Chinese Clinical Oncology

A experimental study of recombined human endostatin in combination with paclitaxel inducing apoptosis of esophageal cancer cell line Eca-109

KONG Xia，WANG Xiumei，SUI Aihua，LIU Yuanyuan

Chinese Clinical Oncology. 2013, 18 (3): 193.

Abstract ( 1017 )

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Objective To investigate the combining effect of the recombined human endostatin（endostar）and paclitaxel on the proliferation and apoptosis of human esophageal carcinoma Eca-109 cells. Methods MTT was used for detecting inhibitory rates of different concentrations of endostar and paclitaxel of monotherapy and combination therapy on the Eca-109 cells at 48h；the shape changes of those cells were observed under the optical microscope；flow cytometry method was used for the detection of apoptosis rates of different groups after stained with Annexin V／PI at 48h；RT-PCR was used to detect the different expression of mRNA for apoptosis related genes（Bcl-2, Bax, p21 and p53） among different groups at 48h. Results The half inhibitory concentration （IC₅₀） at 48h of endostar and paclitaxel on the Eca-109 cells were 276.6627μg/ml and 3.8789μg/ml. Inhibition rates of the endostar group，paclitaxel group，the concurrently medicated group，the endostar followed by paclitaxel group and the paclitaxel followed by endostar group were （33.62±2.30）％，（49.14±1.45）％，（56.29±0.71）％，（41.88±1.23）％ and （51.48±0.98）％. The cell inhibition rate of endostar and paclitaxel medicating concurrently was higher than other groups（P＜0.05）. Under optical microscope，those medicated cells had typical apoptotic morphological changes. The apoptosis rates of endostar group， paclitaxel group， the concurrent group， endostar followed by paclitaxel group and the paclitaxel followed by endostar group were （8.78±0.19）％，（13.82±0.15）％，（18.88±0.29）％，（11.37±0.24）％ and （14.88±0.34）％，respectively. The differences among the groups and compared with the negative control group were all statistically significant（P＜0.05）. Compared with the control group，the endostar group and two sequential groups significantly decreased mRNA expression of Bcl-2，and the paclitaxel group also reduced the mRNA expression of Bcl-2. The three ways of drug combination all presented a decreasing mRNA expression of Bax. Every group could decrease the expression of p21. Sequential medication groups reduced the expression of p53. Conclusion Endostar in combination with paclitaxel can synergisticly induce apoptosis of the human esophageal carcinoma cell，and the mechanism may be related to the reduced expressions of antiapoptosis genes.

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Effects of up-regulated expression of miR-125a on cell apoptosis of human lung cancer A549 cells and possible mechanisms

HU Jinhua，WU Yuquan，CHEN Qingyong，ZHAO Yuanyuan，JIAO Demin.

Chinese Clinical Oncology. 2013, 18 (3): 199.

Abstract ( 1239 )

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bjective To explore the effect of up-regulated expression of microRNA-125a（miR-125a） on cell apoptosis of human lung cancer A549 cells and possible mechanisms. Methods The miR-125a sequence was synthesized and cloned into eukaryotic expression plasmid pGenesil-1 to construct recombinant plasmid pGenesil-miR-125a.Meanwhile，a control plasmid pGenesil control was constructed. The above plasmids were transfected into human lung cancer A549 cells using liposomes and divided into three groups： A549 cells transfected with pGenesilmiR-125（A549-miR-125a group），A549 cells transfected with pGenesil control（A549-control group）and A549 cells without transfection（A549）. Quantitative realtime polymerase chain reaction（QPCR） was used to measure the levels of miR-125a（normalized to U6 mRNA levels） after transfection. The percentage of apoptosis was determined by Annexin V-FITC／PI double staining with flow cytometry analysis. Western blot was employed to analyze the protein levels of p53. Results The recombinant plasmid pGenesil-miR-125a was verified by restriction analysis and DNA sequencing. The level of miR-125a in A549-miR-125a group was 2.72±0.41，higher than 0.97±0.16 of A549-control group and 0.96±0.11 of A549 group（P＜0.01）. The apoptotic rate of A549-miR-125a group was（31.04±2.48）％，higher than （6.91±0.72）％ of A549-control group and （6.73±0.56）％ of A549 group（P＜0.05）. The level of p53 protein in A549-miR-125a group was 3.91±0.46，higher than 1.01±0.06 of A549 control group and 0.99±0.04 of A549 group（P＜0.01）. Conclusion Up-regulated expression of miR-125a can promote the apoptosis of lung cancer A549 cells with the possible mechanism of the up regulation of p53.

