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1.
Support Care Cancer ; 32(6): 385, 2024 May 27.
Article in English | MEDLINE | ID: mdl-38801450

ABSTRACT

PURPOSE: To identify symptom clusters (SCs) in patients with lung cancer who are undergoing initial chemotherapy and to identify the sentinel symptoms of each SC. METHODS: A convenience sampling method was used to recruit patients with lung cancer who were undergoing their initial chemotherapy treatment. Patient information was collected using the General Demographic Questionnaire, MD Anderson Symptom Inventory (including the lung cancer module) and a schedule documenting the initial occurrence of symptoms. The Walktrap algorithm was employed to identify SCs, while sentinel symptoms within each SC were identified using the Apriori algorithm in conjunction with the initial occurrence time of symptoms. RESULTS: A total of 169 patients with lung cancer participated in this study, and four SCs were identified: the psychological SC (difficulty remembering, sadness, dry mouth, numbness or tingling, and distress), somatic SC (pain, fatigue, sleep disturbance, and drowsiness), respiratory SC (coughing, expectoration, chest tightness, and shortness of breath), and digestive SC (nausea, poor appetite, constipation, vomiting, and weight loss). Sadness, fatigue, and coughing were identified as sentinel symptoms of the psychological, somatic, and respiratory SCs, respectively. However, no sentinel symptom was identified for the digestive SC. CONCLUSION: Patients with lung cancer who are undergoing chemotherapy encounter a spectrum of symptoms, often presenting as SCs. The sentinel symptom of each SC emerges earlier than the other symptoms and is characterized by its sensitivity, significance, and driving force. It serves as a vital indicator of the SC and assumes a sentry role. Targeting sentinel symptoms might be a promising strategy for determining the optimal timing of interventions and for mitigating or decelerating the progression of the other symptoms within the SC.


Subject(s)
Lung Neoplasms , Humans , Lung Neoplasms/drug therapy , Female , Male , Middle Aged , Aged , Surveys and Questionnaires , Antineoplastic Agents/adverse effects , Antineoplastic Agents/administration & dosage , Adult , Algorithms , Aged, 80 and over
2.
Semin Oncol Nurs ; 40(3): 151651, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38704342

ABSTRACT

OBJECTIVES: This study aimed to identify symptom clusters in lung cancer patients undergoing chemotherapy and the central and bridge symptoms within each symptom cluster. METHODS: In this cross-sectional study, 1,255 patients with lung cancer were recruited through convenience sampling at Nanfang Hospital. Patient symptom burden was assessed using the M.D. Anderson Symptom Inventory (MDASI) and the Lung Cancer module of the MDASI (MDASI-LC). Symptom clusters were identified using the Walktrap algorithm, and central and bridge symptoms in the symptom clusters were identified by network analysis. RESULTS: The patients included 818 (65.18%) males and 437 (34.82%) females with a mean age of 56.56 ± 11.78 years. Four symptom clusters were identified: fatigue, gastrointestinal, psychoneurological and respiratory. Their central symptoms were fatigue, vomiting, distress and hemoptysis, respectively, and their bridge symptoms were pain, vomiting, dry mouth and shortness of breath. CONCLUSIONS: Lung cancer symptoms show certain strong correlations with each other, resulting in symptom clusters. Central symptoms may influence other symptoms within a symptom cluster, and bridge symptoms might impact the density of the symptom network. This study identified central and bridge symptoms in lung cancer patients undergoing chemotherapy. Targeting these symptoms with interventions for symptom clusters could make symptom management more precise and effective. IMPLICATIONS FOR NURSING PRACTICE: In clinical settings, the burden of symptom clusters may be reduced by intervening against the central symptoms of these symptom clusters. Alternatively, if the objective is to diminish the connections between different symptom clusters and holistically alleviate the overall burden, interventions focused on bridge symptoms may be employed.


