Purpose: To evaluate the efficacy and the side effects of 3 D-conformal radiotherapy for malignant thoracic tumor. Methods: Between September 1999 and August 2002, 36 patients with malignant thoracic tumor were treated with 3D-conformal radiotherapy. Twenty-two patients had primary lung cancer, 12 patients had metastatic lung cancer, and 2 patients had malignant mediastinal tumor. All 36 patients were pathologically confirmed. Squamous cell carcinoma 16 cases, adenocarcinoma 15 cases, small cell carcinoma 2 cases, embryonal carcinoma 1 case, malignant thymoma 1 case and sarcoma 1 case. For the primary tumor, conventional radiotherapy was first used to 50Gy/25F/5W, followed by 3D-conformal radiotherapy 16-20Gy(4Gy per fraction, 3 fractions per week) with MLC or cone from 5 ~6 non coplanar or coplanar static ports. For metastatic tumor, using arc therapy to only 28-40Gy(4Gy per fraction, 3 fractions per week, 7-10 fractions) with cone from 1 ~ 4 arcs. Tumor volumes from 1. 85 cm3 to 104. 61 cm3 with a median of 24. 96 cm3 in 3D-CRT. Results: To evaluate the effects, thoracic CT scan was taken two months after completion of 3D-conformal radiotherapy. In 34 evaluated patients, 13 cases obtained CR, 14 PR, 5 NC, and 2PD. The overall 1 and 2-year survival rates were 74. 1% and 38.4%. Toxicity consisted of grade 1 acute radiation pneumonitis in 17 patients, grade 2 in 10 patients, grade 3 in 1 patients, and 2 patients dead of radiation pneumonitis ( with non coplanar technique), late complication was radiation pulmonary fibrosis, grade 1 in 20 cases, grade 2 in 8 cases. Conclusions: 3D-conformal radiotherapy as complement of conventional external beam radiotherapy for malignant thoracic tumor can obtain better short-term effects, although the survival is yet to be investigated. But attention must be given to the irradiation technique, the irradiation volume should not be too large and beams angles appropriately adjusted to avoid excessive irradiated volume in normal lung.

Objective Objective To evaluate the efficacy and comphcations of late course acceler- ated hypofractionated three dimensional conformal radiation therapy (3DCRT) for patients with stageⅢnon small cell lung cancer (NSCLC). Methods Sixty patients with stageⅢNSCLC were randomized into 2 groups: Late course accelerated hypofractionated 3DCRT group(group A—30 patients) and conventional fractionated radiation therapy group (group B—30 patients). In group A, 30 patients, at first, received a dose of 40 Gy at 2 Gy per fraction, 5 times a week, which followed by late course accelerated hypofractionat- ed 3DCRT with a dose of 16-20 Gy at 4 Gy per fraction, 3 times a week. In group B, 30 patients received a dose of 60-66 Gy at 2 Gy per fraction, 5 times a week. Chemotherapy, including vinorelbine and cisplatin, was given one cycle during radiotherapy and 3 cycles after radiotherapy for all patients. Results Group A had a higher complete response rate (47% vs 20%, P

Objective To explore the changes of carcino-embryonic antigen (CEA) and carbohydrate antigen-199 (CA-199) before and after radiotherapy and chemotherapy in patients with local advanced gastric cancer, and to analyze the significance of the changes. Methods A total of 38 patients with local advanced gastric cancer who received radiotherapy and chemotherapy in our hospital from July 2003 to June 2011 were selected, and another 38 healthy subjects who received physical examination in our hospital at the same period of time were randomly selected. CEA and CA-199 levels of patients with gastric cancer before and after radiotherapy and chemotherapy, as well as the levels of healthy subjects were measured respectively. Venous blood samples were collected for all subjects at early morning under fast-ing condition, and the blood samples were tested by electro-chemiluminescence before gastric cancer was diagnosed by levels of CEA and CA-199 indices. Results The levels of CEA and CA-199 in patients with advanced gastric cancer were higher than those in the healthy subjects. After radiotherapy and chemotherapy, levels of CEA and CA-199 signifi-cantly reduced, and significantly lower than those before radiotherapy and chemotherapy. Accuracy, specificity and sen-sitivity of CEA were 91.67%, 96.67% and 86.67% respectively, and accuracy, specificity and sensitivity of CA-199 were 76.67%, 83.33% and 76.00% respectively. Total positive rate for all patients after radiotherapy and chemother-apy reduced to 42.11%(16/38). Total positive rate for patients with decreased CEA was lower, and 3-year total survival rate was higher. The total positive rate for patients with decreased CA-199 was lower, and the disease free survival rate and 2-year total survival rate were both higher, the differences were statistically significant (P<0.05 for both). Con-clusion The levels of CEA and CA-199 significantly reduce after radiotherapy and chemotherapy for patients with local advanced gastric cancer, and the accuracy of CEA and CA-199 for diagnosing local advanced gastric cancer is high. The possibilities of poor prognosis significantly rise when levels of CEA and CA-199 after radiotherapy increase. The levels of CEA and CA-199 after the treatment are positively correlated with the proportion of positive patients, disease free survival rate and 3-year survival rate.