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Expressions of erythropoietin and erythropoietin receptor mRNA in non-small cell lung cancer

YU Tingting，SHAN Li，HAN Zhigang.

Chinese Clinical Oncology. 2013, 18 (3): 203.

Abstract ( 1205 )

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Efficacy of bronchial arterial chemotherapy on non-small cell lung cancer and correlations with changes of ERCC1，VEGF and SE-CAD

GUO Weidong，ZHANG Huijie，BAO Lifeng.

Chinese Clinical Oncology. 2013, 18 (3): 207.

Abstract ( 914 )

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Objective To explore the efficacy of bronchial arterial chemotherapy（BAI） in treatment of non-small cell lung cancer（NSCLC）and the correlations with changes of serum excision repair cross complementing 1（ERCC1），vascular endothelial growth factor（VEGF） and soluble E-cadherin（SE-CAD）levels in patients with NSCLC before and after intervention therapy. Methods Image data of 60 NSCLC patients in the preoperative and postoperative were collected and to evaluate the shorttime curative effects and the levels of serum ERCC1， VEGF and SE-CAD were detected by ELISA before and after treatment in 60 patients with NSCLC treated by BAI. Results After 2 cycles treatment of BAI，the size of patients tumor has been controlled in various degrees with an effective rate of 61.7％，and the effective rate of squamous cell carcinoma and adenocarcinoma was 78.4％ and 34.8％（P＜0.05）. The expressions of serum ERCC1 after one week and one month increased significantly compared with pre-treatment（P＜0.05）. The effective rate of patients who had low serum ERCC1 after treatment of BAI was 71.1％ and high serum ERCC1 was 45.5％ of patients. Serum level of VEGF and SE-CAD decreased significantly compared with pre-treatment（P＜0.05）. The main toxic reactions were myelosupression，gastrointestinal reaction and stethalgia，and hepatic and kidney function lesion was with low occurrence rate. Conclusion BAI is one of safe and effective methods towards locally advanced NSCLC. Levels of serum ERCC1，VEGF and SE-CAD may be used as indicators of efficacy and prognosis.

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Influence of californium-252 neutron ray on the expressions of the VEGF and Gli-1 in tumor tissues from cervical cancer patients

LIU Xingjing，QIAN Shen，LI Feng，CHEN Juan，SONG Ni，HOU Bing，HUANG Zuoping，SONG Xiaojun.

Chinese Clinical Oncology. 2013, 18 (3): 212.

Abstract ( 972 )

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Objective To investigate the influence of californium-252（252Cf） neutron ray on the expressions of the glioma-associated oncogene homolog 1（Gli-1） and vascular endothelial growth factor（VEGF） in tumor tissues from cervical cancer patients.Methods The cervical cancer tissues from 25 cervical cancer patients receiving 252Cf neutron ray brachytherapy and external irradiation were collected. The expressions of VEGF and Gli-1 before and after radiotherapy in cervical cancer tissues were detected by immunohistochemical SP method and western blot，respectively. The VEGF positive cells and the Gli-1 relative optical density of different pathological parameters before and after radiotherapy were compared. Five cases of cervicitis tissues were chosen as control. Results The high expression rate of VEGF and the relative optical density of Gli-1 in cervical cancer tissues before radiotherapy were 80.0％ and 0.80±1.73，higher than 44.0％ and 0.41±0.65 after radiotherapy and 20.0％ and 0.20±0.50 in cervicitis tissues with significant differences（P＜0.05）. The VEGF positive cells and the Gli-1 relative optical density after treatment of different stages and differentiation levels were lower than before（P＜0.05）.
ConclusionThe 252Cf neutron ray can significantly decrease the expressions of VEGF and Gli-1.

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The correlation between apparent diffusion coefficient of advanced colorectal cancer and response to chemotherapy

ZENG Jiangzheng，LEI Junhua，HONG Tao，SU Qunhao，SHI Yushen，WANG Xiaolong，HAO Xinbao.

