Chinese Clinical Oncology

Relationship between DR4 gene promoter methylation and TRAIL resistant in lung adenocarcinoma

QI Xiaoyan，WANG Wenwu， SHI Bin， XU Yao， ZHANG Yan， CHEN Xi， OUYANG Xuenong

Chinese Clinical Oncology. 2015, 20 (2): 97.

Abstract ( 1170 )

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Objective To investigate the relationship between DR4 gene promoter methylation and tumor necrosis factorrelated apotosisinducing ligand（TRAIL） resistant in lung adenocarcinoma. Methods Lung adenocarcinoma cells A549, LTEP-α-2 untreated by 5-aza-2'-deoxycytidine（5-Az-CdR） and treated by 5-Aza-CdR for 3 days were selected. Cell counting kit-8（CCK-8）assay was used to determine the inhibitory rate of cell proliferation，and the cell morphological was observed by inverted microscope. The apoptosis of cells was detected by flow cytometry. The protein and mRNA expression levels of DR4 gene in lung adenocarcinoma cell lines（A549， LTEP-α-2） were detected by Western blotting and RT-PCR methods. The methylation of DR4 gene promoter region was examined by methylation-specific PCR（MSP）. Results Lung adenocarcinoma cells（A549， LTEP-alpha-2） were highly resistance to TRAIL at the low concentration. After increasing the concentration of TRAIL（15.625, 31.25, 62.5, 125, 250, 500 μg/ml）， cell growth was inhibited and existed in a dose and time dependent after 24 and 48 hours. After cells were treated by 5-Aza-CdR， the inhibitory effects of lung adenocarcinoma cell treated by TRAIL was significantly higher than before treatment（P＜0.05）.The morphology of the cells was round， shrinkage and even shedding under the microscope. After cells were treated by 125 μg／ml 5-Aza-CdR， the apoptosis rate of lung adenocarcinoma cells induced by TRAIL was significantly much more higher than before treatment（P＜0.05）. Expressions of DR4 mRNA and protein in A549， LTEP-α-2 cells were low， and DR4 gene promoter was methylation state. After cells were treated by 5-Aza-CdR， the expressions of DR4 mRNA and protein were more increased significantly than before treatment（P＜0.05）， and DR4 gene promoter was unmethylated. Conclusion 5-Aza-CdR can reverse DR4 gene promoter methylation state， regulating the level of gene expression， increasing TRAILinduced apoptosis in lung cancer cells， furthermore， reversing TRAIL resistance. Therefore， 5-Aza-CdR combined with TRAIL may be a new strategy for the treatment of lung adenocarcinoma.

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Influence of nm23-H1 gene transfection on expressions of MMP-9 and TIMP-1 in lung cancer cells

ZHENG Haixia， CUI Yongyan， SHEN Donglan， PENG An， HE Yanling.

Chinese Clinical Oncology. 2015, 20 (2): 104.

Abstract ( 1191 )

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Objective To investigate the influence of nm23-H1 gene transfection on the expressions of matrix metalloproterinase 9（MMP-9）and tissue inhibitor of metalloproteinase 1（TIMP-1） in lung cancer cells. Methods nm23-H1 gene was transfected into lung cancer cell line L9981 by gene transfection technology. SemiRT-PCR was used to detect the different mRNA expressions of TIMP-1 and MMP-9 between transfected and nontransfected lung cancer cell lines. Flow cytometry was used to detect the different protein expressions of TIMP-1 and MMP-9 between transfected and non-transfected lung cancer cell lines. Results The mRNA and protein levels of TIMP-1 in transfected lung cancer cell lines were stronger than those in non-transfected lung cancer cell lines. The mRNA and protein levels of MMP9 in transfected lung cancer cell lines were weaker than those in non-transfected lung cancer cell lines. Conclusion The nm23-H1 gene can up-regulate expressions of TIMP-1 and down-regulate expressions of MMP-9 in lung cancer cell line L9981.

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Regulatory effect of miR-155 on the proliferation， apoptosis and expression of breast cancer resistance protein

CHEN Shuru， HUANG Yukang， WU Chucheng， CHEN Di， FANG Qin， PENG Weiqiang.

