Antioxidant properties of Lactobacillus-fermented and non-fermented Graptopetalum paraguayense E. Walther at different stages of maturity.

Accumulation of bioactive compounds, during developmental stages of Graptopetalum paraguayense E. Walther, was investigated between 30 and 90days as a function of physiological maturity. Three distinct phases were defined: immature phase (30days), intermediate developmental phase (30-60days), and maturation phase (60-90days). Gallic acid and quercetin, antioxidative bioactive compounds, were identified as biomarkers for determining the optimum physiological maturity stage in G. paraguayense E. Walther. With regard to the antioxidant activity of G. paraguayense E. Walther at different developmental stages, the results indicated that the leaves of immature G. paraguayense E. Walther had the highest 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulphonate) (ABTS-), superoxide radical-, and 1,1-diphenyl-2-picrylhydrazyl (DPPH·)-scavenging activities. Fermentation of G. paraguayense E. Walther with Lactobacillus plantarum BCRC 10357 significantly increased the level of flavonoids and total phenolics, including quercetin and gallic acid. Total phenols were the major naturally occurring antioxidant components in lactic acid bacteria-fermented G. paraguayense E. Walther.

[Clinical characteristics and prognosis of primary nasal mucosal melanoma--a report of 44 cases].

BACKGROUND & OBJECTIVE: Primary mucosal malignant melanoma of the nasal cavity, paranasal sinuses, and nasopharynx is rare and current research data of this disease are mainly from western populations. This study was to analyze the clinical characteristics of this disease and prognositic factors. METHODS: From Jan. 1971 to Jul. 2005, 66 patients with primary nasal mucosal melanoma were treated in Cancer Center of Sun Yat-sen University, China. Demographics and baseline characteristics, treatments, recurrence, metastasis, and survival were documented in hospital records. All records of these patients were analyzed retrospectively. Kaplan-Meier method was used to calculate survival rate; Cox model was used to analyze prognostic factors. RESULTS: Among 44 evaluable cases, 37 were originated from the nasal cavity, 5 from the paranasal sinuses, and 2 from the nasopharynx. Cervical lymphadenopathy at initial presentation occurred in 12 patients. Of the 31 patients received operation-dominated treatment, 8 received adjuvant radiotherapy, 13 received adjuvant chemotherapy, and 6 received adjuvant non-specific immunotherapy. The median time of follow-up was 29 months. Local recurrence, cervical lymphadenopathy, and distant metastasis occurred in 24, 10, and 11 patients, respectively, during follow-up. The median survival time was 24 months and the 5-year survival time was 25%. Clinical stage affected prognosis, whereas age, gender, site, primary tumor mass, and adjuvant therapy were not correlated to survival status. CONCLUSION: Nasal mucosal melanoma has high incidence of local recurrence and distant metastasis, especially cervical lymphadenopathy. Clinical stage affects the prognosis.

[Comparing CHOP, CHOP+HD-MTX,and BFM-90 regimens in the survival rate of children and adolescents with B cell non-Hodgkin's lymphoma].

