Radiation therapy is one of the main treatment methods for patients with thoracic malignant tumors, which can effectively improve the survival rate of the patients. However, radiation therapy can also cause damage to normal tissues while treating tumors, leading to radiation-induced lung injury such as radiation pneumonia and pulmonary fibrosis. Radiation-induced lung injury is a complex pathophysiological process involving many factors, and its prevention and treatment is one of the difficult problems in the field of radiation medicine. Therefore, the search for sensitive predictors of radiation-induced lung injury can guide clinical radiotherapy and reduce the incidence of radiation-induced lung injury. With the in-depth study of intestinal flora, it can drive immune cells or metabolites to reach lung tissue through the circulatory system to play a role, and participate in the occurrence, development and treatment of lung diseases. At present, there are few studies on intestinal flora and radiation-induced lung injury. Therefore, this paper will comprehensively elaborate the interaction between intestinal flora and radiation-induced lung injury, so as to provide a new direction and strategy for studying the protective effect of intestinal flora on radiation-induced lung injury.
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Humans ; Lung Injury/prevention & control* ; Gastrointestinal Microbiome ; Lung Neoplasms/radiotherapy* ; Lung/pathology* ; Radiation Injuries/metabolism* ; Thoracic Neoplasms

OBJECTIVETo explore the combined anti-tumor effect of radiation therapy and gene-targeted suppression of tumor neovasculature in lung adenocarcinoma in vivo, and to explore the feasibility of micro-PET/CT in dynamic evaluation of treatment effectiveness.

METHODSThirty 5-6-week old male BALB/c nude mice were used in this study. The mouse models of xenotransplanted human lung adenocarcinoma were divided into 5 groups at random, six mice in each group: the control group, radiation treatment alone group and three groups of recombinant baculovirus plus radiation treatment (intratumoral injection, tail vein injection, and intramuscular injection). The tumor volume was measured every 2 days. Growth delay time (GD) and growth inhibition rate was calculated. FDG metabolism was evaluated by micro-PET-CT before and after treatment. The expressions of VEGF, CD31 and Ki-67 were detected by immunohistochemistry (IHC).

RESULTSThe tumor growth delay was >12 days, and the tumor inhibition rate was >45% in the recombinant baculovirus combined with radiotherapy groups, significantly higher than that of the radiotherapy alone group (P < 0.05). Immunohistochemical analysis showed that the expressions of VEGF, CD31 and Ki-67 were significantly lower than that in other groups (P < 0.05). The micro-PET-CT assessment showed that the FDG-metabolism in the recombinant baculovirus combined with radiotherapy groups was significantly reduced (P < 0.05), and the SUVmax (FDG metabolism) of transplanted tumors after treatment was also markedly decreased in comparison with that of the control group. The tumor volume after treatment was significantly correlated with SUVmax in the recombinant baculovirus intratumoral injection + radiotherapy group(r = 0.976), recombinant baculovirus intravenous injection + radiotherapy group (r = 0.954), recombinant baculovirus intramuscular injection + radiotherapy group (r = 0.929), and radiotherapy alone group (r = 0.871, P < 0.05).

CONCLUSIONSThe recombinant baculovirus containing Egr1 promoter and K5 gene combined with radiotherapy enhances the suppressing effect on the growth of lung adenocarcinoma in the tumor-bearing nude mice. The inducibility of Egr1 promoter by radiation allows the targeting and controllability of treatment. Micro-PET-CT results have a good correlation with the treatment effectiveness. Therefore, it can be used in real-time evaluation of tumor metabolic function in vivo.

