Objective To introduce the research progress in the effect of chemotherapeutic resistance of metabolic enzymes of gemcitabine to pancreatic cancer.Methods Recent literatures about metabolic enzymes that played key roles in mediating gemcitabine chemotherapeutic resistance of pancreatic cancer were collected and reviewed. Results The metabolic enzymes of gemcitabine, such as hENT1, dCK, RRM1 and CDA, were closely related to chemotherapeutic resistance of pancreatic cancer. The relationship between the single nucleotide polymorphism of metabolic enzymes and the resistance to gemcitabine remained to be clarified. Conclusion Multiple factors are involved in the mechanism of chemotherapeutic resistance of pancreatic cancer to gemcitabine, which needs further research.
ObjectiveTo observe the effect of systemic chemotherapy on conditions of tumor infiltrating,metastasis and disease-specific survival (DSS) for advanced retinoblastoma (RB). MethodsForty-one patients with advanced RB who received enucleation were enrolled in this study. There were 26 males and 15 females, age at diagnosis was ranged from 2 to 72 months, with a mean of 23.08 months. There were 16 bilateral patients and 25 unilateral patients; 13 group D eyes and 28 group E eyes. 16 patients received enucleation as the primary treatment (operation group), 25 eyes received chemotherapy before enucleation (chemotherapy group). There was no significant statistical difference between two groups for the gender, unilateral and bilateral, international staging or diagnostic age (P>0.05). The histopathology report was performed to assess the risk of postoperative tumor-node-metastasis staging (pTNM) in each patient, and the extent of tumor invasion in the optic nerve, choroid and anterior chamber was divided into 3 levels of low risk, medium risk and high risk. Five deaths were all in the group E with chemotherapy before enucleation. Using R software survival analysis software package survfit function, the application of Kaplan-Meier estimation method, DSS of RB children was calculated from the time of diagnosis, up to the date of the death of patient. DSS differences between chemotherapy, operation group and eye removal time (more than 3 months, less than 3 months) in group E RB children were analyzed. ResultsThe proportion of high risk pTNM stage in chemotherapy group was significantly lower than the operation group. But there was no significant difference between the two groups in the overall risk classification (χ2=3.130,P=0.077). For group D eyes, the overall risk classification in chemotherapy group was significantly lower than the operation group (χ2=5.870,P=0.015). There was no significant difference between the two groups in the overall risk of group E eyes (χ2=0.020,P=0.889). The DSS in chemotherapy group and operation group were 0.71 and 1.00, respectively; the difference was significant (χ2=3.700,P=0.05). The DSS in children whose enucleation delayed for more than 3 months and children whose enucleation performed within 3 months were 0.64 and 1.00, respectively; the difference was significant (χ2=4.800,P=0.028). ConclusionSystemic chemotherapy did not reduce the risk of tumor invasion and metastasis in patients with advanced RB. Instead, it will reduce the DSS in group E eyes of RB.
ObjectiveTo establish multidrugresistance cell substrain of human hepatocellular carcinoma and to investigate its characteristics.MethodsSMMC7721 cell strain was cultured in Adriamycin(ADM). The multidrugresistance cell substrain SMMC7721/ADM was harvested after a long period of culture by gradually increasing the concentration of ADM and its characteristics were investigated. Results①The drug resistance of SMMC7721/ADM to ADM increased by 33.3 times, to Vincristine 16.8 times, to Diamminedichloroplatinum 2.8 times. ②The drug resistance cell substrain had almost the same growth velocity as its parental generation. The doubling time was 32.0 hours and 30.5 hours respectively. They had the analogous growth curves. ③The obvious difference between the drug resistance cell substrain and its parental generation was that the former’s microvilli became thick, short and scattered by scanning and transmitting electron microscopy. ④The multidrug resistance cell substrain kept the characteristics of hepatocellular carcinoma, it could be transplanted into the subcutaneous tissue of nude mice. ⑤The drug resistance of the cell substrain reduced to 28.0% and 9.2%after removal of the drug for 1 month and 2 months respectively, its drug resistance could remain stable (35.4 times) after 2 months of culture in ADM (0.04 μg/ml).ConclusionThe SMMC7721/ADM cell substrain has the stable fundamental characteristics of a drug resistance cell strain.
