Prognostic significance of changes in CA 15-3 serum levels during chemotherapy in metastatic breast cancer patients

Summary Tumor response to first-line chemotherapy in advanced breast cancer offers prognostic information and may be used as a surrogate marker for evaluating treatment efficacy. With this study we wanted to determine whether changes in circulating serum CA 15-3 levels during chemotherapy provided additional information for prognostic prediction. Serum CA 15-3 was measured at baseline and after 3 and 6 months during anthracycline-based first-line chemotherapy in 526 patients with advanced breast cancer prospectively enrolled in five phase II-III trials. Changes in marker levels were correlated with disease response, time to progression and overall survival. In all, 336 patients attained a disease response. A significant relationship was found between disease response and CA 15-3 variations, although many individual discrepancies were also observed. At the 6-month time point, the median time to progression was 15.3 months in patients with normal marker levels throughout the study, 11.7 months in those with a CA15-3 reduction >25%, 9.6 months in those with elevated baseline CA 15-3 levels which did not change during therapy and 8.6 months in those with increased marker levels (p < 0.001). The median survival was 42.3, 29.7, 28.5, and 24.8 months, respectively (p < 0.002). The prognostic role of changes in CA 15-3 levels was maintained in the patient subset attaining disease response or stabilization to treatment (p < 0.001) and after adjusting for clinical response and major prognostic parameters in the multivariate analysis (p < 0.001). In conclusion, monitoring serum CA 15-3 levels during first-line chemotherapy in advanced breast cancer patients provides prognostic information independently from tumor response.     

芪参益气滴丸对糖尿病大鼠视网膜AGEs及RAGE mRNA表达的影响

目的观察芪参益气滴丸对糖尿病大鼠视网膜内晚期糖基化终末产物(advanced glycation endproducts,AGEs)及其受体(receptor for advanced glycation end products,RAGE)mRNA表达的影响。方法 70只SD大鼠以链脲佐菌素(65 mg/kg)诱导糖尿病大鼠模型,随机分成模型组、阳性对照组(羟苯磺酸钙胶囊)和芪参益气滴丸组,另设正常对照组12只。10个月后用免疫组织化学方法检测各组视网膜AGEs表达水平,反转录聚合酶链反应检测RAGE mRNA表达水平。结果糖尿病大鼠视网膜AGEs和RAGE mRNA表达较正常组增强(P<0.01);阳性对照组和芪参益气滴丸组视网膜AGEs和RAGE mRNA表达较模型组降低(P<0.01)。结论芪参益气滴丸可降低视网膜AGEs和RAGE mRNA的表达,从而减轻视网膜微血管损伤。     

中药联合化疗防治根治术后局部进展期胃癌复发转移的Meta分析

目的 通过Meta分析探索中医药联合化疗防治局部进展期胃癌（LAGC）术后复发转移的有效性及安全性,评价中医药提高辅助化疗期间患者生活质量、免疫功能、减轻不良反应的作用。方法 计算机检索CNKI、Wanfang、PubMed等数据库相关随机对照临床研究。对研究文献进行筛选与数据提取,应用Cochrane提供的review manager 5.3软件进行Meta分析。结果 共纳入18个RCTs,Meta分析显示,对比单纯化疗,中医药联合化疗可以提高LAGC术后KPS评分、提高CD3⁺指标、提高CD4⁺/CD8⁺,降低术后白细胞减少、血红蛋白减少、血小板减少、恶心呕吐症状、腹泻、神经系统毒性反应发生率。在术后QLQ-C30评分以及肝、肾功能异常发生率方面,中医药联合化疗与单纯化疗疗效相当;中医药联合化疗可以降低LAGC术后1年、2年、3年、5年累计复发转移率,延长DFS。结论 中医药联合化疗对比单纯化疗可提高LAGC术后患者免疫水平及KPS评分,降低不良反应发生率,降低LAGC术后累计复发转移率,提高DFS。     