Adenocarcinoma ; metabolism ; pathology ; radiotherapy ; Animals ; Baculoviridae ; genetics ; Cell Line, Tumor ; Combined Modality Therapy ; Early Growth Response Protein 1 ; genetics ; physiology ; Fluorodeoxyglucose F18 ; Genetic Therapy ; Genetic Vectors ; Humans ; Ki-67 Antigen ; metabolism ; Lung Neoplasms ; metabolism ; pathology ; radiotherapy ; Male ; Mice, Inbred BALB C ; Mice, Nude ; Molecular Targeted Therapy ; Neoplasm Transplantation ; Peptide Fragments ; genetics ; physiology ; Plasminogen ; genetics ; physiology ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Positron-Emission Tomography ; Promoter Regions, Genetic ; Random Allocation ; Recombinant Proteins ; genetics ; Tomography, X-Ray Computed ; Tumor Burden ; Vascular Endothelial Growth Factor A ; metabolism

OBJECTIVETo explore the relationship between epidermal growth factor receptor (EGFR) gene expression and radiosensitivity of non-small-cell lung cancer (NSCLC) cells.

METHODSEGFR sequence-specific double-stranded RNA (dsRNA-EGFR) was chemically synthesized. NSCLC cell line SPC-A1 was transfected with dsRNA-EGFR formulated with Lipofectamine 2000. Western blot and real-time PCR were used to determine the EGFR mRNA and protein expression, respectively. Colony inhibition test was adopted to observe the radiosensitizing effect. To establish the nude mouse tumor models, calculate the tumor growth inhibition rate and make the tumor growth curve by measuring its size and weight.

RESULTSEGFR mRNA levels were 1.51 ± 0.22, 1.38 ± 0.15 and 0.45 ± 0.11 in the control group, dsRNA-unrelated group and dsRNA-EGFR group, respectively (F = 482.7, P < 0.01). The contents of EGFR protein were 2340.87 ± 10.99, 2231.85 ± 35.66 and 832.03 ± 39.13 in the control group, dsRNA-unrelated group and dsRNA-EGFR group, respectively (F = 263.3, P < 0.05). Compared with the control group, dsRNA-EGFR sequence specifically decreased the expressions of EGFR mRNA by 70.2% and EGFR protein by 64.5%. The colony inhibition rates of the control group, dsRNA-unrelated combined with radiotherapy group and dsRNA-EGFR combined with radiotherapy group were 9.3%, 12.5% and 65.5%, and the tumor growth inhibition rates were 21.3%, 24.4% and 64.2%, respectively. The combination of dsRNA-EGFR and radiotherapy significantly inhibited the tumor growth in vitro and in vivo.

CONCLUSIONSDsRNA-EGFR shows an apparent inhibitory effect on the expression of EGFR mRNA and protein of NSCLC cells, effectively inhibit the tumor growth in vivo, and enhance the radiosensitivity of NSCLC.

Adenocarcinoma ; metabolism ; pathology ; radiotherapy ; Animals ; Cell Line, Tumor ; Cell Proliferation ; radiation effects ; Humans ; Lung Neoplasms ; metabolism ; pathology ; radiotherapy ; Male ; Mice ; Mice, Nude ; Neoplasm Transplantation ; RNA, Double-Stranded ; genetics ; RNA, Messenger ; metabolism ; Radiation Tolerance ; Random Allocation ; Receptor, Epidermal Growth Factor ; genetics ; metabolism ; Transfection ; Tumor Burden ; radiation effects

Skeletal metastases result in significant morbidity and mortality. This is particularly true of cancers with a strong predilection for the bone, such as breast, prostate, and lung cancers. There is currently no reliable cure for skeletal metastasis, and palliative therapy options are limited. The Wnt signaling pathway has been found to play an integral role in the process of skeletal metastasis and may be an important clinical target. Several experimental models of skeletal metastasis have been used to find new biomarkers and test new treatments. In this review, we discuss pathologic process of bone metastasis, the roles of the Wnt signaling, and the available experimental models and treatments.
Animals ; Bone Neoplasms ; drug therapy ; metabolism ; radiotherapy ; secondary ; surgery ; Breast Neoplasms ; metabolism ; pathology ; Disease Models, Animal ; Drug Delivery Systems ; Female ; Humans ; Lung Neoplasms ; metabolism ; pathology ; Male ; Mice ; Prostatic Neoplasms ; metabolism ; pathology ; Wnt Proteins ; metabolism ; Wnt Signaling Pathway ; beta Catenin ; metabolism

OBJECTIVETo investigate the clinical pathological features of fibrosarcomatous dermatofibrosarcoma protuberans (FS-DFSP).