Subject(s)
Lung Neoplasms , Humans , Female , Male , Lung Neoplasms/complications , Lung Neoplasms/drug therapy , Middle Aged , Cross-Sectional Studies , Aged , Fatigue/etiology , Adult , Quality of Life , Symptom Assessment , Surveys and Questionnaires
3.
Cancer Nurs ; 2024 Jan 11.
Article in English | MEDLINE | ID: mdl-38206596

ABSTRACT

BACKGROUND: Patients with advanced cancer may experience symptom clusters during treatment (eg, fatigue, pain, sleep disturbance, depression). Understanding the characteristics and factors associated with symptom cluster classes among this patient population is essential for effective symptom management. OBJECTIVE: The aims of this study were to identify symptom cluster (fatigue-pain-sleep disturbance-depression) classes and explore influencing factors in patients with advanced cancer during the treatment. METHODS: A cross-sectional survey was conducted in an oncology department of a tertiary hospital in China from September 2020 to March 2021. Cancer patients (stage III/IV) 18 years or older completed the questionnaires on pain, fatigue, sleep disturbance, depression, physical activity, and exercise self-efficacy. Latent class analysis and multinomial logistic regression were used. RESULTS: Three hundred sixty-five patients who were male (65.2%) and younger than 60 years (59.5%) completed questionnaires. Three symptom cluster classes were identified: class 1 ("low symptom burden" class), class 2 ("fatigue-insomnia" class), and class 3 ("high symptom burden" class), with a percentage of 54.5%, 38.6%, and 6.8%, respectively. The quality-of-life score, introversion/extroversion, economic burden, Karnofsky Performance Status, albumin level, and exercise self-efficacy were significantly different among the 3 classes (P < .05). CONCLUSION: Patients with advanced cancer were classified into 3 distinct classes, with class 1 having the best function. Results from this study reveal that Karnofsky Performance Status, albumin level, and exercise self-efficacy were significant factors for the latent classes of symptom cluster. IMPLICATIONS FOR PRACTICE: Exercise self-efficacy is important for personalized interventions and improving symptom management efficiency.

4.
Patient Educ Couns ; 114: 107795, 2023 09.
Article in English | MEDLINE | ID: mdl-37244130

ABSTRACT

OBJECTIVES: Cancer patients' involvement in treatment decision-making is affected by various factors, with the mechanisms not readily understood. This study explores the underlying mechanisms based on the Capability, Opportunity, Motivation and Behavior (COM-B) model and literature review. METHODS: A cross-sectional survey was conducted and 300 cancer patients conveniently recruited from three tertiary hospitals validly completed the self-administered questionnaires. Structural equation modeling (SEM) approach was used to test the hypothesized model. RESULTS: The findings generally supported the hypothesized model, which could explain 45% of the variance in cancer patients' involvement in treatment decision-making. Cancer patients' health literacy and perceived facilitation of involvement from health professionals had direct and indirect effects on their actual involvement, with the total effect ß = 0.594, ß = 0.223, P < 0.001, respectively. Patients' views of involvement in treatment decision-making had a direct effect on their actual involvement (ß = 0.296, P < 0.001) and completely mediated the relationship between self-efficacy and their actual involvement (ß = 0.040, P < 0.05). CONCLUSIONS: Findings support the COM-B model's explanatory potential in the context of cancer patients' involvement in treatment decision-making.


Subject(s)
Health Literacy , Neoplasms , Humans , Cross-Sectional Studies , Motivation , Patient Participation , Neoplasms/therapy , Decision Making
5.
Asia Pac J Oncol Nurs ; 10(4): 100200, 2023 Apr.
Article in English | MEDLINE | ID: mdl-36890861

ABSTRACT

Objective: To explore the association between the pain-fatigue-sleep disturbance-depression symptom cluster (SC) and cancer-related cognitive impairment (CRCI) in patients having lung cancer and to identify other factors influencing CRCI. Methods: A cross-sectional study was conducted to investigate 378 patients having lung cancer in China from October 2021 to July 2022. The perceived cognitive impairment scale and the general anxiety disorder-7 were used to assess patients' cognitive impairment and anxiety, respectively. The pain-fatigue-sleep disturbance-depression SC was assessed with the brief fatigue inventory, the brief pain inventory, the Patient Health Questionnaire-9, and the Athens Insomnia Scale. Latent class analysis by Mplus.7.4 was used to identify latent classes of the SC. We adjusted for covariates in the multivariable logistic regression model to examine the relationship between the pain-fatigue-sleep disturbance-depression SC and CRCI. Results: Among patients having lung cancer, two SC classes were identified: high and low symptom burden groups. In the crude model, compared to the low symptom burden group, the high symptom group had greater odds of developing CRCI (odds ratio: 10.065, 95% confidence interval: 4.138-24.478). After adjusting for covariates, in model 1, the high symptom group still had greater odds of developing CRCI (odds ratio: 5.531, 95% confidence interval: 2.133-14.336). Additionally, a diagnosis of over 6 months, anxiety, leisure activity, and a high platelet-to-lymphocyte ratio were found to be influencing factors of CRCI (all P â€‹< â€‹0.05). Conclusions: Our study revealed that a high symptom burden is a significant risk factor for CRCI, which may provide a new perspective for managing CRCI in lung patients having cancer.

