High-dose epirubicin in patients with advanced or recurrent uterine sarcoma

Twenty patients with advanced or recurrent uterine sarcoma who had not received prior chemotherapy, were treated with epirubicin 120 mg m⁻² intravenously every 3 weeks. Four patients (20%) achieved complete response (pathologically confirmed in three cases) and three (15%) achieved partial response. The overall response rate was 35% (95% CI: 15–59). no response was observed for pelvic lesions in previously irradiated areas. Three patients (15%) exhibited stable disease, while 10 (50%) had progressive disease. The median number of courses was six in responders and two in non-responders. The median survival was 48 months (range 19–50+ months) in responders and 6 months (range 2–18 months) in non-responders. Adverse effects consisted primarily of myelosuppression, nausea and vomiting. No patients experienced life-threatening toxicity. High-dose epirubicin appears to be active in patients with advanced or recurrent uterine sarcoma.     

5种抗肿瘤抗生素对人白血病细胞DNA嵌合能力的观察

采用琼脂糖电泳法观察５种抗癌药对白血病细胞ＤＮＡ的嵌合能力。结果发现表阿霉素同进口阿霉素在５０μｇ／ｍｌ浓度时可与ＤＮＡ发生嵌合效应；国产阿霉素在较高浓度（１００μｇ／ｍｌ）和柔红霉素需高浓度（２００μｇ／ｍｌ）才显示嵌合效应；而米托蒽醌在较低浓度（２５μｇ／ｍｌ）即可发生此作用。本实验体现了作用机制类同的抗肿瘤药物对ＤＮＡ嵌合能力的差异。     

丝裂霉素和表柔比星诱导人膀胱癌T24细胞凋亡的体外实验研究

目的:探讨丝裂霉素和表柔比星诱导人膀胱癌T24细胞凋亡的机制。方法:采用MTT法、流式细胞术以及光镜和透射电子显微镜技术,研究不同浓度的丝裂霉素和表柔比星对人膀胱癌T24细胞的抑制作用。结果:丝裂霉素和表柔比星均可抑制人膀胱癌T24细胞的增殖,且两药的抑制效应均随着药物浓度的增大而增强。当浓度为100mg/L时,两药对T24细胞增殖的抑制率分别为90.1%、95.6%,G1期前出现明显的凋亡峰,可见胞内空泡形成、核染色质凝聚等典型细胞凋亡特征。结论:丝裂霉素和表柔比星具有抑制人膀胱癌T24细胞生长和诱导人膀胱癌T24细胞凋亡的作用,此种作用与药物浓度呈依赖关系,亦可能是两药拮抗肿瘤的主要机制。     

裴氏消风散联合碳酸氢钠治疗表阿霉素渗漏损伤的实验研究

目的:探讨安全、有效的表阿霉素渗漏损伤最佳治疗方案。方法:将家兔12只制作成表阿霉素渗漏损伤模型,随机分为A、B、C、D组,每组3只。A组用3%碳酸氢钠1ml加5%地塞米松0.1mg作局部封闭、用裴氏消风散冷外敷;B组用0.1g/5ml利多卡因1ml作局部封闭后用硫酸镁湿敷;C组用0.1g/5ml利多卡因1ml作局部封闭后用烧伤膏外敷;D组用0.1g/5ml利多卡因1ml作局部封闭后冷敷。治疗后2天、7天取4组局部组织进行组织学检查,20天对局部皮肤损伤进行分度评价。结果:治疗后2天、7天四组局部组织进行组织学评价及20天局部皮肤损伤进行分度评价比较,差异有统计学意义(均P<0.01),以A组效果最优。结论:局部配合裴氏消风散联合碳酸氢钠地塞米松治疗组,具有减轻表阿霉素渗漏所致局部组织损伤及促进损伤修复的良好作用。     

pH-and thermo-sensitive pluronic/poly(acrylic acid) in situ hydrogels for sustained release of an anticancer drug

In this study, we developed oral in situ gelling formulations composed of pluronic (Plu) and polyacrylic acid (PAA) for the delivery of an anticancer drug, epirubicin (Epi). We investigated various Plu/PAA/Epi formulations for their physicochemical properties and in vitro permeation and accumulation, as well as for in vivo pharmacokinetic and antitumor efficacy. A scanning electron microscopic (SEM) image of Plu 14%/PAA 0.75%/Epi hydrogel showed a sponge-like structure. This formulation has suitable gelation time, water content, bioadhesive force, structural stability, and a high permeation percentage of Epi, with sustained drug release characteristics for 96?h. This hydrogel was retained at the end of the ileum near the colon of Sprague-Dawley (SD) rats for at least 12?h. An in vivo pharmacokinetic study using SD rats showed that after oral administration in this formulation, Epi had prolonged half-life, greater area under the curve, and higher relative bioavailability than in an oral Epi solution. In vivo tumor growth inhibition of Epi in this formulation was more pronounced compared with oral Epi and intravenous Epi solutions in CT-26 mouse colon adenocarcinoma bearing Balb/c mice. This study highlights the advantages of using oral in situ temperature- and pH-sensitive hydrogels for future cancer therapy.     