Chinese Clinical Oncology. 2015, 20 (2): 108.

Abstract ( 1182 )

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Objective To explore the regulatory effect of microRNA-155 （miR-155） on the proliferation， apoptosis and expression of breast cancer resistance protein. Methods The real-time quantitative PCR （qRT-PCR） was employed to measure the miR-155 level in MCF-7 cells and human normal breast epithelium cells. The MCF-7 cells were randomly assigned into four groups according to the experiment protocol： control group， blank group， inhibition group （transfection with miR-155 inhibitor） and over-expression group （transfection with miR-155 mimics）. The qRT-PCR was used to detect the transfection effect at 24， 48， 72 and 96 h after transfection. Methyl thiazolyl tetrazolium （MTT） assay was used to assess the proliferation ability at 24， 48， 72 and 96 h after transfection. The apoptosis rate was evaluated at 24 and 48 h after transfection by PI／Annexin V double staining with flow cytometry. Western blotting was used to measure the expression levels of breast cancer resistance protein （BRCP）， P-glycoprotein （P-gp） and multidrug resistance associated protein 1 （MRP1） protein.
ResultsThere was higher level of miR-155 in MCF-7 cells versus human normal breast epithelium cells （P＜0.05）. Transfection with miR-155 inhibitor or mimics could reduce or increase the level of miR155 in time dependent manner in MCF-7 cells （P＜0.05）； In comparison with control group， the rates of proliferation and expression levels of BRCP， P-gp and MRP1 decreased in inhibition group but increased in overexpression group （P＜0.05）. The apoptosis rate increased in inhibition group but decreased in overexpression group（P＜0.05）. Conclusion There is higher level of miR-155 in MCF-7 cells. Down-regulation of miR-155 presents an inhibitory effect on the proliferation and expression of drug resistance related protein along with the induction of apoptosis.

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Expression of hedgehog signaling pathway related protein Gli1 in breast cancer and its clinical significance

FENG Fubin， ZHUANG Jing， LIU Ruijuan， WANG Congcong， TANG Shifeng， SUN Changgang.

Chinese Clinical Oncology. 2015, 20 (2): 112.

Abstract ( 1153 )

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Objective To investigate the expression of hedgehog signaling pathway related protein Gli1 in breast cancer and its clinical significance.
Methods The immunohistochemical method was used to detect the expression of Gli1 in 102 cases of breast invasive ductal carcinoma and 30 cases of corresponding adjacent normal breast tissues， and then its relationship with clinicopathological features were analyzed. Results The positive expression rate of Gli1 in breast cancer tissues was 75.5％（77／102）， higher than 26.7％（8／30） of paired adjacent normal tissues， with significant difference （P＜0.05）.The expression of Gli1 was related with axillary lymph node metastases， estrogen receopter， but not related with age， postmenopause， tumor size， pathological stage， histological grade， progesterone receptor and human epidermal growth factor receptor 2（P＞0.05）. Conclusion Hedgehog signaling pathway related protein Gli1 is high expression in breast cancer tissues and it have some effect of negative regulation on estrogen receptor.

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Predictive value of serum CEA for efficacy and prognosis of EGFR mutant advanced lung adenocarcinoma treated with TKIs

NONG Jingying， WANG Jinghui， YANG Xinjie， LV Jialin， WU Yuhua， ZHANG Shucai.

Chinese Clinical Oncology. 2015, 20 (2): 116.

Abstract ( 1178 )

