (4) factors influencing postoperative chemotherapy resistance. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and compari-son between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was conducted using the Pearson chi-square test. Univariate analysis was conducted using the corresponding statistical methods based on data type. Multivariate analysis was conducted using the Logistic regression model with forward method. Kaplan-Meier method was used to draw survival curve, and Log-Rank test was used for survival analysis. Results:(1) Follow-up. All 255 patients were followed up for 18.6(16.7,21.4)months. The median survival time of 255 patients was 18.2[95% confidence interval ( CI) as 15.8-20.6]months. (2) Postoperative chemotherapy. Of the 255 patients, there were 5 cases receiving postoperative chemotherapy as gemcitabine monotherapy, 167 cases receiving postoperative chemotherapy as the AG combination (gemcitabine plus albumin-bound paclitaxel), 74 cases receiving postoperative chemotherapy as the GS combination (gemcitabine plus S-1) and 9 cases receiving postoperative chemotherapy as the GP combination (gemcitabine plus platinum). (3) Drug resistance and changing of regimen. Of the 255 patients, 81 cases completed the course of postoperative chemotherapy and evaluation. Of the 81 patients, there were 18 cases with no recurrence or metastasis of tumor, 10 cases with tumor local recurrence, 40 cases with tumor lymph node metastasis or distant metas-tasis, 3 cases with tumor local recurrence combined with distant metastasis, 10 cases with elevation of CA19-9. Of the 81 patients, 18 cases responded to chemotherapy, 63 cases underwent resistant to chemotherapy, including 11 cases with primary resistance and 52 cases with acquired resistance. The 63 patients with chemotherapy resistance underwent changing of regimen. (4) Factors influencing postoperative chemotherapy resistance. Results of multivariate analysis showed that chemotherapy cycle<6 is an independent risk factor for postoperative chemotherapy resistance in patients ( hazard ratio=17.18, 95% CI as 2.07-142.28, P<0.05). Conclusion:Adjuvant chemotherapy cycle <6 is an independent risk factor for postoperative chemotherapy resistance for gemcitabine based chemo-therapy in pancreatic cancer patients receiving radical resection.

Influence of perioperative probiotics supplement on short-term clinical outcomes in gastric cancer patients receiving neoadjuvant chemotherapy combined with radical gastrectomy: a prospective study / 中华消化外科杂志

