PURPOSE: We compared the prophylatic effects and complications of intravesical instillation of the epirubicin and Bacillus Calmette-Guerin (BCG) in patients with stage T1 bladder cancer. MATERIALS AND METHODS: A total 87 patients with stage T1 bladder cancer were treated with transurethral resection (TUR) between January 1992 and April 1998. Of them, 51 patients received BCG (Connaught strain, 81mg), 16 patients received 50mg epirubicin and 20 patients underwent TUR alone. The patients were followed for 18-78 months (mean 40 months). Recurrence rates, progression rates, mean months to tumor recurrence, recurrence free survival rate using Kaplan-Meier curve and complications were compared among three groups. RESULTS: The overall recurrence rate was 27.5% in BCG group, 37.5% in epirubicin group and 65% in control group. Mean months to tumor recurrence and recurrence free survival rate showed that both drugs were superior to TUR alone. The incidence of complications was 94% in BCG group and 12.5% in epirubicin group. CONCLUSIONS: BCG and epirubicin were superior to TUR alone in the prophylaxis of recurrence in stage T1 bladder cancer. Although the prophylactic efficacy of BCG was a little higher than that of the epirubicin, the toxicity rate of epirubicin was much lower than that of BCG. Therefore, epirubicin may be regarded as an alternative treatment of the BCG, especially for the patients who cannot tolerate the side effects of BCG.
Administration, Intravesical ; Bacillus* ; Epirubicin* ; Humans ; Incidence ; Mycobacterium bovis ; Recurrence ; Survival Rate ; Urinary Bladder Neoplasms* ; Urinary Bladder*

OBJECTIVETo evaluate the effect of combination of eicosapentaenoic acid (EPA) and The effects of EPA and epirubicin (EPI) on the human gastric carcinoma cell MGC-803 in vitro.

METHODSEPI were measured by MTT assay , and the interaction between these two agents was evaluated by the isobologram technique of Berenbaum. Morphous of cell was observed by phase-contrast and electron microscope. Flow cytometry was used for cell cycle analysis.

RESULTSEPA significantly inhibited the growth of MGC-803 cells in a dose- and time-dependent way (P < 0.01). Numerous abnormal particles were found around the nucleus of MGC-803 cells under phase-contrast microscope, and also many electron-dense material in cytoplasm were found under electron microscope. EPA significantly stimulated the growth of human embryonal pulmonary fibroblast (HPF) dose-dependently (P < 0.01). A strong synergism was found between EPA and EPI in MGC-803 cells. EPA induced G0/G1-phase arrest but without statistical significance (P > 0.05), and EPI significantly induced S-phase arrest (P < 0.05) in MGC-803 cells.

CONCLUSIONSEPA can inhibit cell growth in gastric carcinoma cells but not in normal cells. EPA and EPI have synergetic effect in the inhibition of gastric carcinoma cells. Compared with EPI monotherapy, the combination of EPI and EPA can reduce the dosage of EPI.

Antineoplastic Combined Chemotherapy Protocols ; pharmacology ; Arachidonic Acids ; administration & dosage ; Cell Line, Tumor ; Drug Synergism ; Epirubicin ; administration & dosage ; Humans

OBJECTIVETo evaluate postoperative transcatheter arterial chemoembolization (TACE) in the prevention of postoperative recurrence of hepatocellular carcinoma (HCC).

METHODSIn TACE group, 987 HCC patients without any evidence of recurrence at the first TACE were treated by prophylactic TACE postoperatively within one or two months. In the control group, 643 HCC patients were not treated by prophylactic TACE for comparison. The correlation between the first recurrence and prophylactic TACE was analyzed.

RESULTSRecurrence rate in the TACE and control group was 22.2% (219/987) and 61.6% (396/643) within 6 months (P < 0.01); 78% (770/987) and 74.7% (480/643) within 12 months (P > 0.05); 88.6% (874/987) and 80.1% (515/643) within 18 months (P < 0.01), respectively.

