Chinese Clinical Oncology

EGFR gene promoter methylation and the sensitivity of gefitinib in non-small cell lung cancer

Chinese Clinical Oncology. 2012, 17 (9): 769.

Abstract ( 1389 )

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Objective To examine the relationship between EGFR gene promoter methylation and the sensitivity of gefitinib in nonsmall cell lung cancer（NSCLC） cell lines. Methods HCC827, H1650, H1975, H358, H1299 and A549 cells were treated with different dose of gefitinib separately. Cell counting kit8（CCK-8） assay was used to determine the cell proliferation inhibition rate. The protein and mRNA expression levels of EGFR were detected by Western blotting and RTPCR methods. The methylation of EGFR gene promoter region was examined by methylationspecific PCR.
ResultsEGFR mutation status：HCC827 and H1650 cells were exon 19 deletions; H1975 cells were exon 21 L858R point and exon 20 T790M insertion mutations，and H358，H1299，A549 were all wide type cells. According to the 50% inhibition concentration（IC50）, the HCC827 was most sensitive to genfitinib and H538 was moderately sensitive, while H1650 was nonsensitive. H1299 and A549 were less sensitive to genfitinib. The expression of EGFR protein and mRNA were relatively higher in HCC827 and H358 cells comparing with other four cell lines（P＜0.05）. EGFR gene promoter region was unmethylated in HCC827 cells and partly methylated in H358 cells，while in other four cells were all methylated. Conclusion EGFR gene promoter methylation may contribute to the downregulation of EGFR gene and consequently affect the sensitivity of gefitinib in NSCLC cell lines.Analysis of methylation status of EGFR gene promoter may have definite value in predicting the therapeutic response of gefitinib.

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Involvement of PI3K／Akt／mTOR signaling pathway in epirubicininduced apoptosis and antiproliferation of Jurkat cells

Chinese Clinical Oncology. 2012, 17 (9): 780.

Abstract ( 1108 )

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Objective To investigate the role of PI3K／Akt／mTOR signaling pathway in epirubicininduced apoptosis and antiproliferation of human Tcell lymphoma cell line Jurkat. Methods The effects of 0， 1.25， 2.5， 5， 10μmol／L epirubicin and 0， 0.25， 0.5， 1， 2μmol／L dual PI3K／mTOR inhibitor（NVP-BEZ235） on human Tcell lymphoma cell line Jurkat proliferation after 48h was assessed by CCK8. The apoptosis of Jurkat cells with 0， 1.25， 2.5， 5， 10μmol／L epirubicin after 48h，5μmol／L epirubicin and 2μmol／L NVPBEZ235 after 0， 12， 24， 36 and 48h was detected by Annexin Ⅴ／PE double staining flow cytometry. The effects of 5， 10μmol／L epirubicin at 0， 6， 12， 24， 48h and the change of combining 2μmol／L NVPBEZ235 at 24, 48h with 5μmol/L epirubicin on the expressions of Akt, p-Akt, mTOR, pmTOR, p70s6k and pp70s6k were detected by Western blotting method. Results Epirubicin could inhibit proliferation of Jurkat cells and induce its apoptosis. When Jurkat was treated by 5μmol／L epirubicin， the apoptosis rate was 57.72％. The apoptotic effect was concentrationdependent. Epirubicininduced apoptosis of Jurkat cells was along with the changes of Akt， mTOR， p70s6k and their phosphorylation levels. NVPBEZ235 reduced the phosphorylation levels of Akt and p70s6k in Jurkat cells， which significantly improved the apoptosis of Jurkat cells. The apoptotic rate rose from 57.72％ to 78.31％ because of 2μmol／L NVPBEZ235 combining with 5μmol／L epirubicin after 48h. Conclusion Epirubicininduced apoptosis of Jurkat cells has a relation with PI3K／Akt／mTOR signaling pathway， when the pathway inhibitors combined with epirubicin， the cells sensitivity of epirubicin has improved to some extent.

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Tumor targeting study of new dye IR-808 by nearinfrared fluorescence imaging in vivo

Chinese Clinical Oncology. 2012, 17 (9): 785.