Objective: To observe the safety and clinical efficacy of tumor antigen-pulsed dendritic cell(DC) vaccine in treatment of advanced malignant tumor.Methods: Ninety-one patients with non-small cell lung cancer,colon and rectal cancer,melanoma,renal carcinoma,breast cancer and other malignant tumors were enrolled in this study.All patients met the selecting standard and signed informed consent.Human dendritic cells were obtained from peripheral blood monocytes by culturing them with granulocyte macrophage-colony stimulating factor and interleukin-4.DC vaccine was prepared from tumor antigen pulsed immature dendritic cells in vitro.Patients received the vaccine therapy once every week and one cycle was defined as once every week for 3 weeks.Results: All the patients received 96 cycles of DC vaccine treatment.Symptoms of toxicity included fever,shivering,aching pain of muscle,asthenia,itching,stifle and transient fatigue;most of the symptoms automatically recovered.Clinical efficacy of the treatment was evaluated in 76 patients.Thirty-one of the 76 patients were stable after treatment and 45 were in progressive situation,with the clinical benefiting rate being 40.8%.Eighty-five patients were followed up.The median time for progression was 2.6 months;the overall survival time was 0.9-30.6 months;and the median survival period was 4.5 months,with the one year survival rate being 9.2%.Conclusion: The results suggest that the DC vaccine therapy is well tolerated in treating patients with advanced malignant tumors and has satisfactory clinical benefit;the clinical value of DC vaccine therapy needs to be further observed.

BACKGROUND On March 2022, the United States Food and Drug Administration(FDA) announced the approval of radiolabeled drug lutetium Lu 177 vipivotide tetraxetan for treatment of adult patients with prostate specific membrane antigen(PSMA)-positive metastatic castration-resistant prostate cancer who have been treated with androgen-receptor pathway inhibition and taxane-based chemotherapy. As PSMA is barely expressed on non-prostatic tissue, it has a very low background accumulation in healthy tissue, consequently, avoiding severe adverse drug reaction of lutetium Lu 177 vipivotide tetraxetan. A multicenter phase Ⅲ VISION study(NCT 03511664) showed that about 30% of patients with evaluable disease at baseline demonstrated an overall response with lutetium Lu 177 vipivotide tetraxetan plus standard care, compared to only 2% in the control arm. The high efficacy and mild adverse drug reaction of lutetium Lu 177 vipivotide tetraxetan cause opportunities for the healthcare systems and represent an important next step towards novel oncotherapy, but also cause great challenges in its clinical use due to lack of practical experience. Currently, data on the large sample and real-world comprehensive safety of lutetium Lu 177 vipivotide tetraxetan are still limited. Therefore, it is necessary to employ data mining algorithms to seek out the potential adverse event signals of lutetium Lu 177 vipivotide tetraxetan by post-marketing monitoring. METHODS FDA Adverse Event Reporting System(FAERS) is a publicly available, voluntary, and spontaneous reporting database. In the present study, the adverse events reported from the second quarter of 2022 to the fourth quarter of 2022 with lutetium Lu 177 vipivotide tetraxetan from FAERS were retrospectively analyzed. Seven types of datasets, including patient demographic and administrative information(DEMO), drug information(DRUG), therapy start dates and end dates for reported drugs(THER), adverse event results(OUTC), adverse event sources(PRSP), coded for the adverse events(REAC), and indications for use/diagnosis(INDI) were used. The reports of lutetium Lu 177 vipivotide tetraxetan were identified using generic name(LUTETIUM LU-177 VIPIVOTIDE TETRAXETAN in prod_ai column) and trade name(PLUVICTO in drug name column) in the DRUG dataset. The adverse event reports with the role_cod as the primary suspected(PS) were chose. Next, the report characteristics, demographic characteristics and onset time of lutetium Lu 177 vipivotide tetraxetan-associated adverse events were analyzed. The adverse events were coded using preferred terms(PT) derived from the standardized Medical Dictionary for Regulatory Activities 25.1(MedDRA), which contained 27 system organ classes(SOCs). Four algorithms, including reporting odds ratio(ROR), proportional reporting ratio(PRR), Bayesian confidence propagation neural network(BCPNN) and multi-item gamma Poisson shrinker(MGPS) were used to detect the signals. All the four data mining algorithms were based on the disproportionality analysis. An adverse event signal was detected only when it conformed to all of the four algorithms criteria simultaneously. RESULTS A total of 634 reports associated with lutetium Lu 177 vipivotide tetraxetan were considered. As a whole, the number of reports had increased gradually month-on-month, and 568(89.6%) reports occurred in the United States. The most common age and body weight groups were 61-80 years(75.4%) and 61-80 kg(50.9%), respectively. Most reports occurred within 30 d after administration of lutetium Lu 177 vipivotide tetraxetan, accounting for 41.5%. Based on 4 algorithms of ROR, PRR, BCPNN and MGPS, six effective signals at the PT level were detected, including anaemia(PT: 10002034), thrombocytopenia(PT: 10043554), laboratory test abnormal(PT: 10023547), platelet count decreased(PT: 10035528), full blood count decreased(PT: 10017413) and dry mouth(PT: 10013781). CONCLUSION When using lutetium Lu 177 vipivotide tetraxetan, it is important to strengthen clinical monitoring within one month and pay attentions to laboratory results including complete blood cell and platelet count. This study might provide powerful support for clinical monitoring of lutetium Lu 177 vipivotide tetraxetan.