6.
BMC Psychiatry ; 22(1): 353, 2022 05 24.
Article in English | MEDLINE | ID: mdl-35610595

ABSTRACT

BACKGROUND: Suicidal ideation in cancer patients is a critical challenge. At present, few studies focus on factors associated with suicidal ideation, and predictive models are still lacking. This study aimed at investigating the risk factors for suicidal ideation among cancer patients, and developed a predictive nomogram to screen high risk cancer patients for early prevention and intervention. METHODS: A questionnaire survey was conducted among cancer patients between May 2021 and January 2022. The factors associated with suicidal ideation were used to construct a multivariate logistic regression model, which was visualized as a predictive nomogram to evaluate the risk of suicidal ideation. Areas under the curve, calibration plot, decision curve analysis, and internal and external validation were used to validate the discrimination, calibration and clinical usefulness of the model. RESULTS: A total of 820 patients with cancer were recruited for this study and 213 (25.98%) developed suicidal ideation. Levels of demoralization, depression and cancer staging, marital status, residence, medical financial burden, and living condition were influence factors for suicidal ideation. Comparing nomogram with Self-rating Idea of Suicide Scale (SIOSS), the nomogram had a satisfactory discrimination ability with an AUC of 0.859 (95% CI: 0.827-0.890) and 0.818 (95% CI: 0.764-0.873) in the training and validation sets, respectively. The calibration plot and decision curve analysis revealed that this nomogram was in good fitness and could be beneficial in clinical applications. CONCLUSIONS: Suicidal ideation is common in cancer patients. Levels of demoralization, depression and cancer staging were independent predictors of suicidal ideation. The nomogram is an effective and simple tool for predictive suicidal ideation in cancer patients.


Subject(s)
Neoplasms , Suicidal Ideation , Factor Analysis, Statistical , Humans , Nomograms , Risk Factors
7.
Psychooncology ; 31(1): 70-77, 2022 01.
Article in English | MEDLINE | ID: mdl-34322963

ABSTRACT

OBJECTIVES: To explore the relationship between patient's health literacy and perceived shared decision-making (SDM) among Chinese cancer patients. METHODS: A cross-sectional study was conducted involving a convenience sample of 458 cancer patients from four public hospitals in Guangzhou, China. Patients' self-reported data were collected using the Health Literacy Management Scale (HeLMS) and the nine-item Shared Decision-Making Questionnaire (SDM-Q-9). Hierarchical multiple regressions, controlling for patient-doctor relationship, social support, sociodemographic and clinical variables were conducted to explore the effect of health literacy on perceived SDM. RESULTS: Health literacy itself accounted for 68.0% of the variance in perceived SDM. Higher scores in domains "information acquisition ability," and "communication interaction ability" of HeLMS were significantly associated with a higher level of perceived SDM after controlling the covariates (R2  = 75.7%). CONCLUSIONS: Health literacy, especially the information acquisition ability and communication interaction ability, played a prominent role for Chinese cancer patients to be involved in treatment decision making.


