1.Adverse reactions of chemoradiotherapy with docetaxel after modified radical mastectomy in locally advanced breast cancer
Ying LU ; Haixin HUANG ; Hui YANG ; Dagui CHEN
Chinese Journal of Clinical Oncology 2016;43(10):438-441
Objective:To compare the adverse reactions of concurrent chemoradiotherapy with docetaxel versus those of sequential and scheduled adjuvant therapy after a modified radical mastectomy in locally advanced breast cancer. Additionally, this work aims to evaluate the safety and feasibility of a synchronous therapy schedule. Methods:A total of 155 female breast cancer patients in the Fourth Affiliated Hospital of Guangxi Medical University were enrol ed from January 2009 to December 2014. Al the patients were diagnosed with infiltrating ductal carcinoma and stage pT3-4, pN1-3c M0, or pAnyTpN2-3cM0 after modified radical mastectomy. After completing the fluorouracil+epirubicin+cyclophosphamide adjuvant chemotherapy, all the patients were randomly divided into two groups by using the method of sealed envelopes. The synchronous group, which received synchronous chemoradiotherapy with docetaxel, comprised 78 cases. The sequential group, which received radiotherapy fol owing docetaxel chemotherapy, comprised 77 cases. The clinical toxic reactions and effects in both groups were assessed after all schedules. Results:A median follow-up period of 39 (16-62) months showed that the radiation side effects of the synchronous and sequential groups were mild. No patients with 3-4 grade radiation-induced skin reactions or symptoms of heart and lung radiation side effects were reported. The rate of 1-2 grade radiation-induced skin reactions was 89.7%(70/78) in the synchronous group and 88.3%(68/77) in the sequential group, but the difference was not statistically significant (P>0.05). The three-year recurrence-free survival rate was 92.3%(72/78) in the synchronous group and 81.8%(63/77) in the sequential group, and the difference was statistically significant (P=0.046). Conclusion:Synchronous chemoradiotherapy with docetaxel as adjuvant therapy exhibited mild and tolerable adverse reactions fol owing modified radical mastectomy in local y advanced breast cancer. Compared with the sequential schedule, the synchronous schedule showed a significantly increased three-year recurrence-free survival rate. Therefore, a synchronous chemo-radiotherapy schedule is safe and feasible and can be used as a treatment option for locally advanced breast cancer.
2.Study for gene mutation detection of circulating DNA with ligase-ELISA reaction
Haizhong CUI ; Na XIAO ; Yongping ZHANG ; Dagui CHEN ; Yitong TANG
Tianjin Medical Journal 2015;43(5):533-536
Objective To establish a single nucleotide polymorphisms genotyping (SNP) method for a convenient, accurate, and routine analysis of clinical samples. Methods Based on the design of oligonucleotide probe, the assay was performed through three steps:the conjunction of the detection probe, universal amplification, labeling and ELISA reaction. The genotype of each SNP was revealed by reading signals of each set of reaction tubes. This assay was applied to detect sixty-two plasma samples of lung cancer for circulating DNA for three SNPs of EGFR, c.2573T>G(L858R), EGFR, c.2582T>G>T(G719C). Results were compared with those obtained by direct sequencing. Results The heterozygote mutation was identified for L858R by both methods, although no mutation was detected for L861Q and G719C. Six samples were identified as heterozygotes with the new method, and only two samples were unambiguously identified as heterozygotes by the direct sequencing. Two additional samples could not be identified as heterozygotes because the peak of mutant allele was very low compared with that of wild allele. Conclusion The developed method enabled accurate identification of SNP in a convenient manner, and which is adapted to routine analysis from heterogeneous samples unambiguously.
3.Coating for dexamethasone-eluting intravascular stent and its drug sustained release in vitro
Yongpeng CHEN ; Guixue WANG ; Yan CHEN ; Xianchun JIN ; Yanbin HOU ; Lailong LUO ; Dagui SUN
Journal of Third Military Medical University 2003;0(10):-
Objective To prepare the coating of dexamethasone-eluting intravascular stent and observe the features of its delayed release in vitro.Methods Spray painting and dipping coating were used respectively to prepare stent coating,and then high performance liquid chromatography(HPLC)was used to detect the drug loading.The stents prepared by dipping coating were set in a flow of 50 ml PBS buffer at a velocity of 20 ml/min,and 0.5 ml buffer was collected at 6 h and 1,2,4,6,8,10,12,15 d respectively with another 0.5 ml fresh PBS being added immediately.The drug content of the 0.5 ml buffer was detected by HPLC for drug sustained release in vitro.Results The drug loading of stents prepared by spray painting was(24.26?5.23)?g,while that stents prepared by dipping coating for 4 d was(93.15?7.83)?g.Drugs were released slowly and the release rate reached 84% at 15 d.Conclusion The dipping coating-prepared stents have evident effect of sustained release.
