2.Efficacy and safety of neoadjuvant chemotherapy with modified FOLFOX7 regimen on the treatment of advanced gastric cancer.
Jun ZHANG ; Ren-Xiong CHEN ; Jing ZHANG ; Jun CAI ; Hua MENG ; Guo-Cong WU ; Zhong-Tao ZHANG ; Yu WANG ; Kang-Li WANG
Chinese Medical Journal 2012;125(12):2144-2150
BACKGROUNDGastric cancer is one of the most common types of malignant tumors in China and East Asia and has the highest mortality rate of the malignant gastrointestinal tumors. Neoadjuvant chemotherapy is a systemic or local chemotherapy that is given prior to the local treatment of malignant tumors. Neoadjuvant therapy is currently showing some positive prospects; however, its clinical effects remain controversial. In this study, we used the modified FOLFOX7 (mFOLFOX7) regimen as a neoadjuvant chemotherapy regimen. Perioperative clinical and pathological efficacy, toxicity, effects of surgery, postoperative observation, and prognosis were studied to investigate its clinical efficacy and safety.
METHODSEighty patients with advanced gastric cancer were treated in our surgery department from 2005 to 2009; 38 of these patients received mFOLFOX7 neoadjuvant chemotherapy, the other 42 patients assigned to the control group. The perioperative effects of mFOLFOX7 chemotherapy, including clinical effects and toxicity, were observed in each patient.
RESULTSAfter mFOLFOX7 chemotherapy, clinical and pathologic stages decreased in 21.1% and 36.8% of the patients, respectively, but the results were not statistically significant (P = 0.129). The clinical response rate was 50% (19/38). Toxicity was mild; most adverse events were grade I or II and involved no severe infections or deaths. Compared with the control group, the radical resection rate increased (92.1% vs. 85.7%; P = 0.437); surgical effects were completed without an increased incidence of perioperative complications. The 1-, 2-, and 3-year survival rates were 78.70%, 57.40%, and 51.66%, respectively, in the neoadjuvant chemotherapy group and 78.57%, 56.87%, and 43.16%, respectively, in the control group.
CONCLUSIONSThe mFOLFOX7 regimen was very effective and well-tolerated as a neoadjuvant chemotherapy for advanced gastric cancer. However, the 1-, 2-, and 3-year survival rates in the mFOLFOX7 group were not significantly different from the control group.
Adult ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Female ; Fluorouracil ; adverse effects ; therapeutic use ; Humans ; Leucovorin ; adverse effects ; therapeutic use ; Male ; Middle Aged ; Neoadjuvant Therapy ; adverse effects ; methods ; Organoplatinum Compounds ; adverse effects ; therapeutic use ; Stomach Neoplasms ; drug therapy ; surgery
3.Report of two cases of hepatitis B virus reactivation in primary liver carcinoma patients treated with the FOLFOX chemotherapy regimen.
Feng WANG ; Shukui QIN ; Haiqing HUA ; Xiufeng LIU ; Wenshu QU ; Ping LI
Chinese Journal of Hepatology 2014;22(3):236-238
Adult
;
Antineoplastic Combined Chemotherapy Protocols
;
adverse effects
;
Fluorouracil
;
adverse effects
;
Hepatitis B virus
;
drug effects
;
physiology
;
Humans
;
Leucovorin
;
adverse effects
;
Liver Neoplasms
;
drug therapy
;
pathology
;
Male
;
Middle Aged
;
Neoplasm Staging
;
Organoplatinum Compounds
;
adverse effects
;
Virus Activation
;
drug effects
4.Interstitial Lung Disease Associated with Combination Chemotherapy of Oxaliplatin, 5-Fluorouracil, and Leucovorin.
Sul PARK ; Jae Jin JUNG ; Goeng Bae KIM ; Hyung Sik YOON ; Sang Hun KO ; Jae Ee KO ; Yeun Seun LEE
The Korean Journal of Gastroenterology 2010;55(5):340-343
Oxaliplatin with 5-fluorouracil plus leucovorin (FOLFOX) has become the standard treatment in patients with colorectal cancer. Among known toxicities induced by oxaliplatin, hematological, gastrointestinal and neurological toxicities are common. However, acute pulmonary toxicity associated with oxaliplatin is unusual. One case of interstitial lung disease associated with the FOLFOX protocol is reported here.
