自体CIK细胞联合同步放化疗治疗局部晚期食管癌的临床研究

目的:探讨自体CIK细胞联合同步放化疗对局部晚期食管癌患者的临床疗效,监测患者细胞免疫功能、生活质量的变化,并评价其近期疗效和毒副反应。方法:选取2011年9月至2013年12月60例局部晚期食管癌患者,分为对照组30例,采用同步放化疗治疗;试验组30例,采用同步放化疗联合CIK细胞治疗。采用流式细胞术检测患者外周血T淋巴细胞亚群水平变化。结果:治疗后组间比较,试验组患者较对照组患者细胞免疫功能显著升高,其中CD3+T淋巴细胞百分率［(73.5±5.6）% vs （64.8±5.8）%,P=0.041］和CD3+CD56+T淋巴细胞百分率［(16.1±1.6）% vs （4.2±0.8）%,P=0.011］均较对照组显著升高。试验组的DCR较对照组明显提高,差异有统计学意义（90.0% vs 63.3%,P=0.030）。试验组生存质量明显改善且毒副反应轻。结论:与单纯同步放化疗相比,自体CIK细胞联合同步放化疗可显著提高局部晚期食管癌患者T淋巴细胞免疫功能,有效控制肿瘤生长,安全可靠。     

Selections of appropriate regimen of high-dose chemotherapy combined with adoptive cellular therapy with dendritic and cytokine-induced killer cells improved progression-free and overall survival in patients with metastatic breast cancer: reargument of such contentious therapeutic preferences

Background

We hypothesized that combination of dendritic cell (DC) with autologous cytokine-induced killer (CIK) immunotherapy in setting of high-dose chemotherapy (HDC) would be effective for selected metastatic breast cancer (MBC) patients.

Patients and methods

Our previous work showed thiotepa could eradicate breast cancer stem cells. From 2004 to 2009, 79 patients received standard dose chemotherapy (SDC) of 75 mg/m² docetaxel and 75 mg/m² thiotepa versus 87 patients of HDC + DC/CIK: 120 mg/m² docetaxel to mobilize peripheral CD34⁺ progenitor cells, a sequence of HDC (120 mg/m² docetaxel, plus 175 mg/m² thiotepa) + DC/CIK, with or without 400 mg/m² carboplatin depending upon bone marrow function. The endpoints were response rates (RR), progression-free survival (PFS), and overall survival (OS).

Results

Compared with SDC, PFS and OS were improved in HDC + DC/CIK (median PFS 10.2 vs. 3.7 months, P < 0.001; median OS 33.1 vs. 15.2 months, P < 0.001). Patients of pre-menopausal, HDC as first-line treatment after metastasis, or with visceral metastasis showed prolonged PFS and OS. SDC group also achieved the similar response as previous reports.

Conclusion

Our study demonstrated the novel combination of HDC with DC/CIK to be an effective choice for the selected MBC population, in which choosing appropriate chemo regimens played important roles, and also specific HDC regimen plus DC/CIK immunotherapy showed the clinical benefits compared with chemotherapy alone.     

A phase II trial of Xeloda and oxaliplatin (XELOX) neo-adjuvant chemotherapy followed by surgery for advanced gastric cancer patients with para-aortic lymph node metastasis

Purpose

Gastric cancer with para-aortic lymph node (PAN) involvement is regarded as advanced disease, and only chemotherapy is recommended from the guidelines. In unresectable cases, neoadjuvant chemotherapy could prolong survival if conversion to resectability could be achieved.

Methods

The study was a single-arm phase II trial. Patients who were diagnosed with gastric cancer and PAN involvement (Stations No. 16a2/16b1) were treated with capecitabine and oxaliplatin combination chemotherapy every 3 weeks for a maximum of six cycles. After every two cycles, abdominal computed tomographic scans were repeated to evaluate the response, and surgery was performed at the physician^’s discretion in patients with sufficient tumor response, followed by chemotherapy with the same regimen to complete a total of six cycles. The primary end point was the response rate of the preoperative chemotherapy. The secondary end points were R0 resection rate, progression-free survival (PFS), overall survival (OS), and adverse events.

