孙晓生教授指导应用食疗和艾灸在 肿瘤化疗和康复期调治经验

〔摘 要〕　肿瘤患者在化疗期间免疫力受到重创,元气亏虚,孙晓生教授提倡应用食疗和艾灸协同调治,重脾胃、培土扶正、 调护元气、安神固元是重要的调治原则。通过性味功效、辨证施膳、增效减毒等多角度配膳,可以减轻化疗常见的不良反应; 灸为纯阳,散寒除湿、温中开郁,“ 暖艾疗法 ” 艾灸可以起到安神固元、缓解焦虑、改善脏腑功能,具有良好的扶正驱邪、 简便廉验的优点;应用食疗和艾灸改善患者生活质量,利于心理治疗和延长生存期。     

Molecular Basis of Resveratrol-Induced Resensitization of Acquired Drug-Resistant Cancer Cells

Multidrug resistance (MDR) to anticancer drugs remains a serious obstacle to the success of cancer chemotherapy. Resveratrol, a polyphenol, present in natural products exerts anticancer activity and acts as a potential MDR inhibitor in various drug-resistant cancer cells. In the process of resensitization of drug-resistant cancer cells, resveratrol has been shown to interfere with ABC transporters and drug-metabolizing enzymes, increase DNA damage, inhibit cell cycle progression, and induce apoptosis and autophagy, as well as prevent the induction of epithelial to mesenchymal transition (EMT) and cancer stem cells (CSCs). This review summarizes the mechanisms by which resveratrol counteracts MDR in acquired drug-resistant cancer cell lines and provides a critical basis for understanding the regulation of MDR as well as the development of MDR-inhibiting drugs.     

Doxorubicin‐induced normal breast epithelial cellular aging and its related breast cancer growth through mitochondrial autophagy and oxidative stress mitigated by ginsenoside Rh2

Clinical dose of doxorubicin (100 nM) induced cellular senescence and various secretory phenotypes in breast cancer and normal epithelial cells. Herein, we reported the detailed mechanism underlying ginsenoside Rh2‐mediated NF‐κB inhibition, and mitophagy promotion were evaluated by antibody array assay, western blotting analysis, and immunocytostaining. Ginsenoside Rh2 suppressed the protein levels of TRAF6, p62, phosphorylated IKK, and IκB, which consequently inactivated NF‐κB activity. Rh2‐mediated secretory phenotype was delineated by the suppressed IL‐8 secretion. Senescent epithelial cells showed increased level of reactive oxygen species (ROS), which was significantly abrogated by Rh2, with upregulation on SIRT 3 and SIRT 5 and subsequent increase in SOD1 and SOD2. Rh2 remarkably favored mitophagy by the increased expressions of PINK1 and Parkin and decreased level of PGC‐1α. A decreased secretion of IL‐8 challenged by mitophagy inhibitor Mdivi‐1 with an NF‐κB luciferase system was confirmed. Importantly, secretory senescent epithelial cells promoted the breast cancer (MCF‐7) proliferation while decreased the survival of normal epithelial cells demonstrated by co‐culture system, which was remarkably alleviated by ginsenoside Rh2 treatment. These data included ginsenoside Rh2 regulated ROS and mitochondrial autophagy, which were in large part attributed to secretory phenotype of senescent breast epithelial cells induced by doxorubicin. These findings also suggested that ginsenoside Rh2 is a potential treatment candidate for the attenuation of aging related disease.     

Pharmacodynamics and pharmacokinetics of PLGA-based doxorubicin-loaded implants for tumor therapy

The traditional systemic chemotherapy through intravenous infusion of doxorubicin (DOX) has many side effects. The aim of this study was to develop a PLGA-based DOX-loaded implant and to evaluate the efficacy and drug metabolism distribution of the implant in intratumoral chemotherapy for osteosarcoma (OS). In this study, implants containing DOX, poly(d,l-lactide-co-glycolide), and polyethylene glycol 4000 were prepared by melt-molding method. Then, the antitumor activity and systemic drug distribution of the implants were tested in a K7M2 OS bearing mouse model. The scanning electron microscope images showed that DOX was uniformly dispersed in the polymer matrix. Both the in vitro and in vivo release profiles of implants are characterized by three-phase release. Implantation of DOX-loaded implants into tumors can inhibit tumor growth in a dose-dependent manner. The pharmacokinetic behavior shows that intratumor chemotherapy through implants has a much higher drug concentration in tumors than in normal tissues, which may be the reason for improving antitumor activity and reducing systemic side effects. In summary, the drug release of the implants prepared in this study is sustained and stable, which promotes long-term local accumulation of drugs in tumors, improves the efficacy of chemotherapy and has low toxicity to normal tissues.     