CONCLUSIONPostoperative prophylactic TACE may be able to suppress the recurrence formation for HCC patients with or without definite residual lesion within 6 months.

Carcinoma, Hepatocellular ; surgery ; therapy ; Chemoembolization, Therapeutic ; Epirubicin ; administration & dosage ; Female ; Humans ; Iodized Oil ; administration & dosage ; Liver Neoplasms ; surgery ; therapy ; Male ; Neoplasm Recurrence, Local ; prevention & control ; Postoperative Period

PURPOSETo exam the relationship between HER2 over-expression and different adjuvant chemotherapies in breast cancer.

PATIENTS AND METHODSA total of 1625 primary breast cancer patients who received post-surgery adjuvant chemotherapy in Tianjin Cancer Hospital, China, from July 2002 to November 2005 were included in the study. Among them, 600 patients were given CMF (CTX+MTX+5-Fu) regimen, 600 given CEF (CTX+E-ADM+5-Fu) regimen, and 425 given anthracyclines plus taxanes regimen, with mean follow-up time of 42 months.

RESULTSIn CMF treatment group, the 3-year disease free survival (DFS) in HER2 over-expressed patients was lower than that of the HER2-negative ones (89.80% vs 91.24%, P=0.0348); in node-positive subgroup, the 3-year DFS was 84.72% in HER2 over-expressed patients, and 90.18% in the HER-2-negative ones (P=0.0271). Compared to CMF regimen, anthracyclines and anthracyclines plus taxanes regimens are more effective (P<0.05) in node-positive HER2 over-expression than those in the node-negative.

CONCLUSIONHER2 over-expression is an independent index for predicting poor prognosis and short DFS for breast cancer patients. HER2 over-expressed patients are resistant to CMF regimen chemotherapy, but sensitive to anthracyclines-based or anthracyclines plus taxanes regimen. HER2 expression can be taken as a marker for therapies in breast cancer.

Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Breast Neoplasms ; chemistry ; drug therapy ; mortality ; Cyclophosphamide ; administration & dosage ; Epirubicin ; administration & dosage ; Female ; Fluorouracil ; administration & dosage ; Humans ; Methotrexate ; administration & dosage ; Middle Aged ; Receptor, ErbB-2 ; analysis

OBJECTIVETo explore the feasibility of short-term neoadjuvant chemotherapy (NACT) in patients with advanced gastric cancer (AGC), and to compare clinical efficacy of short-term neoadjuvant chemotherapy with different ways.

METHODSClinical data of 310 AGC patients treated with one course of NACT using EOF regimen(epirubicin, oxaliplatin and fluorouracil plus calcium folinate) in our hospital from January 2008 to December 2011 were retrospectively analyzes. Efficacy was compared between regional arterial infusion chemotherapy and intravenously chemotherapy.

RESULTSAll the 310 AGC patients completed one course of NACT and none was interrupted by adverse events. Postoperative pathological remission rate was 33.9% (105/310) and 5 patients (1.6%) had complete pathological remission. The pathologic response rate in the regional arterial infusion chemotherapy group was higher than that in the intravenously chemotherapy group(42.4% vs. 23.6%, P = 0.001). Multivariate analysis revealed that chemotherapy method(HR=1.827, 95% CI:1.006-3.316, P = 0.048) was associated with significantly higher pathologic response.

CONCLUSIONSPathological response rate is quite low following short-term NACT. Regional arterial infusion chemotherapy with short-term NACT can improve the pathological response rate of advanced gastric cancer.

Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Epirubicin ; Fluorouracil ; Humans ; Infusions, Intra-Arterial ; Leucovorin ; Neoadjuvant Therapy ; Organoplatinum Compounds ; Remission Induction ; Retrospective Studies ; Stomach Neoplasms ; drug therapy

OBJECTIVETo explore the efficacy of intraperitoneally injected epirubicin (EPI)-loaded poly (d, l)-lactic acid (PLA) microspheres (MS) alone or combined with free epirubicin (FEPI) in treating hepatocellular carcinoma (HCC) in mice.

