1.Effects ofBaitouweng Decoction on Intestinal Mucosal Healing of Ulcerative Colitis and Study on Partial Mechanism
Zhaohui TAN ; Ronghuo LIU ; Lihua ZOU ; Ping CAO ; Hongsong HU
Chinese Journal of Information on Traditional Chinese Medicine 2016;23(7):30-34
Objective To detect the levels of tumor necrosis factor-α (TNF-α) and interleukin 10 (IL-10) in the plasma of patients with ulcerative colitis (UC); To investigate the clinical efficacy ofBaitouweng Decoction for UC and its influence on intestinal mucosal healing and partial mechanism.Methods Totally 66 patients with UC were randomly assigned to the treatment group and the control group. Patients in the treatment group were treated with Baitouweng Decoction (oral and enema treatment) and those in the control group took Mesalazine for 4 weeks. Before and after treatment, the therapeutic effects were assessed by Mayo scoring system and the grading of activities was evaluated by Baron Endoscope. Serum levels of TNF-α and IL-10 were detected by ELISA. Besides, another 20 healthy volunteers were recruited as the healthy control group for comparison.Results The endoscopic remission rate was 51.4% (19/35) in treatment group, higher than that of the control group (25.8%, 8/31,P<0.05). The clinical remission rate and efficacy rate in the treatment group were 74.2% and 88.6% respectively, higher than those of the control group (45.1% and 64.5%,P<0.05). The histological remission rate and efficacy rate in the treatment group were 25.7% and 54.3% respectively, higher than those of the control group (16.1% and 35.5%), without statistical significance (P>0.05). Serum levels of TNF-α were obviously positive correlated with Mayo score, Baron score and histology score (r=0.836, 0.735, 0.527,P<0.01). Serum levels of IL-10 were obviously negative correlated with Mayo score, Baron score and histology score (r=-0.704, -0.695, -0.509,P<0.01). Compared with pre-treatment, the serum levels of TNF-α significantly decreased (P<0.01), while the serum levels of IL-10 significantly increased (P<0.01) after treatment withBaitouweng Decoction.ConclusionBaitouweng Decoction (oral and enema treatment) is effective and safe in patients with UC. Its effects might be involved in regulating the imbalance of pro-inflammatory factors and anti-inflammatory factors, and promoting mucosal healing.
2.Modified docetaxel regimen for prostate cancer patients who got poor tolerance to chemotherapy
Linjun HU ; Changling LI ; Jianzhong SHOU ; Jun TIAN ; Dong WANG ; Zhendong XIAO ; Zejun XIAO ; Xingang BI ; Kaopeng GUAN ; Hongsong BAI ; Chengming XIE ; Xingli SHAN ; Dehu LU ; Xiang AO ; Yonghai CHEN
Chinese Journal of Urology 2017;38(8):615-618
Objective To evaluate the efficacy and safety of the modified docetaxel plus prednisone scheme for the metastatic castration resistant prostate cancer patients who got poor tolerance to chemotherapy.Method The clinical data of 50 metastatic castration resistant prostate cancer who received docetaxel + prednisone chemotherapy from March 2010 to October 2015 were analyzed retrospectively.23 cases received the modified DP regimen (modified group),27 cases received the standard DP regimen (standard group).The median age of the modified group and the standard group were 69 years (47-80 years) and 63 years (52-77 years) (P =0.005).There were 19 and 24 cases with pain in modified group and standard group respectively;10 and 19 cases with lymph node metastasis respectively;3 and 4 cases of visceral metastasis respectively;all of the 50 patients were complicated with bone metastasis.For the pathological Gleason score,there were 7 cases scored ≤7 points,13 cases scored ≥ 8 points and 3 cases unscored in the modified group;7 cases scored ≤7 points,15 cases scored ≥8 points and 5 cases unscored in standard group.There was no significant difference of the pain,metastasis,and Gleason score between the two groups (P > 0.05).Progression free survival (PFS),overall survival (OS)and adverse events were analyzed using Kaplan-Meier curves,and the differences were assessed using the log-rank test.Results In the modified group and standard group,the median follow-up times were 11.0 months and 14.0 months respectively,the median chemotherapy cycles were 4.5 cycles and 5.0 cycles respectively;OS were 18.0 months and 27.5 months respectively (P =0.746).The PFS of the two groups were 6.0 months and 5.2 months,respectively (P =0.822).The PSA response were 13 cases and 17 cases in the modified group and standard group respectively (P =0.615),and the pain response were 8 cases and 7 cases (P =0.927),grade 3 to 4 adverse events were 3 cases and 14 cases (P =0.003).The main adverse events were blood toxicity,neutrophils,gastrointestinal reaction,edema,fatigue and oral mucositis etc.Conclusions Compared with the standard DP scheme,the modified DP scheme had no significant difference in OS,PFS,pain response rate and PSA response rate,while the incidence of grade 3 to 4 adverse events was significantly reduced.Modified DP scheme may be a better choice for patients with metastatic castration resistant prostate cancer who get poor tolerance to chemotherapy.
