Clinical observation of capecitabine plus oxaliplatin in treatment of 68 cases with advanced clastric cancer

Objective： The aim of this study was to evaluate the response rate, time to progression （TTP）, overall survival, and safety of the combination of capecitabine plus oxaliplatin in treatment of advanced gastric cancer （AGC）. Methods： All the patients with advanced gastric cancer who were not received any prior chemotherapy or radiotherapy were treated with combination of capecitabine （1250 mg/m2 twice daily, days 1-14） plus oxaliplatin （130 mg/m2 as a 2-h intravenous infusion on day 1） every 3 weeks. Results： Two cases of complete response （CR） and 34 cases of partial response （PR） were confirmed, giving an overall response rate of 52.9%, of the 68 patients with advanced gastric cancer. The median TTP and overall survival for all patients were 7.3 and 11.9 months, respectively. Grade 3 leukopenia, thrombocytopenia, nausea/vomiting, and diarrhea were observed in 3, 5, 1, and 4 patients, respectively. Yet, no grade 4 toxicity was observed. Conclusion： Capecitabine/ oxaliplatin combination chemotherapy is active in patients with advanced gastric cancer.     

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.     

Clinical research on treatment of advanced androgen independent prostate cancer with Docetaxel and Thalidomide

Objective： To evaluate the clinical effects and adverse reactions of Docetaxel and Thalidomide in treating advanced androgen independent prostate cancer （AIPC）. Methods： 12 cases of advanced AIPC were given a combined treatment of Docetaxel and Thalidomide, with Docetaxel 75 mg/m^2 on day 1 and Thalidomide 100 mg per day as initial dose and 300 mg as terminal dose by an increase of 50 mg every week. Results： The post-treatment values of prostate specific antigen （PSA） were normal （〈 4 ng/L） in 10 patients, less than 50% of pretreatment value in one patient, and no significant change in one patient. The median survival time was 14 months and period of the median symptoms reduction was 16.3 months. Common adverse reactions were tolerable, including nausea, vomiting, leukopenia, anemia and thrombocytopenia. Conclusion： The regimen of Docetaxel combined with Thalidomide was effective and tolerable in the treatment of advanced AIPC.     

Neoadjuvant intra-arterial infusion chemotherapy followed by surgery in patients with locally advanced cervical cancer

Objective： The aim of this study was to investigate the role of preoperative neoadjuvant intra-arterial infusion chemotherapy （NAIC） in treating locally advanced cervical caner. Methods： Nineteen locally advanced cervical cancer （LACC） patients from November 2003 to November 2005 were analyzed retrospectively. NAIC was administrated 2 courses every 2 weeks using a combination of 30 mg/m^2 bleomycin and 50 mg/m^2 cisplatin via bilateral femur artedes. The response to NAIC was assessed by pelvic examination and imaging diagnostics and histological analysis. Two weeks after NAIC radical hysterectomy with pelvic lymphadenectomy was performed. Results： Radical hysterectomy with pelvic lymphadenectomy were performed in 18 patients successfully. The mean tumor reduction rate was 73.04%. The overall clinical response rate of NAIC was 84.2% with 2 complete responses and 16 partial responses. Only 1 nonresponder. Six of 7 cases who had parametrial infiltration had a absence after chemotherapy, no significant change was observed in 1 case who followed by radiotherapy. Multivariate logistic regression analysis indicated that tumor volume prior to treatment was determining factor affecting the efficacy of NAIC in LACC. Conclusion： pre-operative NAIC inhibited the growth of LACC, minimized the size, eliminate effectively the pathologic dsk factors in the pelvic cavity, to improve the operability in cervical cancer patients with stage lib or above, considered inoperable.     

The application of Meta-analysis in the latest comprehensive treatment of breast cancer

Meta-analysis is a kind of systematic review, which uses quantitative method to summarize the results. It is a comprehensive evaluation to the findings of previous studies with higher credibility. Recently, it is applied to all areas of scientific research, particularly in the integrated treatment of breast cancer. Currently, breast cancer is known one of the most common malignant tumors, and its incidence is increasing year by year. Therefore, more and more clinical doctors pay attention to the effect of comprehensive treatment for patients with breast cancer. This article mainly collects the results of comprehensive treatment of breast cancer, in which the method of Meta-analysis is applied. In addition, we discuss the latest progress in order to guide the clinical treatment.     

