Improvements of quality of life in patients with advanced non-small cell lung cancer treated with gefitinib

Objective： The aim of this study was to evaluate the effect of gefitinib on improvement of quality of life （QoL） of patients with advanced non-small cell lung cancer （NSCLC）. Methods： There were 70 patients with advanced NSCLC. One oral gefitinib tablet （250 mg） was administered every day without interruption unless disease progression or unacceptable toxicity occurred. The impact of treatment on disease-related symptoms and QoL was evaluated with the Chinese versions of European Organization for Research and Treatment of Cancer Quality of Life Questionnaires （EORTC QLQ-C30 and QLQ- LC13）. Results： Fifty-eight patients had finished the questionnaires. The mean scores of five functioning scales （physical, role, emotional, cognitional and social） were 62.64, 56.03, 68.41, 64.67, 60.63 respectively after eight weeks of treatment, which were 52.30, 49.43, 64.39, 59.79, 52.30 respectively before treatment, and the mean score of global QoL after and before treatment was 60.17 and 52.70 respectively. There was statistical difference in five functioning scales and global QoL （P 〈 0.05）. Mean scores of main general symptoms （fatigue and appetite loss） were 57.66 and 48.08 respectively after eight weeks of treatment, which were 61.11 and 51.72 respectively before treatment, and mean scores of disease-related symptoms （dyspnoea, coughing, empsyxis, pain in chest）were 48.66, 47.13, 26.82, 24.71 respectively after eight weeks of treatment, which were 54.98, 53.64, 27.78, 28.54 respectively before treatment. There was statistical difference in fatigue, dyspnoea, cough and pain in chest （P 〈 0.05）. Response rate of five functioning and global QoL were all more than 50% after gefitinib treatment. Response rate of main general symptoms and disease-related symptoms were all more than 40%. QoL and symptom response correlated with disease control. The patients with better QoL had longer survival. Conclusion： gefitinib treatment can improve the QoL and symptoms of advanced NSCLC patient     

Experience with the surgical treatment of patients with both esophageal carcinoma and bullous emphysema

Objective： We aimed to investigate the security and feasibility of the simultaneous surgery for patients with both esophageal carcinoma and bullous emphysema. Methods： We described simultaneous surgery performed on 49 cases with both esophaoeal carcinoma and buUous emphysema, accounting for 2.5% of all esophagectomy patients from January 2000 to January 2003. Radical resection of upper and mid-thoracic esophageal cancer was performed in 31 cases, including three approaches from the right chest, left neck and midsection. Thirty-six patients were underwent cervical anastomosis and 13 cases were operated by intrathoracic anastomosis. Results： No perioperative period death occurred. And postoperative com- plications were as follows： cervical anastomotic leakage in 9 cases, lung infection in 11 cases, pulmonary air leak in 13 cases （2 cases lasted for 4 weeks）, recurrent laryngeal nerve damage in 4 cases, supraventricular tachycardia in 4 cases. Patients all recovered and left the hospital with average hospitalization time of 17.5 days. Conclusion： Patients with both esophageal carcinoma and bullous can perform the esophageal carcinoma resection and lung volume reduction surgery （LVRS） simulta- neously. It will not increase the mortality rate and show the feasibility and safety in patients.     

Clinical study of docetaxel combined with concurrent radiotherapy in patients with advanced nasopharyngeal carcinoma

