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  • 临床肿瘤学杂志
    主管:解放军无锡联勤保障中心
    主办:解放军东部战区总医院
    编辑出版:临床肿瘤学杂志编辑部
    主编:秦叔逵
    编辑部主任:龚新雷
    地址:南京市杨公井34标34号
    邮编:210002
    电话:(025)84400143;80864363
    E-mail: lczlx@vip.163.com
    邮发代号:28-267
    刊期:月刊
    定价:每期15元,全年180元
    标准刊号: ISSN 1009-0460
    CN 32-1577/R
     
Table of Content
30 June 2013, Volume 18 Issue 6
论著
Relationship between DAPK promoter methylation and gefitinib resistance in lung cancer cell lines
WU Weiqin,ZHANG Xiaoyuan,XU Haifeng,XU Jing,SHEN Jie,LU Kaihua.
Chinese Clinical Oncology. 2013, 18 (6):  481. 
Abstract ( 890 )   PDF(pc) (786KB) ( 640 )   Save

Objective To explore the relationship between death associated protein kinase(DAPK) promoter methylation and epidermal growth factor receptortyrosine kinase inhibitor(EGFR-TKI) resistance in human lung cancer cell lines. Methods Two EGFR-mutation lung cancer cells(H1650, PC9) and two wild type lung cancer cells(A549, H520) were treated with 5-aza-CdR(1μmol/L) plus gefitinib at different concentrations. The cell proliferation was determined by CCK-8 assay. Apoptosis of cells was observed using flow cytometry. The mRNA expression level of DAPK was detected by RT-PCR. The methylation of DAPK gene promoter region was examined by methylationspecific PCR. Results Gefitinib had proliferative inhibition on the 4 lung cancer cell lines at different extent in a dose dependent manner. CCK-8 assay showed that inhibitive effect of H1650 and H520 cells after 5-aza-CdR demethylation was significantly stronger than before(P<0.05). Flow cytometry results showed that the apoptosis rate of H1650 and H520 cells treated with 5-aza-CdR was significantly higher than that of them untreated with 5-aza-CdR(P<0.05). In lung cancer cell lines without the processing of 5-aza-CdR, the gefitinib sensitive PC9 and A549 cell lines displayed high expression of DAPK mRNA, with the gene promoter in a non-methylation state, while in drug-resistant type(H1650 and H520 cell lines), the DAPK mRNA expression level was low with DAPK promoter in high methylation state. Removing the methylation of DAPK gene promoter region in H1650 and H520 cell lines by 5-aza-CdR, DAPK gene expression and gefitinib sensitivity in H1650 and H520 cell lines apparently increased compared to the previous(P<0.05), but the drug sensitivity in PC9 and A549 cell lines did not change(P>0.05). Conclusion High promoter methylation of tumor suppressor gene DAPK can lead to down-regulation of DAPK gene expression, and reduce the sensitivity of gefitinib on NSCLC. It may provide a new method for predicting clinical curative effect to develop DAPK gene methylation state detection.

