A phase 2 trial of gemcitabine, 5-fluorouracil, and radiation therapy in locally advanced nonmetastatic pancreatic adenocarcinoma : cancer and Leukemia Group B (CALGB) 80003

BACKGROUND:

The purpose of this study was to assess the efficacy and safety of 5‐fluorouracil (5FU) and gemcitabine administered concurrently with radiation in patients with locally advanced, nonmetastatic pancreatic cancer.

METHODS:

Eligible patients had histologically confirmed pancreatic adenocarcinoma deemed locally unresectable without evidence of metastatic disease. In addition, all patients underwent laparoscopy or laparotomy before study entry to rule out peritoneal carcinomatosis. Patients received radiation therapy (50.4 Gy) with concurrent infusional 5FU (200 mg/m² 5 days/week) and weekly gemcitabine (200 mg/m²). After a 3‐week break, patients received weekly gemcitabine at 1000 mg/m² for 3 of 4 weeks, for 4 cycles. The primary endpoint of the trial was the proportion of patients surviving 9 months from study entry. Secondary endpoints included objective tumor response, CA19‐9 response, overall survival (OS) time to progression (TTP), and toxicity.

RESULTS:

Between November 2001 and October 2004, 81 patients were enrolled, 78 of whom were eligible for analysis. With a median follow‐up of 55.2 months, the median OS was 12.2 months (95% confidence interval [CI], 10.9‐14.9) and the median TTP was 10 months (95% CI, 6.4‐12.0). An objective tumor response was seen in 19 patients (25%), and among 56 patients with an elevated CA19‐9 at baseline, 29 (52%) had a sustained CA19‐9 response. Overall, 41% of patients had grade 3 or greater treatment‐related gastrointestinal adverse events.

CONCLUSIONS:

The combination of 5FU, gemcitabine, and radiation is well tolerated. Survival is comparable with the best results of other recent studies of 5FU and radiation or gemcitabine and radiation. Cancer 2011;. © 2010 American Cancer Society.     

Rehabilitation in lung diseases: ‘Education’ component of pulmonary rehabilitation

Pulmonary rehabilitation (PR) is a complex intervention with described core components of individualized exercise training and inter‐disciplinary education in international guidelines. Compared to the overwhelming evidence of benefit for exercise training, the education component has received little attention. Educating patients about their symptoms and disease management appears intuitive to improve their health, but how and when is less clear. PR has provided an opportunity for educational activities and traditionally this has been delivered in the form of didactic lectures. The field is evolving and challenges are apparent raising important questions. What is the purpose and outcomes of the education component? Do specific diseases require specific education or PR programmes? How to provide interdisciplinary education? Is the timing optimal within the disease trajectory (most patients are referred to PR with moderate to severe disease)? Can technology help? Our review explores the recent evidence for the ‘education’ component of PR synthesizing the global guidelines. We discuss the challenges for patients as learners, healthcare professionals as educators and propose future directions for this core component of PR.     

低剂量碳离子全身辐射对小鼠淋巴细胞增殖及血清干扰素的影响

目的:观察小于0.1Gy剂量碳离子全身辐射引起的小鼠脾淋巴细胞增殖及血清干扰素的变化。方法:实验于2006-11在中国科学院近代物理研究所医学物理实验室进行。①实验过程:取昆明系小鼠30只,采用完全随机设计方法分为5组,每组6只,采用离子束进行全身照射。12C6 离子照射在兰州重离子研究装置(HIRFL)辐照终端进行,照射剂量为0,0.01,0.03,0.05,0.10Gy。麻醉照射后24h,小鼠摘眼球取血。②实验评估:采用ELISA法测定血清γ-干扰素含量,操作严格按试剂盒说明进行。将眼球取血后的小鼠脱颈处死,无菌条件下取出脾脏,常规制备单细胞悬液,采用MTT法检测刀豆蛋白A和脂多糖对脾淋巴细胞的增殖作用。结果:30只小鼠均进入结果分析。①辐射对小鼠血清干扰素的影响:与未照射正常小鼠比较,0.01Gy和0.03Gy碳离子束照射后,小鼠血清中γ-干扰素含量明显增高(P<0.05)。照射剂量继续增大至0.05Gy和0.10Gy时,血清γ-干扰素含量下降。②辐射对小鼠脾淋巴细胞增殖的影响:与未照射组比较,0.01Gy碳离子束照射可明显促进刀豆蛋白A诱导的T淋巴细胞增殖和脂多糖诱导的B淋巴细胞增殖(P<0.001,P<0.001),其促进作用与0.03Gy组比较,差异有显著性意义(P<0.01)。0.05Gy照射开始抑制脾淋巴细胞增殖指数,当照射剂量增大为0.10Gy时显示出明显的抑制作用。结论:0.01Gy和0.03Gy碳离子束照射能刺激淋巴细胞增殖,并能诱导γ-干扰素活性以增强机体免疫力。     

高密度脂蛋白胆固醇的检测方法及标准化研究进展

高密度脂蛋白胆固醇的检测方法及标准化研究进展鄢盛恺林其燧众多流行病学研究证实，高密度脂蛋白胆固醇（ＨＤＬ－Ｃ）水平与动脉粥样硬化（ＡＳ）呈负相关。美国Ｆｒａｍｉｎｇｈａｍ的研究显示，ＨＤＬ－Ｃ每减少０．０２６ｍｍｏｌ／Ｌ（１ｍｇ／ｄｌ），冠心病（ＣＨ...     

Genotoxicity studies on green tea catechin

The beneficial effects of tea catechins are well documented. We evaluated the genotoxic potential of a green tea catechin preparation using established genotoxicity assays, including a bacterial reverse mutation assay (Ames test), a chromosomal aberration assay in cultured Chinese hamster lung cells (CHL/IU), a mouse lymphoma L5178Y/tk assay, and a bone marrow micronucleus (MN) assay in ICR CD mice and SD rats. No significant increases in the number of revertant colonies were observed in the Ames test, but positive responses were observed in two in vitro assays: the chromosomal aberration assay and mouse lymphoma L5178/tk assay. However, the in vivo study demonstrated no significant increase in micronucleated polychromatic erythrocytes (MNPCE) in the bone marrow of both ICR CD mice and SD rats administered a high dose of the green tea catechin preparation up to 2000 mg/kg. Combined with favorable epidemiological information suggesting a chemopreventive effect of tea catechins on carcinogenesis, we conclude that green tea catechin presents no significant genotoxic concern under the anticipated conditions of use. These results are consistent with other genotoxicity studies of tea catechins, which show minimal, if any, genotoxic potential.