ABSTRACT
PURPOSE: Chemotherapy-induced nausea and vomiting (CINV) have a negative impact on patients' quality of life and frequently pointed to as a major factor for treatment abandonment. Serotonin (5-HT3) receptor antagonist is considered as key treatment for CINV. Ramosetron and palonosetron are recently developed 5-HT3 receptor antagonists and known as more superior than other first-generation 5-HT3 receptor antagonists. The purpose of this study was to compare the efficacy of ramosetron and palonosetron and determine which drug is more effective for prevention of CINV. METHODS: Colorectal cancer patients treated with chemotherapy were enrolled consecutively. Patients were assigned to receive intravenous injection of ramosetron 0.3 mg or palonosetron 0.25 mg at 30 minutes before initiation of moderately emetogenic chemotherapy. Ramosetron group added oral administration of 0.1 mg ramosetron on the second and third days of chemotherapy. Efficacy parameter consisted of nausea and vomiting. RESULTS: Ninety-one patients received ramosetron and 89 patients received palonosetron. Presentation of vomiting and nausea symptoms was not significantly different between the two groups during acute (0-24 hours) and delayed period (after 24 hours). CONCLUSION: The incidence of CINV between the ramosetron and the palonosetron group has not shown any difference during acute, delayed, and overall period.
ABSTRACT
PURPOSE: This study evaluated the efficacy of neoadjuvant chemotherapy combining 5-flurouracil/folinic acid with irinotecan (FOLFIRI) in colorectal multiple liver metastases regardless of resectability. METHODS: Forty-four patients with multiple (at least two) colorectal liver metastases were enrolled at seven tertiary referral hospitals between May 2007 and September 2010. All patients received the FOLFIRI chemotherapeutic regimen. Response to chemotherapy was assessed after three cycles (6 weeks) and once more after six cycles (12 weeks) of treatment. RESULTS: Objective response was noted in 27 patients (61.4%) and 4 patients (9.1%) had progressive disease. Of 44 patients, 10 patients (22.7%) underwent curative surgery (R0 resection) and 34 patients did not receive R0 resection. Grades 3 to 4 hematological toxicity was noted in 12 patients (27.3%) and grades 3 to 4 nonhematologic toxicity was identified in 5 patients (11.4%). CONCLUSION: FOLFIRI chemotherapy as a neoadjuvant chemotherapy for multiple colorectal liver metastases regardless of resectability demonstrated the possibility of R0 resection, high rate of objective response, and tolerable toxicities in this study.
ABSTRACT
PURPOSE: The clinical availability of 2-deoxy-2-[18F] fluoro-D-glucose (FDG) dual-time point positron emission tomography/computerized tomography (DTPP) has been investigated in diverse oncologic fields. The aim of this preliminary study was to evaluate the relationship between various immunohistopathologic markers reflecting disease progression of colorectal cancer and parameters extracted from FDG DTPP in colorectal cancer patients. MATERIALS AND METHODS: Forty-seven patients with histologically confirmed colorectal cancer were analyzed in this preliminary study. FDG DTPP consisted of an early scan 1 h after FDG injection and a delayed scan 1.5 h after the early scan. Based on an analysis of FDG DTPP, we estimated the maximum standardized uptake value (SUV) of tumors on the early and delayed scans (SUVearly and SUVdelayed, respectively). The retention index (RI) was calculated as follows: (SUVdelayed - SUVearly) × 100/ SUVearly. The clinicopathological findings (size and T and N stages) and immunohistochemical factors [glucose transporter 1 (GLUT-1), hexokinase 2 (HK-2), p53, P504S, and ß-catenin] were analyzed by visual analysis. RESULTS: The RIs calculated from the SUVs ranged from -1.8 to 73.4 (31.8 ± 15.5). The RIs were significantly higher in patients with high T stages (T3 and T4) than with low T stages (T1 and T2; p < 0.05). Among the immunohistochemical analytic markers, GLUT-1 had the highest positive staining rate (93.6%) compared to other markers. Based on univariable analysis, it was shown that the RI of high-level GLUT-1 expression was significantly higher than low-level GLUT-1 expression (p = 0.01), and the RI of high-level p53 expression was slightly higher than low-level p53 expression (p = 0.08). Multivariate analysis to investigate a link between RI and clinicopathologic parameters of colorectal carcinoma showed that GLUT-1, p53, and T staging were independently connected with increased RIs (p < 0.05, total) using backward selection methods. There was no significant statistical relationship between SUVearly and SUVdelayed and clinicopathologic parameters in this study. CONCLUSION: The RIs obtained from preoperative colorectal cancers had a significant relationship to tumor size, T staging, GLUT-1, and p53, in contrast to SUVearly or SUVdelayed. Compared with previous reports, our results showed that RI can better predict GLUT-1 expression than HK-2 and other immunohistochemical markers. This study demonstrated that the RI might have the potential to be applied as a prognostic marker in preoperative colorectal cancer.
ABSTRACT
PURPOSE: Recently, two alternatively spliced survivin variants, survivin-ΔEx3 and survivin-2B, were identified in a single copy of the survivin gene. It has been reported that the expressions of survivin splice variants significantly correlates with the clinical results in many types of human carcinoma. We investigated the transcription levels of survivin and its splice variants in human colorectal carcinomas, and analyzed correlations between survivin expression levels and clinicopathologic features. METHODS: We used Western blot and real-time quantitative reverse transcription polymerase chain reaction (RT-PCR) to analyze the protein and mRNA expression levels of survivin variants in 51 colorectal carcinomas. The quantitative RT-PCR was performed using primer pairs specific for survivin and each of its splice variants, then normalized for the gene that encodes glyceraldehydes-3-phosphate dehydrogenase. RESULTS: In Western blotting, the protein levels of survivin were higher in the tumor tissue than in normal tissue. The expression of survivin, survivin-2B and survivin-ΔEx3 mRNA was present in 96%, 64.7%, and 82.4% of the samples, respectively. When the pathologic parameters were compared, colorectal cancers of advanced pT stages showed significant decrease in survivin-2B mRNA expression by the quantitative RT-PCR (P < 0.001). CONCLUSION: The decreased expression of survivin-2B might be related to tumor progression in colorectal cancers. This finding indicates that alternatively spliced variants of survivin may be involved in refining the functions of survivin during tumor progression.