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Experimental study of tumstatin on growth of implanted liver cancer in nude mice
ZHU Yuerong, WANG Bing, HE Yujie, YANG Ruining, LOU Xiaowei, HAN Ping, QIU Hong.
Chinese Clinical Oncology. 2013, 18 (6):  486. 
Abstract ( 1303 )   PDF(pc) (543KB) ( 425 )   Save
Objective To investigate the inhibitory effect of tumstatin lentiviral vector (Lenti-Tum) on the growth of transplanted hepatic carcinoma in nude mice and explore its possible application in the gene therapy of human hepatocarcinoma. Methods The subcutaneous hepatic carcinoma SMCC-7721 xenograft was successfully established in nude mice. Peri-tumoral and intra-tumoral injection of 100μl PBS (PBS group), 5×109 TU of green fluorescent protein lentiviral vector (Lenti-GFP group) and 5×109 TU Lenti-Tum (Lenti-Tum group) were carried out in nude mice bearing human hepatic carcinoma xenograft. The tumor volumes of the three groups were observed. Reverse transcriptase polymerase chain reaction and Western blotting were employed to detect the mRNA and protein levels of tumstatin, respectively. The survival times of three groups were analyzed using the Kaplan-Meier method. Results The tumor volume of Lenti-Tum group was (702.1 ± 143.7) mm3, less than (1622.2 ± 253.8) mm3 in PBS group and (1538.5 ± 284.9) mm3 in Lenti-GFP group (P<0.05). The inhibitory rate of Lenti-Tum group was 56.7%, higher than 5.2% in Lenti-GFP group (P<0.05). Both the mRNA and protein levels of tumstatin in LentiTum group were higher than those in other two groups (P<0.05).The median overall survival in Lenti-Tum group was 100 days, much longer than 58 days in PBS group and 59 days in Lenti-GFP group(P<0.05). Conclusion The Lenti-Tum can significantly inhibit the growth of hepatic carcinoma SMCC-7721 xenograft and prolong the overall survival time of nude mice.
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The influences of sodium butyrate on endometrial cancer cell proliferation and the expression of NDRG1
CHEN Ling, GENG Xiaoxing
Chinese Clinical Oncology. 2013, 18 (6):  490. 
Abstract ( 1028 )   PDF(pc) (600KB) ( 432 )   Save
Objective To investigate the anti-proliferative effects induced by sodium butyrate(NaB) on human endometrial carcinoma HEC-2B cell line and its influence on N-myc downstream regulated gene 1(NDRG1) expression. Methods The HEC-2B cells were exposed to various concentrations of NaB for 48 and 72h. The cell proliferation was evaluated by MTT assay. The morphological changes of the HEC-2B cells were observed by inverted fluorescence microscope. The expression of NDRG1 protein was determined by Western blotting method. Results MTT assay showed that NaB inhibited the growth of HEC-2B cell line in a dose- and time-dependent manner in vitro(P<0.5).After NaB treatment for 48h,evident morphological changes with pathognomonic feature of apoptosis were observed. Western blotting showed that the expression of NDRG1 protein were gradually down-regulated with the increasing of NaB concentration. Conclusion NaB can significantly inhibit the growth of human endometrial carcinoma in vitro and its mechanism may be related to the down-regulation of NDRG1 protein expression.
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Predictive value of MITF gene amplification in metastatic melanoma patients receiving recombined human endostatin and dacarbazine as first-line treatment
MA Jiafang, KONG Yan, CUI Chuanliang, LIANG Long, ZHANG Qiannan, TANG Bixia, DAI Jie, GUO Jun.
Chinese Clinical Oncology. 2013, 18 (6):  494. 
Abstract ( 1320 )   PDF(pc) (531KB) ( 494 )   Save
Objective To investigate the predictive effect of microphthalmiaassociated transcription factor(MITF) gene amplification on clinical outcome of recombined human endostatin(endostar) plus dacarbazine as firstline treatment for patients with metastatic melanoma. Methods MITF gene amplification in tumor tissues obtained from 60 metastatic melanoma patients were determined by quantitative real-time PCR. All the patients were followed for disease control rate and long-term efficacy. Results Of 60 tumor tissues, 56 were evaluable for MITF gene detection. MITF gene amplification was detected in 29 of 56 patients(51.8%), 31.2%(5/16) of acral, 63.2%(12/19) of non-acral, 80.0%(8/10) of mucosal and 36.4%(4/11) of unknown primary melanoma(P=0.050). The disease control rate of patients with or without MITF gene amplification were 586% and 81.5%(P=0.063); and the median time to progression were 6.4 months(95%CI:0.5-12.2 months) and 8.4 months(95%CI:6.8-10.3 months),respectively(P=0.169). Conclusion MITF gene amplification rate of Chinese metastatic melanoma is high. It seems to have potential to predict the efficacy of endostar plus dacarbazine in treatment of metastatic melanoma. Further survival data needs long-term follow-up.