Abstract ( 1260 )

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The clinical observation of single and multipleday dosing of palonosetron preventing chemotherapyinduced nausea and vomiting

Chinese Clinical Oncology. 2012, 17 (9): 790.

Abstract ( 1024 )

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Objective To evaluate the antiemetic efficacy and safety of single and multipleday dosing of palonosetron in patients receiving chemotherapy.
MethodsA total of 451 patients were randomized to receive a single intravenous dose of palonosetron 025 mg 30 min before chemotherapy on day 1（group A， n=232）， or palonosetron 025 mg once daily 30 min before chemotherapy on days 1，3 and 5（group B， n=219）. In group B， patients that received chemotherapy less than 2 days， and who were without vomiting and nausea occurred on the fourth day after chemotherapy， were not received palonosetron on day 5. The clinical effects and adverse reaction were analyzed between two groups.
ResultsThe complete remission（CR） rates for emesis and nausea in the whole chemotherapy course of group B was 52.97％，higher than 38.36％ of group A（P=0.002）. The CR rates for acute emesis and nausea were 5819％ for group A and 62.56％ for group B（P=0.340）， which demonstrated no statistical difference. Comparisons of CR rates for delayed emesis and nausea yielded statistical difference between group A and group B（46.98％ vs.65.30％， P＜0.001）. There was no statistical difference in CR rates for acute emesis between group A and group B（86.64％ vs.87.21％， P=0.860）. CR rates for emesis were significantly higher for group B than group A during the delayed period （89.95％ vs.71.12％， P＜0.001）. There was no statistical difference in CR rates for acute nausea between group A and group B（58.19％ vs.62.56％， P=0.340）. CR rates for nausea were significantly higher for group B than group A during the delayed period （66.21％ vs.51.72％， P=0.0018）.The rate of rescue treatment for group B was lower than group A（11.42％ vs.19.83％， P=0.014）. There was no statistical difference in incidence of adverse reactions between group A and group B（8.19％ vs.10.05％， P=0.390）. Conclusion Multipleday dosing of palonosetron is superior to a single dose of palonosetron in the prevention of delayed emesis and nausea. There is no statistical difference in incidence of adverse reactions between the two groups.

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Expression of melatonin receptor（MT1）and CUE domaincontaining 2（CUEDC2） in human breast cancer and clinical significance

Chinese Clinical Oncology. 2012, 17 (9): 795.

Abstract ( 959 )

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Objective To explore the relationship and clinical significance between the expressions of melatonin receptor（MT1） and CUE domaincontaining 2（CUEDC2） in breast cancer. Methods Western blotting and immunohistochemical method were performed to detect the expression of MT1 and CUEDC2 in 80 invasive ductal breast cancer， 30 intraductal breast cancer and 30 normal breast tissues. Results The positive expression rates of MT1 in invasive ductal breast cancer， intraductal breast cancer and normal breast tissue were 78.8％，60.0％ and 16.7％ with statistical significance（P＜0.05）. The positive expression rate of CUEDC2 in invasive ductal breast cancer and intraductal breast cancer tissue was 68.8％ and 53.3％, higher than 133％ in normal breast tissue（P＜0.05）. Western blotting showed expressions of MT1 and CUEDC2 in invasive ductal breast cancer were 0.542±0.078 and 0.461±0.057， significantly higher than those in normal breast tissue（P＜0.05）. The positive expressions of MT1 and CUEDC2 in invasive ductal breast carcinoma was correlated with axillary lymphnode metastasis（P=0.034，P=0.027） and histological grade（P=0.018，P=0.022），but not with age and tumor size of patients（P＞0.05）. Positive correlation was observed between the expression of MT1 and CUEDC2 in invasive ductal breast cancer（r=0.44，P＜0.05）.
ConclusionThe overexpression of MT1 and CUEDC2 is related with the occurrence，development and metastasis of breast carcinoma. The combined detection of their expression provides experimental evidence for finding the new intervention targets in the breast cancer gene therapy

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Expression of NDRG1 and associated proteins in breast cancer and their correlatio

Chinese Clinical Oncology. 2012, 17 (9): 801.

