EXPERIMENTAL STUDY OF ANTI－TUMOR EFFECT OF ELECTROCHEMICAL THERAPY ALONE OR IN COMBINATION WITH RADIOTHERAPY

徐晓娜，肖卫群ＥＸＰＥＲＩＭＥＮＴＡＬＳＴＵＤＹＯＦＡＮＴＩ－ＴＵＭＯＲＥＦＦＥＣＴＯＦＥＬＥＣＴＲＯＣＨＥＭＩＣＡＬＴＨＥＲＡＰＹＡＬＯＮＥＯＲＩＮＣＯＭＢＩＮＡＴＩＯＮＷＩＴＨＲＡＤＩＯＴＨＥＲＡＰＹ￥ＸｕＸｉａｏｎａ；ＸｉａｏＷｅｉｑｕｎ（Ｄｅ...     

ENHANCED ANTITUMOR EFFECTS OF SUICIDE GENE THERAPY BY SIMULTANEOUS TRANSFER OF GMCSF GENE IN LEUKEMIA-BEARING MICE

ＥＮＨＡＮＣＥＤＡＮＴＩＴＵＭＯＲＥＦＦＥＣＴＳＯＦＳＵＩＣＩＤＥＧＥＮＥＴＨＥＲＡＰＹＢＹＳＩＭＵＬＴＡＮＥＯＵＳＴＲＡＮＳＦＥＲＯＦＧＭＣＳＦＧＥＮＥＩＮＬＥＵＫＥＭＩＡＢＥＡＲＩＮＧＭＩＣＥ１ＪｕＤｉａｎｗｅｎ鞠佃文ＣａｏＸｕｅｔａｏ２曹雪...     

EXPERIMENTAL AND CLINICAL STUDY OF CONCOMITANT RADIATION THERAPY AND CHEMOTHERAPY FORCERVICAL CARCINOMA

ＥＸＰＥＲＩＭＥＮＴＡＬＡＮＤＣＬＩＮＩＣＡＬＳＴＵＤＹＯＦＣＯＮＣＯＭＩＴＡＮＴＲＡＤＩＡＴＩＯＮＴＨＥＲＡＰＹＡＮＤＣＨＥＭＯＴＨＥＲＡＰＹＦＯＲＣＥＲＶＩＣＡＬＣＡＲＣＩＮＯＭＡ￥ＷｅｉＫｅ；魏克；ＣａｉＳｈｕｍｏ；蔡树模；ＷａｎｇＸｉａｎｇ－...     

ALTERNATING CHEMOTHERAPY AND FRACTIONATED RADIOTHERAPY AS A MODALITY FOR THE TREATMENT OF PRIMARY LIVER CANCER

ＡＬＴＥＲＮＡＴＩＮＧＣＨＥＭＯＴＨＥＲＡＰＹＡＮＤＦＲＡＣＴＩＯＮＡＴＥＤＲＡＤＩＯＴＨＥＲＡＰＹＡＳＡＭＯＤＡＬＩＴＹＦＯＲＴＨＥＴＲＥＡＴＭＥＮＴＯＦＰＲＩＭＡＲＹＬＩＶＥＲＣＡＮＣＥＲＬｕＪｉｚｈｅｎ陆继珍ＬｉＢｉｎｇｘｉｎ李炳鑫ＬｉｕＫａｎ...     

ADYNAMIC STUDY OF THE CYTOTOXICEFFECTS OF HYPERTHERMIA COMBINED WITH CIS－DIAMINE DICHLOROLPLATINUM（DDP） ON HUMAN GASTRIC CANC

ＡＤＹＮＡＭＩＣＳＴＵＤＹＯＦＴＨＥＣＹＴＯＴＯＸＩＣＥＦＦＥＣＴＳＯＦＨＹＰＥＲＴＨＥＲＭＩＡＣＯＭＢＩＮＥＤＷＩＴＨＣＩＳ－ＤＩＡＭＩＮＥＤＩＣＨＬＯＲＯＬＰＬＡＴＩＮＵＭ（ＤＤＰ）ＯＮＨＵＭＡＮＧＡＳＴＲＩＣＣＡＮＣＥＲＣＥＬＬＬＩＮＥＳＭＫＮ...     

