Chinese Clinical Oncology

The role of FAK in osteosarcoma subclone cell lines with different migration capacities and its significance

FENG Sitan，SHI Xin，REN Ke，WU Sujia，SHU Yubing

Chinese Clinical Oncology. 2013, 18 (5): 385.

Abstract ( 1364 )

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Objective To explore the expression of focal adhesion kinase（FAK） in different migration characteristics of osteosarcoma subclone cell lines，as well as its role in the osteosarcoma cell proliferation and migration. Methods Limiting dilution was used to obtain 143B subclone cell lines（A1，A2，A3，A4，A5）with different migration capacities，and their FAK expressions were detected by Western blottting. The role of FAK in the osteosarcoma cells proliferation and migration was studied by small interfering RNA（siRNA） sequence，and the proportion of the cells with lamellipodia was counted by immunofluorescence staining method.
ResultsThe migration ability of osteosarcoma cell lines 143B subclone A2 and A3 was significantly stronger than A1, A4 and A5（P＜0.05），and FAK expressions of cell lines A2 and A3 were significantly higher. The subclone cell line A3 transfected with FAKsiRNA decreased the migration ability（P＜0.05），and the proportion of cells with lamellipodia decreased from 33.3％ to 12.8％（P＜0.05），but there was no change of the cell growth. Conclusion FAK was founded in the 143B osteosarcoma subclone cell lines with stronger migration capacities. FAK may affect the migration ability of osteosarcoma cells through lamellipodia formation，but have no effect on the proliferation of osteosarcoma cells.

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The inhibitory effect of all-trans retinoic acid and arsenic trioxide on the growth of endometrial cancer cells and the relation with NDRG1

CHEN Ling， GENG Xiaoxing

Chinese Clinical Oncology. 2013, 18 (5): 390.

Abstract ( 890 )

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Objective To explore the inhibitory effect of all-trans retinoic acid（ATRA）and arsenic trioxide（As2O3）on the growth of human endometrial cancer HEC-2B cells in vitro and its relation with N-myc downstream regulated gene1（NDRG1）protein. Methods Tetrazolium salt assay（MTT）was used to compare the inhibitory effect of different concentration of ATRA（1×10-7,5×10-7,1×10-6,5×10-6 and 1×10-5mol/L）and As2O3（1.0, 2.0, 4.0, 8.0 and 16.0μmol/L）on the growth of HEC-2B cells. The expression of NDRG1 protein was determined by Western blotting analysis. Results After treated with ATRA and As2O3 for 48h，the HEC-2B cells showed apoptotic change. ATRA 1×10-7-1×10-5mol／L and As2O3 1.0-16.0μmol／L inhibited the cell proliferation in a dose-and time-dependent manner. Western blotting method showed that ATRA and As2O3 down-regulated the expression of NDRG1 protein in a dose-dependent manner. Conclusion ATRA and As2O3 can significantly inhibit the growth of human endometrial cancer HEC-2B cells in vitro. The effect may be related to the down-regulation of NDRG1 protein expression.

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Expression and significance of HSP90 in advanced gastric cancer

WANG Jiahong，CUI Shuzhong，ZHANG Xiangliang，WU Yinbing，TANG Hongsheng

Chinese Clinical Oncology. 2013, 18 (5): 394.

Abstract ( 1106 )

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Objective To investigate the expression of heat shock protein 90（HSP90） in advanced gastric cancer and evaluate its impact on tumor invasion and prognosis of advanced gastric cancer. Methods The expressions of HSP90 in 157 advanced gastric cancer patients were determined by immunohistochemistry. The relationships between HSP90 and clinicopathological characteristics, prognosis of gastric cancer were analyzed. Results The high expression rate of HSP90 was 68.2％（107／157） in 157 advanced gastric cancer samples. The expression of HSP90 was closely related to tumor size，tumor site，depth of invasion，lymph node metastasis and clinical stage（P＜0.05）. In addition，the expression of HSP90 was significantly correlated with MMP-9 in gastric cancer tissues（r=0.514，P＜0.001）. The postoperative median recurrence-free survival（RFS）and overall survival（OS）of 157 gastric cancer patients were 27.0 and 33.0 months，respectively. The postoperative median RFS and OS of patients with low expression of HSP90 were both 60.5 months，while those of patients with high expression of HSP90 were 15.0 months and 20.0 months（P＜0.001，P＜0.001）. Cox regression model showed that HSP90 expression was an independent factor predicting the prognosis of gastric cancer（P＜0.05）.
Conclusion The expression of HSP90 is correlated with tumor invasion and metastasis，and the high expression of HSP90 indicates a poor prognosis.