BACKGROUND & OBJECTIVES: B cell non-Hodgkin's lymphoma (B-NHL) in childhood and adolescence is aggressive. Routine CHOP regimen can improve the survival rate of patients with early-stage disease, but its effect on patients with advanced disease was poor. Therefore, it is worthwhile to further investigate how to treat patients with B-NHL at different stages. This study was designed to retrospectively analyze and compare CHOP, CHOP+HD-MTX, and BFM-90 regimens in the survival rate of children and adolescents with B-NHL,and explore the optimal therapeutic strategy and protocols. METHODS: Thirty cases of 3- to 17-year-old untreated patients with B-NHL were enrolled in CHOP group, with 13 in Stage I/II, and 17 in stage III/IV (St Jude staging), all patients received standard CHOP for 2 to 8 cycles, the regimen was repeated every 3 weeks. Eighteen cases of 3- to 14-year-old untreated patients with B-NHL were enrolled in CHOP+HD-MTX group, with 6 in Stage I/II, and 12 in stage III/IV (St Jude staging), all patients received CHOP+HD-MTX and intrathecal injection for 2 to 8 cycles, the regimen was repeated every 4 weeks. Twenty-five cases of 1.5- to 15-year-old untreated patients with B-NHL were enrolled in BFM-90 group, with 7 in Stage I/II,and 18 in stage III/IV (St Jude staging). The patients with stage I/II disease received A schema alteration with B schema of BFM-90 regimen for 4 to 6 cycles, while the patients with stage III/IV disease received AA schema alteration with BB schema of BFM-90 regimen for 6 cycles, the interval of cycles was 18-21 days. The survival rates were evaluated by Kaplan-Meier method. RESULTS: In CHOP group,complete response (CR) rate was 70% (21/30), and partial response (PR) rate was 13% (4/30). In CHOP+HD-MTX group, CR rate was 83%, PR rate was 16%. In BFM-90 group, CR rate was 96% (24/25), and PR rate was 4% (1/25). The hematologic toxicity incidence was higher in BFM-90 group than in the other 2 groups. In CHOP group, the overall 2-year survival rate was 52.79% (72.73% for Stage I/II, and 37.82% for stage III/IV). In CHOP+HD-MTX group, the overall 2-year survival rate was 55.56 % (83.33 % for Stage I/II, and 41.67 % for stage III/IV). There was no significant difference between CHOP group and CHOP+HD-MTX group in survival rate (P=0.78). In BFM-90 group,2-year event-free survival rate (EFS) was 84.01 % (100% for Stage I/II, and 77.04 % for stage III/IV). The differences in survival rate between BFM-90 group and CHOP group, CHOP+HD-MTX group were both significant (P=0.013, and P=0.034). CONCLUSION: BFM-90 regimen can greatly improve the survival rate of children and adolescents with B-NHL, especially of patients with advanced NHL. CHOP, and CHOP+HD-MTX regimens work better for the early stage patients, but produce low survival rate for patients with advanced NHL. A high intensive chemotherapy like BFM-90 regimen is necessary for children and adolescents with advanced B-NHL.

[Evaluation of efficacy of treatment for 30 children with neuroblastoma].

BACKGROUND & OBJECTIVE: Neuroblastoma is one of common solid tumors in children. The major treatment modality for neuroblastoma (NB) is chemotherapy combined with operation or irradiation. But the survival rate is still low for advanced patients. Further study is needed for improving cure rate of neuroblastoma. This study was designed to evaluate the efficacy of children with neuroblastoma treated in Cancer Center, Sun Yat-sen University, and to explore reasonable therapy strategy. METHODS: The clinical data of 30 children with NB aged from 7 months to 13 years were analyzed retrospectively. These patients were treated with chemotherapy plus operation or radiation. The stages were as follow: II, n=2; III, n=12; IV, n=15; IVS, n=1. Chemotherapy regimen was CAV (cyclophosphamide 750 mg/m(2) d1, vincristine 1.5 mg/m(2), d1, Adriamycin 50 mg/m(2) d1) alternated with EP (teniposide or etoposide 60 mg/m(2) d1-d5, cisplatin 20 mg/m(2) d1-d5). The resection would be done after 4 to 6 cycles of chemotherapy if possible. The chemotherapy or radiation would be done after resection. If operation was not available, the patients continued to receive the chemotherapy. The patients with stage IVS only received cyclophosphamide plus vincristine. RESULTS: Among 30 patients, 2 cases achieved complete remission (CR 6.7%) by chemotherapy alone; 21 cases achieved partial remission (PR 70%); 6 cases showed no change (NC 20%); 1 cases showed progressive diseases (3.3%). Overall response rate (CR+PR) were 76.7% by chemotherapy alone. Of 21 PR patients, 9 cases could be resected;4 cases achieved CR after operation; 1 case achieved CR after radiation. The 2-year overall survival rate was 47.8% for all patients; 100% for Stage II/IVS, 34% for stage III, 22% for stage IV, respectively. Grade III/IV hematological toxicity occurred in 41.2% of the CAV regimen and 26.6% of the EP regimen. CONCLUSION: Chemotherapy plus operation or radiation is the major treatment for neuroblastoma. CAV/EP alternative chemotherapy is the active regimen for NB. The toxicity is tolerable. Advance stage NB needs further study for improving the prognosis.