Chinese Clinical Oncology. 2013, 18 (3): 216.

Abstract ( 1297 )

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Objective To investigate the changes of apparent diffusion coefficient（ADC） of advanced colorectal cancer pre-and post-chemotherapy，as well as the correlation of ADC with response to chemotherapy. Methods Forty patients with advanced colorectal cancer received FOLFOX 4 regimen：oxaliplatin 85mg／m2 iv，d1；leucovorin 200mg／m2 iv，d1，d2；fluorouracil（5-FU） 400mg／m2 bolus，d1，d2；5-FU 600mg／m2，civ 22h，d1，d2. Fourteen days was a cycle and each patient received 12 cycles. The response to chemotherapy was assessed by RECIST 1.1 criteria after 4 cycles treatment. Diffusion-weighted magnetic resonance imaging scan was performed before chemotherapy and at 2nd and 4th cycles post chemotherapy，respectively. Changes of sum of the longest diameter（LD）for all target lesions and tumor ADC values were recorded， and their correlation was analyzed. Results Forty patients were divided into effective group（6 cases of CR，16 cases of PR） and non-effective group（11 cases of SD，7cases of PD）based on the efficacy. In the effective group，ADC values after the 2nd and 4th cycles of chemotherapy were（9.82±2.04）×10-4mm2／s and（10.09±1.95）×10-4mm2／s，significantly higher than（5.63±1.02）×10-4mm2／s before chemotherapy（P=0.009， P=0.001）. While in the non-effective group， ADC values showed no significant difference（P=0.412）.The ADC value before hemotherapy in the effective group was（5.63±1.02）×10-4mm2／s， significantly lower than（8.97±1.88）×10-4mm2／s in the non-effective group（P=0.021）. In the effective group，the ADC value before chemotherapy showed a negative correlation with the decreased sum percentage of the LD for all target lesions after the forth cycle of chemotherapy（r=-0.681，P=0.004）.The change of ADC value of tumors after the second cycle of chemotherapy showed a positive correlation with the decreased sum percentage of the LD for all target lesions after the forth cycle of chemotherapy（r=0.749，P=0.002）.Conclusion The ADC values before chemotherapy and the changes of ADC values in the early stage after chemotherapy can predict the sensitivity of chemotherapy to advanced colorectal cancer， which can be regarded as a sensitive marker of advanced colorectal cancer at the early stage of chemotherapy.

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Weight change during adjuvant therapy and its correlation with prognosis in 186 cases of breast cancer

CAO Heng，ZHENG Zhendong，LIU Zhaozhe，GUO Fang，ZHANG Guojing，XIE Xiaodong.

Chinese Clinical Oncology. 2013, 18 (3): 220.

Abstract ( 1034 )

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Objective To investigate the influence of weight changes during adjuvant therapy on the prognosis of breast cancer patients after operation.
Methods The clinical data of 186 cases with breast cancer were collected. According to the weight change during adjuvant therapy, 186 patients were divided into 3 groups: weight loss group, weight stable group and weight gain group. The clinicopathological characteristics were analyzed among groups. Log-rank test and Cox proportional hazard model analysis were preformed to make univariate and multivariate analysis on diseasefree survival（DFS）. Results Weight change was associated with age，body mass index，radiotherapy，clinical stage，smoking and gastrointestinal reaction. Univariate analysis showed that weight change was associated with DFS and Cox proportional hazard model analysis showed that during adjuvant therapy weight gain was an independent prognostic factor associated with poorer clinical outcomes in breast cancer patients（χ2=12.107，P=0.002）. Conclusion Weight change during adjuvant therapy was an independent negative prognostic factor for DFS in breast cancer patients. Therefore, maintaining normal weight may contribute to the prevention of breast cancer.

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Clinical study of bevacizumab combined with FOLFOX regimen or FOLFIRI regimen for patients with metastatic colorectal cancer

U Qian，SHI Yan，CHEN Li，XIAO Xiaoyi，DAI Guanghai.

Chinese Clinical Oncology. 2013, 18 (3): 224.