Results

A total of 48 patients were enrolled. The response rate of the first-line chemotherapy was 49.0 %, and the clinical benefit response was 85.1 %. After a median of four cycles of chemotherapy, 28 patients received surgery (58.3 %). The median PFS and OS of all patients were 10.0 and 29.8 months, respectively. Patients in the surgery group had much longer PFS (18.1 vs. 5.6 mo, P = 0.001) and OS (not reached vs. 12.5 mo, P = 0.016) compared with those in the non-surgery group.

Conclusions

For gastric cancer patients with PAN involvement, neoadjuvant chemotherapy with XELOX demonstrated a good response rate, and a sufficient R0 resection rate, with acceptable toxicities. Further study is needed to confirm the effectiveness of this regimen.     

益气健脾汤联合FOLFOX4方案治疗结直肠癌术后患者的临床研究

Objective

The aim of the study was to observe the clinical efficacy with Yiqi Jianpi decoction combination with FOLFOX4 for the postoperative patients of colorectal cancer (CRC).

Methods

Eighty-five patients were randomly divided into two groups. The treated group (n = 41) received Yiqi Jianpi decoction combined with FOLFOX4 chemotherapy and the control group (n = 44) received FLOFOX4 chemotherapy alone. A treatment course of 6 months was applied to both groups.

Results

The life quality, symptomatic improvement and adverse side effects reducing in the treated group were better than those of the control group.

Conclusion

Yiqi Jianpi decoction combination with FOLFOX4 chemotherapy is effective in the treatment of the postoperative patients with colorectal cancer.     

Patterns of hepatotoxicity after chemotherapy for colorectal cancer liver metastases

Aim

The aim of this study was to assess chemotherapy associated hepatotoxicity after 3 months' treatment and to correlate patterns of hepatotoxicity with perioperative morbidity.

Methods

Liver specimens of 50 patients with liver metastases from colorectal cancer receiving XELOX or FOLFOX4 for six cycles and 13 specimens of non-chemotherapy patients subjected to liver resection were analyzed. Different patterns of hepatotoxicity were evaluated according to widely accepted pathohistological scores. Furthermore, the histomorphological findings were correlated with perioperative morbidity.

Results

Steatosis grades did not differ among the chemotherapy treated groups and non-chemotherapy patients. Chemotherapy showed an independent effect on fibrosis stage. Age and chemotherapy were independently associated with sinusoidal dilatation. Centrilobular vein fibrosis correlated with administration of chemotherapy. Higher fibrosis stages were associated with increased transfusion requirements.

Conclusion

XELOX and FOLFOX4 do not correlate with the development of steatosis or steatohepatitis. We do not detect a difference in liver injury between the XELOX and FOLFOX4 group. Although 5-fluorouracil based chemotherapy may cause profound changes in liver parenchyma, it can be safely applied. However, age and oxaliplatin predispose for the development of sinusoidal dilatation; therefore caution must be taken in old patients treated with oxaliplatin.     

Side Effects during Treatment of Advanced Gastric Carcinoma by Chemotherapy Combined with CIK-cell Transfusion in Elderly People