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Expression of TXNIP in breast cancer and its clinical significance
CHEN Wenjun, LI Rong, LUO Rongcheng.
Chinese Clinical Oncology. 2013, 18 (6):  498. 
Abstract ( 1050 )   PDF(pc) (575KB) ( 517 )   Save
Objective To explore the expression of thioredoxin interacting protein(TXNIP) in breast cancer and its clinical significance. Methods Fifty samples of breast cancer tissues and the corresponding adjacent non-cancerous tissues were collected from 2011 to 2012. The quantitative reverse transcription-PCR(qRT-PCR), Western blotting and immunohistochemical method were used to detect the TXNIP mRNA, protein level and positive expression rate in 16, 7 and 50 samples of breast cancer tissues and the corresponding adjacent noncancerous tissues, respectively. The relationship between the expression of TXNIP and its clinicopathological features in breast cancer was also investigated. Results There was no significant difference between breast cancer tissues and adjacent non-cancerous tissues in mRNA level of TXNIP(39.07±12.34 vs. 40.12±13.13, P>0.05). The protein level and positive expression rate of TXNIP in breast cancer tissues were 0.43±0.11 and 52.0%, lower than 0.85±0.01 and 72.0% in adjacent non-cancerous tissues(P<0.05). There were statistically significant differences of TXNIP expression among different TNM staging and the degree of differentiation in breast cancer tissues, and the positive expression rate of TNM stage Ⅲ-Ⅳ and low differentiation in adjacent non-cancerous tissues were superior to that in breast cancer tissues(P<0.05). Conclusion There are different expressions of TXNIP in breast cancer tissues and adjacent non-cancerous tissues, and TXNIP may be a reference for diagnosis and treatment in breast cancer.
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Expression and clinical significance of P-cadherin in breast cancer
LI Yuanyuan,ZHANG Lijie,WANG Zhuo
Chinese Clinical Oncology. 2013, 18 (6):  502. 
Abstract ( 1137 )   PDF(pc) (801KB) ( 446 )   Save
Objective To investigate the expression of P-cadherin in breast cancer, and analyze its relationship with clinicopathological characteristics. Methods The expression of P-cadherin in 106 cases of breast cancer specimens and 30 adjacent normal tissues were detected by immunohistochemical method(SP),and the relationship between its expression and clinical characteristics were analyzed. Results The positive expression rates of P-cadherin in breast cancer and adjacent normal tissue were 42.5% and 13.3% respectively, and the difference was statistically significant(P<0.05). P-cadherin expression in breast cancer was correlated with TNM stage,histological grade, lymph node metastasis, HER-2 situation, ER and PR(P<0.05), but not correlated with age and tumor size(P>0.05). ConclusionThe over-expression of P-cadherin in breast cancer may relate to the level of malignancy and poor prognosis.
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The expression and prognostic value of Ki67 in gastroenteropancreatic neuroendocrine tumors
ZHOU Yue,QIU Jinrong,DING Xiaorong,YIN Yongmei
Chinese Clinical Oncology. 2013, 18 (6):  506. 
Abstract ( 1245 )   PDF(pc) (802KB) ( 429 )   Save
Objective To assess the expression of Ki-67 in gastroenteropancreatic neuroendocrine tumors(GEP-NETs) and analyze the relationship between TNM stage, pathological grading and prognosis. Methods The clinicopathological features of 110 patients with GEP-NETs treated in the first Affiliated Hospital of Nanjing Medical University from January 2005 to December 2010 were retrospectively reviewed. The expression of Ki-67 in tumor specimens was detected by immunohistochemistry method. According to Ki-67 proliferation index, the pathological grading was carried including G1, G2 and G3.The mortality rate, median overall survival (mOS), 2-year survival rate and the risk for death of different TNM