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ERCC1 expression in peripheral blood lymphocytes versus tumor tissue from gastric cancer

ZHANG Yiyin，GU Kangsheng，YANG Feng

Chinese Clinical Oncology. 2013, 18 (5): 398.

Abstract ( 1141 )

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Objective To investigate the correlation between excision repair crosscomplementation1（ERCC1） expression in tumor tissue and peripheral blood lymphocytes（PBLCs） from gastric cancer，and their expression with clinical features. Methods A total of 53 patients with gastric cancer receiving surgery were studied.ERCC1 protein expression in tumor tissue and PBLCs were determined by immunohistochemical staining. Another 20 cases of PBLCs from gastrointestinal benign disease and the health were collected as control. Results The positive expression rates of ERCC1 were 67.9％，56.6％ and 10.0％ in tumor tissues，PBLCs of gastric cancer，and PBLCs of control group. The expression of ERCC1 in PBLCs of gastric cancer was much higher than that in PBLCs of control group（P＜0.05）. There was no relation between the ERCC1 expression and the clinical characteristics including age，gender，histological type，clinical stage，T stage，metastasis of lymph node and degree of differentiation.The PBLCs ERCC1 expression correlates with the expression in tumor tissues（r=0.475， P=0.000）. Conclusion In gastric cancer，the ERCC1 expression in PBLCs can indirectly reflect the ERCC1 expression in cancer tissues.

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Expressions and significances of PTEN，nm23-H1 and Syk in colorectal cancer

DONG Huacheng，FAN Lixin，PIAO Zhengai，WANG Xiaohong，WANG Hai，WANG Lishuang

Chinese Clinical Oncology. 2013, 18 (5): 403.

Abstract ( 1319 )

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Objective To evaluate the expressions of PTEN，nm23-H1 and Syk in colorectal cancer and their relationships with the carcinogenesis，development，invasion and metastasis of colorectal cancer. Methods The expression of PTEN，nm23-H1 and Syk proteins in 60 cancer tissues and 30 normal colorectal mucous tissues were determined by the immunohistochemical SP method. Their correlations with clinicopathologic features were analyzed. Results The positive rates of PTEN，nm23H1 and Syk expression was 90.0％（27／30），93.3％（28／30）and 96.7％（29／30） in normal tissues，higher than 36.7％（22／60），41.7％（25／60）and 31.7％（19／60）in colorectal cancer tissues，respectively（P＜0.01）. The expression of the three proteins in colorectal cancer tissues were not associated with age，gender，tumor size or tumor location（P＞0.05）. The expressions of PTEN and Syk were significantly related with differentiation，depth of invasion，lymph node metastasis and Duke's staging. And the expression of nm23-H1 was associated with depth of invasion，lymph node metastasis and Duke's staging. The expression of the three proteins in colorectal cancer tissues were possitively related. Conclusion The expressions of PTEN，nm23-H1 and Syk in colorectal cancer are related to carcinogenesis，development，invasion and metastasis. The joint detection of these three makers can be used to determine the biological behavior and prognosis of colorectal cancer.

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Expression and significance of connexin43 in hilar cholangiocarcinoma

WANG Fei，YANG Ning，ZHANG Haibin，ZHAO Jun，YANG Guangshun

Chinese Clinical Oncology. 2013, 18 (5): 408.