OBJECTIVE To study the side effects and therapeutic results of autologous cytokine-induced killer(CIK)cell treatment in elderly patients with advanced gastric cancer. METHODS CIK cells were induced and cultured using biotechnics in vitro,and then the cells were infused back into the patients.Sixty elderly gastric cancer patients treated by chemotherapy(FOLFOX4 protocol)were followed-up.Among them,29 patients were treated with CIK cells during application of chemotherapy.Short-term curative effects and adverse events from the CIK transfusion and chemotherapy were observed. RESULTS Eight cases developed partial remission(PR),9 cases moderate remission(MR),7 cases stable disease(SD)and 5 cases progressive disease(PD).Out of a total of 29 patients who received chemotherapy combined with autologous CIK therapy, the total remission rate(PR MR)was 58.6%.The total remission rate following chemotherapy alone was 45.2%,including 5 PR cases,9 MR cases,7 SD cases,and 10 PD cases.There was a relatively lower rate of severe chemotherapic toxicities in the CIK- cell transfusion group.Side e?ects of autologous CIK transfusion included chills(13 cases),fever(9 cases),nausea and vomiting (1 case)and general malaise(3 cases).Side effects were treated with conventional therapy resulting in their amelioration.No patients developed shock,blood capillary leakage syndrome,or abnormalities in routine blood,urine,liver and renal function tests. CONCLUSION Adoptive immunotherapy with autologous CIK cells may decrease the clinical signs and symptoms of elderly patients who suffer from advanced gastric cancer.Adverse reactions of patients can be alleviated by conventional therapy. Autologous CIK-cell transfusion may improve endurance to chemotherapy.     

Phase I trial of hepatic arterial infusion (HAI) of floxuridine with modified oxaliplatin, 5-fluorouracil and leucovorin (m-FOLFOX6) in Chinese patients with unresectable liver metastases from colorectal cancer

Purpose

Chemoradiotherapy followed by total mesorectal excision (TME) is the standard treatment for locally advanced rectal cancer. Although this approach decreases the risk of local recurrence, pelvic radiation is associated with long-term morbidity and delays systemic treatment. We conducted this study to evaluate the feasibility of neoadjuvant capecitabine and oxaliplatin (XELOX) plus bevacizumab as a treatment for high-risk localized rectal cancer.

Methods

Patients with T4 or lymph node-positive rectal cancer were treated with three cycles of XELOX plus bevacizumab and one additional cycle of XELOX. This was followed by TME performed 3–8 weeks after the last chemotherapy session.

Results

Twenty-five patients were recruited between December 2009 and November 2011. In seven of the patients (28.0 %), grade 3–4 adverse events occurred. After preoperative chemotherapy, the frequency of tumor (T) downstaging was 69.6 %, and that of lymph node (N) downstaging was 78.9 %. Seven patients discontinued the treatment after 2–3 cycles of XELOX plus bevacizumab. The frequency of subsequent surgery was 92 %, and all patients underwent R0 resections. Postoperative complications occurred in six patients (26.1 %). One patient achieved a pathological complete response (pCR) for the primary tumor and lymph nodes, whereas an additional four patients achieved near-pCR. After a median follow-up of 31 months, five patients displayed metastatic progression, including one who suffered local recurrence.

Conclusions

XELOX plus bevacizumab followed by TME is feasible for high-risk localized rectal cancer, as it achieves good tumor regression and causes manageable toxicity.     

The clinical effects of DC-CIK cells combined with chemotherapy in the treatment of advanced NSCLC

Objective

The aim of the study was to evaluate the safety and therapeutic effects of autologous dendritic cells co-cultured with cytokine-induced killer cells (DC-CIK) combined with chemotherapy in advanced non-small cell lung cancer (NSCLC) patients.

Methods

Fifty patients with advanced NSCLC (stages III to IV), who had received therapies in our Center (Department of Biotherapy, Affiliated to Cancer Hospital of Shanxi Medical University, Taiyuan, China) from August 2008 to January 2010, were treated by DC-CIK + chemotherapy as the combined treatment group; fifty advanced NSCLC patients treated with chemotherapy at the same time served as controls. The immunologic function, short-term therapeutic effects, the 1-year survival rate, the life quality, the chemotherapy side effects were compared between the two groups, the safety and therapeutic effects of DC-CIK cells therapy were observed too.