Objective:To investigate the influence of perioperative probiotics supplement on short-term clinical outcomes in gastric cancer patients receiving neoadjuvant chemotherapy combined with radical gastrectomy.Methods:The prospective randomized controlled study was conducted. The clinicopathological data of 80 patients who underwent neoadjuvant chemotherapy combined with radical gastrectomy in the Affiliated Hospital of Qingdao University from July 2020 to September 2021 were selected. Based on random number table, patients were allocated into two groups. Patients undergoing perioperative probiotics supplement were allocated into the experiment group, and patients undergoing perioperative conventional treatment were allocated into the control group, respectively. Observation indicators: (1) grouping situations of the enrolled patients; (2) intraoperative situations; (3) follow-up and postoperative situations; (4) inflammation related hematological indexes. Follow-up was conducted using telephone interview and outpatient examina-tion to detect postoperative complications and startup of adjuvant chemotherapy up to October 31,2021. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was performed using the chi-square test or Fisher exact probability. Comparison of ordinal data was analyzed using the Mann-Whitney U test. Repeated measurement data were analyzed by the repeated ANOVA or generalized estimating equation. Results:(1) Grouping situations of the enrolled patients. A total of 80 patients were selected for eligibility. There were 51 males and 29 females, aged 64(42-80)years. Of the 80 patients, there were 40 patients in the experiment group and 40 patients in the control group, respectively. (2) Intraoperative situations. All patients in the experiment group and the control group underwent radical gastrectomy successfully. Cases with yield pathologic TNM (ypTNM) stage 0, stage Ⅰ, stage Ⅱ, stage Ⅲ after neoadjuvant chemotherapy, cases undergoing laparoscopic radical gastrectomy or Da Vinci robotic radical gastrectomy, the operation time, the volume of intraoperative blood loss, cases undergoing digestive tract recons-truction as Billroth Ⅱ anastomosis or Roux-en-Y anastomosis were 2, 7, 15, 13, 19, 21,205(180-240)minutes, 50(30-60)mL, 6, 34 in the experiment group, versus 4, 6, 12, 16, 23, 17, 218(190-251)minutes, 50(43-60)mL, 11, 29 in the control group, showing no significant difference in the above indicators between the two groups ( U=683.00, χ2=0.80, U=668.00, 681.00, χ2=1.87, P>0.05). (3) Follow-up and postoperative situations. All the 80 patients were followed up for 1 month after surgery. Cases with postoperative infectious complications were 6 in the experiment group, versus 15 in the control group, showing a significant difference between the two groups ( χ2=5.23, P<0.05). The application of antimicrobial agent, time to postoperative first flatus, time to postoperative first defecation, time to tolerance of solid food, duration of postoperative hospital stay, time to postopera-tive startup of adjuvant chemotherapy were 3(3-6)doses, 53(49-66)hours, 72(62-82)hours, (72±18)hours, 6.0(5.5-7.0)days, 26.0(25.0-28.0)days in the experiment group, versus 6(3-10)doses, 66(60-88)hours, 94(82-112)hours, (107±23)hours, 7.0(6.4-8.3)days, 30.0(28.0-33.0)days in the control group, showing significant differences in the above indicators between the two groups ( U=471.50, 432.00, 343.50, t=-7.62, U=411.50, 319.50, P<0.05). (4) Inflam-mation related hematological indexes. ① The white blood cell counts before surgery and at postoperative day 1, 3, 5 were (5.6±1.4)×10 9/L, (9.9±3.2)×10 9/L, (7.7±2.6)×10 9/L, (6.8±1.8)×10 9/L in the experiment group, versus (6.1±1.9)×10 9/L, (12.3±2.9)×10 9/L, (9.7±3.6)×10 9/L, (7.8±2.7)×10 9/L in the control group, meeting the mauchly′s test of sphericity ( χ2=4.17, P>0.05). Results of intrasubject effect test showed that there were significant differences in the time effect, intervention effect and interaction effect of white blood cell counts between the two groups ( F=106.61, 10.45, 4.56, P<0.05). ② The neutrophilic granulocyte percentages before surgery and at postoperative day 1, 3, 5 were 55%±10%, 76%±11%, 73%±9%, 69%±9% in the experiment group, versus 56%±9%, 84%±5%, 79%±8%, 74%±9% in the control group, not meeting the mauchly′s test of sphericity ( χ2=16.63, P<0.05). Results of multi-variate test showed that there were significant differences in the time effect, intervention effect and interaction effect of neutrophilic granulocyte percentages between the two groups ( F=92.42, 11.46, 5.55, P<0.05). ③ The levels of C-reactive protein before surgery and at postoperative day 1, 3, 5 were 1.35(1.15-1.97)mg/L, 14.94(8.24-21.22)mg/L, 33.39(13.02-66.02)mg/L, 18.36(8.27-60.43)mg/L in the experiment group, versus 1.62(0.97-2.27)mg/L, 24.03(10.42-36.52)mg/L, 81.66(31.20-116.76)mg/L, 46.84(28.30-80.26)mg/L in the control group, not meeting the normal distribution. Results of generalized estimation equation test showed that there were significant differences in the time effect, intervention effect and interaction effect of levels of C-reactive protein between the two groups ( Waldχ2=145.74, 9.48, 9.90, P<0.05). ④ The levels of procalcitonin before surgery and at postoperative day 1, 3, 5 were 0.02(0.02-0.04)μg/L, 0.08(0.06-0.12)μg/L, 0.12(0.07-0.21)μg/L, 0.09(0.06-0.15)μg/L in the experiment group, versus 0.02(0.02-0.04)μg/L, 0.14(0.07-0.71)μg/L, 0.35(0.14-0.71)μg/L, 0.24(0.10-0.48)μg/L in the control group, not meeting the normal distribution. Results of generalized estimation equation test showed that there were signifi-cant differences in the time effect, intervention effect and interaction effect of levels of procalcitonin between the two groups ( Waldχ2=62.88, 14.71, 18.33, P<0.05). Conclusion:Perioperative supple-ment of probiotics can reduce the incidence of postoperative infectious com-plications and the application of antimicrobial agent, promote recovery of gastrointestinal function, reduce the level of inflammation related indexes, shorten the duration of postoperative hospital stay and the time to postoperative startup of chemotherapy in patients undergoing neoadjuvant chemotherapy combined with radical gastrectomy.