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Objective To investigate the effects of pretreatment serum carcinoembryonic antigen（CEA）on the efficacy and survival of tyrosine kinase inhibitors （TKIs） in the EGFRmutant patients with advanced lung adenocarcinoma. Methods The clinical data of 120 patients with EGFR mutant advanced lung adenocarcinoma treated with gefitinib， erlotinib or icotinib hydrochloride at our department between December 2005 and April 2013 were retrospectively reviewed， and influencing factors of response and survival were analyzed. Differences in efficacy between variables were evaluated using the Response Evaluation Criteria in Solid Tumors（RECIST）（version 1.1）. Progression free survival（PFS）and overall survival（OS） were estimated by the KaplanMeier method. Independent risk factors were assessed in multivariate analysis using the Cox proportional hazards model.
ResultsThe response rate（RR） and disease control rate（DCR） were 57.5％ and 94.2％， respectively， the median PFS was 9.0 months（95%CI：7.91-10.09 months） and median OS was 23.5 months（95%CI：17.89-29.11 months）. The pretreatment serum CEA level was positive （≥5 ng／ml） for 44.2％ of the patients. Neither the RR to TKIs （55.2％ vs. 60.4％， P=0.5721） nor PFS（10.0 months vs. 8.0 months， P＞0.05） had significant differences between the two groups of CEA＜5 ng／ml and CEA≥5 ng／ml. The median OS of patients with CEA＜5 ng／ml was significantly better （30.0 months vs. 17.2months， P=0.022）. A multivariate analysis indicated smoking， serum CEA and PS performance scoring to be independent prognostic factors. Conclusion It shows that the serum CEA＜5 ng／ml may not be a predictive factor for the efficacy of EGFRTKIs， but it is a positive prognostic factor for EGFR mutant advanced lung adenocarcinoma patients undergoing this treatment.

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Prognostic analysis of metastatic non-small cell lung cancer patients treated with helical tomotherapy

LI Zhong， LI Jing， LI Zhiqiang， WANG Yan， ZHONG Yu，ZHANG Jinjian， WEN Ting，HOU Youxian，JIA Junsong，CHEN Jing，XU Yanhong

Chinese Clinical Oncology. 2015, 20 (2): 122.

Abstract ( 1027 )

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Objective To investigate the prognosis and influential factors in metastatic nonsmall cell lung cancer（NSCLC） treated with helical tomotherapy.
MethodsThe clinical data of fifty-one cases of metastatic NSCLC treated by helical tomotherapy technology were collected in our center， from June 2011 to February 2013. Radiation to all the target volume was delivered to a median dose of 42.5 Gy（30-62 Gy） with a median daily dose of 2 Gy（1.8-3 Gy）. The Kaplan-Meier method was used for calculating overall survival rates. The Log-rank test was used for survival difference analysis. The Cox proportional hazards regression model was used for multivariate prognostic analysis.Results All the patients were followed up more than one year， the median survival time of fifty-one cases of metastatic NSCLC was 19.3 months， the 1-year survival rate was 64.7％. Univariate analysis showed that the higher KPS score， adenocarcinoma， prior chemotherapy， without liver metastases and the plan target volume（PTV） ≤1300 cm³ were favorable prognostic factors for survival time in all patients. Multivariate analysis showed that the KPS score， prior chemotherapy and PTV were independent prognostic factors for metastatic NSCLC patients.
Conclusion Helical tomotherapy may further prolong the survival time and improve the prognosis for metastatic NSCLC patients.

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Clinical observation of maintenance therapy with autologous cytokineinduced killer cells in patients with medium and advanced non-small cell lung cancer after first-line treatment

SONG Shuxi， DING Zhenyu， LIU Yongye， YU Huiying， SUN Yinghui， HAN Yaling， MA Dongchu， XIE Xiaodong.

Chinese Clinical Oncology. 2015, 20 (2): 127.

Abstract ( 1107 )