贝伐珠单抗联合化疗治疗晚期乳腺癌疗效及安全性的Meta分析

目的:系统评价贝伐珠单抗联合化疗治疗晚期乳腺癌的疗效及安全性.方法:计算机检索PubMed、The Cochrane Library、EMbase、维普、中国知网和万方等数据库,检索时间为建库至2020年9月,按照严格的纳入和排除标准筛选文献和提取资料后,采用RevMan 5.3软件进行Meta分析.最终纳入10篇包括...     

NP和GP方案治疗晚期非小细胞肺癌的疗效比较

目的 诺维本加顺铂(NP)和健择加顺铂(GP)方案均是目前治疗晚期非小细胞肺癌的常用方案,本研究对两种方案进行了有效率、存活率和不良反应等方面的比较.方法 自1999～2004年,总共80例晚期非小细胞肺癌(Ⅲb期或Ⅳ期)参与研究,采用NP方案治疗40例、GP方案40例,比较其疗效及不良反应.结果 总有效率NP方案为27.5%,GP方案为22.5%(P＞0.05);平均存活时间NP方案为9.4个月,GP方案为8.6个月(P＞0.05);1年存活率NP方案为10.0%,GP方案为7.5%(P＞0.05).两种方案的主要不良反应均为骨髓抑制,白细胞下降至Ⅲ、Ⅳ度者NP方案为45%,GP方案为40%(P＞0.05);化疗后出现Ⅲ、Ⅳ度便秘者NP方案为25.0%,GP方案为7.5%(P＜0.05).结论 NP方案和GP方案治疗晚期非小细胞肺癌效果确实,且较一致,耐受性均较好,但使用NP方案要注意预防便秘.     

乳腺癌新辅助化疗后原发灶临床完全缓解对腋淋巴结转阴的预测作用

目的 判断腋窝淋巴结阳性乳腺癌新辅助化疗(neoadjuvant chemotherapy,NAC)后原发灶临床完全缓解能否预测腋窝淋巴结病理转阴.方法 2016年10月 ～2019年10月收治的乳腺癌病人95例,淋巴结穿刺均阳性,临床分期T1-3,N1-2期,且均完成NAC后有腋窝淋巴结清扫(axillary lym...     

Clinical outcomes for nasopharyngeal cancer with intracranial extension after taxane-based induction chemotherapy and concurrent chemo-radiotherapy in the modern era

ObjectiveTo evaluate the survival outcomes for a cohort of nasopharyngeal cancer with intracranial extension (ICE) treated with induction chemotherapy (ICT) followed by chemo-intensity-modulated radiotherapy (CTRT) at a tertiary cancer center.MethodsWe retrospectively analyzed 45 patients with histologically proven, non-metastatic NPC with ICE treated at our institute between October 2008 and October 2016. Patients were classified as minor ICE or major ICE, based on the extent of ICE. All the patients received 2–3 cycles of a taxane-based ICT regimen followed by CTRT. Radiotherapy was delivered with “risk-adapted” intensity-modulated radiotherapy (IMRT) technique in all patients.ResultsAfter a median follow up of 45 months (range: 8–113 months), the estimated 5-year DFS, LRFS, DMFS, and OS of the entire cohort was 58%, 82%, 67% and 74% respectively. On multivariate analysis, histological subtype was an independent predictor of LRFS, and age was an independent predictor of DFS. The extent of ICE showed only a trend towards worse DFS (P = 0.06). None of the factors significantly predicted for DMFS or OS. Gender, N-stage, and response to ICT did not significantly affect any of the outcomes. Grade 2 or worse subcutaneous fibrosis was seen in 22% of patients and grade 2 or worse xerostomia was seen in 24% of patients at last follow up. Thirty-three percent of the patients developed clinical hypothyroidism at last follow up. None of the patients experienced any neurological or vascular complications.ConclusionsTaxane-based induction chemotherapy followed by chemo-intensity modulated radiotherapy resulted in excellent locoregional control and survival with acceptable toxicities in patients of nasopharyngeal cancer with intracranial extension. Distant metastasis continues to be the predominant problem in these patients.