3. Progress in research of sensitive markers to neoadjuvant chemotherapy in muscle invasive bladder cancer
Zhilong HU ; Hongsong BAI ; Jianzhong SHOU
Chinese Journal of Urology 2020;41(1):68-71
Bladder cancer is one of the tenth most common malignant tumors in Chinese men. Almost 20% to 30% patients are diagnosed as the muscle-invasive bladder cancer (MIBC) at the first diagnosis.In the past, radical cystectomy (RC) was the first-line treatment with MIBC.The current researches' results show that, neoadjuvant chemotherapy combined with RC can improve the tumor complete response rate and prolong the overall survival of patients with MIBC, comparing with the RC alone. It has become the recommended standard first line treatment for MIBC, which has the possiblity of preserving bladder. Lots of researches indicate that the application of cisplatin-based neoadjuvant chemotherapy in patients with MIBC is becoming more and more popular. However, there is still the possibility of ineffectiveness or tumor progression. Therefore, discussions about the sensitivity of neoadjuvant chemotherapy have always been a hot spot in urological tumor research. In order to provide guidance and help for clinical work, the article reviews the sensitivity of neoadjuvant chemotherapy of bladder urothelial carcinoma.
4.Docetaxel tolerance to metastatic castration-resistant prostate cancer and the correlation between dose and prognosis
Linjun HU ; Changling LI ; Jianzhong SHOU ; Jun TIAN ; Dong WANG ; Zhendong XIAO ; Zejun XIAO ; Xingang BI ; Kaopeng GUAN ; Hongsong BAI ; Chengming XIE ; Xingli SHAN ; Dehu LU ; Xiang AO ; Yonghai CHEN
Chinese Journal of Urology 2019;40(1):31-36
Objective To investigate the dose of docetaxel appropriate for patients with metastatic castration-resistant prostate cancer and its affects to the prognosis.Methods A retrospective analysis was performed on the clinical data of 75 patients with metastatic castration-resistant prostate cancer admitted from March 2010 to July 2016 who received docetaxel combined with prednisone chemotherapy.The patients were divided into the low-dose group (n =43,docetaxel < 65 mg/m2),the middle-dose group (n =21,docetaxel 65-70 mg/m2) and the high-dose group (n =11,docetaxel > 70 mg/m2).The median age in the low-dose group,middle-dose group and high-dose group was 67 (53-80),66 (56-78) and 61 (47-76) years old,respectively.Among 75 patients with bone metastasis,2 patients had no evidence of bone metastasis in the low-dose group.The lymph node metastasis was found in 26,13 and 6 cases in each group,respectively.And visceral and other metastasis were founded in 11,4 and 2 cases,respectively.The Gleason score in the low-dose group was≤7 points in 15 cases,≥8 points in 22 cases and no score in 6 cases.The Gleason score inthe middle-dose group was ≤7 points in 4 cases,≥8 points in 13 cases and no score in 4 cases.The Gleason score in the high-dose group was ≤7 points in 3 cases,≥8 points in 5 cases and no score in 3 cases.The number of patients with pain in the low-dose group,middle-dose group and high-dose group was 36,12 and 9,respectively,there were no significant differences in the above indicators (P > 0.05),except age,which showed relatively more aged patients in the low-dose group,(P =0.045).Kaplan-Meier method was used to compare the overall survival (OS),progression-free survival (PFS) and the incidence of ≥CTCAE-4 grade 3 adverse reactions between the two groups.The Cox regression model was adopted to analyzed the factors that might affect patient prognosis,including the effective time of first-line endocrine therapy,hemoglobin level,ECOG score,pain score,number