卡培他滨单药治疗老年晚期胃癌临床分析

目的：观察卡培他滨单药治疗老年晚期胃癌的疗效和不良反应。方法：经病理确诊局部晚期或远处转移的老年晚期胃癌患者23例,应用卡培他滨单药化疗,剂量为1000mg／m^2,2次／日,连用14天,每3周为1个周期。结果：共完成治疗87个周期,最短1周期,最长9个周期。16例可评价疗效,部分缓解（PR）3例,稳定（SD）9例,进展（PD）4例,有效率18．8％,疾病控制率75％。中位疾病进展时间（TTP）5个月,中位总生存（OS）8个月,1年生存率22．7％。不良反应主要为胃肠道反应和手足综合征,大部分为I－Ⅱ度,耐受良好。结论：卡培他滨单药治疗老年晚期胃癌近期疗效确切,依从性好,不良反应可耐受。     

Quelle place pour la radiothérapie dans la prise en charge des cancers du pancréas localisés ?

At diagnosis, about 15% of patients with pancreatic cancer present with a resectable tumour, 50% have a metastatic tumour, and 25% a locally advanced tumor (non-metastatic but unresectable due to vascular invasion) or borderline resectable. Despite the technical progress made in the field of radiation therapy and the improvement of the efficacy of chemotherapy, the prognosis of these patients remains very poor. Recently, the role of radiation therapy in the management of pancreatic cancer has been much debated. This review aims to evaluate the role of radiation therapy for these patients.     

不同化疗方案在局部晚期宫颈癌患者治疗中的应用效果对比

目的 研究不同化疗方案在局部晚期宫颈癌患者治疗中的应用效果.方法 选择局部晚期宫颈癌患者100例,采用随机数表法将所有患者分为观察组和对照组,各50例.观察组采用顺铂联合紫杉醇进行化疗,对照组采用5-氟尿嘧啶联合顺铂进行化疗,以21天作为1个疗程.比较2组患者的临床疗效以及化疗后的不良反应情况.结果 2组患者相比,观察组术中出血量、手术时间和阴道切缘阳性率明显低于对照组,差异有统计学意义(P<0.05).观察组的客观缓解率高达68.0%,显著高于对照组,差异有统计学意义(P<0.05).观察组化疗不良反应集中在Ⅰ度、Ⅱ度,明显轻于对照组,差异有统计学意义(P<0.05).结论 采用顺铂联合紫杉醇进行化疗,临床效果较好,且患者的不良反应较轻,值得在临床上推广.     

紫杉醇联合卡铂三周方案同步胸部放疗治疗不宜手术的局部晚期非小细胞肺癌疗效和安全性研究:一项来自单中心的回顾性研究

背景与目的 对于局部晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)同步放化疗是推荐的标准治疗.理想的化疗方案并未确立.本研究拟回顾性分析紫杉醇/卡铂(paclitaxel/carboplatin,PC)三周方案同步胸部放疗治疗局部晚期NSCLC的疗效和安全性,并与标准的依托泊苷/顺铂(cisplatin/etoposide,PE)方案进行比较.方法 回顾性分析北京协和医院2012年1月-2014年6月收治的局部晚期NSCLC患者共43例,其中15例接受PC三周方案同步胸部放疗,28例接受PE方案同步胸部放疗.比较两组患者的临床特征、疗效和不良反应.结果 全组患者:客观缓解率(objective response rate,ORR)为41.9％,疾病控制率(disease control rate,DCR)为90.7％,中位无疾病进展生存时间(progression-free survival,PFS)为10,6个月(95％CI:7.4-13.8),中位总生存期(overall survival,OS)为19.2个月(95％Ch15.3-23.1).PC组和PE组在疗效上无统计学差异(ORR:33.3％vs 46.4％,DCR:86.7％vs 92.9％,P=0.638;PFS:6.6个月vs 12.2个月,P=0.389;OS:16.1个月vs 22.1个月,P=0.555).不良反应可处理,两组均未发生治疗相关死亡.结论 PC三周方案同步胸部放疗治疗局部晚期NSCLC与标准PE方案疗效相似,不良反应可接受,在临床中可采用.     