STUDIES ON THE GAP JUNCTIONAL INTERCELLULARCOMMUNICATION OF HUMAN NASOPHARYNGEALCARCINOMA CELLS AND THE EFFECT OF RII

ＳＴＵＤＩＥＳＯＮＴＨＥＧＡＰＪＵＮＣＴＩＯＮＡＬＩＮＴＥＲＣＥＬＬＵＬＡＲＣＯＭＭＵＮＩＣＡＴＩＯＮＯＦＨＵＭＡＮＮＡＳＯＰＨＡＲＹＮＧＥＡＬＣＡＲＣＩＮＯＭＡ　ＣＥＬＬＳＡＮＤＴＨＥＥＦＦＥＣＴＯＦＲＩＩＨａｎＬｉｑｕｎ韩立群；ＧａｏＪｉｎ高进；...     

EXPERIMENTAL STUDIES ON RADIATION-INDUCIBLE HUMAN TNF GENE THERAPY FOR CANCER

ＥＸＰＥＲＩＭＥＮＴＡＬＳＴＵＤＩＥＳＯＮＲＡＤＩＡＴＩＯＮ－ＩＮＤＵＣＩＢＬＥＨＵＭＡＮＴＮＦＧＥＮＥＴＨＥＲＡＰＹＦＯＲＣＡＮＣＥＲＣａｏＸｕｅｔａｏ曹雪涛ＺｈａｎｇＷｅｉｐｉｎｇ章卫平ＷａｎｇＪｉａｎｌｉ王建莉ＨｕａｎｇＸｉｎ黄欣ＱｉｎＺｈｉｈ...     

PRELIMINARY STUDY OF RETROVIRAL MEDIATED TRANSFER OF THE HUMAN mdr-1 GENE INTO MURINE AND HUMAN HEMATOPOIETIC STEM/PROGENITOR CELLS

ＰＲＥＬＩＭＩＮＡＲＹＳＴＵＤＹＯＦＲＥＴＲＯＶＩＲＡＬＭＥＤＩＡＴＥＤＴＲＡＮＳＦＥＲＯＦＴＨＥＨＵＭＡＮｍｄｒ１ＧＥＮＥＩＮＴＯＭＵＲＩＮＥＡＮＤＨＵＭＡＮＨＥＭＡＴＯＰＯＩＥＴＩＣＳＴＥＭ／ＰＲＯＧＥＮＩＴＯＲＣＥＬＬＳＦｅｎｇＫａｉ冯凯Ｐｅ...     

ISOLATION AND CHARACTERIZATION OF AN ADRIAMYCIN－RESISTANT SUBLINE OF THE HUMAN GASTRIC ADENOCARCINOMA CELLLINE

ＩＳＯＬＡＴＩＯＮＡＮＤＣＨＡＲＡＣＴＥＲＩＺＡＴＩＯＮＯＦＡＮＡＤＲＩＡＭＹＣＩＮ－ＲＥＳＩＳＴＡＮＴＳＵＢＬＩＮＥＯＦＴＨＥＨＵＭＡＮＧＡＳＴＲＩＣＡＤＥＮＯＣＡＲＣＩＮＯＭＡＣＥＬＬＬＩＮＥＷａｎｇＹａｎｐｉｎｇ；王艳萍；ＸｕＧａｎｇ；徐刚（Ｉ...     

Ara-C INDUCED APOPTOSIS IN HUMAN MYELOID LEUKEMIA CELL LINE HL-60: INDUCING APOPTOSIS IS THE PRIMARY MECHANISM OF CHEMOTHERAPY

ＡｒａＣＩＮＤＵＣＥＤＡＰＯＰＴＯＳＩＳＩＮＨＵＭＡＮＭＹＥＬＯＩＤＬＥＵＫＥＭＩＡＣＥＬＬＬＩＮＥＨＬ６０：ＩＮＤＵＣＩＮＧＡＰＯＰＴＯＳＩＳＩＳＴＨＥＰＲＩＭＡＲＹＭＥＣＨＡＮＩＳＭＯＦＣＨＥＭＯＴＨＥＲＡＰＹＺｈｏｕＪｉａｎｆｅｎｇ周剑锋...     

