Efficacy comparison between hepatic arterial infusion chemotherapy plus systemic chemotherapy used as first-line and non-first-line treatments for the patients of colorectal cancers with unresectable hepatic metastases

Objective： The combination of hepatic arterial chemotherapy （HAIC） and systemic chemotherapy （SYC） has potential effect on colorectal cancer （CRC） patients with unresectable hepatic metastasis. The aim of this retrospective study was to investigate the efficacy and safety of this combined therapeutic regimen on Chinese patients based on single institute experiences. Methods： All 54 patients of this retrospective analysis were diagnosed with CRC with unresectable liver metas tasis and received combined HAIC and SYC. Among the patients, 23 of them received HAIC plus SYC when they developed liver metastases as firstline treatment （Group 1）, and 31 patients received HAIC plus SYC as nonfirstline treatment （Group 2）. The different efficacy in two groups was analyzed by SPSS 19.0. Results： The overall response rate （ORR） were 52.2% and 25.8% respectively in Groups 1 and 2 （P = 0.047）, and the disease control rate （DCR） were 65.2% and 35.5% respec tively in Groups 1 and 2 （P = 0.031）. The median progressionfree survival （PFS） were 6.8 and 3.3 months （P = 0.002）, the median hepatic progressionfree survival （HPFS） were 8.8 and 3.7 months （P = 0.001）, and the median overall survival （OS） were 18.8 and 13.7 months （P = 0.121） in Groups 1 and 2, respectively. No fatal reaction was observed and no significant difference of adverse reaction was found in two groups. Grade 3/4 toxic effects included neutropenia （9.7% in Group 2 only）, gastrointestinal reaction （8.7% in Group 1 and 6.5% in Group 2）, stomatitis （6.5% in Group 2 only） and hyperbilirubinemia （4.3% in Group 1 only）. Conclusion： HAIC combined with SYC showed promising efficacy and safe profiles on CRC patients with unresectable liver metastases.     

Diagnostic value of bile CEA assay for the detection of liver metastasis from colorectal cancer

Objective： We measured CEA （carcinoembryonic antigen） levels in both serum and bile from patients with coloroctal cancer （CRC） to evaluate the relationship between bile CEA levels and liver metastasis （LM）. Methods： Throe groups were enrolled in our study. Primary CRC group： 27 patients with CRC but without LM; LM group： 14 patients with LM from CRC; Controlled group： 20 patients with benign biliary diseases （cholelithiasis or cholecystitis）. Both serum and bile were collected to measure CEA levels in all groups but only bile CEA was measured in controlled group. Results： Bile CEA level in LM group was significantly higher than that of the primary CRC group （314.27 and 13.07 ng/mL respectively; P 〈 0.05）. In LM group bile CEA level was significantly higher than serum CEA level （314.27 and 43.51 ng/mL respectively; P 〈 0.05）. Bile CEA level was more relevant to the number and size of LM than the primary tumor factors. Conclusion： In confirmed CRC liver metastasis, the bile CEA level is significantly elevated. Bile CEA assay may be of potential value in diagnosis of liver metastasis,especially for the occult LM.     

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.     

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.     

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     

Efficacy and safety profiles of cetuximab in Chinese patients with colorectal cancer

Objective： The aim of this study was to investigate the efficacy and safety profiles of cetuximab, the commonly used monoclonal antibody of epidermal growth factor receptor, based on Chinese patients with colorectal cancer. Methods： All the papers studied on Chinese patients with gastrointestinal cancer treated by cetuximab and found in both databases of Chinese journal database for fulltext and PubMed were collected. The commonly used efficacy index such as disease control rate （CR ＋ PR ＋ SD） and response rate （CR ＋ PR） were analyzed, and the cetuximab related side effects such acne-like rash and nail change and hypersensitivity were analyzed too. Results： （1） There were 10 original papers contained total 152 patients with gastrointestinal cancer who were the candidates to analyze the safety profiles, and contained 130 patients with colorectal cancer who were candidates to analyze the efficacy. （2） The disease control rate and response rate in the whole group was 73.5% （95% CI： 65.5%-81.5%） and 29.1% （95% CI： 20.9%-37.3%）, respectively; In first-line setting group they were 70.0% （95% CI： 55%-85%） and 41.7% （95% CI： 25.6%-57.8%）, respectively; In non-first line setting group they were 71.6% （95% CI： 61.8%-81.4%） and 23.5% （95% CI： 14.3%-32.7%）, respectively. The disease control rate between the two line-setting groups was insignificant, but the response rate between the two line-setting groups was significant （P = 0.045）. （3） The incidence of acne-like rash was 72.0% （95% CI： 64.8%-79.2%）, the degree Ⅰ-Ⅱ and degree Ⅲ-Ⅳ account for 56.0% （95% CI： 48.1%-63.9%） and 16.0% （95% CI： 10.1%-21.9%）, respectively. No treatment related death, and the hypersensitivity was under control. Conclusion： This study is the first study to summarize the data of Chinese patients with colorectal cancer treated by cetuximab-contained regimen, it showed that the monoclonal antibody was effective and safe for Chinese patients as the West p