Subject(s)
Health Literacy , Neoplasms , Cross-Sectional Studies , Decision Making , Decision Making, Shared , Humans , Neoplasms/therapy , Patient Participation , Physician-Patient Relations
8.
JBI Database System Rev Implement Rep ; 16(10): 2038-2049, 2018 10.
Article in English | MEDLINE | ID: mdl-30335042

ABSTRACT

OBJECTIVES: This project aimed to identify and promote evidence-based practice in the management of cancer related fatigue (CRF) in the oncology unit of Nanfang Hospital, affiliated with the Southern Medical University in People's Republic of China. INTRODUCTION: Cancer-related fatigue is one of the most common symptoms in patients with cancer and significantly affects their functioning and quality of life. However, it is often inadequately addressed and evidence-based practices are not always followed. METHODS: The Joanna Briggs Institute (JBI) has a validated audit and feedback tool to assist with best practice implementation audits. The JBI Practical Application of Clinical Evidence System (PACES) was used in this project. A three-phase project was undertaken: i) a pre-implementation audit of current practice against evidence-based audit criteria, ii) identification of barriers and implementation of strategies to improve practice using the JBI Getting Research into Practice (GRiP) tool and iii) a post-implementation audit. RESULTS: The baseline audit results identified non-compliance to best practice in all areas of CRF. Strategies to improve practice involved relevant education for nurses, establishment of a CRF management routine and related documentation systems and displaying and distributing educational materials for the patients. Improved compliance was shown across all audit criteria in post-evaluation. CONCLUSIONS: The implementation of institution specific evidence-based resources demonstrated immediate improvement in CRF management and practice. Continuous effort is required to maintain changes and further improve practice. Future projects should focus on measuring the impact of changed practice on patient outcomes.


Subject(s)
Evidence-Based Practice/methods , Fatigue/etiology , Fatigue/nursing , Neoplasms/complications , Neoplasms/nursing , Adult , China/epidemiology , Clinical Audit , Evidence-Based Practice/standards , Fatigue/epidemiology , Fatigue/psychology , Guideline Adherence/trends , Health Plan Implementation , Hospitalization , Humans , Medical Oncology , Neoplasms/epidemiology , Neoplasms/psychology , Nursing Staff, Hospital/education , Quality of Life
9.
Burns ; 39(5): 923-34, 2013 Aug.
Article in English | MEDLINE | ID: mdl-23465795

ABSTRACT

We previously reported Rho kinase is involved in vessel hyper-permeability caused by burns. Here we further explore the Rho kinase downstream signaling, it is found that its specific inhibitor Y27632 significantly diminishes the activation of JNK and p38 MAPKs but not ERK that induced by serum from burned rats (burn-serum). JNK activation was found involved in the expression of HUVEC adhesion molecules following thermal injury, although not in the process of stress fiber formation. Inhibition of various MAPKs by specific inhibitors showed that SB203580 (inhibitor of p38), but neither SP600125 (inhibitor of JNK) nor PD98059 (inhibitor of ERK), abolish activation of the p38 downstream kinase MK2. Demonstration of stress fibers by fluorescent-labeled phalloidin showed that inhibition of MK2, either by its specific inhibitor or by dominant negative adeno-viral-carried constructs, significantly reduced burn-serum-induced HUVEC stress-fiber formation, while inhibition of another downstream p38 MAPK kinase, PRAK, had no such effects. Transfection of dominant negative adeno-viral MK2 (Ad-MK2(A)) significantly inhibited thermal injury-induced blood vessel hyper-permeability in rats and, moreover, prolonged the survival of burned rats beyond 72 h following thermal injury. One of the mechanisms behind these phenomena is that Ad-MK2(A) causes a significant depression of burn-serum-induced HSP27-phosphorylation, while the adeno-viral transported dominant negative PRAK (Ad-PRAK(A)) does not block. Although the effect of blockade of MK2 through its adeno-viral approach requires further study and investigation of alternatives to know for sure, we may have found a new pathway behind thermal-injury-induced blood vessel hyper-permeability, namely: Rho kinase>p38>MK2>HSP27.