Results

There was no obvious change of subsets of T cells in peripheral blood before and after therapy in DC-CIK + chemotherapy group, and IFN-?? was improved after therapy in this group (P < 0.05); in chemotherapy alone group, the ratios of CD3⁺CD4⁺, CD3⁺CD8⁺, CD3^?CD56⁺ cells and the secretion of IL-2, TNF-?? decreased significantly after therapy (P < 0.05); the ratios of CD3⁺CD8⁺, CD3⁺CD56⁺ were improved after cell culture (P < 0.05). The disease control rate (DCR) of DC-CIK + chemotherapy group was higher than that in the chemotherapy alone group (78.0% vs 56.0%, P < 0.05); the 1-year survival rates of DC-CIK + chemotherapy group and chemotherapy alone group were 50% and 44% respectively, had no significant difference. Compared with chemotherapy alone group, the occurrence of chemotherapy side effects (including bone marrow suppression, nausea and vomiting, peripheral nerve toxicity) was less in the DC-CIK + chemotherapy group (P < 0.05). The physical and appetite were better in DC-CIK + chemotherapy group after therapy.

Conclusion

To compare with simple chemotherapy, DC-CIK + chemotherapy for advanced NSCLC is safe and effective, and it can improve patients?? life quality and remission rate, and prolong their survival time.     

Quality of life of older adult patients receiving docetaxel-based chemotherapy triplets for esophagogastric adenocarcinoma: a randomized study of the Arbeitsgemeinschaft Internistische Onkologie (AIO)

Background

Treatment of patients with advanced or metastatic esophagogastric adenocarcinoma should not only prolong life but also provide relief of symptoms and improve quality of life (QOL). Esophagogastric adenocarcinoma mainly occurs in elderly patients, but they are underrepresented in most clinical trials and often do not receive effective combination chemotherapy, most probably for fear of intolerance. Using validated instruments, we prospectively assessed QOL within the randomized FLOT65+ phase II trial.

Methods

Within the FLOT65+ trial, a total of 143 patients aged ≥65 years were randomly allocated to receive biweekly oxaliplatin plus 5-fluorouracil (5-FU) continuous infusion and folinic acid (FLO) or the same regimen in combination with docetaxel 50 mg/m² (FLOT). The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) and the gastric module STO22 were administered every 8 weeks until progression. Time to definitive deterioration of QOL parameters was analyzed and compared within the treatment arms.

Results

The median age of patients was 70 years. Patients receiving FLOT exhibited higher response rates and had improved disease-free and progression-free survival (PFS). The proportions of patients with evaluable baseline EORTC QLQ-C30 and STO22 questionnaires were balanced (83 % in FLOT and 89 % in FLO). Considering evaluable patients with assessable questionnaires (n = 123), neither functioning nor symptom parameters differed significantly in favor of one of the two treatment groups. Particularly, there was no significant difference regarding time to definitive deterioration of global health status/quality of life from baseline (primary endpoint). Notably, patients receiving FLO or FLOT as palliative treatment (n = 98) achieved comparable QOL results.

Conclusions

Although toxicity was higher in patients receiving FLOT, no negative impact of the addition of docetaxel on QOL parameters could be demonstrated. Thus, elderly patients in need of intensified chemotherapy may receive FLOT without compromising patient-reported outcome parameters.     

Out-of-pocket payment and cost-effectiveness of XELOX and XELOX plus bevacizumab therapy: from the perspective of metastatic colorectal cancer patients in Japan

Objective

The purpose of our study was to estimate the out-of-pocket payment and cost-effectiveness of capecitabine plus oxaliplatin (XELOX) or XELOX plus bevacizumab from the perspective of patients with metastatic colorectal cancer (MCRC).

Methods

Based on the NO16966 and NO16967 trials, the mean out-of-pocket payment was calculated from patient-level data. Out-of-pocket payments for 16 cycles (11 months) of first-line chemotherapy and 8 cycles (5 months) of second-line chemotherapy were included. In addition, incremental cost-effectiveness ratios (ICERs) for first-line bevacizumab were calculated by dividing the difference of the out-of-pocket payment by the difference of the mean number of progression-free survival (PFS) years or quality-adjusted PFS (QAPFS) years.