stages and histological grades were analyzed. Results Seventy-eight patients were available for follow-up. The mortality rate of patients with stage Ⅰ, Ⅱ, Ⅲ and Ⅳ were 8.7%, 11.5%, 36.0% and 75.0%; mOS were 68.0, 49.0,39.0 and 24.0 months; 2-year survival rates were 91.7%, 85.7%, 61.9% and 50.0%. The mortality rate of patients with G1, G2 and G3 were 9.4%, 50.0% and 55.6%; mOS were 73.0, 28.0 and 28.0 months; 2-year survival rates were 91.7%, 42.9% and 50.0%.There were significant differences among different TNM stages and pathological grades on mOS and 2-year survival rate (P<0.01). The risks of death of stage Ⅲ and stage Ⅳ increased relative to stage Ⅰ(P<0.05), as well as G2 and G3 relative to G1(P<0.01). Conclusion The GEP-NETs with later TNM stage or higher Ki-67 proliferation index showed worse prognosis.
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Olanzapine combined granisetron and dexamethasone for the prevention of chemotherapyinduced emesis and nausea in cancer patients: A phase Ⅰ trial
YUAN Lingyan, JIAO Xiaodong, WANG Zhan, QIAN Jianxin, LI Li, WANG Jiejun
Chinese Clinical Oncology. 2013, 18 (6):  511. 
Abstract ( 1296 )   PDF(pc) (586KB) ( 600 )   Save
Objective To investigate the maximum tolerated dose of olanzapine for preventing emesis and nausea during chemotherapy in cancer patients. Methods This study was designed with olanzapine,using a six-cohort dose escalation of at least 3 patients per cohort,combining granisetron and dexamethasone for the prevention of chemotherapyinduced emesis and nausea in cancer patients. The initial dose cohort of olanzapine was 25mg; the terminal one was 20mg. Olanzapine was administered from one day before experiment to 14th day of experiment(d-1-d14) per night. If no dose-limiting toxicity was observed, the study could escalate to the next cohort. Results Eighteen patients were enrolled in the protocol and fifteen patients completed it. Two patient experienced a doselimiting toxicity(grade 3) of dry mouth and somnolence in 15mg cohort. Thus the study stopped on this cohort. In this study adverse events above grade 2 were somnolence, sedation, dizziness, akathisia, constipation, fatigue and bone marrow suppression.
Conclusion Olanzapine is well tolerated and safe in using recommended dose 15mg on d-1 to d14 per night.
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Clinical observation of non-small cell lung cancer with brain metastasis treated by gefitinib
WANG Feng,WANG Lin,QIN Shukui,HUA Haiqing,CHEN Yingxia,LIU Xiufeng,YANG Ningrong
Chinese Clinical Oncology. 2013, 18 (6):  515. 
Abstract ( 1223 )   PDF(pc) (743KB) ( 487 )   Save
Objective To evaluate clinical efficacy and adverse events of gefitinib in patients of non-small cell lung cancer(NSCLC)with brain metastasis. Methods NSCLC patients with brain metastases were treated with gefitinib. Gefitinib was given orally 250mg/d. The effect was evaluated according to RECIST 1.0 criterion. Survival analysis was compared with Kaplan-Meier method and Log-rank test respectively. The multivariate analysis was performed with Cox’s proportion risk model. Results Of all the 40 patients, in terms of intracranial lesions, complete response(CR) was observed in 3 patients(7.5%), partial response(PR) was observed in 10 patients(25.0%), stable disease(SD) in 26 patients(65.0%) and progressive disease(PD) in 1 patients(2.5%), objective response rate(ORR) and disease control rate(DCR) were 32.5% and 97.5%, respectively. As for systemic disease, PR was observed in 14 patients(35.0%), SD in 23 patients(57.5%) and PD in 3 patients(7.5%), RR and DCR were 35.0% and 92.5%, respectively. The median time to disease progression(mTTP) was 245 days and it was related to the onset of brain metastasis(P=0.000) and solitary brain metastasis(P=0.015), but there was no statistical difference among different subtypes of gender,age, brain radiotherapy,treatment opportunity,and smoking(P>0.05). The median overall survival time(mOS) was 590 days, and 1- and 2-year survival rates were 77.5% and 30.0%, respectively. The multivariate analysis showed that OS had no statistical difference among subtypes. The improvement rates of respiratory systerm and nervous system were 67.7%(12/18) and 85.7%(12/14). The common side effects were rash and diarrhea, which were mainly in grade 1-2.Conclusion The patients with heterochronous brain metastasis or solitary brain metastasis may have better time to progression. Gefitinib may be effective and tolerable in NSCLC patients with brain metastasis and appears to be a possible new treatment option.