Subject(s)
Burns/physiopathology , Capillary Permeability/physiology , Intracellular Signaling Peptides and Proteins/physiology , MAP Kinase Signaling System/physiology , Protein Serine-Threonine Kinases/physiology , Actins/metabolism , Amides/pharmacology , Analysis of Variance , Animals , Burns/metabolism , Capillary Permeability/drug effects , Cells, Cultured , Disease Models, Animal , Enzyme Inhibitors/pharmacology , Extracellular Signal-Regulated MAP Kinases/metabolism , Human Umbilical Vein Endothelial Cells/metabolism , Male , Pyridines/pharmacology , Rats , Rats, Sprague-Dawley , p38 Mitogen-Activated Protein Kinases/metabolism , rho-Associated Kinases/physiology
10.
Cancer Immunol Immunother ; 62(1): 183-90, 2013 Jan.
Article in English | MEDLINE | ID: mdl-22864395

ABSTRACT

Maml1 is emerging as a coactivator of many signaling pathways, including the Notch and Wnt pathways. Targeting Maml1 in melanoma cells efficiently knocks down the downstream transcriptional repressors Hey1 and Hes1, resulting in melanoma cell senescence, cellular differentiation, and increased melanin production. Significantly, higher IFNß and chemokine gene transcripts have been observed, together with increased STAT1 and decreased STAT3 and NF-κB signaling activities. Although decreased cell proliferation contributes to slower tumor growth in vivo, the depletion of NK and CD8(+) T cells in an shMaml1-B16 tumor carrier mouse leads to more rapid tumor growth than that observed in control shC002-B16 tumors. This result demonstrates that the knockdown of Maml1 transcription and function contributes to increased immune surveillance. The knockdown of Maml1 transcription in the human melanoma cell line M537 also results in senescence, IFNß upregulation, increased chemokine gene expression, and greater NK and CD8(+) T cell migration in a transwell system. This study demonstrated that targeting Maml1-induced tumor cell senescence and differentiation may alter the tumor microenvironment and cytokine and chemokine profiles and may also promote innate and adaptive immune cell infiltration and function.


Subject(s)
Adaptive Immunity/immunology , Cellular Senescence , Immunity, Innate/immunology , Melanoma/immunology , Melanoma/pathology , Nuclear Proteins/deficiency , Transcription Factors/deficiency , Adaptive Immunity/genetics , Animals , Cell Differentiation/immunology , Cell Line, Tumor , Cellular Senescence/genetics , Cellular Senescence/immunology , Cytokines/biosynthesis , Cytokines/immunology , Gene Knockdown Techniques , Humans , Immunity, Innate/genetics , Immunoblotting , Melanoma/genetics , Mice , Microscopy, Confocal , Nuclear Proteins/genetics , Nuclear Proteins/immunology , RNA, Small Interfering , Real-Time Polymerase Chain Reaction , Transcription Factors/genetics , Transcription Factors/immunology , Transfection
11.
Nan Fang Yi Ke Da Xue Xue Bao ; 30(3): 523-5, 2010 Mar.
Article in Chinese | MEDLINE | ID: mdl-20335126

ABSTRACT

OBJECTIVE: To investigate the killing effect of ZD6474 combined with adriamycin (ADM) on MCF-7 human breast cancer cells. METHODS: The inhibitory effects of ZD6474 and ADM alone and in combination on the proliferation of MCF-7 cells were assessed by MTT assay. The cell cycle and cell apoptosis were detected by flow cytometry. RESULTS: ZD6474 and ADM both significantly inhibited the proliferation of MCF-7 cells, showing a synergistic effect of their reactions in combined use (P<0.05). ZD6474 or ADM alone caused cell cycle arrest at G0/G1 and S phases, respectively. Combined use of the two drugs resulted in significant reduction of the M-phase cell percentage and cell cycle arrest at G0/G1 and S phases. The coadministration of the drugs significantly increased the apoptosis rate of the cells as compared with ZD6474 or ADM treatment alone (P<0.05). CONCLUSIONS: ZD6474 and ADM show a synergistic effect in inhibiting the proliferation and inducing apoptosis of MCF-7 cells.