METHODSMice that were transplanted with H22 ascites HCC were randomized into seven groups, which were intraperitoneally injected with blank microspheres, normal saline, three different doses of microspheres (9, 18, and 36 mg/kg EPI) , FEPI (9 mg/kg) , and the combination (microspheres with EPI 4.5 mg/kg + FEPI 4.5 mg/kg). The survival time of all animals was recorded. The rates of increase in life span of all the treatment groups were calculated.

RESULTSEPI-PLA-MS significantly prolonged the survival time of HCC mice in a dose-dependent manner, with a maximal tolerated dose (MTD) of 18 - 36 mg/kg. The combination group had the highest average survival time, median survival time, and rate of increase in life span, which were (40.0 +/- 16.9) days, 33.5 days, and 222.58%, respectively.

CONCLUSIONEPI-PLA-MS combined with FEPI is highly effective in treating HCC in mice when intraperitoneally injected.

Animals ; Delayed-Action Preparations ; Epirubicin ; administration & dosage ; therapeutic use ; Infusions, Parenteral ; Lactic Acid ; Liver Neoplasms, Experimental ; drug therapy ; Male ; Mice ; Microspheres ; Polyesters ; Polymers

OBJECTIVETo evaluate the clinical efficacy and toxicity of vinorelbine (N) and epirubicin (E) as the neoadjuvant chemotherapy regimen in the treatment of locally advanced breast cancer (LABC).

METHODSFrom September 2001 to December 2004, 158 patients with LABC were treated with NE chemotherapy before operation. Neoadjuvant chemotherapy containing vinorelbine (N), 25 mg/m(2) (days 1 and 8) and epirubicin (E), 60 mg/m(2) (days 1) was administered every 3 weeks for three cycles before local treatment.

RESULTSResponse in the breast: the clinical objective response was 81.6% [23.4% (37/158) cCR and 58.2% (92/158) PR], 16.5% (26/158) SD and 1.9% (3/158) PD. Pathological complete response was found in 29 cases (18.3%). Eighteen cases (26.5%) who have positive FNA result in the axillary lymphnode before chemotherapy showed negative result in the surgery specimen. The most common toxicities were neutropenia, alopecia and nausea/vomiting. Neutropenia grade 3 - 4 was reported in 111 patients (70.3%) and there was no toxic deaths.

CONCLUSIONSThe combination of vinorelbine and epirubicin is a very active and well-tolerated regimen as neoadjuvant chemotherapy for the LABC.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Breast Neoplasms ; drug therapy ; pathology ; Chemotherapy, Adjuvant ; Drug Administration Schedule ; Epirubicin ; administration & dosage ; Female ; Humans ; Middle Aged ; Neoplasm Staging ; Treatment Outcome ; Vinblastine ; administration & dosage ; analogs & derivatives

OBJECTIVETo investigate the efficiency and safety of different regimens by intravesical instillation of epirubicin, a derivative of adriamycin, for the prevention of primary superficial bladder carcinoma from recurrence.

METHODSNinety patients supplemented with intravesical epirubicin instillation after operation were randomly divided into three groups: Group A--80 mg in one dose; Group B--repeated epirubicin 40 mg q wk x 4-8 sessions followed by q month to the end of the second year; or Group C--50 mg q month to the same duration. All patients were followed up for two years by observing the recurrence rates and side effects.

RESULTSThe recurrence rate of groups A, B and C at one year was 16.7%, 13.3% and 16.7%, respectively, without any significant difference observed. However, it was 50.0%, 36.7% and 36.7% at two years, at which time the recurrence rate of group A was significantly higher than those of groups B and C. The side effects rate was 23.3%, 40.0% and 33.3% for groups A, B and C, respectively. The more instillations the patients had, the more severe side effects were.

CONCLUSIONEarly postoperative single high dose intravesical instillation of epirubicin combined with repeated lower doses of the same drug every month may be an efficient and safe regimen to prevent the primary superficial bladder carcinoma from recurrence.