Abstract ( 972 )

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Objective To investigate the expression of N-myc down stream regulated gene 1（NDRG1） in breast carcinoma tissues and the relations with ER， PR， p53， c-erb-B2. Methods The expressions of NDRG1，ER，PR， p53 and c-erb-B2 proteins were detected in 82 breast carcinoma samples by immunohistochemical staining， then the correlation of their expression was analyzed. The relationship between clinical characteristics and NDRG1 expression was also studied. Results The positive rate of NDRG1 protein expression was higher in early stage breast cancer than that in advanced breast cancer（P=0.014）. NDRG1 protein expression has significantly negative correlation with p53（r=-0.233， P=0.035）， but no association could be detected among NDRG1，ER， PR and c-erb-B2（P＞0.05）. Conclusion NDRG1 plays an important inhibition role in the development of breast cancer，and it may be considered as a valuabe marker for the gene research and therapy of breast carcinoma.

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Expression and clinical significance of SBEM and hMAM in patients of breast cancer

Chinese Clinical Oncology. 2012, 17 (9): 809.

Abstract ( 1032 )

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Objective To explore the expression and clinical significance of small breast epithelial mucin（SBEM） and human mammaglobin（hMAM） in breast cancer patients. Methods The expression of SBEM mRNA and hMAM mRNA in peripheral blood samples of 109 primary breast cancer patients and 25 controls（5 healthy donors and 20 other tumor patients）were detected by RTPCR. The percentages of SBEM+/hMAM+ cell were measured by flow cytometry（FCM）. The relationship between them and clinicopathologic features were analyzed. Results RT-PCR results showed that SBEM mRNA and hMAM mRNA only expressed in peripheral blood of breast cancer patients， while no expression was found in that of controls. FCM showed that the percentages of SBEM+ and hMAM+ cells in peripheral blood were 55.9％（61／109） and 40.4％（44／109） in breast cancer， much higher than 10％ in controls. Both SBEM mRNA and hMAM mRNA expression were related to TNM stage and lymph node metastasis， but not to age， tumor size， hormone receptor and C-erbB2. ConclusionSBEM mRNA and hMAM mRNA highly expressed in peripheral blood of breast cancer， and the united detection of them may be helpful to judge hematogenous micrometastasis of breast cancer.

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Expressions of DLL4， COX-2 and MMP-2 in breast cancer tissues and its significance

Chinese Clinical Oncology. 2012, 17 (9): 814.

Abstract ( 1188 )

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ObjectiveTo study the expressions of DLL4（deltalike ligand 4）， COX-2（Cyclooxygenase-2） and MMP-2（matrix metalloproteinase-2） in different molecular subtypes of breast cancer and analyze their correlation.
MethodsThe expressions of DLL4， COX-2 and MMP-2 were determined by SP immunohistochemistry in 100 cases of breast carcinoma （41 luminal A， 18 lumianl B， 22 HER-2 overexpression and 19 basallike subtypes） and 40 cases of adjacent normal breast tissues. Then the correlation of DLL4， COX-2 and MMP2 expression with lymph node metastasis was analyzed.
ResultsThe positive expression rates of DLL4，COX-2 and MMP-2 in breast cancer were 73.0％， 81.0％ and 93.0％， significantly higher than those in adjacent normal breast tissues（P＜0.05）. The positive rates of DLL4， COX-2 and MMP-2 were 95.5％， 100.0％ and 100.0％ in HER-2 overexpression type， and 89.5％， 94.7％ and 100.0％ in basal-like subtype. They were significantly higher than those in luminal A and luminal B subtypes（P＜0.05）. The expression of DLL4，COX-2 and MMP-2 in lymph node metastasis group were 88.7％， 92.5％ and 96.2％ respectively， higher than those without lymph node metastasis group（P＜0.05）. Positive correlation could be found between DLL4 and COX-2, MMP2 expression（r=0.215， P＜0.05； r=0.435， P＜0.05）. Conclusion DLL4， COX-2 and MMP-2 are highly expressed in HER2 overexpression and basallike subtypes of breast cancer. These results suggest that they might be important factors in breast carcinogenesis， development and metastasis. These proteins are indicators of metastasis of breast cancer.

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Expression and prognostic value of MMP13 in nonsmall cell lung cancer

Chinese Clinical Oncology. 2012, 17 (9): 818.