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Objective To investigate the efficacy and safety of maintenance therapy with autologous cytokineinduced killer cells（CIK） in patients with medium and advanced non-small cell lung cancer（NSCLC） after firstline treatment.
MethodsA total of 112 medium and advanced NSCLC patients with therapeutic effect of SD or above after firstline treatment were selected and assigned to treatment group（n=56） and control group（n=56） at random. The treatment group accepted maintenance therapy with autologous CIK cells after the firstline treatment. T lymphocyte subpopulations in peripheral blood were measured and the side effects were estimated according to NCI-CTC 4.0 version. Then， patients of both groups were followed up. Results The statuses of T lymphocyte subpopulation were improved after the therapy with autologous CIK cells and no side effects of grade 3-4 occurred. The median progressionfree survival（PFS） of treatment group was 8.6 months， higher than 7.5 months of control group（P＜0.05）. The median overall survival（OS） in treatment group and control group were 19.2 and 18.6 months without significant difference（P＞0.05）. In treatment group， the median PFS in patients with therapeutic effect ≥50％ PR-CR was 11.5 months， higher than 7.9 months in patients with ＜50％ PR-SD and the difference was significant（P＜0.05）， but no difference was observed on the median OS between both subgroups（P＞005）. In control group, there was no significant difference on the median PFS and OS between patients with therapeutic effect ≥50％ PR-CR or ＜50％ PR-SD（P＞0.05）. In the cases whose therapeutic effect ≥50％ PR-CR， the median PFS was 11.5 months in treatment group， higher than 8.8 months in control group with significant difference（P＜0.05）， but no difference was observed on the median OS between both groups（P＞0.05）.
Conclusion Maintenance therapy with autologous CIK cells in patients with medium and advanced NSCLC after firstline treatment improves the immune function and enhances the ability of antitumor effect by natural immunity with a prolonged PFS and welltolerated toxicity.

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Clinicopathological characteristics and prognosis analysis among different molecular subtypes of breast invasive ductal carcinoma

PANG Qiong， NAN Haocheng， MA Jiequn， ZHAI Haicheng， CHEN Yimeng， QU Shengyang， NAN Kejun， HE Jianjun.

Chinese Clinical Oncology. 2015, 20 (2): 132.

Abstract ( 1160 )

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Objective To investigate the relationship between molecular subtype and prognosis of invasive ductal carcinoma（IDC） of breast.
Methods Clinical data of 822 patients with clinicopathologically resectable breast IDC in the First Affiliated Hospital of Xi'an Jiaotong University were collected from January 2000 to December 2012. Based on immunohistochemistry， we categorized the breast cancer as the following molecular subtypes：Luminal A， Luminal B， HER-2 overexpression and triple-negative breast cancer（TNBC）. The correlation of prognosis in different breast cancer molecular subtypes with age， tumor size， lymph node metastasis and clinical stage were analyzed. Results Among 822 cases， 54 cases were found with recurrence or metastasis and 46 cases died with the mortality of 5.6％. The result showed statistical differences among different molecular subtypes of breast cancer regarding the age， tumor size and clinical stage（P＜0.05）, but no statistical difference was observed on the lymph node metastasis（P＞0.05）. Survival analysis showed that factors affecting the prognosis were age， clinical stage， tumor size， lymph node metastasis status and molecular subtypes. Multivariate analysis found that the molecular subtypes and lymph node metastasis status were the independent factors of breast cancer prognosis. The prognosis of HER-2 subtype breast cancer was the worst.
Conclusion Breast cancer molecular subtypes classification has great significance in predicting the prognosis of breast cancer and needs further study to appy to clinical individual treatment of breast cancer patients.

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The value of combined detection of serum HE4， CA153 in diagnosing breast invasive ductal carcinoma

QIN Tian， GONG Zhifeng， QIU Meiting， WU Yongxiao.

Chinese Clinical Oncology. 2015, 20 (2): 137.

Abstract ( 1123 )

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Objective To investigate the value of combined detection of serum carbohydrate antigen 153 （CA153）and human epididymis protein 4 （HE4） in diagnosing breast infiltrative ductal carcinoma.
Methods In this study， 276 breast invasive ductal carcinoma patients， 79 benign breast diseases patients and 66 healthy female volunteers were detected expressions of serum CA153 and HE4 by chemiluminescence immune analysis method and the ELISA method. The relationship between the expressions of CA153， HE4 and clinicopathological characteristics of breast infiltrative ductal carcinoma was analyzed.
Results In breast invasive ductal carcinoma group， the expressions of CA153 and HE4 were （28.03±37.76）U/L and （105.45±95.26）pmol/L， which were significantly higher than benign disease group and the healthy control group （P＜0.05）. The sensitivity， accuracy， area under ROC curve（AUC） of CA153 combined with HE4 were 61.23％， 69.60％ and 0.759， which were significantly higher than single indicator（P＜0.05）. While the statistical difference of specificity was not observed（P＞0.05）. The expressions of serum CA153 and HE4 related to whether triplenegative breast cancer， lymph node metastasis and clinical stage（P＜0.05）.
Conclusion The combined detection of CA153 and HE4 can be the diagnosis index of breast infiltrative ductal carcinoma.