低剂量PF方案持续注射治疗晚期肝癌的疗效观察

目的 观察低剂量PF方案持续注射治疗晚期原发性肝癌(PHC)的疗效和毒副反应.方法 70例晚期PHC随机分为两组,治疗组36例给予低剂量PF持续静脉注射方案:DDP 3 mg/(m2·d),civ,d1-5/周;CF 100 mg,civ,d1,4/周;5-Fu 170 mg/(m2·d),civ,6～8 h/d,d1-7/周,连用3周为1周期,至少完成1个周期或以上.对照组34例给予最佳支持治疗.结果 治疗组和对照组的临床症状改善(即临床受益反应)有效率分别为55.6%(20/36)、23.5%(8/34),差异有统计学意义(P<0.01),中位生存期均为17.00周,治疗组的毒副反应可以耐受.结论 低剂量PF持续静脉注射方案治疗晚期PHC,毒副反应可耐受,可以提高生存质量,但未延长生存期.     

Elevated IgG and IgM Autoantibodies to Advanced Glycation End Products of Vascular Elastin in Hypertensive Patients with Type 2 Diabetes: Relevance to Disease Initiation and Progression

The increased glycation of elastin is an important factor in vascular changes in diabetes. Using the ELISA method, we determined serum levels of IgM and IgG autoantibodies to advanced glycation end products of vascular elastin (anti-AGE EL IgM and anti-AGE EL IgG) in 59 hypertensive patients with type 2 diabetes (T2D) and 20 healthy controls. Serum levels of matrix metalloproteinases-2 and -9 (MMP-2 and MMP-9) and the C-reactive protein (CRP) were also determined. The levels of anti-AGE EL IgM antibodies in the T2D group were similar to those in the control group, while those of anti-AGE EL IgG antibodies were significantly higher (p = 0.017). Significant positive correlations were found between the levels of anti-AGE EL IgM antibodies and MMP-2 (r = 0.322; p = 0.013) and between the levels of anti-AGE EL IgG antibodies and CRP (r = 0.265; p = 0.042). Our study showed that elevated anti-AGE EL IgG antibody levels may be an indicator of the enhanced AGE-modification and inflammatory-mediated destruction of vascular elastin in hypertensive patients with T2D. Anti-AGE EL IgM antibodies may reflect changes in vascular MMP-2 activity, and their elevated levels may be a sign of early vascular damage.     

榄香注射液及华蟾素注射液分别联合TACE治疗中晚期原发性肝癌临床研究

目的:观察比较榄香注射液及华蟾素注射液分别联合肝动脉导管化疗栓塞治疗中晚期原发性肝癌的临床疗效及不良反应发生率的差异。方法:纳入104例2018年8月—2020年1月于肿瘤科治疗的中晚期原发性肝癌患者作为研究对象,按照治疗方案的不同随机分成2组各52例。2组患者均给予肝动脉导管化疗栓塞(TACE)治疗1次,华蟾素注射液组予华蟾素注射液10 m L加入到5%葡萄糖注射液500 m L中静脉滴注,每天1次。榄香注射液组加用榄香注射液静脉滴注,每次0.4 g,每天1次,2组连续治疗15 d后休息15 d,连续治疗2个疗程。观察比较2组临床疗效、肝功能指标[(谷丙转氨酶(ALT)、谷草转氨酶(AST)及总胆红素(TBil)]的变化及甲胎蛋白(AFP)、卡氏评分(KPS)和肿瘤体积的变化,以及不良反应发生率的差异。结果:临床疗效总有效率榄香注射液组88.46%,华蟾素注射液组71.15%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组血清ALT、AST和TBil水平较治疗前均显著降低,差异均有统计学意义(P<0.05);2组间血清ALT、AST和TBil水平相比较,差异无统...