Short-term efficacy of camrelizumab combined with induction chemotherapy followed by concurrent chemoradiotherapy for patients with locally advanced nasopharyngeal carcinoma / 中华放射医学与防护杂志

Objective:To investigate the clinical effect and safety of camrelizumab combined with induction chemotherapy followed by concurrent chemoradiotherapy for patients with locally advanced nasopharyngeal carcinoma (NPC).Methods:A total of 24 patients with stage Ⅲ-IV A NPC were recruited prospectively to receive two cycles of camrelizumab combined with induction chemotherapy (docetaxel 75 mg/m 2+ cisplatin 25 mg/m 2 for three consecutive days) followed by concurrent chemoradiotherapy (prescription doses: 6 996 cGy in 33 fractions for PGTV and PGTV nd, 6 006 cGy in 33 fractions for PTV 1, 5 096 cGy in 28 fractions for PTV 2, and concurrent cisplatin chemotherapy with a dose of 75 mg/m 2). The short-term efficacy and adverse reactions were evaluated. Results:After induction therapy, nasopharyngeal lesions showed an objective response rate (ORR) of 91.6%, including 45.8% of complete response (CR) and 45.8% of partial response (PR); cervical lymph nodes showed an ORR of 95.8% (CR: 4.2%; PR: 91.6%). Seventeen patients accepted a reexamination under a nasopharyngoscope, and the biting biopsy result indicated that 13 patients among them had complete pathologic response. After concurrent chemoradiotherapy, nasopharyngeal lesions and cervical lymph nodes showed CR rates of 83.3% and 91.7% and PR rates of 16.7% and 8.3%, respectively. After the induction therapy, 13 patients with stage IV A NPC had ORR (PR) rates of 92.4% and 92.4%, respectively, at nasopharyngeal lesions and cervical lymph nodes. After concurrent chemoradiotherapy, the patients with stage IV A NPC had CR rates of 84.6% and 92.3% and PR rates of 15.4% and 7.7%, respectively, at nasopharyngeal lesions and cervical lymph nodes. Major adverse reactions include leukopenia, granulopenia, anemia, radioactive acute oropharyngeal mucositis and dermatitis, digestive tract reaction, fatigue, hypothyroidism, aminotransferase elevation, and reactive capillary hyperplasia. Conclusions:Camrelizumab combined with induction chemotherapy followed by concurrent chemoradiotherapy can achieve high short-term efficacy for patients with locally advanced nasopharyngeal carcinoma, without increasing the incidence of adverse reactions. Its long-term efficacy deserves further research.

A multi-omics approach based on 1H-NMR metabonomics combined with target protein analysis to reveal the mechanism of RIAISs on cervical carcinoma patients.

Cervical carcinoma (CC) is the fourth most common cancer in females and radiotherapy is always as the definitive therapy for cervical cancer patients who are not suitable for surgery. Radiation-induced acute intestinal symptoms (RIAISs) occur in 50-80% of cervical cancer patients. Some research shows that RIAISs may relate to inflammatory reaction by radiotherapy but the action mechanism is also not clearly and the details of the molecular mechanism are still urgently needed. In this paper, basing on 1H-NMR metabonomic and bioinformatics analysis, an integrated multi-omics analysis including metabonomics and bioinformatics was performed. We propose a hypothesis about pathogenic mechanism on RIAISs and proofed it through western-blot. Our results indicated significant dysregulation of metabolic pathways in RIAIS patients. Most importantly, we found that RIAISs were associated p53 and PI3K-AKT pathway.