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Analysis of prognostic factors in 210 patients with advanced esophageal carcinoma after chemoradiotherapy

Chinese Clinical Oncology. 2015, 20 (2): 140.

Abstract ( 1036 )

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Objective To investigate the clinical effects， side effects and related factors of prognosis during chemoradiotherapy in patients with advanced esophageal carcinoma. Methods 210 patients with esophageal carcinoma underwent chemoradiotherapy were selected for retrospective analysis. Of the 210 cases， 84 underwent sequential chemoradiotherapy and 126 concurrent chemoradiotherapy. IMRT was implemented at a dose of 60-66 Gy， combined with 2-6 cycles of paclitaxel plus platinum antineoplastic agent chemotherapy for esophageal squamous carcinoma. Response to chemotherapy was assessed by RECIST criteria 1.1 and toxicity was evaluated according to National Cancer Institute Common Toxicity Criteria 30 and acute and chronic radiation injury classification standard of radiation therapy oncology group trial （RTOG）. Follow-up data from radiation therapy and chemotherapy were investigated. Potential prognostic factors were analyzed by univariate analysis and Cox proportional hazard model.
ResultsIn 210 patients, complete response（CR） was observed in 79 patients, partical response（PR） in 99 patients, stable disease（SD） in 21 patients, progressive disease（PD） in 11 patients. The response rate（RR） was 84.8%. The 1， 3year survival rates of the patients with esophageal carcinoma were 79.6％ and 52.2％， respectively. The median survival time was 41.0 months. Concurrent chemoradiotherapy failed to show significant survival advantages than sequential chemoradiotheraphy （P＞0.05）. Univariate analysis showed factors that significantly affected the prognosis included tumor location， N stage， M stage， clinical stage， radiation esophagitis， radiation esophageal stricture and low serum albumin （P＜0.05）. Multivariate analysis revealed that tumor location， N stage， radiation esophageal stricture， and low serum albumin were independent prognostic factors. The main side effects were decreased hemoglobin， radiation esophagitis， radiation esophageal stricture， radiation pneumonitis and hypoproteinemia. The incidence of radiation esophagitis in sequential chemoradiotheraphy was higher than that of concurrent chemoradiotherapy （P＜0.05）. Conclusion Tumor location， N stage， radiation esophageal stricture and low serum albumin are independent prognostic factors in advanced esophageal carcinoma after chemoradiotherapy. Timely treatment of side effects might improve prognosis of esophageal carcinoma.

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A survey on symptom frequency and intensity in hospitalized advanced cancer patients with depressive disorder

YU Yang， LIU Yong， LI Qing， JIN Xin， LIU Fei.

Chinese Clinical Oncology. 2015, 20 (2): 145.

Abstract ( 1146 )

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Objective To investigate the frequency and intensity of symptoms in hospitalized advanced cancer patients with depressive disorder， then the relationship between these symptoms and depression was analyzed.
MethodsOne hundred ninetysix patients were surveyed by Edmonton Symptom Assessment System （ESAS） and SelfRating Depression Scale （SDS）. Chi-Square test and Wilcoxon ranksum test were used respectively to compare the incidence and intensity of the patients with and without depressive symptoms， and Spearman correlation coefficients was used for the analysis of correlation between depression and symptoms.
ResultsIn 196 patients， 76（38.8％） patients had depressive disorder （SDS≥53）. Compared with the patients without depressive symptoms， the high frequent symptoms expressed by patients with depressive disorder were worse wellbeing （98.7％ vs.86.7％，P=0.029）， worse appetite （97.3％ vs.74.2％，P=0.002）， pain （94.7％ vs.63.3％，P＜0.001）， anxiety （84.2％ vs.49.2％，P＜0.001）， dyspnea （84.2％ vs.71.7％，P=0.021）， drowsiness （73.7％ vs. 55.8％；P=0.006） and nausea （61.8％ vs.38.3％，P＜0.001）， respectively. However， these patients with depressive disorder expressed higher intensity of symptoms （ESAS≥1）［median （P25-P75）］including worse wellbeing［7（5-8）， P.0.001］， fatigue［7（5-8）， P＜0.001］， worse appetite［6（4-8）， P=0.010］， anxiety［5（3-7）， P＜0.001］， and dyspnea［5（3-7）， P=0.019］. Spearman's correlation analysis showed that there was a significant association between SDS and other symptoms in the ESAS. Correlation coefficients of SDS with depression， fatigue and anxiety were 0.57， 0.52 and 0.51， respectively （P＜0.001）.
Conclusion Expression of symptom burdens may be higher and more severe in hospitalized advanced cancer patients with depression. The awareness of symptom frequency and intensity not only help us to identify depression and make some interventions， but also help us to take more concern about the severe symptoms， so as to improve the quality of life of cancer patients.