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Ovarian function castration combined with aromatase inhibitors in the treatment of metastatic breast cancer in premenopausal women
YANG Tingting, WANG Tao, BIAN Li, JIANG Hang, ZHANG Shaohua, WU Shikai, JIANG Zefei
Chinese Clinical Oncology. 2013, 18 (6):  521. 
Abstract ( 1214 )   PDF(pc) (544KB) ( 519 )   Save
Objective To evaluate the clinical efficacy and prognosis in patients receiving ovarian function castration combined with aromatase inhibitors treatment for premenopausal metastatic breast cancer. Methods One hundred and forty hormone dependent mastatic breast cancer patients received ovarian function castration(ovarian resection surgery or goserelin) combined with aromatase inhibitors(anastrozole,letrozole or exemestane) were analyzed retrospectively. The clinical efficacy and prognosis of all patients were evaluated.
Results All the patients’ median progression free survival(PFS) was 8.0 months and the clinical benefit rate was 56.3%. The PFS of patients received firstline treatment and second-line or above were 9.0 months(95%CI:6.3-11.7) and 6.0 months(95%CI:4.1-7.9), respectively; the clinical benefit rates of two groups were 66.7%, 39.7%; the median clinical benefit time were 13.1 months(95%CI:10.9-16.3) and 9.3 months(95%CI:6.8-11.8).In subgroup analysis, the patients who had single organ metastasis, no visceral metastasis and nonreceived chemotherapy before obtained better curative effects. Cox regression analysis showed the number of metastatic position was independent factors of PFS.
ConclusionThe combination of ovarian function castration and aromatase inhibitors is effective endocrine therapy regiment with well-tolerated toxicity for patients with premenopausal metastatic breast cancer. It can be recommended as first-line therapy for the premenopausal and hormone dependent matastatic breast cancer patients.
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Comparison of efficacy and safety of gemcitabine combined chemotherapy regimen after the failure of taxane and anthracycline therapy for metastatic breast cancer
CHEN Yingxia, QIN Shukui, WANG Lin, LIU Xiufeng, HUA Haiqing,GONG Xinlei, HUANG Yong,GENG Haiyun
Chinese Clinical Oncology. 2013, 18 (6):  525. 
Abstract ( 1238 )   PDF(pc) (566KB) ( 434 )   Save
Objective To observe the efficacy and safety of gemcitabine combined with capecitabine or fluorouracil(5-FU), cisplatin or carboplatin and hydroxycamptothecine(HCPT) rescue treatment after failure of taxane and anthracycline therapy in patients with metastatic breast cancer, providing reference for the eligible chemotherapy for metastatic breast cancer that has progressed after axane and anthracycline therapy. Methods Sixty-five patients progressive to taxane and anthracycline therapy were enrolled. Subgroup and chemotherapy regimen were: GX group: gemcitabine 800-1000mg/m2, d1, d8, capecitabine 850-1000mg/m2 bid, d1-14 or 5-FU 500mg/m2 d1-5; GP group: gemcitabine 800-1000 mg/m2, d1, d8, cisplatin 70mg/m2 or carboplatin AUC=46; GH group: gemcitabine 800-1000 mg/m2, d1, d8, HCPT 6-8 mg/d, sharing 5-6 days. Three weeks was a cycle. The efficacy was evaluated every 2 cycles. The patients with disease control were given six cycles of chemotherapy. Results Sixty-four patients were available for objective response evaluation, and adverse events were evaluated among 65 patients. The response rates were 36.4%, 33.3% and 30.0% in GX-group, GP-group and GH-group, respectively(P>0.05). The median progression free survival were 8(1-22)months, 8(1-48)months and 6(2-12)months without significant difference(P=0.415);the median overall survival were 14.5(6-37) months, 14(4-48)months and 16(5-63)months without significant difference(P=0.653). The incidence rates of grade 34 adverse reactions were low among 3 groups. Conclusion The treatment of gemcitabine-based combined chemotherapy regimen showed good efficacy in metastatic breast cancer patients with failure of taxane and anthracycline therapy.
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Efficacy and safety of S-1 and oxaliplatin combined with or not with paclitaxel for advanced gastric cancer

