1.Prognosis-relevant factors in primary vaginal carcinoma
Yue ZENG ; Ting LIAO ; Lilai CHEN ; He WANG
Chinese Journal of Clinical Oncology 2017;44(12):612-615
Objective:To evaluate prognosis factors of primary vaginal cancer. Methods:Data of 80 patients who were hospitalized in the Department of Gynecology and Oncology of Guangxi Tumor Hospital from January 2003 to January 2015 were retrospectively ana-lyzed. All the patients were divided into radiotherapy group (n=49) and surpery group (n=31). Based on radiation mode, the patients with radiotherapy were divided into two-dimensional radiotherapy group (n=29) and three-dimensional radiotherapy (3DRT) group (n=20). Prognosis and complications between two subgroups were compared. Surgical patients were divided into laparoscopic surgery group (n=16) and laparotomy surgery group (n=15) with comparing therapeutic feasibility of video-laparoscopic operation and laparot-omy for primary vaginal carcinoma treatment. Results:Univariate analysis showed that FIGO stage, pathology, tumor size, and extent of vaginal mass involvement were related to prognosis (P<0.05). Multivariate analysis showed that FIGO stage and pathology were in-dependent prognostic factors. Statistical differences of 5-year survival were significant between 2DRT (20.9%) and 3DRT (58.6%) groups (P=0.022). Incidences of urinary tract (14/29, 48.27%) and gastrointestinal symptoms (15/29, 51.72%) in 2DRT group and in 3DRT (3/20,15%;4/20,20%) are different significantly (P<0.05). Hospitalization days of laparotomy surgery group (57.00 ± 41.75) were significantly longer than that of laparoscopic surgery group (29.56 ± 7.30) (P=0.024). Conclusion: Applying laparoscopic surgery and 3DRT improved quality of life without decreasing survival rate of patients with vaginal cancer.
2.The 18F-fluorodeoxyglucose positron emission tomograhy in predicting residual retro-peritoneal tumor after chemotherapy of testis germ cell tumors
Shuo WANG ; Peng DU ; Xingxing TANG ; Chao AN ; Qiang ZHAO ; Ning ZHANG ; Yong YANG
Chinese Journal of Clinical Oncology 2017;44(12):608-611
Objective:To determine the value of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) scans in identify-ing the residual retroperitoneal tumor after chemotherapy of testis germ cell tumors. Methods:Sixteen testis germ cell tumor patients with metastasis of retroperitoneal lymph nodes who were treated in our hospital from February 2014 to December 2016 were select-ed for the study from February 2014 to December 2016. After 4-6 cycles of chemotherapy, their CT scans showed residual masses with diameters greater than 2 cm. The retroperitoneal lymph nodes were dissected after the 18F-FDG PET exam. The post-surgery pathology results were compared with the results of the 18F-FDG PET exam. Results:Residual tumors were found in 5 of 10 patients with 18F-FDG PET positive. Residual tumor was absent in 4 of 6 patients with 18F-FDG PET negative, while residual mature teratoma tumors were found in two patients. The accuracy rate, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the 18F-FDG PET exam were 56.25%(9/16), 71.42%(5/7), 44.44%(4/9), 50.00%(5/10), and 66.67%(4/6), respectively. Conclusion: 18F-FDG PET is highly sensitive. However, many factors influence the result of 18F-FDG PET. Mature teratoma leads to a false negative re-sult, whereas massive tissue inflammation leads to a false positive result. Therefore, more clinical examinations should be made.
3.Assessment of features and prognostic factors of 146 gastric cancer patients with bone metastasis
Furong KOU ; Ming LU ; Jifang GONG ; Lin SHEN
Chinese Journal of Clinical Oncology 2017;44(12):594-599
Objective:Influence of clinicopathological characteristics and different therapy patterns on the overall survival of patients with gastric cancer with bone metastasis was investigated. Methods:A total of 146 gastric cancer patients with bone metastasis were enrolled from December 1996 to December 2014. Data of clinicopathological characteristics, treatment methods, and overall survival were collected. Univariate and multivariate analyses were performed using log-rank tests and Cox's proportional hazard model, respec-tively. Results:A total of 51 (34.9%) patients had synchronous metastasis, while 95 (65.1%) had metachronous metastasis. Moreover, 35 (24.0%) patients only had bone metastasis, while 111 (76.0%) patients were complicated with other organ metastases, such as liver (30.0%), peritoneal (24.0%), lung (15.1%), and bone marrow (7.5%). After diagnosis of bone metastasis, bisphosphonates, bone radio-therapy and bone surgery were applied in 99 (67.8%), 34 (23.3%), and 5 (3.4%) patients, respectively. Additionally, 96 (65.6%) patients received palliative chemotherapy. The median overall survival was 5.8 months (95%CI:4.284-7.316). Multivariate analysis revealed that KPS<80 (P=0.030), bone marrow metastasis (P<0.001), elevated serum CA199 (P<0.001), and without palliative chemotherapy (P<0.001) were independent poor prognostic factors. Conclusion:The outcome of gastric cancer with bone metastasis is very poor, espe-cially in patients with bone marrow metastasis, worse KPS, and elevated CA199. Palliative chemotherapy may be beneficial for the sur-vival of these patients.