Preparation of folate-modified pullulan acetate nanoparticles for tumor-targeted drug delivery

The purpose of this work was to develop a novel nano-carrier with targeting property to tumor. In this study, pullulan acetate (PA) was synthesized by the acetylation of pullulan to simplify the preparation technique of nanoparticles. Folic acid (FA) was conjugated to PA in order to improve the cancer-targeting activity. The products were characterized by proton nuclear magnetic resonance (¹H NMR) spectroscopy. Epirubicin-loaded nanoparticles were prepared by a solvent diffusion method. The loading efficiencies and EPI content increased with the amount of triethylamine (TEA) increasing in some degree. FPA nanoparticles could incorporate more epirubicin than PA nanoparticles. The folate-modified PA nanoparticles (FPA/EPI NPs) exhibited faster drug release than PA nanoparticles (PA/EPI NPs) in vitro. Confocal image analysis and flow cytometry test revealed that FPA/EPI NPs exhibited a greater extent of cellular uptake than PA/EPI NPs against KB cells over-expressing folate receptors on the surface. FPA/EPI NPs also showed higher cytotoxicity than PA/EPI NPs. The cytotoxic effect of FPA/EPI NPs to KB cells was inhibited by an excess amount of folic acid, suggesting that the binding and/or uptake were mediated by the folate receptor.     

多西紫杉醇联合表阿霉素新辅助化疗治疗三阴性乳腺癌与非三阴性乳腺癌的疗效比较

目的比较多西紫杉醇联合表阿霉素对三阴性乳腺癌和非三阴性乳腺癌的新辅助化疗的疗效及毒副反应。方法 172例乳腺癌患者接受多西紫杉醇联合表阿霉素方案新辅助化疗,比较观察该方案对三阴性乳腺癌与非三阴性乳腺癌的疗效及毒副反应的差别。结果 172例患者中,59例（34.3%）为三阴性乳腺癌,113（65.7%）例为非三阴性乳腺癌。172例患者的总有效率为85.5%,其中临床完全缓解率为34.9%,病理完全缓解率为23.8%。三阴性乳腺癌的临床完全缓解率（47.5%）、病理完全缓解率（44.1%）明显高于非三阴性乳腺癌（28.3%、13.3%）（P〈0.05）。三阴性乳腺癌的5 a无病生存率和5 a总生存率分别为54.2%和76.3%,低于非三阴性乳腺癌的80.5%和94.7%（P〈0.05）。结论多西紫杉醇联合表阿霉素方案用于乳腺癌的新辅助化疗安全有效,三阴性乳腺癌更易获得近期疗效,而非三阴性乳腺癌远期疗效较好。     

多西他赛与表柔比星联合用于局部晚期乳腺癌新辅助化疗的临床疗效观察

目的 为提高临床治愈率,了解采用多西他赛联合表柔比星对局部晚期乳腺癌新辅助化疗的临床价值.方法 选择2009年1月～2010年12月该院38例局部晚期乳腺癌患者,回顾分析多西他赛与表柔比星联合化疗的临床效果及化疗期间的不良反应.结果 38例患者中,病理完全缓解者8例,临床完全缓解者8例,临床部分缓解者12例,稳定者5例,无效者5例.38例患者中,出现口腔黏膜炎者13例,恶心或呕吐者24例,脱发反应者20例,白细胞减少者35例,血小板下降者37例.结论 采用多西他赛联合表柔比星对局部晚期乳腺癌进行新辅助化疗,疗效显著,而期间产生的不良反应大部分患者能耐受,值得临床推广.     

Clinical outcome of adjuvant radiotherapy for squamous cell carcinoma of the breast; a multicenter retrospective cohort study

BackgroundBecause primary squamous cell carcinoma (SCC) of the breast is a rare disease, the standard therapy has not been established. We examined the clinical outcomes of postoperative adjuvant radiotherapy for breast SCC.Material and methodsWe conducted a multicenter retrospective cohort study. Patients diagnosed with primary breast SCC who received adjuvant radiotherapy as part of their primary definitive treatment were included. Overall survival (OS), breast cancer-specific survival (BCSS), and recurrence-free interval (RFi) were evaluated.ResultsBetween January 2002 and December 2017, 25 breast SCC patients received adjuvant radiotherapy as a primary treatment were included. Median follow-up time was 43.5 months. Three (12%), fifteen (60%) and seven (28%) patients had clinical stage I, II and III disease, respectively. Fourteen patients underwent breast-conserving surgery and subsequent adjuvant radiotherapy. Eleven patients underwent mastectomy and post-mastectomy radiotherapy. Ten patients received regional lymph node irradiation. Nine (36%) patients had disease recurrence. The first site of recurrence was locoregional in five, but distant metastasis arose in one. Concurrent local and distant metastasis were seen in two. Six cases of local recurrence occurred within the irradiated site. Seven patients died, and six of the deaths were due to breast cancer. Five-year OS, BCSS, and Rfi were 69%, 70%, and 63%, respectively. In multivariate analysis, age and lymphatic invasion were associated with increased risk of recurrence.ConclusionBreast SCC has a high incidence of locoregional recurrence and poor prognosis. Age and lymphatic invasion are significant risk factors for recurrence.