Abstract ( 927 )

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Objective To explore the expression of MMP13 and its relationship with invasion，metastasis and prognosis of nonsmall cell lung cancer（NSCLC）.
MethodsThe expression of MMP13 was detected by immunohistochemistry in 87 specimens of NSCLC tissues and 30 specimens of adjacent normal tissue. χ2 test was applied to analyze the relationship between expression and clinicopathologic characteristics. KaplanMeier univariate and multivariate Cox model were applied to analyze the survival of NSCLC.
Results The positive expression rates of MMP13 in NSCLC and adjacent normal lung tissues were 70.1％（61／87）and 6.7％（2／30） with significant differences（P＜0.001）. The expression of MMP13 was associated with T stages， lymphatic metastasis and TNM stages（P＜0.05）. Kaplan-Meier univariate analysis revealed the five-year survival rate of MMP13positive patients was lower than that of MMP13negative patients（18.4% vs. 52.1%, P=0.001）. Meanwhile, TNM stages（P＜0.001）， lymphatic metastasis（P＜0.001）and T stages（P=0.002） could influnce the survival time of patients with NSCLC. Cox multivariate survival analysis revealed only MMP13 expression（P=0.042）and TNM stages（P=0.001）as independent prognostic factors. Conclusion MMP13 is closely correlated with invasion and metastasis of lung cancer， and its positive expression may suggest poor prognosis in NSCLC patients.

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Association between polymorphisms in the splicing regulatory region of hMSH2 gene and incidence of familial or under-50 age gastric cancer

Chinese Clinical Oncology. 2012, 17 (9): 822.

Abstract ( 709 )

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Objective To investigate the association between IVS10+12G＞A and IVS12-6T＞C polymorphisms in the hMSH2 gene and incidence of familial or under 50 age gastric cancer.
MethodsA casecontrol study has been taken on subjects including 149 sporadic cases， 100 familial cases and 260 healthy individual controls to investigate whether such polymorphisms affecting the risk of developing gastric cancer. Peripheral blood cell DNA was obtained from all subjects. IVS10+12 G＞A and IVS12-6T＞C polymorphisms in hMSH2 gene were detected using a PCRbased DHPLC and verified by DNA sequencing.
ResultsThe frequencies of IVS10+12 G＞A and IVS12-6T＞C polymorphisms in 249 patients were significantly higher than those in 260 controls. IVS10+12 G＞A and IVS12-6T＞C polymorphisms jointly affected the onset of gastric cancer，especially in familial cases. No difference was found between 149 sporadic patients and 260 controls. The stratification analysis of confounding factors showed that hMSH2 gene IVS10+12 G＞A and IVS12-6 T＞C polymorphisms exist mainly in under 50 age patients（P＜0.05）， and significantly correlated with sauerkraut dietary factor（P＜0.05）.
ConclusionThe IVS10+12G＞A and IVS12-6T＞C polymorphisms in hMSH2 gene are associated with increased risk of developing gastric cancer in familial or under 50 age population. Determination of these polymorphisms may be suitable to identify individuals with increased risk of gastric cancer.

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Polymorphism of CTLA-4 gene promoter region and extron region in gastric cancer

Chinese Clinical Oncology. 2012, 17 (9): 828.

Abstract ( 1177 )

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Objective To analyze the relationship between polymorphism in CTLA4 gene extron 49 site and promoter 1722 and susceptibility to gastric cancer in Qingdao area. Methods Polymerase chain reaction-restriction fragment length polymorphism and direct sequencing were performed to analyze the genotype of the polymorphism in 49 site and 1722 site. Their correlation with clinicopathological characteristics of gastric cancer was analyzed.
Results The frequency of AG and GG genotype in 49 site in gastric cancer group and atrophic gastritis group were higher than those in the control group（P＜0.05）; and men with gastric cancer carried more AG and GG genotype than women. The frequency of all genotype in 1722 site in gastric cancer and atrophic gastritis group was not significantly different from control group.The single nucleotide polymorphism of promoter 1722 was not associated with gender，age， differentiation and TNM staging of gastric cancer. Conclusion There is a relationship between CTLA-4+49 A／G polymorphism and susceptibility to gastric cancer.

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Clinical study of the number of circulating CD34+ cells in the peripheral blood from patients with myelodysplastic syndromes

Chinese Clinical Oncology. 2012, 17 (9): 832.