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Survey of cancer patients' view of death

RAO Jie， FU Qiang， WU Qiansheng， YU Shiying

Chinese Clinical Oncology. 2015, 20 (2): 150.

Abstract ( 1089 )

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Objective To investigate the cancer patients view of death and its related factors. Methods A questionnaire survey was designed by ourselves and conducted on cancer patients. Results One hundred questionnaires were sent out, receiving 99 efficient questionnaires. The patients who minded talking about death related issues were 27.27％. Whether patients minded talking about death was related with their education degree（P=0.005）， dwelling environment（P=0.009）， the contact with critically ill or dying patients（P=0.001）， the contact with deaths（P=0.003）， whether witnessed relatives at the end of life（P=0.042）， and the feel of attending funeral（P=0.001）. In the patients who didnt mind talking about death， more than half of them thought that death should let nature take its course； for dying person the patients who chose should “rescue as far as possible” and “depend on the state of illness” were similar in the proportions（44.44％ vs. 50.00％）； the most concerns when majority of patients met death were “unfinished family responsibilities”（63.89％） and “friends and relatives will be sad”（11.11％）； for place of death， two-thirds of the patients chose at home， only 18.06％ chose in hospital. Conclusion It will be great importance of implementing palliative and hospice care， as well as enhancing cancer patients' quality of life.

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Clinical observation of docetaxel based regimens as the secondline chemotherapy in osteosarcoma

ZHU Haodong， WU Zhigang， WANG Zhen， GUO Zheng， SHI Lei， CHEN Guojing， FU Jun， LI Xiaokang

Chinese Clinical Oncology. 2015, 20 (2): 155.

Abstract ( 1077 )

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Objective To investigate the efficacy and side effects of docetaxel based regimens as the secondline chemotherapy in osteosarcoma with lung metastasis. Methods From January 2012 to December 2013， 11 osteosarcoma patients with lung metastasis whom failed from firstline chemotherapy were taken docetaxel（75 mg/m², d₈） combined with gemcitabine（675 mg/m², d₁, d₈）／platinum（30 mg/m², d₂） as the second-line chemotherapy. 21 days was a cycle. The firstline chemotherapy contained cisplatin， ifosfamide， adriamycin methotrexate alternating scheme. The efficacy was evaluated by RECIST 1.0 criterion， and side effects were recorded by NCI-CTC 3.0 criterion. Results All patients finished treatment， and could be evaluated. There was no complete remission （CR） case， partial remission （PR） in 1 case， stable disease （SD） in 4 cases， progression of disease （PD） in 6 cases； and the response rate（RR） was 9.1％， disease control rate （DCR） was 45.5％. During the follow-up period， 3 patients died. The median progression free survival time was 10.5 months， the median overall survival time was 18.0 months， and 1-year survival rate was 83.3％. The major adverse reactions were limiting myelosuppression during chemotherapy. There was no patients with renal dysfunction and allergic reaction， grade 4 neutropenia and thrombocytopenia was occured in 1 case.
Conclusion Docetaxel based regimen is effective as the secondline chemotherapy in osteosarcoma with lung metastasis， and the shortterm curative effect is satisfactory， toxicity can be tolerated.