Aged
;
Antineoplastic Agents/*adverse effects/therapeutic use
;
Antineoplastic Combined Chemotherapy Protocols
;
Colorectal Neoplasms/drug therapy
;
Fluorouracil/*adverse effects/therapeutic use
;
Humans
;
Leucovorin/*adverse effects/therapeutic use
;
Lung Diseases, Interstitial/chemically induced/*etiology/radiography
;
Male
;
Organoplatinum Compounds/*adverse effects/therapeutic use
5.Interstitial Lung Disease Associated with Combination Chemotherapy of Oxaliplatin, 5-Fluorouracil, and Leucovorin.
Sul PARK ; Jae Jin JUNG ; Goeng Bae KIM ; Hyung Sik YOON ; Sang Hun KO ; Jae Ee KO ; Yeun Seun LEE
The Korean Journal of Gastroenterology 2010;55(5):340-343
Oxaliplatin with 5-fluorouracil plus leucovorin (FOLFOX) has become the standard treatment in patients with colorectal cancer. Among known toxicities induced by oxaliplatin, hematological, gastrointestinal and neurological toxicities are common. However, acute pulmonary toxicity associated with oxaliplatin is unusual. One case of interstitial lung disease associated with the FOLFOX protocol is reported here.
Aged
;
Antineoplastic Agents/*adverse effects/therapeutic use
;
Antineoplastic Combined Chemotherapy Protocols
;
Colorectal Neoplasms/drug therapy
;
Fluorouracil/*adverse effects/therapeutic use
;
Humans
;
Leucovorin/*adverse effects/therapeutic use
;
Lung Diseases, Interstitial/chemically induced/*etiology/radiography
;
Male
;
Organoplatinum Compounds/*adverse effects/therapeutic use
6.Safety and efficacy of preoperative mFOLFOX6 regimen chemotherapy for locally resectable advanced rectal cancer.
Journal of Central South University(Medical Sciences) 2021;46(1):32-38
OBJECTIVES:
Neoadjuvant chemotherapy combined with radical surgery has become the treatment model for locally advanced rectal cancer. The purpose of this study was to evaluate the safety and efficacy of postoperative mFOLFOX6 regimen chemotherapy for locally resectable advanced rectal cancer.
METHODS:
This was a prospective study. A total of 82 patients with locally advanced rectal cancer admitted to Affiliated Nanhua Hospital, University of South China from February 2015 to December 2017 were selected as the subjects. The patients received 4 courses of mFOLFOX6 chemotherapy and underwent surgery within 4-6 weeks after chemotherapy. The incidences of chemotherapy-related adverse reactions, postoperative complications, and clinical pathological reactions were analyzed.
RESULTS:
In the period from mFOLFOX6 chemotherapy to preoperative, 82 patients with locally advanced rectal cancer was reported chemotherapy-related adverse reactions, including Grade 4 neutropenia (2.4%), catheter related infection (2.4%), and anorexia (2.4%), Grade 3 nausea (2.4%) and anorexia (2.4%), Grade 2 neutropenia (14.6%) and peripheral neuropathy (7.3%). Finally, 76 patients with locally advanced rectal cancer completed surgery, including 56 (73.7%) with anterior rectum resection, 16 (21.1%) with abdominal perineal resection, and 72 (94.7%) with pelvic nerve preservation. A total of 22 (28.9%) patients had surgical complications, including 8 (10.5%) with complications of Grade 3 or above. The complications with high incidence were intestinal obstruction, anastomotic leakage, and sepsis. Among the 76 patients who completed chemotherapy and surgery, T stage was decreased in 28 (36.8%) and N stage was decreased in 44 (57.9%); forty-two (55.3%) were in pathological Stage I, 20 (26.3%) in Stage IIA, 12 (15.8%) in Stage IIB, and 2 (2.6%) in Stage IIIA. Ten patients were suspected of tumor invasion of surrounding organs before chemotherapy, of which 4 patients did not need to extend the resection of surrounding organs after chemotherapy and achieved R0 resection of tumor; 2 in T
CONCLUSIONS
Preoperative mFOLFOX6 regimen chemotherapy for locally resectable advanced rectal cancer is a safe and feasible treatment strategy, and it is worthy of clinical application.