Abstract ( 1088 )

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Objective To investigate the expression of connexin43 in hilar cholangiocarcinoma and its clinical significance.
MethodsThe expression of connexin43 was detected in 49 specimens of hilar cholangiocarcinoma and adjacent normal tisssues using immunohistochemistry （IHC）. The correlations between connexin43 expression and clinical pathological features，disease free survival（DFS）or overall survival（OS）were analyzed. Results IHC showed that the expression of connexin43 was observed in 28 cases （57.1％） of 49 primary tumors，and it was seldom found in adjacent normal tissues. The expression of connexin43 was significantly associated with TNM staging，histological differentiation and tumor size，but not related to sex，age，lymph node metastasis, surgery and perineural invasion. Univariate analysis demonstrated that patients with positive expression of connexin43 had shorter median DFS and OS than those without connexin43 expression（11.5month vs.21.4month，P＜0.05; 20.7month vs.38.4month，P＜0.05）. Multivariate survival analysis revealed that connexin43 was an independent factor in predicting tumor recurrence and the outcome of patients with hilar cholangiocarcinoma. Conclusion The expression of connexin43 is correlated with the occurrence and progression of hilar cholangiocarcinoma，suggesting the importance of connexin43 as a factor of prognosis.

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Expression and clinical significance of TLR-2 and TLR-5 in diffuse large B-cell lymphoma

ZHANG Cui，ZHANG Qingyuan，ZHANG Minghui，LU Kangping， WANG Yan，ZHAO Shu

Chinese Clinical Oncology. 2013, 18 (5): 412.

Abstract ( 1280 )

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Objective To investigate the expression of Toll-like receptor-2（TLR-2）and Toll-like receptor-5（TLR-5）in diffuse large B-cell lymphoma（DLBCL）, as well as the relationship of their expression with clinical features. Methods Immunohistochemistry stain was used to determine the expression of TLR-2 and TLR-5 in 60 DLBCL tissues. Twenty-one lymph node reactive hyperplasia tissues were taken as control. The relationship between TLR-2，TLR-5 expression and clinical features was analyzed. Results Positive rates of TLR-2 in DLBCL tissues and control group were 78.3％ and 28.5％（P＜0.05）. The expression of TLR-2 was related with clinical stage，LDH，IPI，subtypes，out of lymph node invasion and systemic symptoms，but not related to age, gender and ECOG score. Positive rates of TLR-5 in DLBCL tissues and control group were 26.6％ and 23.8％（P＞0.05）, and there was no relationship between it and clinical features. Conclusion TLR-5 has no relationship with clinical features of DLBCL；TLR-2 may be related to the occurence and prognosis of DLBCL，could be regarded as an biomarker of prognosis of this disease.

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The relationship between thymidylate synthase polymorphisms and the efficacy of pemetrexed-based chemotherapy in patients with non-small cell lung cancer

YU Fei，LIU Xiaoqing，LI Xiaoyan，GUO Wanfeng，SUN Xuedong，ZHANG Yunmei

Chinese Clinical Oncology. 2013, 18 (5): 416.

Abstract ( 1266 )

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Objective To investigate the relationship between polymorphisms of thymidylate synthase（TYMS）and the efficacy of pemetrexed-based chemotherapy in advanced non-small cell lung cancer（NSCLC）. Methods A total of 67 patients with stage ⅢB-Ⅳ NSCLC received pemetrexed monotherapy or pemetrexed plus platinum combination were enrolled in this study. Pemetrexed was intravenously administrated 500mg／m2 d1，and cisplatin 75mg／m2 or carboplatin AUC 5 d1. Every 3 weeks was a cycle. The genomic DNA extracted from peripheral blood mononuclear cell was used to examine the polymorphisms of TYMS in the 5’and 3'untranslated region（UTR） using PCR and PCRRFLP. Due to PCR results，we analyzed the relationship between TYMS polymorphisms and the efficacy of pemetrexedbased chemotherapy. Results The efficacy of the 67 advanced NSCLC patients could be evaluated. The response rate（RR）and disease control rate（DCR）were 28.4％ and 76.1％. The median progressionfree survival was 3.5 months. There was no significant difference of RR and DCR among the three 5’UTR genotypes of TYMS polymorphism，as well as the three 3’UTR genotypes of TYMS polymorphism. Conclusion The polymorphism of TYMS and efficacy of pemetrexedbased chemotherapy in patients with advanced NSCLC had no obvious relations. The relationship between TYMS polymorphisms and the efficacy of pemetrexed-based chemotherapy will be confirmed by further study.