Administration, Intravesical ; Adult ; Aged ; Antibiotics, Antineoplastic ; administration & dosage ; adverse effects ; Combined Modality Therapy ; Epirubicin ; administration & dosage ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; prevention & control ; Postoperative Period ; Prospective Studies ; Urinary Bladder Neoplasms ; prevention & control ; surgery

In order to assess the effect of long-term versus short-term intravesical chemotherapy in preventing the recurrence of patients with non-muscle-invasive bladder cancer, we searched several databases with words as mesh terms and free text words to find all eligible randomized clinical trials (RCTs) for the comparison of the two strategies of instillation durations. "Observed-Expected events research (O-E)" and "Variance (V)" for calculating hazard ratio (HR) were used in Revman 5.2 software recommended by Cochrane Collabration for data analysis. Sensitivity and subgroup analysis were selected to minish heterogeneity. GRADEpro 3.6 profile recommended by Cochrane Collabration was employed for quality assessment of analyses. Finally, 13 eligible RCTs with 4216 patients were included in this review and 16 comparisons from 13 trials were involved for analysis. The pooled analysis revealed no significant difference between long-term and short-term duration [HR=0.99, 95% CI (0.89, 1.11), P=0.89]. Within the subgroup analysis, patients benefited from long-term instillations with a start regimen of one immediate instillation [HR=0.83, 95% CI (0.69, 1.00), P=0.05]. But patients were not suitable to receive long-term instillations with epirubicin (EPI) [HR=1.01, 95% CI (0.91, 1.13), P=0.78]. The progression rate was not reduced after long-term instillations [HR=0.96, 95% CI (0.66, 1.39), P=0.82]. From our results, patients should not receive introvesical chemotherapy more than half a year. In contrast, patients with one immediate instillation are preferred to have a long-term duration at least one year. Long-term instillations can not reduce the progression rate.
Administration, Intravesical ; Antibiotics, Antineoplastic ; administration & dosage ; adverse effects ; therapeutic use ; Drug Therapy ; methods ; trends ; Epirubicin ; administration & dosage ; adverse effects ; therapeutic use ; Neoplasm Recurrence, Local ; Randomized Controlled Trials as Topic ; Time Factors ; Treatment Outcome ; Urinary Bladder Neoplasms ; drug therapy

OBJECTIVETo investigate whether AJCC staging system(2010 edition) for gastric cancer has influence on the adoption of adjuvant chemotherapy.

METHODSThis was a cohort study and the data were collected from patients who underwent radical surgery and received adjuvant chemotherapy from January 2004 to December 2009. There were 48 patients with stage II( disease and 95 patients with stage III( disease according to TNM staging(2010 edition). Doublets were defined as 5-fluorouracil or capecitabine plus cisplatin or oxaliplatin, while triplets had epirubicin added. Ninety-six patients received doublet chemotherapy and 47 received triplet. All the patients were followed-up in the outpatient clinic until death or the censor time of May 2011.

RESULTSThe median follow-up time was 48 months in this cohort of 143 patients. The two groups had similar disease-free survival(DFS)(median, 23 months vs. 30 months, P>0.05). The median overall survival was 48 months in both groups. Subgroup analysis by TNM staging(2010 edition) showed that the median DFS of patients with stage III( gastric cancer was 15 months in the doublet group, significantly shorter than that of patients in the triplet group (18 months, P<0.05). However, the difference in overall survival was not statistically significant between the two groups. Patients with stage II( disease had comparable DFS and OS between the two groups(all P>0.05).

CONCLUSIONSTriplets regimens (epirubicin, platins and fluorouracil) show benefit on disease-free survival for the stage III( gastric cancer patients staged by TNM staging 2010 edition.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Chemotherapy, Adjuvant ; Cisplatin ; administration & dosage ; Epirubicin ; administration & dosage ; Female ; Fluorouracil ; administration & dosage ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; methods ; Postoperative Care ; Prognosis ; Stomach Neoplasms ; drug therapy ; surgery