of cycles of chemotherapy,age,dose of docetaxel and alkaline phosphatase (ALP).Kaplan-Meier method was used to analyze the effect of dose of docetaxel on the prognosis,and log-rank method was used to test the significance of the results.Results The median OS was respectively 24.1,18.5 and 23.5 months in the low-dose group,middle-dose group and high-dose group,respectively.The median PFS was 5.3 months in all three groups,which didn't show statistically significant differences.The incidence of grade 3/4 adverse reactions in the low-dose group,middle-dose group and high-dose group was 15 cases (34.9%),8 cases (38.1%) and 5 cases (45.5%) respectively.It showed an increasing trend,but no statistically significant difference.The single factors related to OS mainly include the effective time of first-line endocrine therapy,hemoglobin level,ECOG score,pain score,number of cycles of chemotherapy,there was no significant correlation with age,docetaxel dose,ALP and PSA value.Conclusions It is common to receive lower doses of docetaxel in clinical practice for patients with metastatic castration-resistant prostate cancer in China.The efficacy of low-dose docetaxel is similar to that of high doses (standard dosage).There was no significant correlation between the OS and the actual dose of docetaxel in the tolerable range.
5.Neoadjuvant Chemotherapy–Guided Bladder-Sparing Treatment for Muscle-Invasive Bladder Cancer: Results of a Pilot Phase II Study
Hongzhe SHI ; Wen ZHANG ; Xingang BI ; Dong WANG ; Zejun XIAO ; Youyan GUAN ; Kaopeng GUAN ; Jun TIAN ; Hongsong BAI ; Linjun HU ; Chuanzhen CAO ; Weixing JIANG ; Zhilong HU ; Jin ZHANG ; Yan CHEN ; Shan ZHENG ; Xiaoli FENG ; Changling LI ; Yexiong LI ; Jianhui MA ; Yueping LIU ; Aiping ZHOU ; Jianzhong SHOU
Cancer Research and Treatment 2021;53(4):1156-1165
Purpose:
Reduced quality of life after cystectomy has made bladder preservation a popular research topic for muscle-invasive bladder cancer (MIBC). Previous research has indicated significant tumor downstaging after neoadjuvant chemotherapy (NAC). However, maximal transurethral resection of bladder tumor (TURBT) was performed before NAC to define the pathology, impacting the real evaluation of NAC. This research aimed to assess real NAC efficacy without interference from TURBT and apply combined modality therapies guided by NAC efficacy.
Materials and Methods:
Patients with cT2-4aN0M0 MIBC were confirmed by cystoscopic biopsy and imaging. NAC efficacy was assessed by imaging, urine cytology, and cystoscopy with multidisciplinary team discussion. Definite responders (≤ T1) underwent TURBT plus concurrent chemoradiotherapy. Incomplete responders underwent radical cystectomy or partial cystectomy if feasible. The primary endpoint was the bladder preservation rate.
Results:
Fifty-nine patients were enrolled, and the median age was 63 years. Patients with cT3-4 accounted for 75%. The median number of NAC cycles was three. Definite responders were 52.5%. The complete response (CR) was 10.2%, and 59.3% of patients received bladder-sparing treatments. With a median follow-up of 44.6 months, the 3-year overall survival (OS) was 72.8%. Three-year OS and relapse-free survival were 88.4% and 60.0% in the bladder-sparing group but only 74.3% and 37.5% in the cystectomy group. The evaluations of preserved bladder function were satisfactory.
Conclusion
After stratifying MIBC patients by NAC efficacy, definite responders achieved a satisfactory bladder-sparing rate, prognosis, and bladder function. The CR rate reflected the real NAC efficacy for MIBC. This therapy is worth verifying through multicenter research.