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A controlled non-randomized clinical research on chemotherapy combined with rh-endostatin for stage ⅡB ostosarcoma

U Hairong，LI Bin，HUANG Zhen，ZHANG Qing，NIU Xiaohui

Chinese Clinical Oncology. 2013, 18 (5): 421.

Abstract ( 1379 )

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Objective To investigate the efficacy and safety of chemotherapy combined with rhendostatin（endostar）against stage ⅡB ostosarcoma. Methods Patients of stage ⅡB ostosarcoma enrolled in Beijing Jishuitan Hospital from January 2008 to April 2012 were divided into combined group and control group. The regimen of chemotherapy was as follows： methotrexate 10g／m2 iv d1，ifosfamide 3g／m2 iv d1-d5，cisplatin 120mg／m2 iv d1，doxorubicin 30mg／m2 iv d1-d3. Based on the same chemotherapy，endostar was added in combined group（15mg iv d1-d14，21 days was a cycle，for 4 cycles）. Results A total of 388 patients were enrolled in this study， and 58 cases were excluded in the final analysis. In the 330 patients could be evaluated，272 cases were in control group and 58 in combined group. Patients were followed up 6.59 months with a median period of 20.2 months. In the control group，1-，2- and 3-year distant metastasis-free survival rates were 79％，70％ and 65％ respectively，while those of combined group were 93％，86％ and 77％ with statistical difference（P=0.045）. In control group，1-，2-and 3-years of progression-free survival rates were 76％，66％ and 60％，respectively，while those of combined group were 90％，83％ and 74％ with statistical difference（P=0.025）. In the control group，1-，2-and 3-year overall survival rates were 94％，84％ and 79％，while those of combined group were 98％，94％ and 85％ without statistical difference（P=0.220）. The side effects in the two groups were mainly in grade 1-2, and the common grade 3-4 side effects were leucopenia，anemia，hepatic dysfunction，nausea and vomiting. There was no difference in side effects of the two groups. Conclusion The combination of chemotherapy and endostar can significantly improve the distant metastasisfree survival and progression-free survival in osteosarcoma patients，with tolerable side effects，worthy further study.

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Gefitinib versus chemotherapy in the first-line treatment of advanced non-small cell lung cancer：a meta-analysis

QIAO Jianbing，CHEN Wenping

Chinese Clinical Oncology. 2013, 18 (5): 426.

Abstract ( 1238 )

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Objective To assess the efficacy and safety of gefitinib versus platinumbased chemotherapy for patients with advanced nonsmall cell lung cancer（NSCLC）. Methods Such databases as PubMed，Embase，CBM and CNKI were searched to collect the randomized controlled trials comparing gefitinib to platinum-based thirdgeneration chemotherapy as the first-line treatment of advanced NSCLC published before March of 2012. Stata 100 software was used for metaanalysis. Results Four studies involving 1926 patients were included. The result of meta-analysis showed that in patients with known epidermal growth factor receptor（EGFR）mutations or whose tumors likely to harbor a mutation，gefitinib was better than chemotherapy in progress free survival and effective rate（HR=0.43，95％CI：0.32-0.58，P＜0.001；71.5％ vs.38.1％，OR=4.04，95％CI：2.90-5.61，P＜0.001），and there was no significant difference between the two groups in the overall survival （HR=0.93，95％CI：0.75-1.15，P=0.492）. In the aspect of safety，the major adverse events for gefitinib were rash，diarrhea and aminotransferase elevation，whereas platinum-based chemotherapy was associated with more neutropenia，anemia and thrombocytopenia.
Conclusion Gefitinib shows more superiority and can be used as the first-line drug for EGFR-mutated advanced NSCLC.