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Clinical observation of TP induction chemotherapy combined with concurrent chemoradiotherapy in untreated locally advanced nasopharyngeal carcinoma

XIE Yalin， XIE Jianming

Chinese Clinical Oncology. 2015, 20 (2): 160.

Abstract ( 1061 )

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Objective To compare the efficacy and side effects of untreated locally advanced nasopharyngeal carcinoma by TP induction chemotherapy regimen or PF regimen. Methods The locally advanced nasopharyngeal carcinoma patients were randomly divided into group A（n=30， TP regimen： docetaxel 75 mg／m2 d1，cisplatin 75 mg／m2 d2， 21 days as a cycle） and group B（n=29，PF regimen： cisplatin 75 mg／m2 d1， fluorouracil 750 mg／m2 civ d1d5， 21 days as a cycle）. After induction chemotherapy for three cycles， all patients underwent concurrent chemoradiotherapy. Chemotherapy was taken as follow： cisplatin 80 mg／m2 d1， 21 days as a cycle. The radiotherapy dosage was 2.0 Gy per fraction，5 fractions a week，for 6 weeks，and total dosage was 60 Gy. The efficacy was evaluated and the survival was followed-up. Results There were no significant differences in the objective response rate （76.7％ vs. 79.3％， P＞0.05） and overall survival （39.4 months vs. 36.0 months， P＞0.05） between the two groups. But the progressionfree survival of group A was longer than group B （12.7 months vs.10.3 months， P=0.044）. The main side effects in two groups were hematologic toxicities and mucosities with no statistical difference（P＞0.05）. Conclusion TP and PF induction chemotherapy combined with concurrent chemoradiotherapy had equal clinical efficacy in the treatment of locally advanced nasopharyngeal carcinoma. TP induction chemotherapy can be a viable alternative treatment of nasopharyngeal carcinoma.

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Simultaneous bilateral laparoscopic inguinal lymphadenectomy for penile carcinoma

CHENG Shaoping， MA Xin， GUO Gang， ZHANG Xu.

Chinese Clinical Oncology. 2015, 20 (2): 164.

Abstract ( 1064 )

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Objective To evaluate the clinical effect of simultaneous bilateral laparoscopic inguinal lymphadenectomy for penile cancer. Methods From April 2012 to August 2014， 14 patients with squamous cell carcinoma of the penis receiving simultaneous bilateral laparoscopic inguinal lymphadenectomy were enrolled. The perioperative results and followup data were analyzed. Results The operations were successfully performed in all patients. The mean operative time was 112 min. The mean blood loss was 47 ml. The mean hospital duration was 10 d. The mean number of lymph nodes was 9.1. One patient had fever and there was seroma in his right limb after operation but he got recover soon. The other patients had no complications. Followup ranged from 2 to 48 months， there was no evidence of recurrence and metastasis. Conclusion Simultaneous bilateral laparoscopic inguinal lymphadenectomy is a safe and effective technique. It leads to less intraoperative blood loss， less hospitalization duration， less postoperative complications and quick postoperative recovery.

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Clinical observation of lobaplatin versus cisplatin combined with etoposide in the treatment of extensive-stage small cell lung cancer

WANG Jun， WANG Jianzhong， ZHANG Changchun， YANG Yong， LUO Yi

Chinese Clinical Oncology. 2015, 20 (2): 168.

Abstract ( 1120 )

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Objective To investigate the therapeutic effect， long term survival and side effects on small cell lung cancer（SCLC） patients treated with lobaplatin combined with etoposide. Methods Eighty-five patients with extensivestage SCLC were retrospectively analyzed. Among these patients， 85 patients were assigned to EL group（etoposide 80 mg／m²， d1-d5+lobaplatin 30 mg／m²， d₁； 21 days as a cycle； n=42） and EP group（etoposide 80 mg／m²， d1-d5+cisplatin 25 mg／m²， d₁-d₃； 21 days as a cycle； n=43）. Efficacy and toxicities were evaluated after 2 or more cycles.
ResultsThe overall response rate were 59.5％ and 53.5％， and the disease control rate were 80.9％ and 76.7％ in EL group and EP group without significant difference（P＞0.05）. The median progression free survival of EL group was 6.5 months， higher than 4.5 months in EP group with significant difference（P＜0.05）. There were higher incidences of thrombocytopenia but lower incidence of nausea and vomiting and liver and kidney impairment in EL group versus EP group（P＜0.05）. Conclusion Compared with the EP regimen， the EL regimen can prolong the median progression survival and reduce gastrointestinal toxicity.