Objective To evaluate the clinical efficacy and safety of hyperthermia combined with radiotherapy and chemotherapy (HRCT) for non-small cell lung cancer (NSCLC), so as to provide references for further clinical practice and research. Methods The databases such as The Cochrane Library, PubMed, EMbase, CBM, CNKI, VIP and WanFang Data were searched on computer from the date of their establishment to May 1st of 2011, and other sources as supplied were also retrieved to collect all the relevant randomized controlled trials (RCTs) on comparing HRCT with non-HRCT. The quality of the included trials was assessed according to the Cochrane Handbook 5.1 for Systematic Review and the features of this study as well. Meta-analyses were conducted by using RevMan 5.1 software. Results A total of eight RCTs involving 546 patients were included. The results of meta-analyses showed that: a) Total effective rate: The total effective rate of HRCT was higher than other non-HRCT therapies, and there were significant differences in HRCT compared with radio-chemotherapy, hyperthermia plus chemotherapy, and pure chemotherapy, the OR and 95%CI were 2.05 (1.18, 3.56), 3.41 (1.12, 10.38), and 6.11 (1.20, 31.16), respectively; and b) Safety evaluation: The incidence rates of radiation pneumonitis, radiation esophagitis and granulocytopenia were all lower in the HRCT group than that in the radio-chemotherapy group, but the significant differences were only found in the incidence rate of granulocytopenia (OR=0.34 (0.19, 0.59). Conclusion Compared with other therapies, HRCT tends to improve the clinical efficacy and safety for NSCLC, but this result needs to be proved by more clinical trials. HRCT is superior to the routine radio-chemotherapy in both efficacy and safety, but the relevant evidence for proving its long-term efficacy and safety is still required.
ObjectiveTo evaluate the clinical efficacy of shenfu injection in reducing the side effects of chemotherapy in patients with cancer. MethodsWe searched Medline, PubMed, EMbase, VIP, Chinese science and technology periodical database full text database, China journal full database, Chinese biomedical literature database, and WANFANG database the durationi was from January 1994 to May 2013 for controlled trials about the use of shenfu injection to reduce the side effects of chemotherapy, without any language limitations. The quality of literature was evaluated by Jadad rating scale, and the included trials were analyze for systematic review. ResultsA total of 30 articles were included, and all of them were from Chinese literature. There were altogether 2039 cases. Compared with single chemotherapy group, the normal rate of white blood cells [RR=1.54, 95%CI (1.28, 1.84), P<0.0000 1], hemoglobin [RR=1.30, 95%CI (1.14, 1.48), P<0.000 1], platelet [RR=1.39, 95%CI (1.19, 1.62), P<0.000 1], and the number of patients without vomiting or sickness [RR=1.54, 95%CI (1.30, 1.81), P<0.0000 1] in the shenfu treatment group were all significantly higher. The life quality of the shenfu treatment group was also obviously better than the single chemotherapy group. ConclusionCompared with single chemotherapy, shenfu injection can reduce the peripheral blood cell reduction, gastrointestinal reaction and improve the patients' quality of life. Because the quality of included studies in this research is generally low, it is necessary to design a more reasonable and strict experiment with a large sample to get an exact conclusion.
Objective To analyze the efficacy and safety of Intra-arterial chemotherapy (IAC) as secondly treatment in children with retinoblastoma (RB). Methods 42 eyes of 34 consecutive RB patients were enrolled in the study after intravenous chemotherapy (IVC), including 26 males and 8 females. The average age is 14.1 months. 21 cases were bilateral and 7 cases were unilateral. A total of 42 eyes of 34 patients were classified according to the International Intraocular Retinoblastoma Classification（IIRC）as group B(n=1, 2.4%), group C (n=3, 7.1%), group D (n=32, 76.2%), or group E (n=6, 14.3%). Tumor recurrence and tumor enlargement after IVC were 4 and 10 eyes respectively, accounting for 9.0% and 24.0% respectively. Sequential treatment after IVC followed by IAC were 28 eyes, accounting for 67.0%. All treatment eyes received IAC combined with laser, cryotherapy and other eye local treatment. The IAC regimen adopted the combination and alternation administration mode, by the combination of melphalan and carboplatin or the combination of melphalan and topotecan. According to the tumor changes after IAC decide whether IAC again. If tumors increased, vitreous or subretinal implants increased will be termination of IAC and enucleation. The mean follow-up time was (21.4±3.7) months after the last IAC treatment and (6.2±2.9) months after enucleation. Ocular preservation rate and complication were evaluated. Results The average IAC procedures performed on 42 eyes were (4.0±0.9). An overall ocular preservation rate of 76.2% was observed during follow-up periods due to calcification or inactivation of tumors (32 eyes), including group B (n=1, 100%), group C (n=1, 33.3%), group D (n=27, 84.4%), group E (n=3, 50%). 10 eyes were enucleated. Among them, 2 eyes of the tumor did not shrink after IAC, tumor recurrence (n=3), vitreous hemorrhage (n=3), enophthalmos (n=1), vitreous disseminated (n=1). 34 cases of children, transient eyelid oedema were 18 cases, vitreous hemorrhage and bone marrow suppression (Ⅰ-Ⅳ) were 1, 22 casese respectively. Conclusions IAC as secondly treatment is safe and effective for RB patients, however, there is still tumor recurrence. No serious ocular local and systemic complications were observed.