Subject(s)
Antineoplastic Agents/pharmacology , Apoptosis/drug effects , Breast Neoplasms/pathology , Doxorubicin/pharmacology , Piperidines/pharmacology , Quinazolines/pharmacology , Antibiotics, Antineoplastic/pharmacology , Cell Cycle/drug effects , Cell Line, Tumor , Cell Proliferation/drug effects , Drug Synergism , Female , Humans
12.
Nan Fang Yi Ke Da Xue Xue Bao ; 27(9): 1444-6, 2007 Sep.
Article in Chinese | MEDLINE | ID: mdl-17884798

ABSTRACT

OBJECTIVE: To evaluate the effects of topical DMSO and intralesional hyaluronidase administration, used alone or in combination, on skin injury due to vinorelbine extravasation in rats. METHODS: Skin injury due to vinorelbine extravasation was induced in the lower extremities of 30 SD rats, which were treated subsequently with topical DMSO, intralesional hyaluronidase, their combination, topical saline, and intralesional saline, with the rats without any treatment as the control. The wound area on 1, 4, 8, 12, 18, 24, 30 days and the time of healing were observed and compared. RESULTS: The wound area on 1, 4, 8, 12, 18, and 24 days were significantly smaller in topical DMSO group than in topical saline and control groups (P<0.05), and so in intralesional hyaluronidase group than in intralesional saline and control groups (P<0.05), but there was no significant difference between single agent (hyaluronidase and DMSO) treatment group and the combined treatment group. The healing time was significantly shorter in topical DMSO and intralesional hyaluronidase groups than in topical and intralesional saline groups and control group ( 24.9-/+3.2 and 21.9-/+3.0 days vs 29.8-/+2.6, 28.6-/+4.1 and 30.6-/+3.0 days, P<0.01), but comparable between the two single agent groups and combined treatment group (23.3-/+3.8 days). CONCLUSION: Intralesional hyaluronidase and topical DMSO application are effective therapies for skin damage due to vinorelbine extravasation, and their combination does not improve the therapeutic effect.


Subject(s)
Dimethyl Sulfoxide/administration & dosage , Dimethyl Sulfoxide/pharmacology , Hyaluronoglucosaminidase/administration & dosage , Hyaluronoglucosaminidase/pharmacology , Skin/drug effects , Skin/injuries , Vinblastine/analogs & derivatives , Administration, Topical , Animals , Drug Therapy, Combination , Female , Injections, Intralesional , Male , Rats , Skin/pathology , Time Factors , Vinblastine/pharmacology , Vinorelbine , Wound Healing/drug effects
13.
Nan Fang Yi Ke Da Xue Xue Bao ; 26(6): 858-9, 2006 Jun.
Article in Chinese | MEDLINE | ID: mdl-16793621

ABSTRACT

OBJECTIVE: To determine the cut-off value of serum neuron-specific enolase (NSE) level for distinguishing small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). METHODS: Serum NSE levels were measured by enzyme-linked immunosorbent assay in 137 patients with NSCLC or SCLC, and the best cut-off value was analyzed using ROC curve. RESULTS: The positivity rate of serum NSE was significantly higher in patients with SCLC than in those with NSCLC (P<0.01). The best cut-off value was 15.45 microg/L using ROC curve, which gave a sensitivity of 66.7% and specificity of 65.7%. CONCLUSION: Serum NSE level may allow simple and cost-effective differentiation of SCLC and NSCLC.


Subject(s)
Carcinoma, Non-Small-Cell Lung/enzymology , Carcinoma, Small Cell/enzymology , Lung Neoplasms/enzymology , Phosphopyruvate Hydratase/blood , Biomarkers, Tumor/blood , Carcinoma, Non-Small-Cell Lung/pathology , Carcinoma, Small Cell/pathology , Diagnosis, Differential , Female , Humans , Lung Neoplasms/pathology , Male , Middle Aged
14.
Nan Fang Yi Ke Da Xue Xue Bao ; 26(2): 234-6, 2006 Feb.
Article in Chinese | MEDLINE | ID: mdl-16503541

ABSTRACT

OBJECTIVE: To observe the killing effect of Herceptin and adriamycin sequentially applied on breast cancer cell line in vitro. METHODS: BT-474 human breast cancer cells in exponential growth phase were treated with Herceptin alone, adriamycin alone and their sequential administration (Herceptin before adriamycin and vice versa), respectively. Under optical microscope, the morphological changes of the cells were observed before and after drug administration. The expression rate and mean fluorescence intensity (MFI) of HER-2/neu and cell death rate were detected by flow cytometry. RESULTS: Microscopically, the cells treated with different protocols all exhibited such changes as darkening and increase of cellular debris with irregular cell morphology. Flow cytometry revealed no significant difference in the expression rate of HER-2/neu in each group before and after treatment, but the MFI of HER-2/neu and death rate of the treated cells were significant different from those of the control group (P<0.05). The cell death rate of Herceptin-pretreated cells was significantly higher than that of adriamycin-pretreated ones (P<0.05). CONCLUSION: Herceptin pretreatment enhances the killing effect of adriamycin on breast cancer cell line BT-474, which provides experimental evidence for designing clinical sequential biochemotherapy of breast cancer.