Preliminary study of the dose of radiotherapy for patients with thoracic esophageal squamous cell carcinoma after local recurrence / 中华放射肿瘤学杂志

Objective:To evaluate the effects of different irradiation doses on postoperative local recurrence in patients with esophageal cancer after radio (chemo) therapy.Methods:Clinical data of 331 esophageal cancer patients presenting with postoperative local recurrence admitted to our hospital from 2009 to 2014 were collected. The recurrence site, the effects of different radiotherapy doses on the prognosis of patients and the independent prognostic factors were retrospectively analyzed. The survival rate was calculated by Kaplan-Meier method. Univariate prognostic analysis was performed by log-rank test. Multivariate prognostic analysis was conducted by Cox proportional hazard regression model.Results:The 1-, 3-and 5-year overall survival rates were 54.3%, 23.2% and 16.6%, respectively. The median overall survival was 13.4 months (95% CI: 11.7-15.0). The median survival of patients with radiotherapy doses< 60 Gy and ≥60 Gy was 10.8 and 13.9 months ( P=0.013). Stratified analysis showed that patients with age< 60 years, no smoking history, no drinking history, no family history, upper thoracic segment, left thoracotomy, N 0 staging, log odds of positive lymph nodes (LODDS)< 0.030, recurrence time ≥ 13.1 months and recurrence site ≥ 2 had better prognosis when receiving radiotherapy dose ≥ 60 Gy ( P=0.038, 0.033, 0.001, 0.003, 0.018, 0.010, 0.041, 0.039, 0.043 and 0.007). Moreover, the short-term clinical efficacy of patients treated with ≥60 Gy dose was significantly better than that of those with<60 Gy dose ( P<0.001), which did not increase the incidence of ≥grade 2 radiation-induced gastritis ( P=0.977) or radiation-induced pneumonitis ( P=0.444). Cox multivariate analysis showed that the LODDS size, prescription dose and short-term efficacy were the independent factors affecting clinical prognosis of patients ( P=0.006, 0.008 and<0.001). Conclusions:The recommended dose for esophageal cancer patients with local recurrence after radiotherapy (chemotherapy) is greater than or equal to 60 Gy. The results of this study need to be confirmed by prospective studies with a large sample size.

Progress and controversy of neoadjuvant therapy for locally advanced gastric cancer / 中华消化外科杂志

Gastric cancer is one of the most common malignant tumors in the world. China is still the country with the highest incidence of gastric cancer and most patients with gastric cancer are in locally advanced stage at the first diagnosis. Traditional radical surgery combined with post-operative adjuvant treatment is difficult to further improve the prognosis of patients. In recent years, the exploration and application of neoadjuvant treatment modes such as chemotherapy, radio-therapy, targeted therapy and immunotherapy in locally advanced gastric cancer have made continuous progress. However, there is still no consensus on the benefit population, regimen options, and efficacy evaluation of neoadjuvant therapy. The authors review and comb the research progress and controversy of neoadjuvant therapy for locally advanced gastric cancer.

Clinical study design of a multicenter, prospective, randomized controlled clinical trial on clinical efficacy of Toripalimab adjuvant therapy on esophageal squamous cell carcinoma patients with post-neoadjuvant positive lymph node staging / 中华消化外科杂志

Neoadjuvant therapy has become the first choice for locally advanced esophageal carcinoma. Patients with post-neoadjuvant positive lymph node staging (ypN+) have poor prognosis, and there is no effective adjuvant therapy. Programmed death protein-1 (PD-1) antibody can obtain better clinical efficacy in the treatment of advanced esophageal cancer. The authors designed a multicenter, prospective, randomized controlled clinical trial of Toripalimab (PD-1 antibody) adjuvant therapy on esophageal squamous cell carcinoma patients with ypN+ after the treatment of neoadjuvant chemotherapy combined with surgical resection, in order to provide clinical practices for the adjuvant treatment of ypN+ patients.

Neumonitis por docetaxel, discusión de un caso / Interstitial pneumonitis due to docetaxel

Resumen La neumonitis intersticial por docetaxel es un evento infrecuente, pero con alto potencial de mortalidad y puede ser potencialmente reversible con el uso de esteroides sistémicos; se considera importante en el diagnóstico diferencial del paciente bajo quimioterapia con síntomas respiratorios. A continuación, se presenta un caso de neumonitis fatal por docetaxel en un paciente con carcinoma de próstata avanzado. Paciente de 80 años de edad con historia de cáncer de próstata de 15 años de evolución, en progresión ósea y ganglionar, y que inició manejo con docetaxel. Después de la aplicación del tercer ciclo presenta disnea de esfuerzos, fiebre, tos seca y deterioro general. Se realizó diagnóstico de neumonitis por docetaxel y se descartaron otras entidades. La neumonitis intersticial por docetaxel es una entidad rara. Los pilares del tratamiento son la suspensión del medicamento, el soporte ventilatorio y el uso de glucocorticoides sistémicos.