ZHONG Fei, SUN Guoping, GU Kangsheng, XIONG Fuxing

Chinese Clinical Oncology. 2013, 18 (6):  530. 
Abstract ( 1241 )   PDF(pc) (585KB) ( 459 )   Save
Objective To compare the efficacy and safety of S-1 and oxaliplatin(L-OHP) combined with or not with paclitaxel(TAX) for advanced gastric cancer. Methods Fifty-three patients with advanced gastric cancer collected from January 2007 to August 2011 in our department were divided into two groups: group A with 26 patients(TAX 175mg/m2 iv, d1; S-1 40mg/m2 po,bid,d1-d14; L-OHP 85mg/m2 iv, d1) and group B with 27 patients(S-1 40mg/m2 po,bid, d1-d14; L-OHP 130mg/m2 iv, d1). Twenty-one days was a cycle. The efficacy and side effects of two groups were evaluated. Results Toxicity could be evaluated in all the patients. The response rate could be evaluated in 52 patients. In group A and group B, the response rate was 56.0% and 40.7%(P=0.271) and the disease control rate was 88.0% and 63.0%(P=0.037), respectively. The median time to progress of two group was 10.0 months and 8.0 months(P=0.061), and the median overall survival was 13.0 months and 10.0months(P=0.060). The main toxicity were hematological and digestive toxic reactions without statistic significance. There were more neurotoxicity in group B(P<0.05), and more alopecia in group A(P<0.05). Conclusion The efficacy of S-1 and L-OHP combined with paclitaxel is superior in the disease control rate for advanced gastric cancer compared with S-1 plus L-OHP regimen and the side effects are tolerable. It is worthy of further clinical study.
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Perspective study of S-1 for elderly patients with gastric cancer after radical surgery
WANG Shuaibing,LIU Hongbo,LIU Weiwei,QI Xiuheng,GUO Qian,ZOU Qinghua,LIU Jun
Chinese Clinical Oncology. 2013, 18 (6):  535. 
Abstract ( 1016 )   PDF(pc) (527KB) ( 412 )   Save
Objective To evaluate the efficacy and toxicity of S-1 for elderly patients with gastric cancer after radical surgery. Methods After D2 radical surgery, 52 cases of elderly gastric cancer were divided into 2 groups randomly. Twenty-six cases were treated by S-1(S-1 40-60mg po,twice a day,d1-d28, 6 weeks was one cycle) as treatment group. The another 26 cases were treated by FOLFOX 4(oxaliplatin 85mg/m2 iv,d1;calcium folinatc 200mg/m2,iv 2h,d1-d2;5-FU 400 mg/m2 iv,d1-d2;5-FU 600 mg/m2,civ 22h,d1-d2,14 days was one cycle)as control group. Curative effects and toxicities were compared between the two groups in the following 2 years. Results All 52 patients were received 6 months’ adjuvant chemotherapy. The 1-year survival rates in treatment and control group was 69.23% and 61.54%,respectively(P>0.05).The 1-year relapse-free survival rates in two groups was 53.85% and 57.69%,respectively(P>0.05). The 2-year survival rates in treatment and control group was 34.62% and 38.46%,respectively(P>0.05). The 2-year relapse-free survival rates in two groups was 30.77% and 23.08%,respectively(P>0.05). Incidence rates of nausea, emesis, diarrhea and PN toxicity were remarkably lower in treatment group than those in control group(P<0.05). Conclusion After D2 radical surgery, curative effects of S-1 is similar to FOLFOX 4 for elderly gastric cancer patients and S-1 has less toxicities.
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Paclitaxel plus cisplatin and fluorouracil(PCF) compared with paclitaxel plus oxaliplatin and capecitabine(POX) as first-line therapy for advanced gastric cancer
CHENG Xianping, HONG Qiaojun, CHEN Mo, WANG Zhanggui.
Chinese Clinical Oncology. 2013, 18 (6):  539. 
Abstract ( 1057 )   PDF(pc) (580KB) ( 443 )   Save
Objective To compare the efficacy and safety of paclitaxel plus cisplatin and fluorouracil(PCF) and paclitaxel plus oxaliplatin and capecitabine(POX) as firstline therapy for advanced gastric cancer(AGC). Methods In this randomized study, 58 patients with AGC were randomly assigned to either paclitaxel 135mg/m2 on day 1 plus cisplatin 20mg/m2 on d1-3 and fluorouracil 500mg/m2 on d1-5 in a 21-day cycle(PCF regimen, n=30) or paclitaxel 135mg/m2on day 1 plus oxaliplatin 100mg/m2 on day 1 and capecitabine 1000mg/m2 twice daily on d1-14 in a 21-day cycle(POX regimen, n=28).
ResultsThe efficacy and toxicity could be assessed among all patients. There were no significant differences in therapeutic efficacy between PCF and POX regimen with respect to response rate(46.7% vs.53.6%), disease control rate(76.7% vs. 85.7%), median progression-free survival(5.8 months vs. 6.5 months) and overall survival(10.2 months vs.11.6 months), respectively. Grade 3/4 neutropenia was more frequent with PCF regimen than POX regimen(30.0% vs. 7.1%), while diarrhea(42.9% vs. 16.7%) and peripheral neuropathy(50.0% vs.23.3%) occurred more frequently with POX regimen. Conclusion PCF and POX regimen had similar efficacy for the firstline treatment of AGC, with different side effects, but acceptable toxicity profiles. POX regimen seemed to be more safe and convenient.
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Evaluating the set-up errors of tumors at different positions using different image guidance frequency protocol from tomotherapy treatments

WEN Ting,LI Jing, ZHANG Jinjian,LI Zhiqiang,HOU Youxian,CHEN Jing,WANG Yan.