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Clinical analysis of cervical cancer with skin metastasis in 5 patients

NA Renhua，ZHANG Yunxia， Gulina Kuerban.

Chinese Clinical Oncology. 2015, 20 (2): 171.

Abstract ( 1091 )

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Objective To explore the clinical features， treatment and prognosis of cervical cancer patients with skin metastasis. Methods From June 2006 to June 2011， 574 cervical cancer patients were treated in our hospital， in which 5 cases was diagnosed as cervical cancer with skin metastasis. The clinical， pathological and followup data of 5 patients were collected and their clinical features, treatment and prognosis were analyzed. Results The incidence rate of cervical cancer with skin metastasis was 087％（5/574）， with stage ⅡA to ⅢB. Among them， 4 cases were diagnosed during the followup of cervical cancer. One patient was diagnosed after resection in her first hospitalization. There were 4 patients with pulmonary， skeletal and other sites of metastasis. Four patients skin lesions were excised completely including 1 patient underwent radionuclide therapy because of multiple bone metastases and bone pain， one patient received systemic chemotherapy， 2 patients received only supportive and symptomatic treatment. One patient couldnt receive complete excision because of metastatic lesions invading skull scalp inward， diagnosed by puncture examination，and underwent conformal intensity modulated radiotherapy. During the followup， 3 patients died, 2 patients still alive.Conclusion Cervical cancer with skin metastasis occurs at a low rate， usually combined with other organs'metastases， and its efficacy and prognosis is poor.

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Research progress on treatment of sorafenib for Chinese patients with advanced hepatocellular carcinoma

GONG Xinlei， QIN Shukui.

Chinese Clinical Oncology. 2015, 20 (2): 175.

Abstract ( 1117 )

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Primary liver cancer is a very common malignant tumor with especially higher incidence in China， very tough treatment and poor prognosis， which mainly consisted of hepatocellular carcinoma （HCC）. The pathogenesis， clinical features， biological behavior， prognosis and treatment selection in Chinese patients are markedly different from those patients in western countries. It is of great significance to explore reasonable treatment strategies of Chinese population. Sorafenib is an oral， multi-targeted， multi-kinase inhibitor， which has been proved to prolong the survival of patients with advanced HCC by large scale， international clinical studies. Sorafenib has been used in China for more than 6 years and demonstrated its good efficacy and safety. However， there are many shortcomings of it. Recently， the domestic scholars have carried out many clinical studies of sorafenib monotherapy and in combination with other drugs or methods to improve its efficacy. This paper comprehensively reviews current situation and progress of related studies.

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Current status and progress of perioperative treatment of esophageal cancer

JIANG Yubo， ZHAO Chuanhua， LI Shanshan， WANG Yan， XU Jianming.

Chinese Clinical Oncology. 2015, 20 (2): 185.

Abstract ( 1101 )

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Esophageal cancer is a highly lethal and aggressive gastrointestinal cancer nationwide. Esophageal squamous cell carcinoma（SCC） is endemic in Asian countries， while adenocarcinoma is more common in western countries. In China， SCC accounted for 95％ of esophageal carcinoma. Surgery is the main treatment method for esophageal cancer. However， the results of surgery alone have been dissatisfactory， with survival rates of approximately 30％ at 5 years. So， new combinations of different protocols have been investigated by many trials. According to accurate preoperative staging， stage Ⅰ and ⅡA esophageal cancer is suitable for direct surgery， while stage ⅡB and Ⅲ should be primarily treated with neoadjuvant chemotherapy or chemoradiation followed by surgery. Adjuvant treatment maybe helpful to improve the outcomes of patients， but it still needs further studies. Furthermore， molecular targeted therapy and predictors for neoadjuvant treatment are increasingly becoming research hotspots of esophageal cancer.

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标准刊号：	ISSN 1009-0460
	CN 32-1577/R