[Comparison of cisplatin combined with gemcitabine versus cisplatin combined with vinorelbine regimen for treatment of patients with advanced non-small cell lung cancer].

BACKGROUND & OBJECTIVE: In most instances, advanced non-small cell lung cancer (NSCLC) is treated with primary chemotherapy. Many chemotherapy regimens can palliate cancer-related symptoms and modestly improve survival and quality of life. This clinical trial was designed to compare the efficacy and toxicity of two regimens: PG regimen [cisplatin and gemcitabine] versus PN regimen [cisplatin and vinorelbine]. METHODS: A total of 64 patients were enrolled in this study, 31 patients received PG regimen and 33 patients received PN regimen. Patients in both groups were well-matched with baseline disease characteristics (P >0.05). RESULTS: In PG group, the response rate was 32.3% [10/31, 95% confidence interval (CI):16.3%-48.7%][1 complete response (CR), 9 partial response (PR), 17 no change (NC), 4 progressive disease (PD)]; whereas in group PN, the response rate was 29.03% (9/31,95% CI:13.1%-44.9%) (0CR, 9PR, 17NC, 5PD). The difference of response rates between two groups was not statistically significant (P=0.526, Chi-square test). The median survival were 12 months for group PG (95%CI:10-14 months) and 11 months for group PN (95% CI:10-12 months). The difference of median survival between two groups was not statistically significant(P=0.5799, log-rang test). The major toxicity was myelosuppression. Leucopenia was more pronounced in group PN (P=0.009), Thrombocytopenia was more pronounced in group PG(P=0.01). CONCLUSION: PG and PN are two effective regimens for the patients with advanced NSCLC; the major toxicity was myelosuppression. Leucopenia was pronounced in group PN. Thrombocytopenia was pronounced in group PG. Neurotoxicity was observed in group PN.

[Clinical results of 295 patients with Hodgkin's disease treated by chemotherapy-predominant comprehensive modality].

BACKGROUND & OBJECTIVE: Hodgkin's disease (HD) is a chemo- and radio-sensitive hematologic malignancy. At present, improvement of cure rate, reduction of long-term toxicity, and maintenance of good quality of life are the major issues in the treatment of HD. The results of long term follow-up from Cancer Center, Sun Yat-sen University were analyzed retrospectively in terms of efficacy and late side effects in this article. METHODS: The results of 295 patients with histology-proven HD from 1970 to 2000, especially from 1980 to 2000 were analyzed. Meanwhile, multivariant analysis (COX model) was employed to determine the prognostic factor. RESULTS: A total of 295 HD patients were treated by chemotherapy-predominant comprehensive modality. The 5, 10, and 20 years overall survival for 295 HD patients were 63.5%, 55.8%, and 47.1%, respectively, with median survival time of 172.3 months (28-351.9 months) at the median follow-up time of 42.9 months (17-351.9 months). The 5, 10, and 20 years overall survival and disease-free survival were 79.6%, 74.5%, and 66.8% as well as 74.5%, 69.4%, and 69.4% respectively for the patients treated with regular chemotherapy and radiotherapy from 1980 to 2000. The incidence rate of late toxicities was low. Multivariate analysis demonstrated that age over 45-year-old, B symptoms and stage III/IV were the main prognostic factors (P = 0.000, P = 0.035, and P = 0.047) in this clinical study. The prognosis of the patients with stage I/II and nodular sclerosis was better in comparison to stages III/IV and other histologic subtypes. CONCLUSIONS: Chemotherapy-predominant combined with involved fields irradiation play an important role in HD treatment with promising long term survival and lower late toxicities. Further investigation for this simplified and convenient comprehensive modality is warranted.