Abstract Interstitial pneumonitis due to docetaxel is an infrequent event but with a high mortality potential; it can be potentially reversible with the use of systemic steroids and is considered important in the differential diagnosis of the patient undergoing chemotherapy with respiratory symptoms. We present a case of fatal pneumonitis due to docetaxel in a patient with advanced prostate carcinoma. An 80-year-old patient with a history of prostate cancer of15 years of evolution, with disease progression in bones and lymph nodes, in whom treatment with Docetaxel was started, after the application of the third cycle, he presented with dyspnea on exertion, fever, dry cough and general deterioration. A diagnosis of pneumonitis due to docetaxel was made, discarding other entities. Interstitial pneumonitis due to docetaxel is a rare entity. The pillars of the treatment are the suspension of the medication, the ventilatory support and the use of systemic glucocorticoids.

Observation of clinical effect of photodynamic therapy on oral leukoplakia in elderly patients / 中华老年医学杂志

Objective@#To observe the clinical efficacy of photodynamic therapy on oral leukoplakia in elderly patients.@*Methods@#In this prospective study, fifteen elderly patients with oral leukoplakia were treated with 5-aminolevulinic acid-based photodynamic therapy(ALA-PDT). After 2 hours of dressing, patients were irradiated using a 635nm semiconductor laser with the power density of 300mW/cm2.Each lesion was irradiated for 6 minutes with energy density of 100J/cm2.The curative effect was evaluated and the adverse reactions were recorded based on the observation of lesion changes.@*Results@#Of the 15 lesions in 15 patients, 4 lesions were treated once, 3 lesions were treated twice.And 6 lesions were cured after three treatments, and 2 patients were cured after four treatments.The average treatment frequency was(2.4±1.1)treatment.The postoperative adverse reaction was pain.The average visual analogue scale was(2.2±0.8)scores after operation, and the duration of pain was(2.6±1.1)days after operation.There was no recurrence for 3 to 9 months after operation.No abnormalities of oral sensation and function were found in patients.@*Conclusions@#ALA-PDT is an effective method for the treatment of oral leukoplakia in elderly patients.

Influence of Taiji quan on the cancer related fatigue and immunity in advanced lung cancer patients with chemotherapy / 中国基层医药

Objective To investigate the efficacy of Taiji quan for cancer related fatigue in advanced lung cancer patients with chemotherapy of paclitaxel combined with cisplatin,and its influence on cellular immune function. Methods From June 2016 to December 2017,78 patients with advanced lung cancer in Zhuji Hospital of Traditional Chinese Medicine were selected and randomly divided into observation group and control group by random number table method,with 39 cases in each group. The control group was treated with TP chemotherapy regimens. On the basis of the control group,the observation group was given Taiji quan. Both two groups were observed for 6 weeks. The scores of cancer related fatigue PFS scale,life quality FACT－G scale and short－term curative effect were compared between the two groups. The cellular immune function T －lymphocyte subsets CD+3, CD+3/CD+4, CD+3/CD+8were detected in the two groups. Results The scores of cancer related fatigue(emotion,feeling,behavior,cognition) of the observation group were obviously lower than those of the control group( t=7. 797,12. 385,9. 386,10. 270,all P=0. 000). After treatment,the scores of life quality FACT－G scale(physiological condition,emotional state,society/family state,function state) of the observation group were remarkably higher than those of the control group(t =6. 764, 6. 218,7. 945,8. 026,all P=0. 000). The short－term effective rate of the observation group was 51. 28% (20/39), which was higher than 25. 64% (10/39) of the control group(χ2=4. 388,P=0. 036). After treatment,the levels of CD+3,CD+3/CD+4of the observation group were obviously higher than those of the control group,while the level of CD+3/CD+8was lower than that of the control group,the differences were statistically significant(t=9. 183,9. 327, 4. 848,all P=0. 000). Conclusion Taiji quan can improve cancer related fatigue and life quality,increase short－term curative effect,and can enhance cellular immune function after chemotherapy of paclitaxel combined with cisplatin.

Observation of clinical effect of photodynamic therapy on oral leukoplakia in elderly patients / 中华老年医学杂志

Objective To observe the clinical efficacy of photodynamic therapy on oral leukoplakia in elderly patients.Methods In this prospective study,fifteen elderly patients with oral leukoplakia were treated with 5 aminolevulinic acid-based photodynamic therapy(ALA PDT).After 2 hours of dressing,patients were irradiated using a 635nm semiconductor laser with the power density of 300mW/cm2.Each lesion was irradiated for 6 minutes with energy density of 100J/cm2.The curative effect was evaluated and the adverse reactions were recorded based on the observation of lesion changes.Results Of the 15 lesions in 15 patients,4 lesions were treated once,3 lesions were treated twice.And 6 lesions were cured after three treatments,and 2 patients were cured after four treatments.The average treatment frequency was (2.4 ± 1.1) treatment.The postoperative adverse reaction was pain.The average visual analogue scale was (2.2 ± 0.8) scores after operation,and the duration of pain was(2.6±1.1)days after operation.There was no recurrence for 3 to 9 months after operation.No abnormalities of oral sensation and function were found in patients.Conclusions ALA-PDT is an effective method for the treatment of oral leukoplakia in elderly patients.