4.A rapid detection method for single nucleotide polymorphisms based on ligase-agarose gel electrophoresis
Haizhong CUI ; Na XIAO ; Yongping ZHANG ; Dagui CHEN ; Yitong TANG ; Xuehong ZHAO ; Jinhui SHAO
Chongqing Medicine 2015;(10):1370-1373,1377
Objective To establish a simple,rapid and sensitive nucleotide polymorphisms genotyping method in order to conduct the routine clinical detections under the simple laboratory condition by this method.Methods Based on the ligase-agarose gel electrophoresis,the oligonucleotide detection probes of mutational sites was designed.The detection underwent the detection probe connecting,purification and universal amplification,finally the mutation genotypes of detection sites were judged by the ap-peared bands in the agarose gel electrophoresis(AGE).With the 3 SNP sites EGFR,c.2573T>G(L858R),EGFR,c.2582T> A (L861Q)and EGFR,c.2155 G>T(G719C)in epidermal growth factor receptor(EGFR)gene as the detection objects,the plasmid template and plasma circulating DNA sample in lung cancer were performed the detection.Results The established method was easy to operate with higher specificity and sensitivity.After 20-30 cycles of PCR amplification,the genotype of detection sites was clearly estimated according to the amplification band.When detecting the mixed alleles in the heterogeneous sample,minimal 2.5%mutation alleles could be detected out.This method and the direct sequencing method could respectively detect 6 cases and 2 cases of heterozygotes mutation in the SNP site of L858R among 62 samples of lung cancer.Conclusion The established detection method for SNP genotyping is suitable to the routine mutation detection on the heterogeneous samples under the simple laboratory condi-tion.
5.Clinical Evidence of Chemotherapy or Endocrine Therapy Maintenance in Patients with Metastatic Breast Cancer: Meta-Analysis of Randomized Clinical Trials and Propensity Score Matching of Multicenter Cohort Study
Wei REN ; Yunfang YU ; Huangming HONG ; Ying WANG ; Quanlong GAO ; Yongjian CHEN ; Peixian CHEN ; Jianli ZHAO ; Qiyun OU ; Dagui LIN ; Tuping FU ; Yujie TAN ; Chenchen LI ; Xinxin XIE ; Guolin YE ; Jun TANG ; Herui YAO
Cancer Research and Treatment 2022;54(4):1038-1052
Purpose:
This study aims to comprehensively evaluate the clinical efficacy of chemotherapy or endocrine therapy maintenance in metastatic breast cancer (MBC) patients.
Materials and Methods:
The meta-analysis of randomized clinical trials (RCTs) and propensity score matching of multicenter cohort study evaluated MBC patients who underwent first-line chemotherapy or endocrine therapy maintenance. This study is registered with PROSPERO: CRD42017071858 and ClinicalTrials.gov: NCT04258163.
Results:
A total of 2,867 patients from 15 RCTs and 760 patients from multicenter cohort were included. The results from meta-analysis showed that chemotherapy maintenance improved progression-free survival (PFS) (hazard ratio [HR], 0.63; 95% confidence interval [CI], 0.54 to 0.73; p < 0.001; moderate-quality evidence) and overall survival (OS) (HR, 0.87; 95% CI 0.78 to 0.97; p=0.016; high-quality evidence) than observation. In the cohort study, for hormone receptor–positive MBC patients, chemotherapy maintenance improved PFS (HR, 0.67; 95% CI, 0.52 to 0.85; p < 0.001) and OS (HR, 0.55; 95% CI 0.42 to 0.73; p < 0.001) compared with observation, and endocrine therapy maintenance also improved PFS (HR, 0.65; 95% CI, 0.53 to 0.80; p < 0.001) and OS (HR, 0.55; 95% CI, 0.44 to 0.69; p < 0.001). There were no differences between chemotherapy and endocrine therapy maintenance in PFS and OS (all p > 0.05). Regardless of the continuum or switch maintenance therapy, showed prolonged survival in MBC patients who were response to first-line treatment.
Conclusion
This study provided evidences for survival benefits of chemotherapy and endocrine therapy maintenance in MBC patients, and there was no difference efficacy between chemotherapy and endocrine therapy maintenance for hormone receptor–positive patients.