Abstract ( 1431 )

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Objective To investigate the efficacy and toxicity of bevacizumab combined with FOLFOX regimen or FOLFIRI regimen for patients with metastatic colorectal cancer（mCRC） as first- or second-line treatment. Methods Fifty-seven patients with mCRC treated by bevacizumab combined with FOLFOX or FOLFIRI in the PLA General Hospital from December 2005 to August 2012 were analyzed retrospectively with their overall response rate（RR），disease control rate（DCR），progressionfree survival（PFS），and overall survival（OS）. The tumor responses were assessed by response evaluation criteria in solid tumors guidelines（RECIST） version 1.1. The adverse reation was evaluated by common terminology criteria for adverse events version 3.0. The survival analysis was used by Kaplan-Meier method. Results Of 57 patients with mCRC，19（33.3％） patients achieved partial response（PR）and 28 patients（49.2％） had stable disease（SD），exhibited an RR of 33.3％，and a DCR of 82.5％. Stratification analysis by first- and second-line treatment or different chemotherapy of bevacizumab combined FOLFOX regimen or FOLFIRI regimen，there were no statistical significance in RR and DCR（P＞0.05）. The median PFS and OS of 57 patients were 8.83 months and 14.80 months, respectively. Stratification analysis by first- and second-line treatment or different chemotherapy of bevacizumab combined FOLFOX regimen or FOLFIRI regimen，there were no statistical significance in median PFS and OS（P＞005）.The main side effects were leukocytopenia，leukocytopenia and nausea and vomiting. The adverse events related to bevacizumab included hypertension，proteinuria and epistaxis，which were mostly in grade1-2 and alleviated by drug treatment. Conclusion Bevacizumab combined with FOLFOX regimen or FOLFIRI regimen is effective and well tolerated in patients with metastatic colorectal cancer.

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Clinical observation of continuing administration of gefitinib for progressed non-small cell lung cancer patients 6 months after initially responding

CHEN Chanjuan，CHEN Zhendong，SUN Tong，YANG Yang，CHENG Huaidong，ZONG Heng.

Chinese Clinical Oncology. 2013, 18 (3): 229.

Abstract ( 591 )

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Objective To observe the clinical manifestation，quality of life（QOL） and followup survival of patients with non-small cell lung cancer（NSCLC）who had initial response to gefitinib for more than 6 months and maintained administration of the regimen even after failure of gefitinib. Methods Gefitinib was taken orally at a dosage of 250 mg daily. The NSCLC patients who had been administrated the regimen successfully more than 6 months were divided into the trail group（whose disease progressed, n=39） and the control group（whose disease didn't progress, n=49）. The QOL for patients with Karnofsky Performance Status Scale（KPS） and Functional Living Index Cancer（FLIC） were evaluated. The follow-up survival of the target lesions progression and the non-target lesions progression were calculated. Results The favorable scores of KPS and FLIC were still kept on 1.0-24.0 months to the patients in the trail group，and the median time was 6.0 months. KPS and FLIC scores were compared by the two groups，and the differences had no significance（Z=-0.976，P=0,329； Z=-0,029，P=0,977）. In the trail group，during the period of initial progress to disease flare and in the period of disease flare to death，the scores of KPS were 85.00±7.31 and 48.00±9.25（P＜0.001）；and the scores of FLIC were 121.24±18.16 and 75.57±21.45（P＜0.001）. The median follow-up survival of patients with the target lesion progress and non-target lesions progress were 7.0 months and 10.0 months in the trail group，and the difference was significant（P=0.018）. Conclusion The patients with NSCLC could gain clinical benefits from continuing the administration of gefitinib，who acquired resistance to the regimen in spite of initial responses to it，especially for the patients with non-target lesion progress.

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Clinical study on domestic pemetrexed combined with carboplatin as the first-line treatment for advanced elderly lung adenocarcinoma patients

CAI Wei，JIANG Lei，SUN Jingping，CHEN Bin.

Chinese Clinical Oncology. 2013, 18 (3): 233.