Effect of oxaliplatin induced autophagy on drug resistance of SGC7901 gastric cancer cells / 国际肿瘤学杂志

Objective To evaluate the effect of oxaliplatin induced autophagy on drug resistance of gastric cancer cells. Methods Gastric cancer SGC7901 cells were cultured in vitro and treated with different concentrations of oxaliplatin. Control group (oxaliplatin 0 μmol/ L),oxaliplatin treatment groups (oxaliplatin 1,2,4 μmol/ L)and oxaliplatin combined with doxorubicin groups (oxaliplatin 0,1,2,4 μmol/ L + doxoru-bicin 4 μmol/ L)were set up. Cells were treated with different conditions for 24 hours. Western blotting and flow cytometry were used to detect the expression of autophagy-related molecule Beclin-1. Methyl thiazolyl tetrazolium (MTT)assay was used to detect the cell viability. Flow cytometry was used to analyze the uptake of doxorubicin in SGC7901 cells. Results The expression of Beclin-1 increased in gastric cancer cells treated with oxaliplatin. The percentages of positive cells treated with 1,2 and 4 μmol/ L oxaliplatin were respectively (9. 51 ± 0. 27)％,(13. 73 ± 0. 80)％ and (20. 17 ± 1. 03)％,control group was (2. 17 ± 0. 15)％,and the difference was statistically significant (F = 111. 10,P < 0. 001). Compared with the control group,Beclin-1 expression significantly increased in each treatment group (P < 0. 05;P < 0. 001;P < 0. 001). Different con-centrations of 1,2,4 μmol/ L oxaliplatin combined with doxorubicin were used to treat gastric cancer SGC7901 cells,fluorescence intensities of doxorubicin were 11567 ± 802,13433 ± 808,15967 ± 472,control group was 10257 ± 367,and the difference was statistically significant (F = 79. 81,P < 0. 001). Compared with the control group,the fluorescence intensity of doxorubicin significantly increased in each treatment group (P <0. 05;P < 0. 001;P < 0. 001 ). After treatment with oxaliplatin (1,2,4 μmol/ L)and doxorubicin (4 μmol/ L)for 24 hours,the cell viability levels were (68. 27 ± 1. 64)％,(51. 72 ± 1. 93)％,(39. 60 ± 1. 80)％ respectively. The cell viability levels of oxaliplatin treated with 1,2 and 4 μmol/ L were respectively (93. 70 ± 1. 15)％,(76. 53 ± 1. 10)％,(74. 00 ± 1. 65)％ . Compared with oxaliplatin alone,oxaliplatin combined with doxorubicin decreased cell viability more obviously,and the differences were statistically signifi-cant (t = 8. 91,P < 0. 001;t = 9. 21,P < 0. 001;t = 10. 34,P < 0. 001). The doxorubicin fluorescence inten-sity of oxaliplatin (2 μmol/ L)combined with doxorubicin (4 μmol/ L)group with pretreatment of autophagy inhibitor was 16898 ± 105,oxaliplatin combined with doxorubicin group was 22245 ± 168,and doxorubicin alone group was 17562 ± 67,and the difference was statistically significant (F = 92. 16,P < 0. 001). Com-pared with the pretreatment group,the doxorubicin fluorescence intensity of oxaliplatin combined with doxorubi-cin group was significantly increased (P < 0. 001). On the other hand,the cell viability levels of the above three groups were (81. 33 ± 3. 54)％,(65. 00 ± 2. 61)％ and (101. 02 ± 3. 58)％,and the difference was statistically significant (F = 90. 66,P < 0. 001). Compared with the pretreatment group,the cell viability level of oxaliplatin combined with doxorubicin group was significantly lower (P < 0. 001). Conclusion Oxaliplatin can reduce the resistance of gastric cancer cells to chemotherapeutics by increasing the level of autophagy in gastric cancer cells,and improve the therapeutic effect of chemotherapy drugs.