Results

The mean out-of-pocket payments for middle-income patients under 70 years of age were JPY 328,000 for 16 cycles of first-line XELOX and JPY 376,000 for XELOX plus bevacizumab. The mean out-of-pocket payment for 8 cycles of second-line XELOX was calculated to be JPY 175,000. Middle-income patients over 70 years of age were required to pay JPY 61,000 and JPY 72,000 for first-line XELOX and XELOX plus bevacizumab, respectively. The ICERs of middle-income patients <70 years of age were JPY 430,000/PFS-year and JPY 720,000/QAPFS-year, and those of middle-income patients >70 years of age were JPY 100,000/PFS-year and JPY 170,000/QAPFS-year.

Conclusions

We clarified the out-of-pocket payment and cost-effectiveness of chemotherapy of MCRC patients in Japan. Our previous survey shows it is highly possible that many patients prefer to pay that incremental out-of-pocket payment to gain one additional QAPFS year. However, our cost-effectiveness analysis was not conducted from the perspective of society or healthcare payers.     

CIK细胞辅助治疗Ⅲ期胃癌

目的 分析细胞因子诱导的杀伤细胞(CIK)辅助治疗Ⅲ期胃癌的临床意义.方法 对 88 例Ⅲ期胃癌根治术后行6周期化疗患者资料进行回顾性分析,其中43例患者于辅助化疗结束后接受CIK细胞治疗至少3个周期为CIK治疗组,45例患者单纯化疗为对照组.对CIK细胞治疗前后T细胞亚群检测结果进行随访观察,对2组总生存期与无瘤生存期进行比较.结果 第1次CIK细胞治疗后2周时,CD3+细胞与CD4+/CD8+ 比值显著升高,2个月时又下降到接近治疗前水平,而CIK细胞连续治疗3周期后2个月CD3+细胞与CD4+/CD8+ 比值均维持在高水平.CIK治疗组与单纯化疗组的中位生存期分别为(42.0±2.6)个月与(36.0±2.9)个月,2组中位无瘤生存期分别为(34.0±2.7)个月与(25.0±2.8)个月,2组总生存期与无瘤生存期比较差异均有统计学意义(P均<0.05).结论 采用CIK细胞辅助治疗Ⅲ期胃癌可以改善患者免疫功能,延缓肿瘤复发,延长患者生存期.     

The clinical research of elemene emulsion combined with FOLFOX4 regimen in the treatment of advanced gastric carcinoma

Objective

The aim of this study was to observe the effects and adverse reactions of elemene emulsion added to the chemotherapy in the treatment of advanced gastric carcinoma (AGC).

Methods

Forty-nine patients were divided randomly into two groups, elemene emulsion group (25 cases, treated with chemotherapy and elemene emulsion) and chemotherapy group (24 cases, treated with chemotherapy only). All patients received chemotherapy. The clinical effects and adverse reactions were evaluated after four cycles.

Results

The response rate (RR) were 60% in elemene emulsion group and 41.7% in chemotherapy group respectively (P < 0.05). The median time to progression and overall survival in elemene emulsion group and in chemotherapy group were 7.1 months and 11.0 months vs 5.2 months and 9.3 months (P < 0.05). A lower rate of neutropenia, nausea, vomiting and diarrhea occurred in elemene emulsion group compared with chemotherapy group (P < 0.05), and there was significant difference in the elevation of life quality as well (48% vs 25%; P < 0.05).

Conclusion

Elemene emulsion in combination with FOLFOX4 regimen can improve the efficacy, decrease the incidence of side effects of chemotherapy and elevate the life quality and prolong the survival time in AGC.     

Effect of neoadjuvant chemotherapy on outcomes of immediate free autologous breast reconstruction

Background

Neoadjuvant chemotherapy (NC) is increasingly being utilised although the effects on outcomes of free autologous breast reconstruction and adjuvant treatment remain unclear. The aim of this study was to examine the effect of NC on complications following immediate free flap breast reconstruction.

