Objective To evaluate the interventional chemoembolization combined with proton radiotherapy in the treatment of hepatocellular carcinoma (HCC) accompanied with cancerous thrombus in the main portal vein. Methods Interventional chemoembolization combined with proton radiotherapy was performed in 46 patients of HCC accompanied with cancerous thrombus in the main portal vein. The proton radiotherapy was broke up into several fractions. The patients were treated with interventional chemoembolization and, alternatively, with proton radiotherapy. The short-term effectiveness and radiation reaction were evaluated. The survival rate was followed up. Results The effective rate was 91.3% . Disappearance of cancerous thrombus in the main portal vein was seen in 45.6% of patients. The liver functions were well restored, with a remarkable reduction in AFP. No acute or delayed radiation-induced hepatic damage or radiation hepatopathy occurred during the course of and after radiotherapy. The survival rate at 1, 6, 12 and 24 months was 100%, 89.1%, 52.2% and 21.4% respectively, with a median survival period of 17.6 months. Conclusion For the patients of HCC accompanied with cancerous thrombus in the main portal vein, interventional chemoembolization combined with proton radiotherapy is an effective, safe and newly-developed therapy.

Objective To evaluate the efficacy and safety of 131I-metaiodobenzylguanidine (131 I-MIBG) in treatment of malignant pheochromocytoma/malignant paraganglioma (MPHEO/MPGL).Methods The clinical data of 96 cases of MPHEO/MPGL (60/36) treated with 131I-MIBG between December 1998 and April 2014 were retrospectively reviewed.Among them,the malignant pheochromocytoma was found in 60 cases and malignant paraganglioma was found in 36 cases.Seventy-eight patients (81.2％)presented initially with hypertension,whereas 18 patients (18.8％) presented adrenal incidentaloma.Before 131I-MIBG treatment,24 h urinary norepinephrine was (409.5± 127.2) nmol,24 h urinary dopamine was (99.3±41.1) nmol,24 h urine adrenaline was (1 409.9±336.0) nmol.Before treatment,the compound iodine solution was given to each one.Then,all patients were given an initial course of 131I-MIBG therapy (5.55,7.40 GBq).Subsequent 131I-MIBG treatment (5.55,7.40 GBq) was undertaken every three to six months.The patients got symptomatic,hormonal or radiological response underwent sbsequent 131I-MIBG therapy (3.70,5.55 GBq) every year.All patients underwent clinical symptoms (headache,palpitate,sweating,hypertension),biochemical (24 h urine catecholamin) and radiological evaluation (CT/MRI) within 6 months to evaluate the efficacy and safety of 131I-MIBG treatment.Results After one to eleven sessions of 131 I-MIBG treatment,in total,266 doses of 131 I-MIBG were administered,average dose was 6.49 GBq.22.9％ of patients demonstrated radiological partial response (≥ 50％ reduction in tumor size) after first or repeated 131 I-MIBG treatment.Eleven cases (11.5％) achieved clinical complete response,41 cases (42.7％) achieved clinical partial response and 23 cases (24.0％) maintained the stable clinic symptoms.After treatment,24 h urinary norepinephrine (164.3±71.6) nmol and dopamine (49.7±24.7) nmol showed significantly decline,compared with those before treatment (P＜ 0.05).While,24 h urinary epinephrine (1 354.7±433.4) nmol had no obvious change (P＞0.05).No life-threatening adverse events were reported,but 2 MPGL patients developed transient leucopenia or thrombocytopenia after four and five times 131 I-MIBG treatment,respectively.Conclusions Treatment with repeated low dose 131I-MIBG is well tolerated and effective in controlling the progression and alleviating the clinical symptoms.The 131I-MIBG therapy is an effective and safe treatment modality for MPHEO/MPGL.

Objective To explore a new molecular target for HSV-tk/GCV system in human liver cancer therapy.Methods The lactose and poly-L-lysine covalently linked compound(Lac-PLL) were prepared by using reductive amination methods and purified by using Sephadex G10 gel filtration.The value of n was determined by methods of phenol-vitriol colorimetry.The plasmid r-pAs16Dr was mixed with the conjugate to form a gene delivery complex named GlanPLL-r-pAs16Dr.The GlanPLL-r-pAs16Dr was transformed to different cell lines such as HepG2 and A549 to confirm the expression of RFP.The expression of HSV-tk was confirmed by RT-PCR.Cells with various concentrations of GCV were observed at different time points using MTT.Results The PLL modified by 34 Lac was obtained by using chemical synthesis.The RFP was expressed in HepG2 by 48h after transfection,and was not expressed in A549.The expression of HSV-tk was only detected in HepG2 using RT-PCR.The HepG2 transformed with GlanPLL-r-pAs16Dr was sensitive to GCV and the growth inhibiting rate was 70.5% with the treatment of low concentration of GCV(1mg/L) for 3 days.The A549 was not sensitive to GCV.Conclusion Lac-PLL,which is easy to prepare,is an efficient carrier for HSV-tk to be delivered to hepatoma cell lines by binding to ASGPR.

Objective To investigate the selective killing effect of MDA/IL-24 on human hepatocellular carcinoma line HepG2 in vitro and provide a theoretical basis for gene therapy of hepatocellular carcinoma.Methods The MDA-7/IL-24 gene was transfected into human hepatocullular carcinoma cell line HepG2 and normal liver cell line L02 with a replication-incompetent adenovirus vector.The mRNA and protein expression of MDA7/IL-24 in HepG2 and L02 cells was examined by RT-PCR and ELISA assay respectively.MTT assay and flow cytometry were used to study tumor cell proliferation and cell cycle in vitro.Hoechst and Annexin-V and PI staining were studied to indicate the apoptosis.Results RT-PCR confirmed that the exogenous MDA-7/IL-24 gene was expressed in HepG2 and L02 cells.The protein product was confirmed by assay of the supernatant with ELISA.MTT and apoptosis test indicated MDA-7/IL-24 induced growth suppression and cell apoptosis of the HepG2 cell in vitro but not in cell line L02,and cell cycle test revealed MDA-7/IL-24 could block HepG2 cell in G2/M but not in L02.Conclusions MDA-7/IL-24 selectively induces growth suppression and apoptosis in lines HepG2 in vitro but not in L02 cell,which indicates that adenovirus mediated MDA-7/IL-24 can be an excellent tool for gene therapy in hepatocellular carcinoma.