Abstract ( 990 )

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Objective To explore the efficacy and safety of domestic pemetrexed combined with carboplatin as the first-line treatment in elderly patients with advanced lung adenocarcinoma. Methods From July 2009 to December 2011，clinical data of 49 elderly（≥65 years）patients with Ⅳ stage lung adenocarcinoma were analyzed retrospectively. Forty-nine patients received domestic pemetrexed 500mg／m2 iv, d1 and carboplatin（AUC=5）iv, d1. Every 3 weeks was a cycle. The recent efficacy was evaluated every 2 cycles and longterm efficacy was followed up. The relevant indexes were analyzed. The side effects were recorded each cycle. Results Among 49 patients，48 patients were treated with pemetrexed combined carboplatin at least 2 cycles. The response rate and disease control rate of the 48 patients were 22.9％ and 64.6％，respectively. The median progression free survival（PFS）was 6.5 months（95％CI：5.7-7.3）， and median overall survival（OS） was 11.3 months（95％CI：10.6-11.9）. According to age，sex，ECOG score，smoking，metastasis numbers，bone metastasis， malignant pleural effusion and brain metastasis，patients were divided into groups. There were significant differences in RR，PFS or OS between groups of ECOG score，smoking and metastasis numbers（P＜0.05）. The major side effects were bone marrow suppression and gastrointestinal toxicity. The adverse events were manageable at grade 1-2. Conclusion Domestic pemetrexed in combination with carboplatin is effective and well tolerated as the first-line treatment in elderly patients with advanced lung adenocarcinoma.

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Clinicopathological characteristics and prognosis of female peritoneal malignant mesothelioma

WANG Jing，ZHU Jiang.

Chinese Clinical Oncology. 2013, 18 (3): 238.

Abstract ( 1044 )

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Objective To explore the features of the clinicopathology and prognosis for female peritoneal malignant mesothelioma（FPMM）. Methods The clinical data and followed up results of 13 cases FPMM were collected and the tumor tissues were studied in histopathology and immunohistochemistry（IHC）. The 5 cases of metastatic poorly differentiated serous carcinomas of ovarian（MPDOSC） and 5 cases of female metastatic poorly differentiated colorectal carcinomas（MPDCC） were studied as contrast. Results Eight cases tumors occurred in pelvic cavity，5 cases occurred in peritonium. All the 13 cases were operated and carried out chemotherapy. There were 12 epithelioid patterns and 1 biopolar pattern in FPMM. The cubic or low columnar tumor cells were covered on tubules or slender and irregular papillae，or polygonal cells were arrayed in solid sheets. The size of the tumor cells with abundant and eosinophilic cytoplasm were similar， nuclear／cytoplasmic area ratio were equal. The nuclei located in center and showed well distributed fine chromatin with a light atypical and a few mitosis. Among the epithelioid tumor cells， there were dispersive giant cells or multinucleations. There was one biphasic differentiation and no sarcomatoid patten. The histological patterns of MPDOSC and MPDCC may be similar to FPMM， but the anaplasia of carcinoma cells was more outstanding. The IHC showed that P-CK， Vimentin，Calretinin were positive and CEA were negative in FPMM. CK7，CA125，p53 were positive in MPDOSC and CK20，CA19-9，CEA were positive in MPDCC. The positive index of Ki-67 was very high in 3 kinds of tumors. Twelve cases were followed up for 6-28 months. Ten cases died and 2 cases survived. The average survival was 14.8±7.8 months. However，the average survival was 10.2±3.7 months in MPDOSC and 6.9±2.1 months in MPDCC respectively. Conclusion The chief sites of FPMM were pelvic cavity. The epithlioid FPMM had their characteristics in histopathology. The IHC phenotype including positive and negative are needed to differential diagnosis. Some FPMM patients can survive longer，so they should be treated positively.

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Small bowel granulocytic sarcoma with CD56+ as a presenting sign of acute monocytic leukemia：1 case report and review of literatures

XU Xihui，OUYANG Jian，XU Yong，CHEN Bing，ZHOU Rongfu，XU Jingyan，ZHANG Qiguo，YANG Yonggong，SHAO Xiaoyan，GUAN Chaoyang.

Chinese Clinical Oncology. 2013, 18 (3): 242.

