Humans ; Medical Oncology ; Neoplasms ; drug therapy ; genetics ; Pharmacogenetics ; methods

Lobectomy has been the primary treatment modality for resectable non-small cell lung cancer.However, recent data showed that surgery alone is not adequate for resectable NSCLC treatment. All patients eligible for surgery with curative intent (stage Ⅰ,Ⅱ,and ⅢA) may benefit from adjuvant chemotherapy.Although combined chemoradiation may improve local control for stage ⅢA disease,radiotherapy has been shown to be harmful for patients with stage Ⅰ and Ⅱ NSCLC after complete resection.The role of neoadjuvant chemotherapy or chemoradiation in resectable NSCLC is controversial.RTOG and SWOG have initiated a phase Ⅲ randomised trial to evaluate the effect of preoperative combined chemoradiation followed by surgical resection and consolidation chemotherapy for stage ⅢA disease.In this review,we discuss the current status of combined management of NSCLC and forecast the future direction of treatment by reviewing a number of landmark publications and ongoing clinical trials..

AIMMultidrug resistance ( MDR) as a major obstacle to successful clinical cancer chemotherapy, searching a novel effective antiresistant drug would be necessary.

METHODSA novel doxorubicin anti-resistant stealth liposomes (DARSLs) was prepared by co-encapsulating doxorubicin (DOX) and verapamil (VER) into stealth liposomes with ammonium sulfate gradient remote loading approach. In vitro cytotoxity of various DOX formulations and in vivo toxicity of DARSLs were evaluated using DOX-resistant rat prostate cancer cell line (MLLB2), human uterus sarcoma cell line (MES-SA/DX5) and normal SD rats, separately.

RESULTSThe DARSLs liposome suspensions mainly consisted of homogeneous large unilamellar vesicles (LUV) with average particle size of (118.1 +/- 22.3) nm. Encapsulation efficiencies of DOX and VER in DARSLs were more than 90% and about 70%, respectively, when the ratio of DOX/VER/Lipid was 1: 0.11 :10 (w/w/w). In vitro cytotoxicity tests of the DARSLs using rat prostate cancer cell line (MLLB2) and human uterus sarcoma cell line (MES-SA/DX5) showed that 5 micromol x L(-1) VER significantly reversed DOX-resistance of these 2 cell lines and DARSLs was the most effective on inhibition of DOX-resistant cell growth. Besides, compared to FDFV, much slower DOX distribution (confocal microscopy) to nuclei and cytoplasm in MLLB2 cells for DARSLs suggested that it might possess distinct mechanism of cytotoxicity. Systemic and cardiac toxicity evaluations in normal SD rats suggested that liposomal encapsulation could significantly improve the severe cardiotoxicity arising from simultanous administration of DOX and VER.

CONCLUSIONDARSLs is a novel anticancer liposome formulation with lower cardiotoxicity, effective drug-resistance reversal and intravenous injection.

Animals ; Antibiotics, Antineoplastic ; administration & dosage ; pharmacology ; toxicity ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Doxorubicin ; administration & dosage ; pharmacology ; toxicity ; Drug Carriers ; Drug Resistance, Multiple ; drug effects ; Drug Resistance, Neoplasm ; drug effects ; Female ; Heart Rate ; drug effects ; Humans ; Liposomes ; Male ; Myocytes, Cardiac ; drug effects ; ultrastructure ; Prostatic Neoplasms ; pathology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Sarcoma ; pathology ; Uterine Neoplasms ; pathology

INTRODUCTIONThe development of secondary tumours as a result of radiation therapy is a rare but serious complication.

CLINICAL PICTUREThis is a case report of a 45-year-old Chinese male who developed postirradiation sarcoma of the sphenoid bone in less than 5 years after radiation therapy for Stage T3N1M0 nasopharyngeal carcinoma.

DISCUSSIONIn the literature, the only case of postirradiation osteosarcoma of the sphenoid bone was after radiation therapy for craniopharyngioma. There was no previously reported case of postirradiation sarcoma of the sphenoid bone after radiation therapy for nasopharyngeal carcinoma.

CONCLUSIONThis is the first case of postirradiation malignant fibrous histiocytoma of the sphenoid to be reported. Of about 3000 patients treated with radiotherapy for nasopharyngeal carcinoma over a 10-year period in Singapore, only 1 patient developed postirradiation tumour of the sphenoid bone.

Bone Neoplasms ; etiology ; secondary ; Fatal Outcome ; Histiocytoma, Malignant Fibrous ; etiology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; pathology ; radiotherapy ; Neoplasms, Radiation-Induced ; etiology ; Sphenoid Bone ; pathology ; Spinal Neoplasms ; radiotherapy ; secondary