METHODSThe clinical history, histopathological features and immunohistochemical characteristics were analyzed in twelve cases of FS-DFSP from January 1997 to February 2011, and related literature were reviewed.

RESULTSAge of the patients (2 females, 10 males) at diagnosis ranged from 41 to 70 years (mean 53 years). Among the 12 cases of FS-DFSP, 9 cases aroused in recurrent ordinary DFSP. Histologically, FS areas in FS-DFSP were characterized by a fascicular and highly cellular histology, frequently showing a characteristic herringbone pattern. FS-DFSP showed diminishment of CD34 staining in FS areas. The labeling index of Ki-67 was much higher in the FS areas (10%-40%) than that in the conventional DFSP areas (2%-5%). All the patients were treated by operation with local excision or wide excision. Postoperative radiotherapy and chemotherapy was administered in two cases respectively. Follow-up information in 9 of 12 patients (9 to 86 months) revealed local recurrence in 6 patients. Distant metastases were seen in two patients. One patient was died in the follow up period.

CONCLUSIONSFS-DFSP is a rare and unique subtype of DFSP and is associated with significant elevated risk of both local and distance metastasis, usually followed by poor outcome. Compared to ordinary DFSP as a borderline neoplasm, FS-DFSP should be considered as a malignant tumor.

Adult ; Aged ; Antigens, CD34 ; metabolism ; Chemotherapy, Adjuvant ; Dermatofibrosarcoma ; metabolism ; pathology ; therapy ; Diagnosis, Differential ; Female ; Fibroma ; pathology ; Fibrosarcoma ; metabolism ; pathology ; therapy ; Follow-Up Studies ; Histiocytoma, Benign Fibrous ; metabolism ; pathology ; Histiocytoma, Malignant Fibrous ; pathology ; Humans ; Ki-67 Antigen ; metabolism ; Lung Neoplasms ; secondary ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Radiotherapy, Adjuvant ; Retrospective Studies ; Skin Neoplasms ; metabolism ; pathology ; therapy

OBJECTIVETo investigate the feasibility of using cartilage link protein of hyaluronic acid (HA-CLP) for defining the tumor boundary in a mouse model of lung carcinoma.

METHODSLung carcinoma was induced in KM mice by chemical carcinogenesis. HA-CLP separated from bovine cartilage and purified by affinity chromatography was labeled with (125)I for autoradiography. Immunohistochemical analysis and Western blotting were used to examine the efficiency of HA-CLP in defining the boundaries of the lung tumors.

RESULTSWith autoradiography, the clearest image of lung cancer was obtained at 2 h. With immunohistochemical method, the tumor boundary was the most clearly displayed at 2 h when the strongest signals of HA-CLP was detected; Western blotting also showed the clearest bands of HA-CLP at 2 h.

CONCLUSIONHA-CLP has the immunogenicity of HABP, and can efficiently indicate lung tumor boundary in autoradiography and immunohistochemistry.

Animals ; Autoradiography ; methods ; Extracellular Matrix Proteins ; metabolism ; pharmacology ; Female ; Hyaluronic Acid ; metabolism ; Immunohistochemistry ; Iodine Radioisotopes ; Lung Neoplasms ; radiotherapy ; Male ; Mice ; Proteoglycans ; metabolism ; pharmacology ; Radiotherapy, Image-Guided ; methods

OBJECTIVETo improve the understanding of thymic neuroendocrine carcinoma (TNC) by retrospective analysis of the clinical data of 21 cases.

METHODSThe clinical data of 21 patients with TNC treated in the Peking Union Medical College Hospital from 1998 to 2010 were retrospectively analyzed.