Abstract ( 1098 )

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Objective To explore the pathogenesis，diagnosis，treatment and outcome of granulocytic sarcomas. Methods A middle aged male patient with CD56+granulocytic sarcoma in his small bowel as the first presenting sign of acute monocytic leukemia was reported and the relevant literatures were reviewed. Results The male patient was 39 years old. The immunohistochemical findings of small bowel mesenteric excision showed granulocytic sarcoma with positive CD56 antigen. Bone marrow cytology examination showed the feature of acute monocytic leukemia. The patient was diagnosed with acute monocytic leukemia with small intestine myeloid sarcoma. The patient achieved complete hematology remission after IA therapy, and the consolidation chemotherapy of IA regimen was followed then. The allogeneic hematopoietic stem cell transplantation would be applied. Conclusion The acute leukemia with the small bowel granulocytic sarcoma as the first presenting sign is relatively rare. The prognosis of granulocytic sarcoma is poor. CD56 antigen probably suggested the patients poor prognosis. So patient after remission should be as soon as possible to be treated by allogeneic hematopoietic stem cell transplantation in order to achieve the long term survival.

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Clinical observation of lobaplatin plus capecitabine in treating 22 advanced breast cancer patients

XIAO Huawu，OUYANG Quchang.

Chinese Clinical Oncology. 2013, 18 (3): 246.

Abstract ( 1075 )

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Objective To evaluate the efficacy and adverse effects of lobaplatin plus capecitabine in the treatment for advanced breast cancer. Methods Twentytwo patients with advanced breast cancer accepted lobaplatin plus capecitabine chemotherapy. Lobaplatin 30mg／m2 iv 3h，d1；capecitabine 2500mg／m2 for twice daily 30min after meal with oral administration， d1d14.Three weeks was a cycle. Objective response was evaluated by RECIST 1.0 standard and adverse effects were evaluated by WHO standard.Results In the 22 patients，no one got CR，with 9 of PR，8 of SD and 5 of PD. The objective response rate was 40.9％ and the disease control rate was 77.3%. The median progressionfree survival was 8.9 months and the median overall survival was 14.2 months. The main adverse effects were gastrointestinal reaction，bone marrow suppresion and handfoot syndrome，mainly in grade 1-2. Conclusion Lobaplatin plus capecitabine regimen is effective and well tolerated for advanced breast cancer，worthy of further clinical study.

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Combined effects of endovascular stent placement and radiotherapy on lung cancer with superior vena cava syndromeA clinical research

ZHANG Wei，GUAN Luan，YIN Haitao，SUN Xinchen，WEN Cuixia.

Chinese Clinical Oncology. 2013, 18 (3): 249.

Abstract ( 844 )

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Objective To evaluate the combined effects of endovascular stent implantation and radiotherapy on lung cancer with superiorvena cava syndrome（SVCS）. Methods Forty-six cases of lung cancer with SVCS were randomly divided into the combined stent placement and radiotherapy group （combined group） and radiotherapy alone group. The stent was implanted using seldinger method. All patients were treated with three dimensional conformal radiation therapy， 2Gy／fraction，5 fractions a week，DT 50-60Gy，5-6 weeks. The rate of clinical effect，survival and side effects of both groups were observed and compared.
ResultsThe symptoms were alleviated in combined group one week after stent implantation, while symptoms were alleviated in radiotherapy alone group 4 weeks after radiation. The patients in combined group got 19 CR and 4 PR，and patients in radiotherapy alone group got 12 CR，5 PR，4 NC and 2 PD. The response rate of combined group was 100.0％，higher than that of radiotherapy alone group（73.9％） with significant difference（P＜0.05）；3，6，9，12 month survival rate of combined group were higher than those of radiotherapy alone group （P＜0.05）. The common side effects were bone marrow suppression，adioactive pneumonia and gastrointestinal reaction, mainly in grade 1-2. There was no difference between two groups（P＞0.05）. Conclusion The endovascular stent implantation in combination with radiotherapy can relieve the obstruction quickly. So it has higher therapeutic effect and longer remission time than radiotherapy alone. It is worth of further study and expand in the clinical application.

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Laparoscopic treatment of colorectal cancer with synchronous hepatic metastasis

YU Liang，LIU Yu，DUAN Shaobin，ZHANG Zengfeng.

Chinese Clinical Oncology. 2013, 18 (3): 252.