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Experience on the implementation of fiducial markers for 504 patients with body malignant tumors

ZHANG Sujing，LI Yu，XU Huijun，YANG Xiao，SONG Liyan LIU Xiaoliang，WU Hao

Chinese Clinical Oncology. 2013, 18 (5): 431.

Abstract ( 1254 )

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Objective To investigate technical points，effect and complications of fiducial implantation for body malignant solid tumors with cyberknife. Methods A total of 504 cases of body malignant solid tumors accepted fiducial implantation under CT guidance before the treatment of cyberknife. The complications and effect were observed. Results Among the 504 cases，the successful rate of fiducial implantation was 99.2％（500／504）. Among the 453 patients with liver nidi， 6 had fiducial migration. One hundred and fifty-eight patients felt pain at the punctured sites and 3 patients had tachycardia. Among the 19 lung cancer patients who accepted paracentesis，1 case had haemothorax and 1 case got pneumothorax. Conclusion The method of fiducial implantation on targets before treating malignant solid tumor with cyberknife is minimally invasive and comparatively safe.

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Clinical observation of radiotherapy combined with S-1 for elder patients with esophageal cancer

WANG Xiangqian，CAI Jing，GU Hongfang，XIA Xiaochun

Chinese Clinical Oncology. 2013, 18 (5): 434.

Abstract ( 1262 )

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Objective To investigate the efficacy and side effects of radiotherapy combined with S-1 for elder patients with esophageal cancer. Methods Sixty elder patients with esophageal cancer were randomly divided into control group and experimental group with thirty cases in each group. Intensity-modulated radiotherapy was applied in the two groups with a total dose of DT 56-64Gy／28-32f. Patients in the experimental group received S-1 chemotherapy concurrent with the radiotherapy on the first day. S-1 was orally given 60mg／m2 daily after meals from d1 to d14 with 21days as a cycle for 2 cycles. Results The efficacy of the 60 patients could be evaluated. In experimental group，CR was in 15 cases，PR in 10 cases，SD in 4 cases and PD in 1 case，and the effective rate was 83.3％. While those of control group were 10，8，8 and 4 cases, and the effective rate was 60.0％. The effective rates of the two groups had statistic significance（P=0.045）.The 1-，2-year survival rates of experimental group were 76.7％ and 56.7％, and those of control group were 53.3％ and 30.0％（P=0.049）.The major adverse effects in the two groups were myelosuppression，digestive tract reaction，radiation esophagitis and radiation pneumonitis，mainly in grade 1-2. The adverse effects between the two groups showed no difference（P＞0.05）. Conclusion Radiotherapy combined with S-1 for elder patients with esophageal cancer is a feasible regimen with tolerable adverse effects and convenient administration，worth clinical application.

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Clinicopathological research on 13 patients with non-small cell lung cancer of EML4-ALK gene positive expression

ZHANG Chu，WANG Lin，ZHAO Jianhua，HUANG Wei，XIA Zhaojun，XUN Chen，QIN Shukui

Chinese Clinical Oncology. 2013, 18 (5): 438.

Abstract ( 1783 )