中晚期胰腺癌三维适形放疗辅助高强度聚焦超声的临床观察

目的观察高强度聚焦超声（HIFU）与三维适形放疗（3D-CRT）联合治疗中晚期胰腺癌的近期疗效及价值。方法 48例中晚期胰腺癌患者（Karnofsky评分60~85分）随机分为两组,每组24例,A组行HIFU＋3D-CRT;B组单纯放疗。两组均采用三维适形放疗,常规分割（2.0 Gy/次,每周5次）,DT40~50 Gy/20~25 Fx。A组患者均予4~8次高强度聚焦超声治疗。结果 A组近期有效率37.5%,B组20.8%,A组临床受益率52.2%,B组为21.7%。两组比较差异有显著性（P〈0.05）。主要毒性反应为白细胞减少和红细胞减少。结论 HIFU＋3D-CRT联合治疗中晚期胰腺癌有较好的疗效,且耐受性较好。     

中晚期胰腺癌动脉灌注化疗并同期放疗的疗效观察

目的 分析中晚期胰腺动脉灌注化疗并同期放疗与单纯放疗的疗效。方法 对１９９２年１月至１９９５年１０月行动脉灌注化疗并同期放疗（综合组）的２２例和单纯放疗（单放组）的２８例中晚期胰腺癌的疗效进行比较分析,两组临床资料具可比性,单放组每周照５次,每次ＤＴ１．８～２．０Ｇｙ,总量５０～６０Ｇｙ／５～６．７周,综合组动脉灌注化疗,每次５－Ｆｕ,１．０ｇ,ＭＭＣ１０ｍｇ,ＤＤＰ６０ｍｇ,每４周一次,平均２．     

晚期胰腺癌术中放疗和外照射：附15例分析

本文收集1981年～1988年治疗的晚期胰腺癌15例,采用术中放疗和外照射进行治疗4例,单纯术后外照射11例.全组病例均有程度不同的姑息效果.11例生存6个～10个月,1例生存超过1.5年.本文认为,改善胰腺癌放射治疗效果,提高病变照射剂量是关键.因此开展术中放疗,术后配合外照射是行之有效的途径.     

Survival advantage of combined chemoradiotherapy compared with resection as the initial treatment of patients with regional pancreatic carcinoma. An outcomes trial

BACKGROUND: Resection of pancreatic carcinoma is resource-intensive with a limited impact on survival. Chemotherapy and/or radiotherapy (RT) have been shown to be effective palliation. To examine whether preoperative chemoradiotherapy as the initial treatment improves survival for patients with a regional pancreatic adenocarcinoma with a minimal chance of being resected successfully, an outcomes trial was conducted. METHODS: Patients with radiologically regional tumors were staged by laparotomy and/or computed tomography followed by endoscopic ultrasonography, angiography, and/or laparoscopy. Those with locally invasive, unresectable, regional pancreatic adenocarcinoma initially were treated with simultaneous split-course RT plus 5-fluorouracil, streptozotocin, and cisplatin (RT-FSP) followed by selective surgery (Group 1). Patients determined to have a resectable tumor initially underwent resection without preoperative chemoradiotherapy, with or without postoperative chemoradiotherapy (Group 2). RESULTS: Over 8 years 159 patients presenting with nonmetastatic pancreatic adenocarcinoma were administered RT-FSP or underwent surgery for resection. Group 1, comprised of 68 patients initially treated with RT-FSP, had a 0% mortality rate within 30 days of entry. In 20 of 30 patients undergoing surgery after RT-FSP, tumors were downstaged and resected. Group 2, comprised of 91 patients who initially underwent successful resection, had a 5% mortality rate within 30 days of entry. Postoperatively, 63 of these patients received chemotherapy with or without RT. The median survival for Group 1 was 23.6 months compared with 14.0 months for Group 2 (P = 0.006) despite more advanced disease cases in Group 1. Survival favored RT-FSP regardless of whether lymph nodes were malignant. The dominant prognostic factor of earlier stage pancreatic carcinoma having an expected survival advantage was reversed by the initial nonoperative treatment. CONCLUSIONS: Based on a reversal of the expected trend that patients with earlier stage resectable carcinoma (T1,2, N0,1, M0) who undergo removal of their tumors survive longer than patients with more advanced regional disease (T3, N0,1, M0), survival was found to improve significantly for patients reliably staged as having locally invasive, unresectable, nonmetastatic pancreatic adenocarcinoma when initially treated with RT-FSP.     