Professor Lu Su's Experience in Treating Bone Marrow Suppression after Chemotherapy of Gynecologic Malignant Tumor / 浙江中医药大学学报

Objective]Discussesing Professor Lu Su's experience for the treatment of gynecologic tumor bone marrow suppression after chemotherapy. [Methods] Through learning from the teacher, collecting and collating the relevant information and medical records ,summarizing the doctor's treatments for bone marrow suppression,introducing the special treatment from nourishing Yin and Yang, dialectical analysis;combination of Chinese and western, foster strengths and circumvent weaknesses;treatment based on overall, overall consideration;Regulate mood,treat both heart and kidney at the same time,and give examples to prove it. [Results] Professor Lu Su believes that the disease in the Yin and Yang as the main pathogenesis of the disease, the treatment nourishing of Yin and Yang, clinical examination of the combination of the dialectical analysis,nourishing Yin and Yang, dialectical analysis, for the treatment of gynecologic tumor bone marrow suppression after chemotherapy, with a certain clinical significance. [Conclusion ]Professor Lu Su's unique method of treatment of gynecologic tumor bone marrow suppression after chemotherapy, has remarkable curative effect.Her treatment and academic thoughts of bone marrow suppression of gynecological tumor after chemotherapy open a new path, unique method, and the effect is significant, the syndrome differentiation typing, prescription and addition and subtraction cut to clinical treatment after chemotherapy myelosuppression is of practical value, it is worth learning.

Treatment of synchronous peritoneal carcinomatosis from gastric cancer with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy with lobaplatin and docetaxel / 中国肿瘤临床

Objective:To evaluate the efficacy and safety of combined cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) with lobaplatin and docetaxel for treatment of synchronous peritoneal carcinomatosis (PC) from gastric cancer. Methods:Fifty patients with synchronous PC from gastric cancer were treated by 52 CRS+HIPEC procedures with 100 mg of lobaplatin and 120 mg of docetaxel in 12000 mL of normal saline at (43 ± 0.5)℃for 60 min. The primary and secondary endpoints were overall survival (OS) and perioperative safety profiles, respectively. Results:At a median follow-up of 22.5 months, the median OS rate was 14.3 (95%CI:7.6-21.0) months, and the 1-, 2-, and 3-year survival rates were 58%, 40%, and 32%, respectively. No perioperative deaths or serious adverse events occurred in 12 cases (23.1%). Multivariate analysis indicated that completeness of cytoreduction, nor-mality of perioperative tumor markers, and adjuvant chemotherapy of more than six cycles were independent predictors for improved survival. Conclusions:CRS+HIPEC with lobaplatin and docetaxel could improve the OS and ensure perioperative safety of patients with synchronous PC from gastric cancer.

Value of apparent diffusion coefficient values in predicting induction chemotherapy response of advanced nasopharyngeal carcinoma / 实用放射学杂志

Objective To predict the response of induction chemotherapy in advanced nasopharyngeal carcinoma (NPC)by using pretreat-ment apparent diffusion coefficient (ADC)values.Methods 35 patients with advanced NPC underwent DWI examination prior to 2-week in-duction chemotherapy.The patients were divided into CR (complete response)group,PR (partial response)one and SD (stable disease)one according to the tumor response of treatment.The effective responders included CR and PR groups.The patients were divided into children-adolescents(below 20 years)group and adults one according to the age,into non-keratinizing undifferentiated carcinoma group and non-kera-tinizing differentiated carcinoma one according to the pathological type,and also into T2,T3 and T4 groups according to the T-staging (UICC2010).Statistical analysis was used to compare the pretreatment ADC values between different groups.Results The average pre-treatment ADC values of CR,PR,responders and SD groups were (0.70±0.06)×10 -3 mm2/s,(0.72±0.04)×10 -3 mm2/s,(0.71± 0.04)×10 -3 mm2/s and (0.85±0.02)×10 -3 mm2/s respectively.The average pretreatment ADC value of the SD group was signif-icantly higher than that of PR group and responders,and the differences were significant (P <0.05).The average pretreatment ADC value of children-adolescents and adults groups were (0.73±0.07)×10 -3 mm2/s and (0.75 ±0.07)× 10 -3 mm2/s,which showed no significant differences.The average pretreatment ADC value of non-keratinizing undifferentiated carcinoma and non-keratinizing dif-ferentiated carcinoma groups were (0.76 ±0.08)×10 -3 mm2/s and (0.74±0.06)×10 -3 mm2/s,which showed no significant differ-ences.The average pretreatment ADC values of T2,T3 and T4 groups were (0.78±0.05)×10 -3 mm2/s,(0.77 ±0.07)×10 -3 mm2/s and (0.75±0.08)×10 -3 mm2/s.Although there were no significant differences between T2,T3 and T4 groups,a trend towards lower ADC was observed with increasing tumor T-staging.Conclusion Pretreatment ADC value is a valuable quantitative parameter,and it can be used for predicting induction chemotherapy response in advanced naso-pharyngeal carcinoma.

