ABSTRACT
Background: To optimize treatment, choosing the appropriate relative dose intensity (RDI) of nab-paclitaxel is an important way to improve patient tolerance, therapeutic efficacy, and survival. However, few studies have focused on the efficacy of the RDI of nab-paclitaxel in patients with advanced pancreatic cancer, and whether the RDI of nab-paclitaxel could be employed as an index for treatment remains unknown. To explore the relationship between RDI of nab-paclitaxel and chemotherapy efficacy, survival, quality of life (QoL), and adverse effects in patients with advanced pancreatic cancer. Methods: In this retrospective study, a total of 32 patients with advanced pancreatic cancer, ECOG score of 0 to 2 were included from January 2017 to March 2020. The patients were treated with nab-paclitaxel combined with gemcitabine as a first-line treatment and divided into high and low RDI groups. Chemotherapy efficacy, survival, QoL, and adverse effects between two groups were compared. Results: The disease control rate (DCR) was 20.0% in the low RDI group, compared with 81.8% in the high RDI group (P=0.002). A good correlation between nab-paclitaxel RDI and short-term efficacy was observed in all 32 patients (r=0.728, P<0.01). Furthermore, the high RDI group had significantly better median overall survival (mOS: 12 vs. 8 months, P=0.034) and median progression-free survival (mPFS: 5.5 vs. 3 months, P=0.052) compared to that of low RDI patients. Univariate regression analysis showed that longer overall survival was associated with lower ECOG score [hazard ratio (HR): 10.88; 95% confidence interval (CI): 2.54-46.5, P=0.001], tumors located in the body or tail of pancreases (HR: 3.82; 95% CI: 1.4-10.3, P=0.0081), and higher RDI (HR: 0.21; 95% CI: 0.071-0.6, P=0.004). The high RDI group had a significantly better physical function and emotional function improvement compared to the low RDI group (P<0.05). Moreover, high RDI did not increasing the severity and frequency of the adverse events. Conclusions: It is recommended to maintain a sufficient RDI of nab-paclitaxel to ensure that the balance between lerability, therapeutic efficacy, and survival benefits is satisfied in patients with advanced pancreatic cancer.
ABSTRACT
OBJECTIVE: To explore the effect of Xiaolong Tongbi (XLTB), a Chinese herbal preparation, on nitric oxide synthase (NOS) containing nerve and epithelial cell apoptosis. METHODS: NOS containing nerve level of various groups prostate was determined by NADPH histochemical staining and morphological quantitative analysis, and the cell apoptosis rate in rats prostatic epithelium was tested immunohistochemically with TUNEL method. RESULTS: After 3 weeks treatment with high dose XLTB, the length density of NOS contained nerves in prostate tissue of rats was 0.113 +/- 0.023, which was significantly different to that in the other 3 groups (low dose XLTB, Finasteride and testosterone) respectively (P < 0.01). Cell apoptosis reached its peak at the day 7 of experiment in XLTB treated groups (9.27%), and Finasteride treated group (5.65%), which lowered slightly at day 14 and got some recovery at day 21. Castration induced cell apoptosis began at day 7 and reached its peak at day 14, which was significantly different from that in the other groups. CONCLUSION: XLTB could increase the NOS contained nerve level and accelerate the apoptosis of epithelial cell in prostate tissue of simulating benign prostatic hyperplasia rats.