4.Relationship between expression of PD-L1 and microsatellite instability of colorectal cancer and its significance
Wen FENG ; Xinxin WU ; Yongjun GUO ; Yuxi CHANG ; Qingxin XIA
Chinese Journal of Clinical Oncology 2017;44(12):589-593
Objective:To investigate the expression and clinical significance of PD-L1 in colorectal cancer (CRC). Methods:A total of 210 CRC patients who accepted radical surgery in our hospital from January 2015 to January 2016 were divided into three groups, namely, high-frequency microsatellite instability (MSI-H), low-frequency microsatellite instability (MSI-L), and microsatellite stable (MSS). The expression of PD-L1 was detected by immunohistochemistry, and the expression characteristics of PD-L1 in different types of CRC were analyzed. Results:CRC cases with low differentiation had a higher expression of PD-L1 than CRC patients with high differ-entiation (P<0.05). PD-L1 had a positive rate of 75.8%in the MSI-H group and a rate of 9.3%in the MSI-L and MSS groups, wherein the difference between the two groups was statistically significant (P<0.05). Conclusion:PD-L1 was positively expressed in some CRC tu-mor tissues, and its positive rate was significantly higher in MSI-H than in MSI-L and MSS. The therapeutic effect of a PD-L1 blocker for patients with MSI-H CRC might be preferable.
5.Enhanced effect of immunomagnetic beads on micro-CT scan of the lung adenocarci-noma mouse model
Yue WANG ; Shiyang PAN ; Juanjuan ZHU ; Ting XU ; Jian XU ; Jingping LIU ; Fang WANG ; Chunrong GU ; Lixia ZHANG
Chinese Journal of Clinical Oncology 2017;44(12):583-588
Objective:To study the signal enhancement of lung adenocarcinoma nude mice after injection of immunomagnetic bead solution (magnetic beads conjugated with monoclonal antibody NJ001) in micro-CT scan. Methods:The models of lung adenocarcino-ma nude mice were established by injecting SPC-A1-luc cells through the tail vein and were validated by bioluminescence imaging (BLI). The nude mice were divided into three groups: physiological saline group, bare magnetic bead group, and immunomagnetic bead group. Three groups of nude mice were injected with physiological saline, 750 nm bare magnetic bead solution, and immuno-magnetic bead solution via the tail vein every week, and micro-CT scan was taken before and 4 h after injection. Immunohistochemis-try (IHC) was used to detect the expression of antigen SP70 in tumor tissues. Results:The tumor was detected in the immunomagnetic bead group at the fourth week, whereas in the physiological saline and bare magnetic bead groups, the tumor was undetectable until the sixth week. The tumor intensities detected at the sixth week by micro-CT scan in the physiological saline, bare magnetic bead, and immunomagnetic bead groups were 59.05 ± 0.66, 60.69 ± 0.55, and 58.25 ± 0.32 before injection and 60.30 ± 1.83, 61.05 ± 0.68, and 67.41±3.82 after injection, respectively. Compared with the tumor intensities before injection, they significantly increased after injec-tion in the immunomagnetic bead group;the difference was statistically significant (P=0.0079). By contrast, no statistical significance was observed in the tumor intensities before and after injection in the physiological saline and bare magnetic bead groups (P=0.1867 and P=0.3839, respectively). Conclusion:The immunomagnetic beads had enhanced effect on micro-CT scan of lung adenocarcinoma nude mouse models.