Comparison of venous port access and peripherally inserted central catheters in adjuvant chemotherapy for patients with breast cancer / 中华内分泌外科杂志

Objective To compare the effects of venous port access ( VPA ) with peripherally inserted central catheters ( PICC) in patients with breast cancer .Methods 120 cases with breast cancer were divided into 2 groups from Jan.2009 to Dec.2010,among whom 60 cases were with VPA when receiving operation , and the other 60 cases were with PICC after the operation .The success rate of catheterization , duration of catheter in-dwelling and catheter-related complications of the 2 groups were compared .Results The one-time success rate of catheterization was 100%in VPA group and 66.7%in PICC group .The catheters were retained for more than 12 months in 59 cases in VPA group,while only 4 cases in PICC group retained catheter for more than 12 months. The complications occurred to 1 case in VPA group ( 1.7%) and 9 cases in PICC group ( 15%) .Conclusion VPA is an ideal pathway for chemotherapy of patients with breast cancer , which can reduce nursing work and is worth to be promoted in clinical practice .

Random and control study comparing gemcitabine administered in fixed dose rate with a more standard infusion combined with oxaliplatin regimens in advanced biliary tract cancer patients / 中国肿瘤临床

Objective:To investigate and compare the effects of oxaliplatin combined with gemcitabine administered in a fixed dose rate and that administered in a more standard infusion in advanced biliary tract cancer patients on chemotherapeutic efficacy, toxicities, and survival time. Methods:A total of 93 cancer patients were recruited from February 1, 2010 to December 12, 2012 in the First Hospital of Huai'an City Affiliated Nanjing Medical College. Those recruited were either newly diagnosed unresectable advanced biliary tract cancer patients by percutaneous liver biopsy or relapse or metastatic biliary tract cancer patients after operation. The patients were randomly divided into two groups. The first group was the study group in which the patients received chemotherapy with gemcitabine in a fixed dose rate of 10 mg/m2 per minute combined with oxaliplatin regimens. The other group was the control group in which the patients received chemotherapy with gemcitabine in a more standardized infusion within 30 min combined with oxaliplatin regimens. Each patient received four cycles, with at least two cycles of chemotherapy with GEMOX regimens every 21 d, with follow-up until death. The chemotherapeutic efficacy was evaluated. Toxicities were documented after each cycle. Results:The clinical characteristics of the two groups were well balanced before chemotherapy (P>0.05). The response rate (RR) and clinical benefit response of the study group were higher than those of the control group (P0.05). Conclusion:Gemcitabine in a fixed dose rate combined with oxaliplatin regimens is a feasible and effective scheme in treating advanced biliary tract cancer patients. RR is higher and OS and TTP are longer under this scheme. Non-hematological toxicities are also well tolerated. However, hematological toxicity is distinguished. These results guide us to be prudent in utilizing this regimen. The investigation of the value of gemcitabine in a fixed dose rate combined with oxaliplatin in treating advanced biliary tract cancer patients is worth pursuing in future clinical trials.

Significance ofβ-tubulin Ⅲexpression in the neoadjuvant chemotherapy of locally advanced cervical carcinoma / 中国医师杂志

Objective To investigate the β-tubulin Ⅲexpression in locally advanced cervical cancers and its significance in the neoadjuvant chemotherapy of cervical cancer .Methods Immunohistochemistry was used to detect the expression of β-tubulin Ⅲin tissue samples from 62 cases of locally advanced cervical cancer patients .Groups paclitaxel +cisplatin/carboplatin (TP) (34 pa-tients) underwent two cycles of TP chemotherapy ,while group 5-fluorouracil+cisplatin(PF) (28 patients) underwent two cycles of PF chemotherapy .Comprehensive analysis of β-tubulinⅢexpressions of TP and PF neoadjuvant chemotherapies revealed the efficien -cy and operation rate .Results The positive rate ofβ-tubulin Ⅲ was 62.90% in locally advanced cervical cancer .β-tubulin Ⅲ ex-pression was not correlated with clinicopathological features in locally advanced cervical cancer ( P >0.05 ) .β-tubulinⅢexpression was correlated with efficiency and operation rate with TP chemotherapy but not with PF chemotherapy .Conclusions In the neoadju-vant chemotherapy of locally advanced cervical cancers ,β-tubulinⅢexpression can be used as an important index to predict the effec-tive rate of combined chemotherapy containing paclitaxel and guide the patients to individual chemotherapy .