Objective To evaluate the effect of the allied chemotherapy with 5-Fu、leucovorin (CF) and levamisole (LV) after resection of colorectal cancer. Methods 242 cases were divided randomly into three groups. 80 cases (group Ⅰ) were treated with 5-Fu and CF. 80 cases(groupⅡ) were treated with 5-Fu and LV. 82 cases (group Ⅲ) were treated with 5-Fu、CF and LV. Results The recurrence rates of group Ⅲ was 12.20%, which was significantly lower than that of group Ⅰ (26.25%) and group Ⅱ(27.50%). (P＜0.05). The 5-year survival rates in group Ⅰ, group Ⅱ and group Ⅲ were 37.50%, 35.00% and 58.54%, respectively, the highest one was in Group Ⅲ (P＜0.01). Conclusion The allied chemotherapy with 5-Fu、CF and LV is an effective therapy for petients of colorectal cancer after surgery, which can significantly decrease the recurrence and improve the 5-year survival rate.
ObjectiveTo investigate the predictive value of thyroid transcription factor-1 (TTF-1) in the treatment of advanced lung adenocarcinoma with different chemotherapy regimens.MethodsA total of 126 patients with advanced lung cancer were divided into three groups according to the chemotherapy regimen, namely a pemetrexed+nedaplatin group (PEM+NDP group), a pemetrexed+cisplatin/carboplatin group (PEM+DDP/CBP group) and a third-generation (3G) chemotherapy+cisplatin/carboplatin group (3G agent+DDP/CBP group). The predictive value of TTF-1 in the above three treatment regimens was analyzed. The patients were followed up by telephone or outpatient visit until April 2017.ResultsThere were no significant differences in disease control rate or objective response rate between the three different chemotherapy regimens (all P>0.05). The survival rate of PEM+NDP group was significantly higher than that of PEM+DDP/CBP group and 3G agent+DDP/CBP group (9.68%vs. 5.56% and 6.80%, both P<0.05). ECOG score and brain metastasis were independent risk factors for the prognosis of chemotherapy regimens. TTF-1 was an independent risk factor for PEM+NDP therapy.ConclusionTTF-1 is an independent risk factor for PEM+NDP chemotherapy, but not for 3G agent + DDP/CBP or PEM+DDP/CBP regimens.
Lung cancer ranks first in the incidence of malignant tumors in China, which is seriously harmful to people’s life and health. Chemotherapy is an effective treatment for lung cancer, and it is also an important cause of cognitive dysfunction. Cognitive impairment is usually evaluated by subjective assessment, neuropsychological testing and neuroimaging research. The mechanism of cognitive impairment in patients with lung cancer caused by chemotherapy may include the accumulation of a large amount of endogenous tau protein in hippocampus, the induction of hippocampal neuroinflammation, and the direct killing effect of drugs on nerve cells. There is no effective treatment for chemotherapy-related cognitive impairment (CRCI), but current studies have found that cognitive education in the form of mind map, diet regulation, physical exercise and caring therapy may contribute to the improvement of cognitive function of lung cancer patients after chemotherapy. Based on the current research results, this article provides new ideas for the research and treatment of lung cancer patients with CRCI in terms of clinical characteristics, evaluation methods, influencing factors, mechanism and prevention strategies.
Objective To establish a scoring system for patients withnon-small cell lung cancer (NSCLC), complicated by chemotherapy and myelosuppression based on Logistic regression analysis. Methods The clinical data of patients with lung cancer who received chemotherapy in our hospital from January 2018 to April 2024 were collected. The influencing factors of chemotherapy complicated with myelosuppression were analyzed by univariate and Logistic regression, and a nematographic model was established. Results Compared with non-myelosuppressive group, there were statistically significant differences in pre-chemotherapy leukocyte, pre-chemotherapy hemoglobin, ECOG score, use of platinum drugs, use of anti-metabolic drugs, use of anti-microtubule drugs in myelosuppressive group (P<0.05). WBC<4.0×109/L (OR:4.166, 95%CI: 1.521~11.410), hemoglobin<110g/L (OR: 6.926, 95%CI: 1.817~26.392), ECOG score ≥2 points (OR: 2.235, 95%CI: 1.032~4.840), platinum drugs (OR: 5.738, 95%CI: 2.514~13.097), anti-microtubule drugs (OR: 4.284, 95%CI: 1.853~9.905) and anti-metabolic drugs (OR: 7.180, 95%CI: 2.608~19.769) was an independent risk factor for chemotherapy complicated with myelopathic depression in lung cancer patients (P<0.05). Model verification results showed that the C-index was 0.817 (95%CI: 0.783~0.851), the calibration curve of the model was close to the ideal curve, and the AUC of the ROC curve was 0.811 (95%CI: 0.780~0.842), which showed a net benefit of the model within the range of 10% to 87.5%. Conclusion The constructed nomogram model can effectively predict the risk of chemotherapy complicated with myelosuppression in non-small cell lung cancer patients.