Methods

A prospective study of immediate free flap breast reconstructions comparing patients who received NC with those who did not was conducted in a single specialist regional unit.

Results

Eighty-seven patients (95 flaps) were included in the study, 30 of which (35 flaps) received NC followed by free flap breast reconstruction. Twenty patients in the NC group had one or more complications compared with 37 patients in the control group (p = 0.87). Nine patients in the NC group had more than one complication compared with 11 patients in the control group, although this difference was not significant (p = 0.26). Both obesity (p = 0.016) and current cigarette smoking (p = 0.014) were significantly associated with the occurrence of any complication in patients who had received NC. Adjuvant radiotherapy was delayed in 3 patients in the NC group, and adjuvant chemotherapy was delayed in 3 control patients (p = 1). The mean preoperative haemoglobin was significantly lower in the NC group than in the control group (p = 0.00037), although there was no significant difference in blood transfusion requirements.

Conclusions

Patients undergoing immediate autologous breast reconstruction following NC have a similar complication and reoperation rate to patients not receiving NC. Preoperative blood haemoglobin level was found to be significantly lower following NC and postoperative blood transfusion triggers should take this into account.     

First-line XELOX plus bevacizumab followed by XELOX plus bevacizumab or single-agent bevacizumab as maintenance therapy in patients with metastatic colorectal cancer: the phase III MACRO TTD study

Purpose.

The aim of this phase III trial was to compare the efficacy and safety of bevacizumab alone with those of bevacizumab and capecitabine plus oxaliplatin (XELOX) as maintenance treatment following induction chemotherapy with XELOX plus bevacizumab in the first-line treatment of patients with metastatic colorectal cancer (mCRC).

Patients and Methods.

Patients were randomly assigned to receive six cycles of bevacizumab, capecitabine, and oxaliplatin every 3 weeks followed by XELOX plus bevacizumab or bevacizumab alone until progression. The primary endpoint was the progression-free survival (PFS) interval; secondary endpoints were the overall survival (OS) time, objective response rate (RR), time to response, duration of response, and safety.

Results.

The intent-to-treat population comprised 480 patients (XELOX plus bevacizumab, n = 239; bevacizumab, n = 241); there were no significant differences in baseline characteristics. The median follow-up was 29.0 months (range, 0–53.2 months). There were no statistically significant differences in the median PFS or OS times or in the RR between the two arms. The most common grade 3 or 4 toxicities in the XELOX plus bevacizumab versus bevacizumab arms were diarrhea, hand–foot syndrome, and neuropathy.

Conclusion.

Although the noninferiority of bevacizumab versus XELOX plus bevacizumab cannot be confirmed, we can reliably exclude a median PFS detriment >3 weeks. This study suggests that maintenance therapy with single-agent bevacizumab may be an appropriate option following induction XELOX plus bevacizumab in mCRC patients.     

Outcomes of multiple salvage chemotherapy for advanced gastric cancer: implications for clinical practice and trial design

Purpose

We analyzed the natural history of advanced gastric cancer with sequential salvage chemotherapy following first-line treatment.

Methods

We studied 532 patients with unresectable gastric adenocarcinoma who were treated at Yonsei Cancer Center (2000–2008). The patients were managed with multiple sequential salvage chemotherapy as allowed by performance status and toxicity profiles. The tumor response was assessed every two cycles.

Results

Four hundred sixty patients received palliative chemotherapy and 72 received supportive care only. The median overall survival was 12.0 months for all patients, 12.1 months for the chemotherapy group, and 2.5 months for the supportive care group (P < 0.001). In the chemotherapy group, 87% received first-line chemotherapy, 47% second-line, 23% third-line, 9% fourth-line, and 3% fifth-line. Response rates were 24.8, 12.6, 10.9, 2.6, and 0% and disease control rates were 76.3, 60.1, 54.2, 54.2, and 53.3% for first- to fifth-line treatment, respectively. The median progression-free survival was 5.5, 3.4, 2.5, 1.9, and 2.0 months and overall survival was 12.1, 7.9, 5.5, 5.0, and 6.8 months. Performance status and metastatic pattern were consistent prognostic factors throughout salvage treatment.