Chinese Clinical Oncology. 2013, 18 (6):  544. 
Abstract ( 923 )   PDF(pc) (757KB) ( 425 )   Save
Objective To evaluate the precision of different image guide frequency protocol in the treatment of tumors at different positions. MethodsSixteen thousands sets of megavoltage CT(MVCT) images were collected from 80 patients with tumors at different positions before 20 treatment fractions, including 20 brain, 20 head and neck(H&N), 20 thoracic and 20 abdominopelvis. The MVCT images of different guide protocols and planning images were matched as to analyze either the deviation value of every five days protocol and daily protocol or the deviation value of every other day protocol and daily protocol. Meanwhile, the frequency of threedimensional positioning error more than 3mm and 5mm in four different positions were investigated. Results The deviations between every five days protocol and every other day protocol on lateral, longitudinal, vertical were(0.42±0.06)mm,(0.68±0.09)mm,(0.28±0.04)mm for the brain tumors;(0.40±0.06)mm,(0.29±0.12)mm,(0.23±0.13)mm for H&N;(0.87±0.12)mm,(1.85±0.16)mm,(0.79±0.11)mm for thoracic;(0.83±0.12)mm,(0.19±0.31)mm,(0.95±0.16)mm for abdomino-pelvis. In the every other day protocol: for brain treatments, 12.25% and 3.25% of treatment fractions were shifted 3mm and 5mm 3 dimension(3D) vector distance; For H&N treatments, 18% and 4.25% of treatment fractions were shifted 3mm and 5mm 3D vector distance; For thoracic treatments, 23% and 12% of treatment fractions were shifted 3mm and 5mm 3D vector distance; For abdominopelvis treatments, 25% and 13.75% of treatment fractions were shifted 3mm and 5mm 3D vector distance. Whereas this occurred for 21.75% and 5%,24.5% and 8.25%, 36% and 23%, 34% and 24.75% of brain, H&N, thoracic and abdomino-pelvis. The deviation values of every five days protocol were higher than those of every other day protocol(P<0.05). Conclusion Improving the image guide frequency can improve the radiotherapy precision.
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临床应用
Clinical observation of drug-resistant gestational trophoblastic neoplasia
SUN Tingting, DENG Yanjie, LIU Jia, JIAO Lanzhou, YU Xiaohui, WANG Jiayuan.
Chinese Clinical Oncology. 2013, 18 (6):  549. 
Abstract ( 1247 )   PDF(pc) (499KB) ( 490 )   Save
Objective To investigate the clinical features, treatment and prognosis of drug-resistant gestational trophoblastic neoplasia(GTN). Methods The clinical data of 15 GTN patients was retrospectively analyzed. ResultsThe 15 cases of drug-resistant GTN were mainly treated by chemotherapy. Among them, there were 10 cases treated by chemotherapy and 5 cases treated by chemotherapy combined with operation. When treatment finished, 12 cases got serologically complete remission and 3 were partial remission, respectively. The patients were followed up for 6-117 months with 3 cases lost to follow up, and no relapse occurred or death in the other 12 cases. Conclusion The drugresistant GTN are mainly treated by chemotherapy. For those with drug-resistant lesions and abnormal serum β-human chorionic gonadotrophin, the treatment of chemotherapy combined with surgery can improve the prognosis.
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Clinical observation of S-1 monotherapy as thirdline or furtherline treatment for advanced non-small cell lung cancer

CHEN Saisai, GAO Ping, GAO Yajie.