RESULTSThere were 12 males and 9 females, with onset age ranging from 13 to 67 years and the mean age of 43 years. The clinical manifestation was diverse, in which the malaise of chest and back accounted for 57.1% (12/21), Cushing's syndrome 33.3% (7/21), multiple endocrine neoplasia type 1 accounted for 4.8% (1/21), pharyngeal malaise 4.8%, superior vena cava syndrome 4.8% (1/21) and asymptomatic patients accounted for 4.8% (1/21). Eighteen of them demonstrated metastasis, in which 13 had metastasis to lymph nodes and local vascular invasion, 9 to lung or pleura, 5 to bone, 1 to liver and 1 was recurred in situ. Twenty of them were treated by surgical resection. Eleven of them received radiotherapy and 9 chemotherapy after surgery. One patient was too severe to endure surgery, and was a treated by chemotherapy only.

CONCLUSIONTNC is rare, and its clinical features are complex, with a high level of malignancy. The first choice of treatment is resection. Adjuvant radiotherapy and/or chemotherapy may be applied in patients with metastasis.

Adolescent ; Adrenocorticotropic Hormone ; metabolism ; Adult ; Aged ; Bone Neoplasms ; secondary ; Carcinoma, Neuroendocrine ; metabolism ; pathology ; secondary ; surgery ; therapy ; Chemotherapy, Adjuvant ; Cushing Syndrome ; metabolism ; pathology ; surgery ; therapy ; Female ; Humans ; Hydrocortisone ; metabolism ; Immunohistochemistry ; Lung Neoplasms ; secondary ; Lymphatic Metastasis ; Male ; Middle Aged ; Multiple Endocrine Neoplasia Type 1 ; metabolism ; pathology ; surgery ; therapy ; Radiotherapy, Adjuvant ; Retrospective Studies ; Thymectomy ; Thymus Neoplasms ; metabolism ; pathology ; surgery ; therapy ; Young Adult

OBJECTIVETo improve the recognition, appropriate diagnosis and treatment of breast carcinosarcoma through analysis of their clinical features, diagnosis, management and prognosis.

METHODSThe clinicopathological data from 25 patients with breast carcinosarcoma treated in our hospital between January 1976 and January 2008 were retrospectively reviewed. The correlation between prognosis and age, tumor size, axillary node status, and treatment modality was analyzed using the statistical software SPSS 13.0. The survival rate was calculated by Kaplan-Meier analysis and compared using log-rank test. Univariate and multivariate factors for survival were analyzed using Cox proportional hazards regression model.

RESULTSAll patients were female and their median age was 56-years. The median tumor diameter was 5.1 cm. The misdiagnosis rate was high by mammography, B-ultrasound and pathological examination of needle aspiration biopsy before operation. So that the diagnosis primarily depended on postoperative histopathologic examination. The ER/PR and HER-2 positive rate of the breast carcinosarcomas was 8.3% and 7.7%, respectively. Invasive ductal carcinoma was the main malignant component accounting for 92.3%, while the sarcoma element was constitutive of fibrosarcoma with a proportion of 46.2%. The overall 5-year survival rate was 57.9% with a median survival time of 86 months after a median follow-up of 52 months. Univariate factor analysis showed that the tumor size (P = 0.012) and treatment methods (P = 0.028) were impact factors, while age and axillary lymph node status were not significantly related with prognosis. Cox multivariate analysis validated that the therapy modality was an independent prognostic factor for breast carcinosarcoma (P = 0.047).

CONCLUSIONSBreast carcinosarcoma is rare and its clinical features are not specific, so that its final diagnosis is mainly based on the postoperative pathology. Tumor size and treatment modality are independent prognostic factors, so the comprehensive therapy mainly based on radical resection is the best treatment modality. The positive expression of ER/PR and HER-2 in breast carcinosarcoma is low, while exploring new target is one of future research directions.

Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; metabolism ; pathology ; therapy ; Carcinosarcoma ; metabolism ; pathology ; therapy ; Chemotherapy, Adjuvant ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; secondary ; Mastectomy ; methods ; Middle Aged ; Neoplasm Recurrence, Local ; Radiotherapy, Adjuvant ; Receptor, ErbB-2 ; metabolism ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Retrospective Studies ; Survival Rate ; Tumor Burden

OBJECTIVETo investigate the effects of brachytherapy with computed tomography-guided percutaneous radioactive I-125 seeds interstitial implantation (ISI) synchronized chemotherapy and Chinese medicine (CM) for the treatment of advanced stage of non-small cell lung cancer (NSCLC).

METHODSNinety patients diagnosed with NSCLC by biopsy were randomly assigned to three groups: the synchronized therapy group (A), the chemotherapy plus CM-treated group (B), and the chemotherapy-treated group (C); a 2-month course of treatment was administered to them all. The effectiveness of treatment was evaluated based on tumor size, tumor markers (carcinoembryonic, squamous cell carcinoma-associated antigen, and cytokeratin 19 fragment), clinical symptoms, and quality of life (QOL) in patients.

RESULTSThe total effective rates of Groups A to C were 83.33%, 46.67%, and 43.33%, respectively. The tumor markers were reduced obviously in Group A, showing signifificant difference compared with those in the other two groups. Additionally, QOL was elevated and cancer-related symptoms were alleviated more signifificant in Group A than those in Group C (all P<0.05).

CONCLUSIONThe synchronized therapy of I-125 implantation with chemotherapy and CM was a safe therapeutic method and can be regarded as a new mode for treatment of advanced-stage NSCLC.

Antineoplastic Agents ; adverse effects ; therapeutic use ; Biomarkers, Tumor ; metabolism ; Brachytherapy ; adverse effects ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; radiotherapy ; Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Iodine Radioisotopes ; Lung Neoplasms ; drug therapy ; radiotherapy ; Male ; Middle Aged ; Quality of Life ; Treatment Outcome

OBJECTIVETo analyze the clinical features, diagnosis, treatment, and prognosis of epithelioid sarcoma (ES).

METHODSThe clinical data of 13 cases with epithelioid sarcoma in the Tianjin Medical University Cancer Institute and Hospital from March 1995 to December 2009 were collected and analyzed. There were 10 males and 3 females in the group, with an average age of 41.5 years (range: 13 to 68 years). Nine patients had classic ES and 4 had proximal-type ES. Surgery was the mainstay of treatment. After the operation, four patients received radiotherapy, five received chemotherapy, and one received chemoradiotherapy.

RESULTSOf the 13 cases, only 1 had multi-locus lesion. The average tumor size was (6.07 ± 1.34) cm. The lymph node involvement was found in 46.2% of the patients. Local and distant failure occurred in 50% and 30% patients, respectively. The most common site for dissemination was the lung. Four cases died within 3 years after initial operation. The 1-, 2-, 5-, 10-year overall survival rates of the 11 cases were 72.7%, 54.5%, 27.3% and 9.1%, respectively, with a median survival time of 27 months.

CONCLUSIONSEpithelioid sarcoma is a rare disease. The prognosis for patients with epithelioid sarcoma is poor because of a high propensity for local recurrence, lymph node metastases, and/or distant metastases. The definite diagnosis depends mainly on the pathologic examination. Wide surgical excision is the mainstay treatment, and radiation and chemotherapy have been used occasionally as adjuvant therapy but have had limited success.

Adolescent ; Adult ; Aged ; Chemotherapy, Adjuvant ; Extremities ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; secondary ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Middle Aged ; Mucin-1 ; metabolism ; Neoplasm Recurrence, Local ; Radiotherapy, Adjuvant ; Retrospective Studies ; Sarcoma ; diagnosis ; metabolism ; pathology ; therapy ; Soft Tissue Neoplasms ; diagnosis ; metabolism ; pathology ; therapy ; Survival Rate ; Vimentin ; metabolism ; Young Adult