Conclusions

Clinical trials may be feasible in second- or third-line salvage chemotherapy for gastric cancer. Future clinical trials in these settings should take into account the low response rate, short progression-free survival, and the prognostic factors for optimal trial design.     

Clinical analysis of preoperative induction chemotherapy with gemcitabine combined with cisplatin for locally advanced non-small cell lung cancer

Objective

The purpose of this study was to assess the curative effect and adverse reaction of preoperative induction chemotherapy with gemcitabine combined with cisplatin for locally advanced non-small cell lung cancer (NSCLC).

Methods

This prospective randomized controlled trial included 115 patients with locally advanced NSCLC were randomly divided into experimental and control groups and were treated from January 2007 to January 2010. The experimental group of 63 cases was treated with two cycles of induction chemotherapy before operation, radical surgery had been performed about three weeks after completion of chemotherapy, followed by received two cycles of chemotherapy. And the control group (52 cases) was treated at first with radical surgery, then treated with four cycles of chemotherapy. Two groups of the cases received routine thoracic radiotherapy with a total dose of 45 Gy. One cycle of gemcitabine combined with cisplatin regimen included gemcitabine 1000 mg/m² on day 1 and day 8 and cisplatin 25 mg/m² on day 1, day 2 and day 3 by intravenous infusion, with 21 days as one cycle. The tumor recurrence was evaluated by chest CT and abdominal B-ultrasound. Efficacy and toxicity results were compared by two groups.

Results

All patients were followed up for three months to two years. The surgical stage of the experimental group reduced, two-years disease-free survival and postoperative recovery in the experimental group were better than in the control group, the difference was statistical significant. Toxicity and side effect after chemotherapy were mainly bone marrow suppression and gastrointestinal reactions, other complications included thrombocytopenia, leukopenia, anemia, liver and kidney dysfunction were no significant difference in two groups.

Conclusion

Preoperative induction chemotherapy with gemcitabine combined with cisplatin for locally advanced lung cancer can reduce the surgical staging and extend the postoperative disease-free survival.     

空气波压力治疗仪治疗奥沙利铂神经毒性的临床观察

Objective

The aim of this study was to observe the efficacy of air wave pressure therapeutic equipment in prevention of oxaliplatin-inducted neurotoxicity.

Methods

Forty-five patients with colorectal cancer were randomly divided into treatment group and control group, treatment group were given the treatment of air wave pressure therapeutic equipment during chemotherapy with oxaliplatin, the control group were given preventive treatment, the oxaliplatin-inducted neurotoxicity was evaluated after each cycle of chemotherapy. Evaluate the chemotherapy efficacy after the third cycle and sixth cycle of chemotherapy.

Results

The treatment group have lower incidence of peripheral nerve toxicity than the control group, the difference was statistically significant (χ² = 13.93; P < 0.01). Chemotherapy effect between the 2 groups was no significant difference (P > 0.05).

Conclusion

Treatment with air wave pressure therapeutic equipment can reduce the incidence of peripheral nerve toxicity during oxaliplatin chemotherapy.     

Correlation between response to chemotherapy with concomitant bevacizumab for hepatic metastasis of colorectal cancer and degree of enhancement using contrast-enhanced computed tomography

Purpose

The imaging factor predicting the response to bevacizumab (BV) as concomitant chemotherapy has yet to be determined. This study examined correlation between response to chemotherapy with concomitant BV for hepatic metastasis of colorectal cancer and degree of contrast enhancement (CE) using contrast-enhanced computed tomography (CT).

Methods

Data were analyzed retrospectively for 35 patients treated with oxaliplatin-based chemotherapy as the first-line chemotherapy. Patient data were divided according to treatment with concomitant BV (BV group: n = 20, non-BV group: n = 15). Using an image control system, the degree of CE was evaluated by the ratio of the contrast-enhanced CT value of hepatic metastatic lesions to plain CT value, whereby patients were classified into the high-CE and low-CE group.