Clinical application of intraperitoneal chemotherapy before surgery for ovarian cancer and its evaluation

Objective： To investigate the clinical efficacy of intraperitoneal chemotherapy before surgery for ovarian cancer. Methods： 60 patients with stages Ⅱ-Ⅳ of ovarian cancer were treated with intraperitoneal chemotherapy of CAP or TP regimen followed by a surgery treatment and another chemotherapy for 6 cycles. And then the efficiency of the therapy was evaluated by analyzing the changes of ascites, the serum CA-125 and CA-19-9 levels and the findings in the operation, and investigating the recurrence of cancer and the survival. Results： After 1-3 cycles of intraperitoneal chemotherapy, serum levels of CA-125 and CA-19-9 and carcinous ascites significantly reduced in all patients, ascites reduce was over 50% in 98.3% cases; all cases were successfully treated with cytoreduction and it was found during the operation that bulky tumor was reduced and looser so as to be easily isolated and removed; PFS of the patients was prolonged, while the toxicity and side-effects were not so serious as beyond the patient toleration. Conclusion： Intraperitoneal chemotherapy before surgery for ovarian cancer has an active efficacy in clinic, being able to improve conditions of surgery and increase the opportunity of maximal cytoreduction, and prolong survival of the patients, and should be a good selection for the treatment of advanced ovarian cancer.     

A clinical study of combination of radiotherapy and IP regimen in the treatment of patients with local advanced esophageal cancer

Objective： The aim of this study was to study the clinical efficacy and toxicity of combination of the radiotherapy and IP regimen for patients with local advanced esophageal cancer. Methods： Sixty-eight cases of local advanced esophageal cancer were randomized into two groups, simple irradiation group （control group, n = 33） receiving conventional radiotherepy to a total of 60 Gy, combined group （research group, n = 35） which received the same radiotherapy as simple irradiation group ptus chemotherapy with IP regimen, patients in research group were treated with infusion of Irinotecan 65 mg/m^2 and DDP 30 mg/m^2 on days 1 and 8. Twenty-one days was a cycle and 4 cycles were given. Results： The remission rate, one and two year disease-free survival rate in research group were significant higher than it in control group. But the incidence of nausea, vomiting, myelosuppression and diarrhea was higher in research group. Conclusion： The efficacy of concomitant radiotherapy and IP regimen for local advanced esophageal cancer is obviously and it can improve the survival rate of patients, which worthy of clinical application.     

Clinical observation of platinum-based combined with concurrent three-dimensional conformal radiotherapy in patients with locally advanced non-small cell lung cancer

Objective： The aim of our study was to explore the shortterm efficacy of platinumbased combined with concur rent chemoradiotherapy for locally advanced nonsmallcell lung cancer （NSCLC）. Methods： Between 2006 to 2010, 78 cases of locally advanced NSCLC were enrolled into this trial. All patients were given platinumbased chemotherapy combined with concurrent threedimensional conformal radiotherapy （3DCRT）. Chest CT scans were obtained during endexpiratory and endinspiratory pauses when performing positioning. Image fusion was done after the image data was transferred to treat ment plan system （TPS）. The target volume was delineated on the fusion images. The chemotherapy was given on the first day of radiotherapy. Comprehensive examinations were conducted 46 weeks after concurrent chemoradiotherapy to assess shortterm efficacy. Results： Complete remission （CR） was achieved in 8 cases and partial remission （PR） in 54 cases. The efficiency rate reached 79.5%. Grade IllIV radiation esophagitis occurred in 11.5%. No exit and death cases during treat ment. Conclusion： Concurrent chemoradiotherapy could significantly improve the shortterm efficacy and prolong survival of stage III NSCLC, meanwhile the adverse reactions could be tolerated.