Antineoplastic Combined Chemotherapy Protocols/adverse effects*
;
China
;
Fluorouracil/adverse effects*
;
Humans
;
Neoadjuvant Therapy
;
Neoplasm Staging
;
Prospective Studies
;
Rectal Neoplasms/surgery*
;
Treatment Outcome
7.5-Fluorouracil in a Collagen Sponge and Glaucoma Filtering Surgery.
Journal of the Korean Ophthalmological Society 1988;29(5):901-907
A histologic study was performed if fibroblast proliferation could be inhibited and filtering bleb longevity could be enhanced in rabbits by delivery of 5-fluorouracil(0.5 mg) in a collagen sponge implant. Results showed that fibroblast proliferation was inhibited and bleb longevity was prolonged when compared to controls. And it is theorized that if an antitumor agents can be delivered in small and sustained amounts after filtering agents can be delivered in small and sustained amounts after filtering surgery, this may enhance bleb longevity and unnecessary drug toxicity.
Antineoplastic Agents
;
Blister
;
Collagen*
;
Drug-Related Side Effects and Adverse Reactions
;
Fibroblasts
;
Filtering Surgery*
;
Fluorouracil*
;
Glaucoma*
;
Longevity
;
Porifera*
;
Rabbits
8.Bletilla striata polysaccharide improves toxic and side effects induced by 5-FU: an untargeted metabolomics study.
Jiang-Tao ZHANG ; Peng LIU ; Wen-Long WANG ; Xin-Xu XIE ; Tao-Hong HE ; Ya-Ru CUI ; Jun YU
China Journal of Chinese Materia Medica 2023;48(13):3612-3622
This study aimed to analyze the effect of Bletilla striata polysaccharide(BSP) on endogenous metabolites in serum of tumor-bearing mice treated with 5-fluorouracil(5-FU) by untargeted metabolomics techniques and explore the mechanism of BSP in alleviating the toxic and side effects induced by 5-FU. Male BALB/C mice were randomly divided into a normal group, a model group, a 5-FU group, and a 5-FU + BSP group, with eight mice in each group. Mouse colon cancer cells(CT26) were transplanted into the mice except for those in the normal group to construct the tumor-bearing mouse model by subcutaneous injection, and 5-FU chemotherapy and BSP treatment were carried out from the second day of modeling. The changes in body weight, diarrhea, and white blood cell count in the peripheral blood were recorded. The mice were sacrificed and sampled when the tumor weight of mice in the model group reached approximately 1 g. TUNEL staining was used to detect the cell apoptosis in the small intestine of each group. The proportions of hematopoietic stem cells and myeloid progenitor cells in bone marrow were measured by flow cytometry. Five serum samples were selected randomly from each group for untargeted metabolomics analysis. The results showed that BSP was not effective in inhibiting colon cancer in mice, but diarrhea, leukopenia, and weight loss caused by 5-FU chemotherapy were significantly improved after BSP intervention. In addition, apoptotic cells decreased in the small intestinal tissues and the percentages of hematopoietic stem cells and myeloid progenitor cells in bone marrow were significantly higher after BSP treatment. Metabolomics results showed that the toxic and side effects of 5-FU resulted in significant decrease in 29 metabolites and significant increase in 22 metabolites in mouse serum. Among them, 19 disordered metabolites showed a return to normal levels in the 5-FU+BSP group. The results of pathway enrichment indicated that metabolic pathways mainly involved pyrimidine metabolism, arachidonic acid metabolism, and steroid hormone biosynthesis. Therefore, BSP may ameliorate the toxic and side effects of 5-FU in the intestinal tract and bone marrow presumably by regulating nucleotide synthesis, inflammatory damage, and hormone production.
Animals
;
Male
;
Mice
;
Colonic Neoplasms/drug therapy*
;
Diarrhea
;
Fluorouracil/adverse effects*
;
Hormones
;
Metabolomics
;
Mice, Inbred BALB C
;
Polysaccharides/pharmacology*
9.Spectrum-effect relationship of total anthraquinone extract of Cassia seeds against fluorouracil-induced liver injury in mice.