Results

After completion of chemotherapy treatment, the degree of enhancement of hepatic metastasis in the BV group was significantly lower than that in the non-BV group (p = 0.03). In the BV group, a significant correlation between higher contrast enhancement and higher tumor shrinkage rate was observed (R ² = 0.25, p = 0.03), whereas no such correlation was noted in the non-BV group. In the high-CE group (n = 18), the tumor shrinkage rate increased to 29.6 % in the BV group compared with ?1.46 % in the non-BV group (p = 0.03), whereas in the low-CE group, no significant difference was noted between patients in the two groups.

Conclusion

Pretreatment evaluation of the degree of CE correlated with the response to concomitant chemotherapy with BV.     

Different relation between ERCC1 overexpression and treatment outcomes of two platinum agents in advanced biliary tract adenocarcinoma patients

Purpose

The aim of this study is to evaluate the effect of excision repair cross-complementation group 1 (ERCC1) expression on treatment outcomes in advanced biliary tract adenocarcinoma (ABTA) patients treated with platinum-based chemotherapy.

Methods

One hundred and six patients with histologically confirmed adenocarcinoma of biliary tract were enrolled at 5 institutions in South Korea between January 2002 and September 2008. Of 106 patients, 93 were assessed by immunohistochemistry from tissue specimens. Sixty-five patients were treated with cisplatin-based regimens and the other 28 treated with oxaliplatin-based ones.

Results

For total study population, no significant differences were noted in progression-free survival (PFS) and overall survival (OS) between ERCC1-negative and ERCC1-positive patients, respectively (4.2 vs. 2.9?months, p?=?0.116; 7.0 vs. 7.8?months, p?=?0.143). In patients treated with cisplatin-based regimens, median PFS and OS were significantly longer in ERCC1-negative group than in ERCC1-positive group, respectively (4.6 vs. 1.9?months, p?=?0.014; 9.1 vs. 7.9?months, p?=?0.017). Disease control rate (DCR) was better in patients with ERCC1 negative than in patients with ERCC1 positive (p?=?0.048). On the other hand, in patients treated with oxaliplatin-containing regimens, median PFS and OS tended to be longer in ERCC1-positive group, but these did not reach statistical significances. Response rate was better in patients with ERCC1 positive (p?=?0.005).

Conclusions

ERCC1 shows a significant prognostic value in ABTA patients treated with cisplatin. A survival benefit was observed in ERCC1-negative patients from cisplatin-containing chemotherapy but not from oxaliplatin-containing ones. The action mechanism of ERCC1 on cisplatin may be different from that on oxaliplatin.     

肿瘤药敏指导下的化疗对非小细胞肺癌并恶性胸水治疗的有效性(英文)

Objective:The aim of the study was to investigate the clinical value and application of ATP based bioluminescence tumor chemosensitivity assay (ATP-TCA) in the chemotherapy for hydrothorax caused by non-small cell lung cancer (NSCLC). Methods:Hydrothorax specimens from 120 NSCLC patients were analyzed by ATP-TCA and the most sensitive chemotherapeutic drugs were used in NSCLC patients (treatment group). At the same time, 56 NSCLC patients with hydrothorax were admitted in our Hospital (Department of Oncology, The No. 2 People’s Hospital of Yibin, China) and given chemotherapy without guidance of the ATP-TCA (control group). Before the third chemotherapeutic cycle, clinical outcomes were analyzed in the two groups. Results:Effective rate of hydrothorax in treatment group was 67%, while 46% in control group (P < 0.05). In refractory hydrothorax patients, they were 69% and 40% (P < 0.05), respectively. In vitro results correlated well with clinical outcomes (P < 0.01). Conclusion:Effective rate of chemotherapy for hydrothorax in NSCLC is higher in treatment group than that in control group. ATP-TCA is especially helpful for refractory hydrothorax.