Objective： The aim of this study was to study the short-term curative effects and adverse reactions of docetaxel （DOC） in concurrent chemoradiotherapy compared to DDP plus 5-Fu （DF） combined with concurrent radiotherapy in patients with advanced nasopharyngeal carcinoma. Methods： Thirty-three patients in the experimental group （DOC group） were given DOC 25 mg/m2 ivgtt, dl, 7 times, concurrent radiotherapy was performed from dl. Thirty-three patients in the control group （DF group） were given cisplatin 25 mg/@ivgtt dl-3 and 5-Fu 550 mg/m2iv, dl-5, 3 weeks a cycle, 2 cycles, and concurrent radiotherapy was performed from dl. Six MV X-ray and 9 MeV electronic line for external irradiation were adopted in concur- rent radiotherapy. Results： The response rates of DOC group and DF group were 90.9% and 93.9%, the rates of neutropenia were 45.45% and 67.74%, and the rates of oral mucositis were 60.61% and 90.32%. Conclusion： The difference of short- term curative effects between DOC group and DF group was not statistically significant in patients with advanced nasopha- ryngeal carcinoma. The rates of adverse reactions were lower in DOC group. DOC combined with concurrent radiotherapy could be a new choice for patients with advanced nasopharyngeal carcinoma.     

Oxaliplatin combined with S-1 capsule in the treatment of 62 cases with advanced gastric cancer

Objective： The aim of this study was to evaluate the efficacy and safety profile of DeFazio （S-l） combined with oxaliplatin against unresectable advanced or metastatic gastric cancer. Methods： Oxaliplatin was given intravenously at 130 mg/m2 for 2 h on dl and S-1 was administered bid. at 80 mg/m2/day on d1-14 followed by a 7-day rest during the 3-week schedule. Results： All 62 patients were assessed for efficacy and adverse events. The response and disease control rates were 47.3% and 80.8%, respectively. The median time to progression was 7.8 months, and the median overall survival was 11.6 months. The grade 3/4 adverse events were hematological toxicities, including neutropenia （11.3%）, thrombocytopenia （9.7%） and gastrointestinal reactions （6.5%）. Conclusion： The SOX regimen （oxaliplatin, 130 mg/m2 d l; S-1, 80 mg/m2/day, bid. d1-14, q3w） provide a favorable efficacy and safety profile in patients with advanced gastric cancer.     

Expression levels of CXCR4 and VEGF correlate with blood-borne metastatic progression and outcome in patients with osteosarcoma

Objective： We determine whether chemokine receptor CXCR4 and vascular endothelial growth factor （VEGF） expression related to the metastasis and survival outcome of patients with osteosarcoma. Methods： Tissue microarray （TMA） was used to detect the expression of CXCR4 and VEGF in 56 osteosarcoma patient samples. Two-year follow-up was performed to observe the metastatic behavior and overall survival of osteosarcoma patients. Results： There was a significant correlation between the expression levels of CXCR4 and VEGF in 56 osteosarcoma patient samples （P = 0.002）. Univariate analysis revealed the expression of CXCR4 and VEGF was not associated with age, gender and the level of ALP but associated with clinical stage. Conclusion： These data raises the possibility that VEGF could regulate the levels of CXCR4 to promote the migration of tumor cells to target organs. CXCR4 and VEGF expression are highly correlated with metastatic progression in patients with osteosarcoma and their immunohistochemical expression have predictive value for the metastatic development.     

Comparison of vinorelbine plus cisplatin with vinorelbine plus capecitabine in patients with anthracyclines- and taxanes-refractory advanced breast cancer

Objective： The aim of our study was to compare the efficacy and toxicities of vinorelbine plus cisplatin （NP） regimen with that of vinorelbine plus capecitabine （NX） regimen in the treatment of anthracycline- and taxane-refractory advanced breast cancer. Methods： Forty-six patients with anthracycline- and taxane-refractory advanced breast cancer were equally randomized into a NP group （n = 23） and a NX group （n = 23）. Response rates and toxicities were evaluated after 2 cycles of chemotherapy. Results： The overall response rate were 48.0% in both groups. There were no significant differences in disease control rates （78.0% vs. 83%） or 1-year survival rates （54.6% vs. 55.9%）. The main adverse events were bone marrow depression and gastrointestinal reaction, and no significant difference was found in toxicities between the groups. Conclusion： For anthracycline- and taxane-refractory advanced breast cancer, NP and NX regimens exerted similar curative effects with acceptable toxicity.