Relationship between the radiation dose of different anatomic bony sites and neutrophil toxicity in three-dimensional radiotherapy concurrent chemotherapy for cervical cancer / 中华放射肿瘤学杂志

Objective:To investigate the correlation between radiation dose of the pelvic bone marrow of different anatomical bony sites and the incidence of neutrophil toxicity during the three-dimensional radiotherapy concurrent chemotherapy for cervical cancer.Methods:Clinical data of 117 cervical cancer patients who received three-dimensional radiotherapy concurrent chemotherapy from 2016 to 2018 were retrospectively analyzed. The dosimetric parameters included D mean, V 5Gy, V 10Gy, V 20Gy, V 30Gy, V 40Gy and V 50Gy. The correlation between the dosimetric parameters and the lowest neutrophil count was analyzed by linear regression analysis. Clinicopathological features and dosimetric parameters were included into the multivariate regression analysis model. Results:The incidence rates of neutrophil toxicity (grade 1-4) were 10.3%, 27.4%, 11.1% and 10.3%, respectively. The linear regression analysis showed that the D mean and V 50Gy of lumbosacral vertebrae (LS), the D mean, V 5Gy, V 10Gy, V 20Gy, V 30Gy, V 40Gy and V 50Gy of the ilium were significantly correlated with the grade 2-4 neutrophil toxicity ( P=0.035、<0.001、<0.001、=0.001、=0.003、=0.001、<0.001、<0.001、<0.001). Multivariate analysis demonstrated that the V 20Gy, V 30Gy and V 50Gy of the LS, the D mean, V 5Gy, V 10Gy, V 20Gy and V 30Gy of the ilium were significantly correlated with the grade 2-4 neutrophil toxicity ( P=0.046、0.038、0.049、0.041、0.039、0.029、0.036、0.029). Conclusion:During the process of three-dimensional radiotherapy concurrent chemotherapy for cervical cancer, the volume of medium-and high-dose of LS and the volume of low-and medium-dose of ilium are significantly correlated with the risk of neutrophil toxicity.

Progress on clinical application of bevacizumab for the treatment of refractory cervical cancer / 浙江大学学报·医学版

Bevacizumab is increasingly used in recurrent, persistent or metastatic cervical cancer. The early retrospective case reports found that bevacizumab combined with 5-FU (including capecitabine) or paclitaxel was well tolerated and displayed encouraging anti-tumor activity in recurrent or persistent cervical cancer. Phase Ⅱ clinical trials showed that bevacizumab was well tolerated and active in the second- and third-line treatment of patients with recurrent cervical cancer. Large scale phase Ⅱ and phase Ⅲ clinical trials demonstrated that bevacizumab-containing chemotherapy was effective in the first- and second-line treatment of patients with persistent cervical cancer, prolonged survival time and improved remission rate. The article also reviews the research progress on predictive factors of bevacizumab efficacy, showing the use of imaging and biomarkers in predicting the efficacy of bevacizumab treatment. In addition, this article analyzes the cost-effectiveness of bevacizumab, finding that bevacizumab combined with chemotherapy meets the standard of cost-effectiveness.

Metastasis to the parotid region as an initial presentation of renal cell carcinoma: A case report.

Distant metastasis of renal cell carcinoma (RCC) to the parotid region is extremely rare, particularly as an initial presentation. In the present study, we report a rare case of parotid region metastasis from RCC as an initial presentation in a 44-year-old female who presented with a painless lump in the right parotid region. Investigation revealed RCC in the left renal region and metastasis to the right iliac area. A radical nephrectomy was performed but the patient refused any further treatment. After seven months, the patient reappeared with systemic multiple metastases, with the exception of previous metastases that were enlarging significantly. On admission, interleukin-2 and local radiotherapy were administered. However, oral mucositis occurred. Targeted therapy with sunitinib was recommended.

Metabonomics-a useful tool for individualized cancer therapy / 浙江大学学报·医学版

Metabonomics has developed rapidly in post-genome era, and becomes a hot topic of omics. The core idea of metabonomics is to determine the metabolites of relatively low-weight molecular in organisms or cells, by a series of analytical methods such as nuclear magnetic resonance, color spectrum and mass spectrogram, then to transform the data of metabolic pattern into useful information, by chemometric tools and pattern recognition software, and to reveal the essence of life activities of the body. With advantages of high-throughput, high-sensitivity and high-accuracy, metabolomics shows great potential and value in cancer individualized treatment. This paper introduces the concept,contents and methods of metabonomics and reviews its application in cancer individualized therapy.