Abstract ( 945 )

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Objective To explore the significance of the number of circulating CD34+ cells in the peripheral blood from patients with myelodysplastic syndromes（MDS） on disease subtype and prognosis. Methods The percentage and absolute count of circulating CD34+ cells of the 16 healthy individuals and 40 patients with MDS were measured by flow cytometry. Forty patients with MDS were divided into RA／RARS／RCMD subgroup or RAEB Ⅰ／RAEB Ⅱ subgroup； favorable chromosomal subgroup， intermediate chromosomal subgroup and poor chromosomal subgroup；intermediate-risk Ⅰ subgroup， intermediaterisk Ⅱ subgroup and highrisk subgroup according to WHO classification， chromosomal abnormalities and international prognostic scoring system（IPSS）. Results The percentage and the absolute count of circulating CD34+ cells in peripheral blood from patients with MDS were 0.67％ and 17.24 cells／μl， while they were 0.03％ and 1.63cells／μl in normal control（both P＜0.01）. In MDS group： the percentage and the absolute count of CD34+ cells in RA／RARS／RCMD subgroup were 0.05％ and 3.50 cells／μl，which were lower than 3.09％ and 81.95 cells／μl in RAEB Ⅰ／RAEB Ⅱ subgroup（both P＜0.01）. The percentage and the absolute count of CD34+ cells in favorable chromosomal subgroup were 0.05％ and 3.50 cells／μl， while they were 1.29％ and 18.23 cells／μl in intermediate subgroup and 3.09％ and 133.10 cells／μl in poor chromosomal subgroup, respectively. With the emergence of chromosomal abnormalities, the percentage and absolute count were gradually increased（P＜0.05）. The percentage and the absolute count of CD34+ cells in intermediaterisk Ⅰ（0.05％ and 3.50 cells／μl），intermediaterisk Ⅱ（1.57％ and 35.55 cells／μl） and highrisk subgroup（8.15％ and 192.05 cells／μl） were gradually increased with the progressive increase of IPSS score（all P＜0.01）.
Conclusion Detection of the number of circulating CD34+ cells in peripheral blood cells may be a useful tool for subtyping and predicting the prognosis of MDS.

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The role of magnetic resonance spectroscopy in the radiotherapy of brain gliomas

Chinese Clinical Oncology. 2012, 17 (9): 836.

Abstract ( 1188 )

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Objective To explore the changes of metabolites in brain gliomas before and after radiotherapy with magnetic resonance spectroscopy（MRS）.
Methods Thirty-one patients with brain gliomas confirmed by pathology after partial surgical resection were underwent routine MRI，contrastenhanced MRI and MRS before and after radiotherapy in a week. The regions of interest（ROI）were placed on the central enhancement region， peritumoral brain edema region and normal white matter region， respectively. The metabolic distribution of each ROI were obtained using GE AW Functool software. The ratios of Cho／Cr，Cho／NAA and NAA／Cr were calculated automatically.
ResultsCompared to preradiotherapy（pre-RT）， the values for Cho and NAA increased after radiation therapy（post-RT） in the enhancement region. The difference in NAA values between preTR and post-RT showed statictical significance（39.295±33.778 vs. 56.062±39.031, P=0.02）， while no significant differences in Cho changes. In peritumoral edema region， Cho declined and NAA values increased post-RT， with no statistical significance for Cho and NAA between pre and post-RT. Compared to pre-RT， the ratios of Cho／Cr，Cho／NAA and NAA／Cr decreased in regions of enhancement and peritumoral edema post-RT. There were significant differences in Cho／Cr and no significant differences in Cho／NAA，NAA／Cr between pre and postRT for both 2 regions. Conclusion MRS shows early changes of metabolism in enhancement and peritumoral edema regions post-RT， which can early reflect the efficacy of radiotherapy.

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A prospective clinical trial of docetaxel combined cisplatin concurrent chemoradiotherapy with later stereotactic body radiotherapy（SBRT）in treatment of locally advanced nonsmall cell lung cancer

Chinese Clinical Oncology. 2012, 17 (9): 840.