Subject(s)
Antibodies, Monoclonal/pharmacology , Doxorubicin/pharmacology , Receptor, ErbB-2/biosynthesis , Antibiotics, Antineoplastic/pharmacology , Antibodies, Monoclonal, Humanized , Antineoplastic Agents/pharmacology , Breast Neoplasms/metabolism , Breast Neoplasms/pathology , Cell Death/drug effects , Cell Line, Tumor , Drug Synergism , Female , Flow Cytometry , Humans , Trastuzumab
15.
Photodiagnosis Photodyn Ther ; 3(4): 266-71, 2006 Dec.
Article in English | MEDLINE | ID: mdl-25046991

ABSTRACT

OBJECTIVES: To evaluate the clinical response and adverse effects of Photofrin photodynamic therapy (PDT) in patients with relapse nasal pharyngeal cancer. METHODS: Thirty patients with relapse nasal pharyngeal cancer were randomly divided into PDT group and chemotherapy group. In PDT group, patients received intravenous administration of Photofrin (2mg/kg b.w.) and 48h later light (200-300J/cm) was delivered by a 630nm diode laser through a cylinder diffuser under endoscopic assistance. Two days after PDT the necrotic tissues were removed and newly identified sites were subject to another round of light irradiation. In chemotherapy group, the routine cisplatin and 5-fluorouracil (DDP/5-FU) remedy was used. Endoscopic and radiological examinations were performed during 6 months follow-up. The Karnofsy Score was used to evaluate the quality of life. RESULTS: The local response and nasal cavity obstruction remission rate in PDT group were better than that in chemotherapy group. The Karnofsy Score was also improved in PDT group. CONCLUSION: This pilot study suggests that Photofrin PDT is effective and safe in treatment of advanced nasal pharyngeal cancer and management of nasal obstruction.

16.
Zhonghua Zhong Liu Za Zhi ; 26(1): 52-4, 2004 Jan.
Article in Chinese | MEDLINE | ID: mdl-15059359

ABSTRACT

OBJECTIVE: To investigate the efficacy and toxicity of recombinant humanized anti-Her-2/neu antibody (Herceptin) and Taxol for patients with Her-2/neu overexpressing metastatic breast cancer. METHODS: Sixty patients with Her-2/neu overexpressing metastatic breast cancer were investigated. Of the 60 cases, 22 were treated with Herceptin and Taxol and 38 with Taxol and doxorubicin. RESULTS: The total response rate (RR) of Herceptin and Taxol was 68.2%, and that of Taxol and doxorubicin was 44.7%. The RR of patients with Her-2/neu(+++) was 75%, while that of patients with Her-2/neu(++) was 50%. The major adverse effects were gastro-intestinal tract reactions, myopathy, bone marrow suppression and alopecia. CONCLUSION: The treatment with Herceptin and Taxol is effective and safe for patients with Her-2/neu overexpressing metastatic breast cancer. The therapeutic effect is related to the degree of Her-2/neu overexpression.


Subject(s)
Antibodies, Monoclonal/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/drug therapy , Paclitaxel/administration & dosage , Receptor, ErbB-2/analysis , Adult , Aged , Antibodies, Monoclonal/adverse effects , Antibodies, Monoclonal, Humanized , Breast Neoplasms/chemistry , Female , Humans , Middle Aged , Paclitaxel/adverse effects , Trastuzumab
17.
Di Yi Jun Yi Da Xue Xue Bao ; 23(12): 1341-3, 2003 Dec.
Article in Chinese | MEDLINE | ID: mdl-14678909