术中术后放化疗在中晚期胰头癌治疗中的应用

背景与目的：中晚期胰头癌手术切除率低,综合治疗是延长患者生命的手段。本研究旨在探讨术中术后放化疗对中晚期胰头癌的治疗作用,以提高中晚期胰头癌的姑息治疗效果。方法：对27例中晚期胰头癌患者外科施行胆肠吻合术,手术中在放疗科行直线加速器肿瘤区直接照射,同时手术中经胃十二指肠动脉置入埋入式化疗泵,手术后行肿瘤区灌注化疗。随访3—29个月,用直接法计算患者生存率。结果：全疗程结束后肿块均有不同程度缩小,肿瘤直径由术前的平均4．8cm缩小至2．7cm。疼痛缓解率为100％。仍生存者22例,死亡5例,6个月生存率为100％,12个月生存率93．7％,24个月生存率20％,死亡的5例患者平均生存期为17．9个月。结论：内引流加术中放疗和灌注化疗是对中晚期胰头癌患者治疗的可行方法。     

术中和体外照射治疗晚期胰腺癌

目的 :分析不能手术切除的晚期胰腺癌术中放射 (IORT)和体外放射 (EBRT)治疗的疗效。方法 :回顾我院 1987- 1999年 75例不能手术切除的晚期胰腺癌患者进行单纯IORT、单纯EBRT和IORT加EBRT治疗的临床资料。结果 :单纯IORT、单纯EBRT和IORT加EBRT治疗的 1年生存率分别为15 2 %、14 3%和 31 8% ,IORT加EBRT治疗的结果优于前两者 ,P <0 0 5。结论 :IORT加EBRT治疗可以延长晚期胰腺癌患者的生存期     

High dose, external beam and intraoperative radiotherapy in the treatment of resectable and unresectable pancreatic cancer

Ninety patients with pancreatic cancer were treated by external beam radiotherapy (EBRT) and/or intraoperative radiotherapy (IORT) with or without surgical resection of the tumor, and the results were compared with those of a historical control comprising 112 patients treated by surgery alone. At an early stage of this study, postoperative EBRT (50-60 Gy) or IORT (25-33 Gy) was given alone, but recently the two modalities have been combined. The combination of high doses of EBRT and IORT was well tolerated provided that the gastrointestinal tract was not irradiated during IORT. Although EBRT plus IORT appeared to yield better results than either EBRT or IORT alone, the difference was not significant on multivariate analysis, and patients receiving EBRT, IORT, or EBRT + IORT were grouped together. Patients receiving radiotherapy in addition to macroscopically curative surgery had a slightly longer median survival time (14 months) than those receiving curative surgery alone (10 months), but the 3-year survival rate was similar (21% vs. 19%). In patients who underwent noncurative resection, the median survival time was significantly longer for the irradiated group (12 months) than for the control group (6.5 months). Also, in patients with unresectable lesions but no distant metastases, irradiation prolonged the median survival time significantly (8 vs. 3.5 months). In this group, there was one 5-year survivor, who received EBRT of 55 Gy plus IORT of 30 Gy to his unresectable pancreatic body lesion. Patients with metastases were also treated for palliation of symptoms, but it was found that irradiation prolonged the median survival time even in such cases (4.5 vs. 2.5 months). Based on these results, we plan to use EBRT plus IORT in all pancreatic cancer patients with no metastases.     