Abstract ( 1137 )

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Objective To explore the laparoscopic treatment of colorectal cancer with synchronous hepatic metastasis at the same stage. Methods Thirty-two colorectal cancer patients with synchronous hepatic metastasis received laparoscopic resection of colorectal cancer，laparoscopic resection of liver metastases and radiofrequency ablation treatment of liver cancer under direct vision at the same time. Results The operations were performed well. The duration of operations was 280 min（range 220-384min）. The amount of bleeding ranged from 240 to 1300ml. No serious complications occurred. All the patients were followed up for 6-32 months after operation，among whom 18 patients were still alive. Seven patients died due to lung，brain or abdominal cavity metastases，3 patients due to recidivation，2 patients of brain hemorrhage and 2 patients of myocardial infarction. Conclusion The treatment of colorectal cancer with synchronous hepatic metastasis using laparoscopic resection of colorectal cancer and liver metastases，as well as radiofrequency ablation methods at the same stage is safe and effective and the trauma in second stage surgery can be avoided.

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Progress and prospect of traditional Chinese medicine on lung cancer

GUAN Nianbo，LIU Hao，LIN Hongsheng.

Chinese Clinical Oncology. 2013, 18 (3): 264.

Abstract ( 1087 )

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Lung cancer remains as a greatest threat to human health. Traditional Chinese medicine（TCM） has unique theoretical system in the treatment of lung cancer and has shown definite efficacy. Integration of traditional Chinese and western medicine is the mainstream and trend for lung cancer treatment. Although achievements have been made in the field of clinical and basic research，there still lacks of methodology and technology which could reflect the real diagnosis and treatment regularity of lung cancer. With further development，lung cancer treatment with TCM will improve in the future.

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CTLA-4 monoclonal antibodytargeted passive immunotherapy for tumor

ZHOU Yan，DONG Wen，MA Jin'an.

Chinese Clinical Oncology. 2013, 18 (3): 268.

Abstract ( 934 )

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Cellular immune system plays a very important role in the body's immune response to malignant tumor. Cytotoxic T lymphocyteassociated antigen 4（CTLA-4） involves in the induction and maintenance of T cell immune tolerance through inhibiting T cell activity，so the monoclonal antibody which blocks the CTLA-4 can stimulate the proliferation of immune cells，thereby enhances the body's immune response to the tumor. This paper mainly reviews the research progresses about CTLA-4 monoclonal antibody drugs（ipilimumab and tremelimumab） in recent years and the clinical application progress of them.

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Advances in clinical treatment of thymoma

LI Min，HU Chunhong.

Chinese Clinical Oncology. 2013, 18 (3): 273.

Abstract ( 986 )

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Thymoma is the most common neoplasm of the anterior mediastinum that is frequently associated with a variety of paraneoplastic syndromes，ranging from an idolent attitude to the possibility of intra and extrathoracic spread. Complete resection is the gold standard at any stage，especially for more aggressive lesions. Surgery is usually considered with a multimodality approach，involving induction and adjuvant therapy. A number of prognostic factors have been validated as predictors of outcome： Masaoka staging，World Health Organization histological classification，completeness of resection，diameter of the tumor，associated paraneoplastic syndromes，involvement of the great vessels, lymph nodes and early onset of recurrence. There is no agreement on the optimum adjuvant therapy and the target population. This review summarizes recent progress in the treatment of thymoma.

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esearch progress of the mechanisms on the drug resistance of EGFR-TKIs in non-small cell lung cancer

WANG Caixia，ZHOU Xiaojun.

Chinese Clinical Oncology. 2013, 18 (3): 279.

Abstract ( 1015 )

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In recent years，medical molecular biology has being rapidly developed and a new era of antitumor treatment is coming with the novel concept for moleculartargeted strategies. Epidemal growth factor receptor tyrosine kinase inhibitors（EGFR-TKIs），such as gefitinib and erlotinib，have being widely used in clinic.However，the efficiency is limited because of the drug resistance or poor sensitivity in some populations with non-small cell lung cancer（NSCLC） during therapy. The review briefly summarizes the progress on mechanisms of EGFR-TKIs resistance and strategies currently being employed to overcome resistance.

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标准刊号：	ISSN 1009-0460
	CN 32-1577/R