Disparate genomic characteristics of concurrent endometrial adenocarcinoma and ovarian granulosa cell tumor,revealed by targeted next-generation sequencing

Concurrence of both endometrial adenocarcinoma and ovarian adult granulosa cell tumor (aGCT) is believed to be related to high estrogen milieu, but genomic alterations of the concurrent endometrial adenocarcinoma and aGCT are not known. For this, we analyzed an uterine endometrial adenocarcinoma and an ovarian aGCT in a same patient by a targeted next generation sequencing (NGS). We found a germline mutation in STK11 (p.L113fs). The endometrial adenocarcinoma harbored FGFR2 and TP53 mutations and the aGCT harbored a FOXL2 (p.C134?W) mutation. These germline and somatic mutations have been reported in non-concurrent tumors. These two tumors harbored 20 CNAs but only one CNA was exactly overlapped in the tumors. Our findings indicate that the concurrent endometrial adenocarcinoma and aGCT in this patient might not be genetically related to each other at germline or somatic level and suggest that such concurrence might be originated from non-genetic backgrounds including stimulated estrogen milieu.     

EGFR status and EGFR ligand expression influence the treatment response of head and neck cancer cell lines

Background: Combination treatment (chemoradiotherapy) is the standard treatment for locally advanced head and neck squamous cell carcinoma (HNSCC); however, treatment resistance and local recurrence are significant problems. A high level of epidermal growth factor receptor (EGFR) has been associated with a more aggressive phenotype as well as decreased responsiveness to radio‐ or chemotherapy. We examined the role of EGFR status and EGFR ligand expression for the treatment response. Methods: Intrinsic sensitivity to radiotherapy, cisplatin, and cetuximab treatments was investigated in 25 HNSCC cell lines. EGFR gene copy number, mRNA and protein expression, EGFR and Akt phosphorylation status, and mRNA expression of the EGFR ligands were analyzed using quantitative PCR and ELISA and assessed for their impact on treatment sensitivity. Results: Different treatment modalities yielded great diversity in outcome; of note, cetuximab treatment stimulated growth in one cell line. When treatments were combined primarily additive effects were observed. While radioresistance tended to be associated with a high level of phosphorylated EGFR (pEGFR; P = 0.09), cetuximab‐resistant cells had low levels of pEGFR (P = 0.13). The three most cetuximab‐sensitive cell lines had high EGFR gene copy numbers. Furthermore, cetuximab treatment response was significantly correlated with epiregulin mRNA expression (r = ?0.408, P = 0.043). Cisplatin‐resistant tumor cells expressed significantly lower levels of EGFR protein (P = 0.04) compared to cisplatin‐sensitive cells and tended to have lower levels of phosphorylated Akt (pAkt; P = 0.13) and lower expression levels of amphiregulin (P = 0.18). Conclusions: Epidermal growth factor receptor status and ligand expression influence the treatment sensitivity of HNSCC cells and may be useful as predictive markers.     

Definitive Chemoradiotherapy for Oesophageal Cancer — A Promising Start on an Exciting Journey

Despite many advances in the management of oesophageal cancer, survival rates remain poor. Currently there is no clear consensus on the optimum management modality for localised disease. Surgery alone or combined with neoadjuvant chemotherapy or chemoradiotherapy and definitive chemoradiotherapy are all treatment options used for treating selected patient groups throughout the world. This overview discusses the evidence for definitive chemoradiotherapy, its role for certain patient groups and compared with other treatment options and how it has evolved with emerging technologies over recent decades. It highlights some key areas of research for future trials, including more precise treatment delivery, treatment intensification and a possible randomised controlled trial comparing radiation and surgical-based treatment.     

Réirradiation de métastases ganglionnaires d’un adénocarcinome œsogastrique par une technique de tomothérapie associée à de l’évérolimus

Advanced gastric cancer or gastro-oesophageal junction cancer after a failure of first line chemotherapy have poor outcome. Hereby, we present the first patient treated by radiotherapy with concurrent everolimus, a mTor inhibitor, for a reirradiation of metastasis invading left axillary, infraclavicular and supraclavicular lymph nodes in progression despite several lines of chemotherapy. After 6 months of follow-up, this association provided a satisfactory anti-tumor efficiency and tolerance. Nevertheless, clinical trials are needed in order to confirm this strategy for the treatment of gastric cancer metastasis.     