Abstract ( 1011 )

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ObjectiveTo evaluate the efficacy and toxicity of docetaxel combined cisplatin concurrent chemoradiotherapy with later stereotactic body radiotherapy（SBRT） in treatment of locally advanced nonsmall ceIl lung cancer（LANSCLC）. Methods A total of 32 eligible patients diagnosed with inoperable LANSCLC（ⅢA or ⅢB） were assigned to treat with docetaxel combined cisplatin chemotherapy at least 3 or 4 cycles（docetaxel 75 mg／m² on day 1，and cisplatin 20 mg／m²on day 1-4，repeated every 3-4 weeks）. The concurrent thoracic radiotherapy was given within one week after the first chemotherapy cycle in all patients. The primary tumors and involved lymph nodes were administrated threedimensional conformal radiotherapy（3DCRT） with a total dose of 50 to 60Gy（200cGy／fraction，5f／week，completed in 5 to 6 weeks）in all patients. After 4-6 weeks of 3DCRT，all patients received computerized tomographic scanning and those with residual tumor lesions were administrated additional stereotactic body radiotherapy（SBRT） with the doses of 18-27Gy（300cGy／fraction，every other day） and without exceeding the tolerated doses of surrounding important normal organ. The efficacy was evaluated according to RECIST criteria.The toxicities were evaluated according to NCI CTC 3.0 criteria and RTOG／EORT radiation reaction criteria. Results All the patients finished the planed concurrent chemoradiotherapy and later SBRT. Though the response rate（RR）raised to 81.2％（26／32）after SBRT，the differences were not significant compared with 68.8％（22／32）after 3DCRT（P＞0.05）.Till the last follewup day，time to progression（TTP）and median survival time（MST） were 12.6 month and 21.8 month， respectively. 1-year progression free survival rate and 1year and 2year overall survival rate were 59.4％，81.3％，46.9%， respectively.The main toxicities were myelosuppression，nausea and vomiting，acute radiation pneumonitis and acute radiation esophagetis. All the toxicities could be relieved and tolerated after appropriate treatment. ConclusionConcurrent chemoradiotherapy with later SBRT can be considered as an effective and feasible approach in treatment of choosed LANSCLC.

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Dosimetric study of SB-CRT and SIBIMRT in metastatic tumor of brain

Chinese Clinical Oncology. 2012, 17 (9): 845.

Abstract ( 999 )

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Objective To compare the dose distribution of SIBIMRT and SBCRT in the radiotherapy of brain metastasis. Methods Eleven patients with multiple brain metastasis tumors were sketched the target areas of metastasis and whole brain through CT simulative localization. Plans of SIB and CRT were made by Varian Eclips system. The whole brain PTV was 40Gy／20f， and the metastasis PGTV was 60Gy／20f in SIB plan. In CRT plan the whole brain PTV was 40Gy／20f， then the metastasis PGTV was an extra boost of 20Gy／10f. The maximum and mean dose of the whole brain， brain stem， optic nerves and lens were compared using a matched pair study. Also we compared the comformity index（CI） and heterogeneity index（HI） of the PGTV.
ResultsThe mean dose of the left and right optic nerves， the whole brain and the brain stem were 35.2±5.2，38.9±5.5，41.9±3.7 and 44.6±4.2Gy in SIB plan， and were 40.7±8.9，42.6±6.4，47.8±7.6 and 49.2±5.3Gy in CRT plan. The maximum dose of these organs were 42.3±3.5，43.6±3.2，46.6±4.1and 55.5±4.7Gy in SIB plan， and were 45.6±3.5，47.3±4.7，50.4±3.6 and 64.3±6.6Gy in CRT plan. The mean and the maximum dose in the SIB plan were less than those in the CRT plan with siginificant differents. The dose of the lens seemed to be no difference in the two plans. The CI of PGTV in the SIB plan was 0.88±0.07, which was significantly superior to 072±011 in the CRT plan. The HI of PGTV in the SIB plan was 1.06±0.02, which is significantly lower than 1.09±0.03 in the CRT plan. The difference of CI and HI was statistically significant. Conclusion On the condition that the wholebrain and the brain metastasis tumor receive the same amount of physical dose， rather than SB-CRT， the SIB-IMRT may more efficiently reduce the dose acting on normal tissues of brain， improve the CI and HI of PTV，and theologically improve the therapeutic effect， reduce the acute and tardus damage caused by radiotherapy.