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ObjectiveTo explore the clinicopathological characteristics of echinoderm microtubuleassociated proteinlike 4anaplastic lymphoma kinase（EML4ALK）fusion genepositive nonsmall cell lung cancer（NSCLC）. Methods The clinical and pathological features of 13 cases of EML4-ALK fusion genepositive NSCLC were investigated in this retrospective analysis. Hematoxylin and eosin staining（HE）was used to evaluate the histopathological features. Immunohistochemical staining for thymidylate synthase（TS）was carried out. DNA amplification followed by direct sequencing was performed to detect the mutations in epidermal growth factor receptor（EGFR）and K-Ras. The efficacy of pemetrexed on this subtype of NSCLC were followed up. Results Thirteen cases of EML4ALK fusion gene-positive NSCLC were adenocarcinoma（male 5 cases, female 8 cases; median age 48 years; 4 cases with smoking history）. Ten cases were of acinarlike structures and 6 cases with mucus present in intracellular and extracellular. None of the tumors examined had mutations in both the EGFR and the K-Ras genes. High expression of TS were found in 3 cases and low expression levels of TS in 10 cases. Seven cases received pemetrexed chemotherapy with the disease control rate of 85.7％ and median time to progression of 5.5 months. Conclusion EML4-ALK-positive NSCLC is mostly found in young female adenocarcinoma patients who are nonsmokers. The pathological characteristics were acinar/predominant with intra／extracytoplasmic mucin. EML4-ALK-positive patients are sensitive to pemetrexed chemotherapy with low TS levels. EML4-ALK-positive cases are without EGFR or K-Ras mutation under the general condition.

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Clinical observation of capecitabine plus docetaxel for the first-line treatment of advanced gastric cancer

WANG Jin，QU Xiujuan，TENG Yue'e，JIN Bo，YU Ping，ZHAO Mingfang，ZHANG Jingdong，SHI Jing，LIU Yunpeng

Chinese Clinical Oncology. 2013, 18 (5): 442.

Abstract ( 1124 )

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Objective To evaluate the efficacy，side effects and survival of capecitabine plus docetaxel for the first-line treatment of advanced gastric cancer. Methods From January 2010 to July 2012，24 cases of advanced gastric cancer were enrolled to receive capecitabine plus docetaxel regimen. Treatment consisted of 3-week cycles of twicedaily capecitabin 1000mg/m2（on days 1-14）and intravenous docetaxel 75mg／m2 1h, d1 or 35mg／m21h,d1,d8. Each patient received at least 2 cycles. The efficacy was evaluated every two cycles and side effects were evaluated each cycle. Results The efficacy could be evaluated in 24 patients, none of them achieved complete responses，3 showed partial responses，20 had stable disease, and 1 got progressive disease. The response rate was 12.5％ and the disease control rate was 95.8％. The median overall survival was 105 months（95％CI：2.47-18.47months）. Ten patients died from disease progression，and the time to progression of 7 patients was 1.7-15.2months. The main side effects were myelosuppression and hand-foot syndrome， mainly in grade 1-2, and none of them suffered treatment related death. Conclusion Capecitabine plus docetaxel regimen for the first-line treatment of advanced gastric cancer has a definite effect with acceptable toxicity，which is worth further study.

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Hepatic transcatheter arterial infusion and chemoembolization in the treatment of liver metastases of neuroendocrine tumors

QIN Lidong， LI Jinpeng

Chinese Clinical Oncology. 2013, 18 (5): 445.

Abstract ( 1274 )

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Objective To evaluate the efficacy and side effect of hepatic transcatheter arterial infusion（TAI）and chemoembolization（TACE） in the treatment of liver metastases of neuroendocrine tumors（NET）. Methods Forty-eight patients with liver metastases of NET underwent interventional therapy from August 2002 to September 2009. Thirty patients with rich blood supply and middling blood supply underwent TACE，while 18 patients with poor blood supply underwent TAI. The efficacy was evaluated 1 month after the interventional therapy. Results Interventional therapy was successfully completed in 48 patients. Patients underwent TACE finished 4.5 times（range 2-9 times） and those underwent TAI finished 4.1 times（range 1-10 times）. The main symptoms and signs in all patients were relieved at different extent with 5 cases in CR，27 in PR，10 in SD and 6 in PD, and the effective rate was 66.6%. The median time to progression（TTP）was 10.0 months and the median overall survival（OS）was 28.0 months in 48 patients. In TACE group，the median TTP was 9.5 months，and median OS was 270 months，while in TAI group were 8.5 months and 24.0 months. The main side effects were pain，fever，vomiting／nausea，fatigue and leukopenia，mainly in grade 1-2. Conclusion Interventional therapy selecting proper modality based on the metastatic lesion's blood supply patterns for unresectable liver metastases of NET may obtain satisfactory efficacy.