ABSTRACT

OBJECTIVE: To evaluate the clinical efficacy and adverse effects of Photofrin photodynamic therapy (PDT) in patients with advanced cancers. METHODS: Forty patients with advanced cancers in stage IV with lumen obstruction, who failed to respond positively to other treatment regimens, received intravenous administration of Photofrin as the photosensitizer at the dose of 2 mg/kg.b.w. 48 h before PDT by 630 nm light (DIOMED) delivered through cylinder diffusing tip quartz fibers that passed through the biopsy channel of a flexible endoscope. PDT endoscopy was repeated, the necrotic tissue removed and, if necessary, the primary sites and other newly identified sites were subjected to a second exposure 8 h later. Two days after the second exposure, endoscopy was again performed and the necrotic tissue removed. Endoscopy was repeated one month after PDT and periodically thereafter as needed to treat symptomatic residual tumor. RESULTS: The total rate of response to the treatment was 74% in these patients, and the rate of lumen obstruction due to the tumors decreased from 90% to 10% after PDT, with significantly improved Karnofsky performance score. CONCLUSION: Photofrin PDT is effective and safe in the treatment of advanced cancer, which may relieve lumen obstruction and improve patient quality of life.


Subject(s)
Dihematoporphyrin Ether/therapeutic use , Neoplasms/drug therapy , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Photochemotherapy/adverse effects
18.
Di Yi Jun Yi Da Xue Xue Bao ; 23(10): 1090-2, 2003 Oct.
Article in English | MEDLINE | ID: mdl-14559703

ABSTRACT

OBJECTIVE: To investigate the relationship between the survival time and the high-expression of epidermal growth factor receptor (EGFR) and human epidermal receptor 2 (HER2) in breast cancer patients, and assess the feasibility of using the two markers either alone or in combination for predicting the prognosis of the patients. METHODS: Breast cancer samples were obtained from 185 patients and measured for the expressions of EGFR and HER-2 by way of immunohistochemistry, and 120 patients (64.9%) were followed up and their survival time recorded. Sixty-five patients (35.1%) failed to be followed for various reasons. RESULTS: Of the 120 patients followed up, death occurred in 28 (15%). Positive HER2 expression was detected in 57.8% and EGFR expression in 40.5% of the all the samples examined. The over-expression of either HER2 or EGFR was in inverse correlation with the survival time (P<0.05 and P<0.01, respectively), and the over-expression of both related to the survival time in similar manner (P<0.05 and P<0.01). CONCLUSION: The high expression of HER2 or/and EGFR suggests a short survival time and an unfavorable prognosis.


Subject(s)
Breast Neoplasms/chemistry , ErbB Receptors/analysis , Receptor, ErbB-2/analysis , Adult , Aged , Aged, 80 and over , Breast Neoplasms/mortality , Breast Neoplasms/therapy , Female , Humans , Immunohistochemistry , Middle Aged
19.
Di Yi Jun Yi Da Xue Xue Bao ; 22(12): 1112-3, 2002 Dec.
Article in Chinese | MEDLINE | ID: mdl-12480588

ABSTRACT

OBJECTIVE: To study the therapeutic effects of radiotherapy combined with traditional Chinese medicine (TCM) on non-small cell lung cancer (NSCLC). METHODS: Ninety-two patients with NSCLC were randomly divided into combined treatment group (n=50) and radiotherapy group (n=42). The former group was given TCM in combination with radiotherapy, and the latter group received radiotherapy only. The adverse effects and quality-of-life (QOL) of all the patients were observed after the treatments. RESULTS: The incidence of adverse effects was much lower in combined treatment group than in radiotherapy group, and significantly greater improvement in QOL of the patients was observed in the former group (P<0.01). CONCLUSION: TCM in the combined treatment for patients with NSCLC can reduce the adverse effects of radiotherapy, and improve the life quality of the patients.


Subject(s)
Carcinoma, Non-Small-Cell Lung/therapy , Drugs, Chinese Herbal/therapeutic use , Lung Neoplasms/therapy , Carcinoma, Non-Small-Cell Lung/drug therapy , Carcinoma, Non-Small-Cell Lung/radiotherapy , Combined Modality Therapy , Drugs, Chinese Herbal/adverse effects , Female , Humans , Lung Neoplasms/drug therapy , Lung Neoplasms/radiotherapy , Male , Medicine, Chinese Traditional , Quality of Life , Radiotherapy/adverse effects
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