Effects of preoperative regional intra-arterial chemotherapy on lymphatic metastasis of pancreatic head carcinoma / 中华消化外科杂志

Objective To evaluate the efficacy of preoperative regional intra-arterial chemotherapy (RIAC) in the treatment of resectable pancreatic head carcinoma. Methods The clinical data of 50 patients with resectable pancreatic head carcinoma who had been admitted to the Research Institute of Pancreatic Diseases of Fudan University from December 2006 to July 2007 were retrospectively analyzed. Patients were randomly divided into2 groups (n =25 in each group): patients in group A were treated with preoperative RIAC followed by regional pancreaticoduodenectomy, and patients in group B were treated with surgical procedure routinely. The lymphatic metastases in the 50 specimens of pancreatic head carcinoma were detected by histological examination with hematoxylin and eosin (HE) staining, and lymphatic micrometastases were detected by immunohistochemical method with staining of cytokeratin AE1/AE3 in 10 specimens with negative HE staining of the lymph nodes in each group. Results There was no significant difference in the incidence of complications, the length of hospital stay and the 1-, 2-year survival rates between the 2 groups (χ2 = 0.12, 2.88, P > 0.05). The incidence of positive lymph node metastasis in group A was 7.1% (52/734), which was significantly higher than 22.1% (118/532) in group B (χ2 = 60.01, P < 0.05). The incidence of lymphatic micrometastasis was 9.4% (30/319) in group A, and 9.1% (23/252) in group B, with no statistical difference between the 2 groups (χ2= 0.01, P > 0.05). Conclusions Preoperative RIAC is helpful in improving the prognosis of patients with resectable pancreatic head carcinoma by reducing the incidence of lymphatic metastasis and decreasing tumor stage.

Influence of rmhTNF on the Chemotherapy Treatment of Small Cell Lung Cancer / 华中科技大学学报（医学）（英德文版）

The efficacy and safety of the recombinant mutant human tumor necrosis factor (rmhTNF) combined with chemotherapy vs chemotherapy alone in the treatment of patients with small cell lung cancer (SCLC) were evaluated in this study. The selected 37 patients with SCLC were divided into experimental group (n = 18) and control group (n = 19). Bothgroups were subjected to EP regimen. While in the experimental group, a regimen of 4 × 106 U/m2 rmhTNF intramuscular injection was given once a day from the 1st to 7th day and 11th to 17th day on the chemotherapy cycle.Twenty-one days were as a chemotherapy cycle and all patients received treatment with 2 cycles.The response rate was 83.3 % (15/18) in the experimental group and 63.2 % (12/19) in the control group respectively (P＜0.05). The KPS score after treatment was 78.4±9.6 in the experimental group and 71.2±9.7 in the control group with the difference being significant (P＜0.05).No severe adverse effects occurred in the two groups. It was concluded that the curative effectiveness of the rmhTNF combined with chemotherapy in the treatment of SCLC was more satisfactory than chemotherapy alone. The former could obviously improve the quality of life of the patients with SCLC.

A Case of Primary Gastric Burkitt's Lymphoma / 대한소화기내시경학회지

Primary gastric lymphomas can be defined as lymphomas which are confined to the stomach without systemic metastasis. Primary gastric Burkitt's lymphoma is a rare disease that belongs to the aggressive non-Hodgkin's lymphomas. Chemotherapy is the mainstay of treatment, even in the localized disease. We report a case of primary gastric Burkitt's lymphoma in a 24-year-old female presenting with an intermittent epigastric pain for 3 months. Upper gastroduodenal endoscopy detected an ulcer with thickened folds on the greater curvature side of the lower body, and histologic examination of the biopsy specimens revealed infiltration of medium-sized lymphoblasts with characteristic "starry sky" macrophages. Abdominal CT scan demonstrated marked gastric wall thickening and regional lymph node enlargement.

A Case of Primary Gastric Burkitt's Lymphoma / 대한소화기내시경학회지

Primary gastric lymphomas can be defined as lymphomas which are confined to the stomach without systemic metastasis. Primary gastric Burkitt's lymphoma is a rare disease that belongs to the aggressive non-Hodgkin's lymphomas. Chemotherapy is the mainstay of treatment, even in the localized disease. We report a case of primary gastric Burkitt's lymphoma in a 24-year-old female presenting with an intermittent epigastric pain for 3 months. Upper gastroduodenal endoscopy detected an ulcer with thickened folds on the greater curvature side of the lower body, and histologic examination of the biopsy specimens revealed infiltration of medium-sized lymphoblasts with characteristic "starry sky" macrophages. Abdominal CT scan demonstrated marked gastric wall thickening and regional lymph node enlargement.