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Dosimetric analysis of postoperative threedimensional conformal and conventional radiotherapy for stage I testicular seminoma

Chinese Clinical Oncology. 2012, 17 (9): 848.

Abstract ( 941 )

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Objective To compare the dose distribution of the threedimensional conformal radiotherapy（3D-CRT）and conventional radiotherapy plan and explore the value of 3DCRT in postorchiectomy radiotherapy for stage I testicular seminoma. Methods After 12 cases diagnosed with stage Ⅰ testicular cell tumors received high inguinal orchiectomy. And then postoperative radiotherapy were performed. 3DCRT plan and virtual conventional treatment plans（VCP）were performed for each patient by the treatment planning systerm（TPS）.The conformal index（CI），heterogeneity index（HI）of each planning target volume（PTV）and the dose of normal organs were analyzed with the dose volume histogram（DVH）.
ResultsThe CI values of PTV were 0.82±0.05 and 0.88±0.06 in VCP and 3D-CRT，respectively.The HI values of PTV were 0.29±0.11 and 0.15±0.03，respectively.3D-CRT was superior to VCP（P＜0.05）. The irradiation volum（IV） of 3D-CRT was lower than that of VCP（5268.20±1018.60cm³vs. 5970.24±1471.49cm³，P＜0.05）. As the mean dose and the ratio of dose volume V15 on the small intestine，3D-CRT was lower than virtual conventional treatment plans（P＜0.05）. The mean dose of testis in 3D-CRT was lower than virtual conventional treatment（P＜0.05）.
Conclusion Conventional radiation field is determined according to the signs of the patient's bone， not necessarily suitable for each patient， while the 3D-CRT is more individualized.3D-CRT is superior to VCP in both dose conformal degrees and dosimetry homogeneity， meanwhile reducing the dose and the volume of the small intestine and testis. Whether these dosimetric advantages can be converted into clinical benefit needs further clinical experiments.

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Clinical observation of oxaliplatin plus gemcitabine in the treatment of advanced biliary tract carcinoma

Chinese Clinical Oncology. 2012, 17 (9): 853.

Abstract ( 935 )

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Objective To evaluate the efficacy and toxicity of oxaliplatin plus gemcitabine in the treatment of advanced biliary tract carcinoma.
Methods Thirtyeight patients with advanced biliary tract carcinoma diagnosed by imageology and histopathology were treated with oxaliplatin 85 mg/m² iv 2h, d₁, gemcitabine 835 mg/m²iv 30min, d₁ and d₈. The regimen was repeated every 21 days and at least two cycles. The evaluation was performed after the chemotherapy for two cycles.
ResultsThirty-eight patients were evaluable for objective response rate. Complete remission (CR) was observed in 1 case and PR in 7 cases, and the objective response rate was 21.1 % (8/38).The main side-effects were myelosuppression, neuro-sensory toxicity and nausea /vomiting. There were no any death events during treatment.
Conclusion Oxaliplatin plus gemcitabine in the treatment of advanced biliary tract carcinoma is effective and tolerable. It is worth of studying in the future.

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Adjuvant chemotherapy in patients with stage ⅠB nonsmall cell lung cancer

Chinese Clinical Oncology. 2012, 17 (9): 856.

Abstract ( 1002 )

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Although surgery is regarded as the best possible treatment for patients with early stage nonsmall cell lung cancer（NSCLC）， only 20％-25％ of patients have resectable disease at presentation. Despite optimal surgical treatment， 5-year survival rates in patients with resectable NSCLC are historically modest（40％）. Adjuvant chemotherapy has been a standard treatment after complete resection in early stage NSCLC，and 4％-15％ patients can benefit from it. In recent years， although multiple randomized trials assessing the efficacy of adjuvant chemotherapy for stage ⅠB NSCLC have been reported， the benefit of adjuvant chemotherapy in patients with stage ⅠB NSCLC is controversial. Herein， we review the results of the major adjuvant chemotherapy trials and find the highrisk patients and their implications for the treatment of stage ⅠB NSCLC.

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标准刊号：	ISSN 1009-0460
	CN 32-1577/R