Surgical resection after preoperative chemoradiotherapy benefits selected patients with unresectable pancreatic cancer

Simultaneous chemoradiation is used in unresectable pancreatic cancer for palliation. It is not known if the use of adjuvant surgery will benefit this group of patients. From November 1991 to September 1998, 47 patients with unresectable pancreatic cancer were treated with simultaneous preoperative radiation therapy (45 Gy) and chemotherapy. Chemotherapy followed three different protocols: cisplatin, 5-fluorouracil +/- paclitaxel; cisplatin, 5-fluorouracil (protracted infusion); and docetaxel and gemcitabine. Whipple pancreatoduodenectomy was performed 1 month after the end of radiation in patients selected for resection. Twenty-three unresectable tumors after preoperative treatment (47%) received an additional dose (10-12 Gy) of radiotherapy using intraoperative or external radiation therapy. Twelve patients (26%) were considered to have clinically resectable tumors after the preoperative treatment. Nine patients had surgery (19% of the total number of patients), and 2 of them had complete pathologic response. After chemoradiation, two patients died of pneumonia and gastrointestinal bleeding, respectively, and another two patients died in the postoperative period. Local recurrence was observed in 22% of the patients and 57% had distant metastases. Three-year survival rates for patients with unresectable and resectable tumors was 0% (median survival 10 months) and 48% (median survival 23 months), respectively (p = 0.0004). Preoperative treatment with chemotherapy and radiotherapy in patients with unresectable pancreatic cancer is feasible. In some patients, the tumor can be resected, and in addition some cases of complete pathologic response were found. Long-term survivors were observed in the group of resected tumors. More effective chemotherapy regimens are needed because the majority of the patients died of metastatic disease.     

Survival benefits of adjuvant chemotherapy with oral doxifluridine (5'-DFUR) following radiotherapy in patients with unresectable pancreatic cancer.

BACKGROUND AND OBJECTIVES: The combination of 5-fluorouracil and radiotherapy is thought to be the most effective treatment for locally unresectable pancreatic carcinoma. The outcomes, however, are far from acceptable from the viewpoint of long-term survival. We assessed the survival benefits of oral adjuvant chemotherapy with doxifluridine (5'-DFUR) following radiotherapy for patients with the disease. METHODS: Thirty-five consecutive patients who underwent bypass surgery and radiotherapy for localized advanced unresectable adenocarcinoma of the pancreas head were retrospectively reviewed in regard to disease progression and survival. Ten of the 35 patients underwent adjuvant chemotherapy with 5'-DFUR after radiotherapy in an outpatient setting. RESULTS: The 1-year survival for patients treated with radiotherapy alone was 29%. The 1-, 2-, and 3-year survivals for patients treated with the adjuvant chemotherapy after radiotherapy were 50, 40, and 30%, respectively (P = 0.0069, log-rank test). The elevation of tumor markers was delayed (P = 0.0346) and local control rate was improved (P = 0.0475) in patients with chemotherapy. Multivariate analysis demonstrated that the adjuvant chemotherapy with 5'-DFUR was a significant independent prognostic factor as well as tumor size. CONCLUSIONS: The adjuvant chemotherapy with 5'-DFUR following radiotherapy led to a significant prolongation of the survival for patients with unresectable localized pancreatic cancer.     

Clinical features of long time survivors with unresectable pancreatic cancer treated by gemcitabine alone

The objective of this study was to clarify the clinical features of long-time survivors with unresectable pancreatic cancer treated by gemcitabine (GEM) alone and to predict survival time after the first course of treatment. Eighteen consecutive patients (median age 65.3 years, range 49-77 years; 12 males, 6 females) with unresectable pancreatic cancer and a baseline Karnofsky's performance state = or >60 were treated with GEM in a dose of 1,000 mg/m(2) weekly x 3 followed by 1 week of rest until progression. The overall response rate was 0% (CR 0, PR 0, SD 11 cases, and PD 5 cases), and the median survival time (MST) was 268 days. We observed a statistically significant difference in the patients with or without liver metastasis at the start of treatment (131.6 vs 324.9 days; p=0.0045). We also evaluated the usefulness of serial CA 19-9 measurements as a biochemical response marker and an outcome prognostic parameter in patients with unresectable pancreatic cancer receiving GEM alone. We classified two subgroups into responders (patients with a decrease of = or >10% of the baseline CA 19-9 level after 4 weeks of chemotherapy) and non-responder (patients with a increase of the baseline CA 19-9 level or with a decrease of <10% of the baseline CA 19-9 level after 4 weeks of chemotherapy). Responder had a significantly better median survival than non-responders (416.6 vs 138.3 days; p=0.009). In conclusion, CA 19-9 serum concentration serves as an early indicator of response to chemotherapy with GEM alone in unresectable pancreatic cancer.