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Clinical observation of recombinant human endostatin combined with chemotherapy in the treatment of liver metastasis of rectal cancer

REN Qing，XIONG Ruihua，TIAN Xiurong，LUO Kepin

Chinese Clinical Oncology. 2013, 18 (5): 449.

Abstract ( 891 )

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Objective To evaluate the efficacy and toxicities of recombinant human endostatin（endostar） combined with chemotherapy for the treatment of liver metastasis of rectal cancer. Methods Endonstar combined with routine chemotherapy agents were administrated to 40 cases with live metastasis of rectal cancer confirmed by histopathology or cytopathology. Endostar of 15mg／d solved in 500ml normal saline was slowly intravenously dropped from day 1 to day 14, and 21 days was a cycle. The chemotherapy agents including FOLFOX 6，FOLFIRI and CapeOX regimens were selected to be given simultaneously. The efficacy was evaluated strictly according to RECIST 1.0 criteria and the toxicity was evaluated according to WHO anti-cancer drug toxicity levels. The long-term efficacy was evaluated according to progression free survival（PFS） and overall survival（OS）. Results The efficacy and toxicity could be evaluated in 40 patients. Of the 40 patients，3 patients achieved CR，9 cases had PR，14 cases had SD, and 14 cases had PD. The response rates was 30.0％ and disease control rate was 65.0％. The median PFS was 8.6 months and the median OS was 17.8 months. The major toxicities were myelosuppression and digestive reaction. Some patients were received neurotoxicity and handfoot syndrome，mainly in grade 1-2. Conclusion Endostar combined with chemotherapy for liver metastasis of rectal cancer has good efficacy and the toxicity is tolerable, which is worth to use in clinic.

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How to optimize the application of gemcitabine on patients with advanced biliary tract cancer

LIU Xiufeng，QIN Shukui

Chinese Clinical Oncology. 2013, 18 (5): 453.

Abstract ( 1263 )

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Biliary tract cancer （BTC）mainly includes gallbladder cancers（GBC）， intrahepatic and extrahepatic cancers（ICC and ECC）with the rising morbidity of the first two kinds recently，and only about 10％ patients have opportunity of radical resection. Gemcitabine combined with cisplatin now has been recognized as the “golden standard” first-line regimen to those with advanced stage BTC. More and more clinical observations or practices presently show that other gecitabine-based combination chemotherapy regimens perhaps have advantages compared to with cisplatin-combination. This review focuses on how to optimize the gemcibatine-based first-line therapy of patients with advanced BTC.

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esearch progress of perioperative therapy for liver metastases of colorectal cancer

CHEN Cui，LI Yuhong

Chinese Clinical Oncology. 2013, 18 (5): 468.

Abstract ( 1289 )

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Surgical resection is the major and most effective therapeutic approach for colorectal cancer with liver metastasis，with a fairly high recurrence rate after operation. It needs to decrease the risk of recurrence and prolong the survival for these patients undergoing surgical removal of liver metastases. Recent years，pre-，post- and peri-operative chemotherapy have been introduced into some studies to solve the problem. Meanwhile，with the development of new agents and new local treatment means，some promising results have been obtained in some studies. Focusing on the challenge，our paper reviews the latest progress of treatment available in clinical practice.

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Advances of medical management in malignant ascites

HE Yifu，LUO Huiqin，HU Bing

Chinese Clinical Oncology. 2013, 18 (5): 472.

Abstract ( 1267 )

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Malignant ascites（MA）are the cancer associated accumulation of fluids in the peritoneal cavity. Symptoms include abdominal distention，nausea，vomiting，anorexia，dyspnea and limbs oedemas，producing a significant reduction in the patients' quality of life. Currently，none of the different options has been subjected to evidence-based clinical trials and there are no accepted guidelines for the management of MA. The challenge for clinicians is to know how to best manage the symptoms of MA patients for optimal outcomes. The purpose of this article is to discuss critically the medical management of MA.

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标准刊号：	ISSN 1009-0460
	CN 32-1577/R