Heng WANG ; Mengqi LI ; Shenxing LI ; Jinggan SHI ; Li HUANG ; Suoting CHENG ; Chuncai ZOU ; Haiyan YAN
Journal of Southern Medical University 2023;43(5):825-831
OBJECTIVE:
To investigate the spectrum-effect relationship between the total anthraquinone extract of Cassia seeds and fluorouracil (5-Fu)-induced liver injury in mice and identify the effective components in the extract.
METHODS:
A mouse model of liver injury was established by intraperitoneal injection of 5-Fu, with bifendate as the positive control. The serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and myeloperoxidase (MPO), superoxide dismutase (SOD) and total antioxidant capacity (T-AOC) in the liver tissue were detected to investigate the effect of the total anthraquinone extract of Cassia seeds (0.4, 0.8 and 1.6 g/kg) on liver injury induced by 5-Fu. HPLC fingerprints of 10 batches of the total anthraquinone extracts were established to analyze the spectrum- effectiveness of the extract against 5- Fu- induced liver injury in mice and screen the effective components using the grey correlation method.
RESULTS:
The 5- Fu- treated mice showed significant differences in liver function parameters from the normal control mice (P < 0.05), suggesting successful modelling. Compared with those in the model group, serum ALT and AST activities were decreased, SOD and T- AOC activities significantly increased, and MPO level was significantly lowered in the mice treated with the total anthraquinone extract (all P < 0.05). HPLC fingerprints of the 31 components in the total anthraquinone extract of Cassia seeds showed good correlations with the potency index of 5-Fu-induced liver injury but with varying correlation strengths. The top 15 components with known correlations included aurantio-obtusina (peak 6), rhein (peak 11), emodin (peak 22), chrysophanol (peak 29) and physcion (peak 30).
CONCLUSION
The effective components in the total anthraquinone extract of Cassia seeds, including aurantio-obtusina, rhein, emodin, chrysophanol, and physcion, are coordinated to produce protective effects against 5-Fu-induced liver injury in mice.
Animals
;
Mice
;
Emodin
;
Cassia
;
Chemical and Drug Induced Liver Injury, Chronic
;
Anthraquinones
;
Antioxidants
;
Fluorouracil/adverse effects*
;
Plant Extracts/pharmacology*
10.Efficacy evaluation of heat-sensitive moxibustion for chemotherapy symptoms of large intestine cancer.
Zhiping LI ; Zhi ZHENG ; Lijun WANG ; Weiyun XIAO ; Jiquan ZENG ; Jing HAO ; Rixin CHEN ; Dingyi XIE
Chinese Acupuncture & Moxibustion 2015;35(10):1010-1013
OBJECTIVETo analyze and evaluate the clinical efficacy of heat-sensitive moxibustion for symptoms of large intestine cancer.
METHODSSixty patients with large intestine cancer were randomly divided into an observation group and a control group, 30 cases in each one. FOLFOX chemotherapy regimen was used in the two groups,and heat-sensitive moxibustion was added in the observation group. The acupoints were Zusanli(ST 36), Sanyinjiao (SP 6) Xuehai (SP 10) and Geshu (BL 17), etc. The treatment was applied once a day,five-day treatment as one course. Four courses were required. The reaction rates of uncomfortable symptoms by the Chinese version of the M. D. Anderson symptom inventory (MDASI-C) scale and clinical effects were analyzed and evaluated in the two groups.
RESULTSAfter treatment, the MDASI-C reaction rate of uncomfortable symptoms in the observation group was 50.4% which was lower than 53.3% in the control group (P < 0.05). The total effective rate of symptom improvement in the observation group was 83.3% (25/30), which was higher than 60.0% (18/30) in the control group (P < 0.05).
CONCLUSIONHeat-sensitive moxibustion can improve symptoms of chemotherapy for large intestine cancer.
Aged ; Antineoplastic Agents ; adverse effects ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Colorectal Neoplasms ; drug therapy ; Drug-Related Side Effects and Adverse Reactions ; etiology ; therapy ; Female ; Fluorouracil ; adverse effects ; therapeutic use ; Humans ; Intestine, Large ; drug effects ; Leucovorin ; adverse effects ; therapeutic use ; Male ; Middle Aged ; Moxibustion ; instrumentation ; Organoplatinum Compounds ; adverse effects ; therapeutic use ; Treatment Outcome