6.Effect of TRPV5 and TRPV6 channels on the biological behaviors of SW480 colon cancer cell line
Hui ZHANG ; Morong LIU ; Hui DONG ; Jingyu XU ; Rui XIE ; Guorong WEN ; Lianhua LIU
Chinese Journal of Clinical Oncology 2017;44(12):577-582
Objective:To investigate the role of TRPV5 and TRPV6 in intracellular calcium regulation and biological behaviors of SW480 colon cancer cells. Methods:qRT-PCR, Western blot, and immunocytochemistry were applied to determine the mRNA and protein ex-pression levels of TRPV5 and TRPV6 in SW480 colon cancer cell line upon treatment with TRPV5 and TRPV6 agonist, 1-25(OH)2D3, and inhibitor, CuCl2. The change of intracellular Ca2+level was examined with a confocal laser scanning microscope. Scratch test, MTT, and TUNEL assays were used to analyze the cell migration, proliferation, and apoptosis, respectively. Results:As an agonist of TRPV5 and TRPV6, 1-25(OH)2D3 significantly up-regulated the mRNA and protein expression levels of TRPV5 and TRPV6 in SW480 cell lines. On the other hand, CuCl2, being an inhibitor of TRPV5 and TRPV6, effectively down-regulated the TRPV5 and TRPV6 mRNA and protein expres-sion levels (P<0.05). The intracellular calcium concentration in SW480 cell line significantly increased upon treatment with 1-25 (OH)2D3, and significantly decreased with CuCl2 treatment (P<0.05). 1-25(OH)2D3 promoted cell proliferation and migration, and inhibit-ed apoptosis of SW480 cell in a time-and dose-dependent manner (P<0.05). However, CuCl2 significantly repressed cell proliferation and migration and induced apoptosis (P<0.05). Conclusion: TRPV5 and TRPV6 can affect the biological behaviors of colon cancer SW480 cells by regulating intracellular Ca2+level.
7.Advances in personalized treatment of small cell lung cancer
Shuang ZHANG ; Jingjing LIU ; Ying CHENG
Chinese Journal of Clinical Oncology 2017;44(12):571-576
Small cell lung cancer (SCLC) is a lethal malignancy characterized by rapid growth, early metastatic spread, and unfavorable survival outcomes. Optimizing treatment for patients with SCLC has been the focus for investigators. The emergence of precision medi-cine and personalized treatment brought significant breakthroughs into SCLC treatment and changed the therapeutic model. The de-velopment of molecular bioinformatics increased our understanding of complex molecular mechanisms of SCLC, and novel targets for personalized treatment have been developed. Clinical trials testing these targets are ongoing, which show the potential of personal-ized treatment for SCLC.
8.Manifestation and therapies of EGFRI-induced dermatological toxicities
Chinese Journal of Clinical Oncology 2017;44(13):673-676
In the past decades, the advent of molecular targeted agents has been a considerable breakthrough for cancer patients, ex-cept for traditional operation, chemotherapy, and radiotherapy. As a novel therapeutic method, molecular targeting treatment is im-portant in the field of medical oncology, in which epidermal growth factor receptor inhibitors (EGFRIs) have been widely used as target-ed agents. Dermatological toxicities are the common side effects associated with the EGFRIs. Diarrhea, weakness, and pneumonia can be observed. EGFRI-induced dermatological toxicities may disrupt the health-related quality of life and cause anticancer treatment dose adjustments or discontinuance. The dermatological toxicities mainly involve rash acneiform, pruritus, xerosis, paronychia, hair change, and skin hypersensitivity. Treatment recommendations from guidelines include antibiotics, corticosteroids, and antihista-mines, but their clinical therapeutic efficacy have not been proven. Therefore, oncologists and dermatologists are investigating effec-tive medication. This article reviews the advances in the study of the clinical manifestations and drug therapies of EGFRI-induced der-matological toxicities to provide reference for clinical practitioners.