EGFR expression as a predictive marker in esophageal squamous cell cancer:Review article

Esophageal cancer（ EC ） is a highly aggressive disease and 8＇h leading cause of death worldwide. Squamous cell cancer is the main histological type in China. Recent improvements in both surgical techniques and adju- vant/neoadjuvant radiotherapy and chemotherapy approaches have increased the survival of patients with the loco- regional disease. However, most of the patients with EC have advanced disease either at diagnosis or at follow-up. Despite recent advances in the treatment, these patients still do poorly. Over expression of the epidermal growth factor receptor in esophageal the role of epidermal growth cancer is associated with poor prognosis. However, very few researches have examined factor receptor（EGFR） in prediction and therapeutic sensitivity to esophageal squamous cell cancer（ESCC）. If pretherapeutic identification of esophageal squamous cell cancer which does not re- spond to chemoradiotherapy （CRT） can be done, it will help to improve the outcome of patients by selecting responders to treatment. In this review we describe the predictive significance of EGFR expression in ESCC.     

护理干预对同步放化疗治疗非小细胞肺癌患者疗效及生活质量的影响

目的探讨护理干预对同步放化疗治疗非小细胞肺癌疗效及生活质量的影响。方法均给予本院50例非小细胞肺癌患者同步放化疗治疗,根据随机数字法,将其分为对照组(常规护理)和观察组(护理干预),各25例,比较2组治疗的临床疗效、生活质量评分及护理满意度。结果与对照组相比,观察组治疗的总有效率显著增高(P0.05),观察组护理后生活质量各维度得分及总分均显著增高(P0.05);与对照组相比,观察组患者对护理服务满意度显著提升(P0.05)。结论同步放化疗治疗非小细胞肺癌期间,有效的护理干预能够提高临床疗效,提升患者的生活质量及满意度。     

Prevalence and significance of anaemia in patients receiving long‐course neoadjuvant chemoradiotherapy for rectal carcinoma

Aim The study aimed to assess the prevalence and significance of anaemia during long‐course neoadjuvant radiotherapy for rectal cancer at our centre. Method Hospital coding and a prospective oncology database were used to identify all patients undergoing long‐course neoadjuvant radiotherapy for rectal cancer at our centre between 2004 and 2009. A retrospective review of computerized records was used to extract individual patient data. Anaemia was defined as a haemoglobin level of < 11.5 g/dl for women and of < 13 g/dl for men. Downstaging was assessed by comparing radiological stage (rTNM) with histological stage (ypTNM). Tumour regression after radiotherapy was assessed using the Rectal Cancer Regression Group (RCRG) scores of 1–3. The results were analysed using Gnu PSPP statistical software. Results There were 70 patients (51 men) of median age 66 (interquartile range 60–72.75) years. Of these, 24 were anaemic. Two (3%) had no haemoglobin level recorded and were excluded. Forty‐two per cent of anaemic patients demonstrated mural (T) downstaging compared with 68% of nonanaemic patients (P = 0.03). There was no difference in nodal downstaging between the groups. The RCRG scores showed more tumour regression in nonanaemic patients than in anaemic patients, as follows: RCRG 1, 59%vs 30%; RCRG 2, 11%vs 17%; and RCRG 3, 38%vs 46% (P < 0.001). Conclusion The prevalence of anaemia in patients undergoing long‐course neoadjuvant radiotherapy was 35%. Anaemia during long‐course neoadjuvant radiotherapy was associated with significant reductions in tumour downstaging and regression.     

食管癌新辅助放化疗疗效预测分子标志物

局部晚期食管癌单纯手术治疗预后较差,新辅助放化疗并手术治疗的方案可明显延长食管癌患者的总体生存时间.目前,该治疗方案已成为欧美国家及我国对局部晚期食管癌进行规范化治疗的指南.然而,由于只有经新辅助放化疗后获得病理缓解的患者可从中获益,治疗无反应的患者预后可能比单纯手术更差.因此,预测食管癌新辅助放化疗的疗效,区分优势人群和耐受人群,从而实现个体化的治疗极为重要.分子标记物用于预测食管癌新辅助放化疗的疗效研究前景广阔,有望广泛应用于临床实践,指导局部晚期食管癌个体化治疗方案的决策.