Chinese Clinical Oncology. 2013, 18 (6):  553. 
Abstract ( 1201 )   Save
Objective To observe the efficacy and toxicity of an oral anticancer fluoropyrimidine derivative(S-1) for previously treated patients with advanced non-small cell lung cancer(NSCLC). Methods Sixty advanced NSCLC patients received second-line or further-line chemotherapy previously were enrolled in this study. Thirty cases were given S-1 orally(group A), the dosage was taken according to body surface, ranging 80mg/d to 120mg/d. Twenty-one days was a cycle. The efficacy and toxicity were evaluated after 2cycle treatment.Another thirty cases were received best supportive care only(group B). Results In group A, there were no CR and PR case, SD was 18 cases, PD was 12 cases and the disease control rate was 60.0%(18/30). The toxicity was mild. The main side effects were gastrointestinal reaction and bone marrow suppression. The median progression free survival(PFS) of group A and group B were 2.5 months and 2.0 months, the median overall survival(OS) were 5.0 months and 3.0 months respectively. Between the two groups, the PFS and OS was not statistically different. Conclusion S-1 exhibits modest activity and acceptable toxicity when was used as a third or subsequent line of chemotherapy in patients with advanced NSCLC.
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综述与讲座
The progression of regulatory T cells and tumor immunity

XIE Dacheng, WANG Liwei.

Chinese Clinical Oncology. 2013, 18 (6):  556. 
Abstract ( 1081 )   PDF(pc) (556KB) ( 747 )   Save
Regulatory T cells(Treg) play a dominant role in selftolerance and control of autoimmune diseases. These cells also play a pivotal role in chronic inflammation and cancer by limiting immune activation and specific immune response. The study shows Treg can be divided into two subsets including natural(n) Treg and inducible(i) Treg. Natural(n) Treg is normally responsible for maintaining peripheral tolerance and immune balance in healthy individuals. Inducible(i) Treg is highly suppressive, therapy-resistant Treg which down-regulate anti-tumor immune responses and promote tumor growth. But this division of labor between nTreg and iTreg is not absolute, and overlap may be common. This review is aim to discuss the phenotypic diversity and plasticity of the Treg, and then investigate the relationship between Treg and tumor prognosis and immunity therapy.
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The regulatory mechanism of autophagy in tumorigenesis and development

LI Dan, LI Chong,JIANG Jingting.

Chinese Clinical Oncology. 2013, 18 (6):  561. 
Abstract ( 1003 )   Save
Autophagy is a selfdigestion process, wrapping cytoplasmic proteins or organelles to form vesicles and degradation in the lysosome. Autophagy plays an important role in the maintenance of intracellular homostasis. Autophagy exists in many tumors and is involved in cell malignant transformation and tumor cell growth. In early phase of tumorigenesis, autophagy is used to clear the intracellular folding abnormal protein and dysfunctional organelles such as mitochondria. Autophagy can also inhibit cell stress response and prevent genetic damage. When tumor developes, autophagy helps tumor cells survive in nutritional deficiencies and hypoxic conditions. The study of autophagy in the occurrence and progression in tumors will provide new therapeutic strategy for tumor treatment.
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The progression of the patients cognitive impairment after radiotherapy of brain metastases

DONG Biao, CHENG Huaidong, CHEN Zhendong.

Chinese Clinical Oncology. 2013, 18 (6):  565. 
Abstract ( 1247 )   Save
Radiotherapy is one of the effective treatments for brain metastases. With the prolonged overall survival of patients with brain metastases, radiation induced neurotoxicity has been gradually being recognized. The influnence of cranial irradiation on cognitive function and its mechanism as well as the methods to evaluate the cognitive function are concerned by the clinical medicine workers. The research findings about the topics are reviewed.
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Combination of CA125 and HE4, and the ROMA model in diagnosis and prognosis of ovarian cancer

NIE Daijing, CHEN Xiaopin.

Chinese Clinical Oncology. 2013, 18 (6):  571. 
Abstract ( 855 )   Save
Ovarian cancer is the leading cause of death among gynecologic malignancies. Due to the hidden onset and the lack of diagnostic tools for early detection, about 70% of patients are detected at a progressed stage of disease, while 60%-70% of patients with ovarian cancer relapse or die within 5 years after diagnosis. The key to improve survival is early diagnosis and early treatment. Tumor markers have significant values in early diagnosis, monitoring and therapeutic evaluation of malignant tumors. Many researchers have done tons of researches on novel tumor markers human epididymis secretory protein 4(HE4), carbohydrate antigen 125(CA125) and risk of ovarian malignancy algorithm in the diagnosis, differential diagnosis and prognosis of ovarian cancer recently. The present article is a review of those studies.
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