9.Efficacy and safety of multiple-dose 5-HT3 receptor antagonists in preventing multi-day-based and highly emetogenic chemotherapy-induced nausea and vomiting
Han WANG ; Hongxue WANG ; Weimin XIE ; Fanghui QIN ; Yongkui LU ; Wenxian ZHOU ; Jing TANG ; Yan LIU ; Aihua TAN
Chinese Journal of Clinical Oncology 2017;44(13):667-672
Objective:To evaluate efficacy and safety of multiple-dose tropisetron plus dexamethasone (DXM) versus palonosetron plus DXM for chemotherapy-induced nausea and vomiting. (CINV) in patients received multiple day-based highly emetogenic chemotherapy. Methods:Cancer patients who were receiving multiday-based highly emetogenic chemotherapy were randomly assigned to AB or BA groups. A randomized, cross self-control ed method was applied. Patients in AB group received palonosetron (0.25 mg) 30 min before chemotherapy on day 1 and 3 or additional day 5 in the first cycle;and with tropisetron (5 mg) 30 min before chemotherapy on day 1, 2, and 3, or sup-plementary days (day 4 and 5) in the second cycle. Patients in BA group were treated with tropisetron in the first cycle and with palonosetron in the second cycle. Tropisetron and palonosetron were administered with DXM (10 mg) on day 1, followed by additional doses (5 mg) on days 2 to 5. Palonosetron group comprised patients in the AB group in the first cycle and BA group in the second cycle, whereas tropisetron group included patients in the AB group in the second cycle and BA group in the first cycle. Efficacy and safety of tropisetron versus palonosetron in preventing CINV were evaluated. Results:Ninety-one patients were included in analyses. At day 3, 4, and 5, incidence rates of nausea in the palonosetron group reached 28.6%, 30.8%, and 24.2%, respectively, and those of the tropisetron group totaled 42.8%, 47.3%, and 39.6%, respectively (P<0.05). At day 4, 5, and 6, incidence rates of vomiting in the palonosetron group measured 28.6%, 18.7%, and 5.5%, respectively, and those of the tropisetron group reached 42.9%, 34.1%, and 14.3%, respectively (P<0.05). From day 4 to day 5, day 6 to day 7, and day 1 to day 7, the palonosetron group yielded significantly lower incidence rates of nausea and vomiting than tropisetron group (P<0.05). Rate of rescue treatment in the palonosetron group was lower than that in tropisetron group (13.2%vs. 24.2%, P=0.057). No statistical difference in toxicities was observed between the two groups. Conclusion:Palonosetron plus DXM features better efficacy than that of tropisetron plus DXM against delayed CINV induced by multiple day-based highly emetogenic chemotherapy, which was well tolerated in the two treatments.
10.PEG-rhG-CSF for peripheral blood stem cell mobilization in patients with relapsed or refractory malignant lymphoma
Shan SHAO ; Haitao BAI ; Chun WANG ; Liping WAN ; Huixia LIU ; Lin WU ; Su LI
Chinese Journal of Clinical Oncology 2017;44(13):662-666
Objective:To compare the efficacy and costs of pegylated recombinant human granulocyte colony stimulating factor (PEG-rhG-CSF) and granulocyte colony stimulating factor (G-CSF) for hematopoietic stem cell mobilization and hematopoietic recovery after transplantation in patients with relapsed or refractory malignant lymphoma. Methods:From July 2014 to October 2016, 15 patients with malignant lymphoma using peripheral blood stem cell mobilization (PBSCM) for autologous peripheral stem cell transplantation (APBSCT) were treated in our institution and enrolled in the PEG-rhG-CSF group (experimental group). We analyzed data from other 15 patients with malignant lymphoma mobilized with G-CSF who were treated in our institution from January 2013 to August 2015 (control group). Results:Patients in both groups were successfully mobilized. The median amounts of CD34+cells collected in the experimental and control groups were 16.2×106/kg and 8.9×106/kg, respectively (P=0.414), and the median amount of mononuclear cell (MNC) was 12.4×108/kg and 9.9× 108/kg, respectively (P=0.519). In the experimental and control groups, the mean durations of mobilization were 10.66±1.45 and 9.33±1.83 days (P=0.234), the mean durations of neutropenia during mobilization were 4.20±2.17 and 3.80±2.04 days (P=0.608), the mean durations of absolute neutrophil count recovery after APBSCT were 10.14±1.29 and 10.93±2.69 days (P=0.327), and the mean durations of platelet recovery were 10.36±2.27 and 12.27±3.38 days (P=0.121). Mobilization and hematopoietic recovery after APBSCT were not significantly different between the two groups. The cost was lower in the experimental group than that in the control group (RMB 3,960 yuan versus RMB 11,479.3±2,401.3 yuan). Conclusion:High-dose chemotherapy combined with PEG-rhG-CSF is a promising, effective, and low-cost mobilization regimen for patients with relapsed or refractory malignant lymphoma.