Objective To evaluate the effectiveness and safety of nedaplatin combined with chemotherapy versus cisplatin combined with chemotherapy for advanced non-small cell lung cancer (NSCLC). Methods The randomized controlled trials (RCTs) on nedaplatin combined with chemotherapy versus cisplatin combined with chemotherapy for advanced NSCLC were searched in The Cochrane Library, PubMed, EMbase, CBM, VIP and WanFang Data from the date of their establishment to January 2012. According to the inclusion and exclusion criteria, two reviewers independently screened the studies, extracted the data and assessed the quality. Then RevMan 5.0 software was used for meta-analysis. Results A total of 15 RCTs involving 1 076 patients were included. The results of meta-analysis showed that, compared with the cisplatin combined with chemotherapy, nedaplatin combined with chemotherapy could reduce the risks of nausea and vomiting (RR=0.56, 95%CI 0.48 to 0.65, Plt;0.000 01), decrease the risk of renal function impairment (RR=0.47, 95%CI 0.30 to 0.74, P=0.001), but increase the risk of thrombocytopenia (RR=1.59, 95%CI 1.20 to 2.11, P=0.001). There were no significant differences between the two groups in objective response rate (ORR) (RR=1.09, 95%CI 0.92 to 1.29, P=0.03), leukopenia (RR=1.05, 95%CI 0.92 to 1.19, P=0.50), and hemoglobin reduction (RR=0.92, 95%CI 0.80 to 1.07, P=0.30). Conclusion Compared with cisplatin combined with chemotherapy for advanced NSCLC patients, nedaplatin in combination with chemotherapy can significantly reduce the risks of nausea, vomiting and renal function impairment. Although the ORRs are similar in the two groups, nedaplatin combined with chemotherapy can cause a higher risk of thrombocytopenia. For the quality restriction and possible publication bias of the included studies, more high quality RCTs are required to further verify this conclusion.
Objective To systematically evaluate the clinical effectiveness and safety of raltitrexed plus cisplatin in the treatment of malignant pleural mesothelioma (MPM) when compared with other chemotherapy regimens. Methods We electronically searched PubMed, Embase, The Cochrane Library and Chinese Biomedicine Database to March, 2007. Randomized controlled trials (RCTs) and quasi-RCTs were identified, and Revman 4.2.10 was applied for statistical analyses. Results One RCT involving 250 patients was included, which compared raltitrexed plus cisplatin versus cisplatin alone in the treatment of MPM. In the intention-to-treat population, the median survival time was statistically longer in the raltitrexed plus cisplatin group as compared to cisplatin alone group. (11.4 versus 8.8 months, P=0.048). The incidence of grade 3/4 toxicities was similar between the two groups. Conclusion The current evidence available showed that, the combination of raltitrexed and cisplatin may prolong the survival time for MPM patients, with a low incidence of grade 3/4 toxicities. However, more high-quality RCTs are required to further define its clinical effectiveness.
【摘要】 目的 采用循证医学的方法评价甘露聚糖肽联合顺铂对比单用顺铂治疗恶性胸腔积液的有效性和安全性。 方法 计算机检索中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊全文数据库、万方数据库，收集甘露聚糖肽联合顺铂对比单用顺铂治疗恶性胸腔积液的随机对照试验，检索时间为各数据库建库至2011年3月。对文献进行质量评价，用RevMan 5.0软件对数据进行Meta分析。 结果 共纳入6项研究，所有文献质量均为C级。共收入388例患者，Meta分析结果显示甘露聚糖肽联合顺铂组与单用顺铂组相比，总有效率前者高于后者，差异有统计学意义（Plt;0.05）；消化道不良反应发生率两组组间差异无统计学意义（P=0.05）；骨髓抑制发生率前者低于后者，差异有统计学意义（Plt;0.05）；Karnofsky评分提高率前者高于后者，差异有统计学意义（Plt;0.05）。 结论 系统评价表明，甘露聚糖肽联合顺铂治疗恶性胸腔积液的疗效优于单用顺铂的方案。【Abstract】 Objective To assess the clinical efficacy and safety of mannatide plus cisplatin treating malignant pleural effusion. Methods Literatures were retrieved from CBM, VIP, CNKI, Wanfang databases by computer. Literatures were enrolled according to inclusion and exclusion criteria, and the quality of studies was evaluated according to the Cochrane Library handbook. The period duration of searching was between the establishment of the databases and March, 2011. Meta-analysis was conducted by RevMan 5.0 software. Results The meta-analysis of 6 included RCT, all ranked C, which involved 388 patients. The Meta-analysis showed that the total effective rate in mannatide plus cisplatin group significantly differed from that in cisplatin group (P＜0.05). There were no significant difference in the adverse reaction of digestive tract between the two intervention groups (P=0.05). The adverse reaction of marrow depression inmannatide plus cisplatin group was much lower than that in cisplatin group (P＜0.05). The increase of KPS in mannatide plus cisplatin group was higher than that in cisplatin group (P＜0.05). Conclusions The analysis indicates mannatide plus cisplatin has a better effect on malignant pleural effusion than single cisplatin. However, the reliability of this review is affected by poor quality of included studies, and large-scale randomized controlled trials of high quality are needed to confirm the conclusions above.
目的:研究TRAIL对卵巢癌COC1/DDP细胞生长的影响，以及化疗药物DDP等对TRAIL受体（DR4、DR5）表达的影响，揭示TRAIL与COC1/DDP细胞顺铂耐药性的关系。方法:用MTT法检测不同浓度TRAIL蛋白和TRAIL与DDP联合用药对COC1/DDP细胞生长的影响，用RTPCR方法检测DDP对TRAIL受体（DR4、DR5）表达的影响。结果:①TRAIL蛋白对COC1/DDP细胞生长有抑制作用，且随着TRAIL蛋白浓度升高，细胞抑制率逐渐上升。②DDP（2.5μg/mL）对COC1/DDP细胞生长抑制作用较弱（抑制率为3.31%），DDP在加入TRAIL蛋白后对细胞生长抑制率显著升高（Plt;0.05）。③DDP使COC1/DDP细胞的DR5表达水平显著增强为正常对照组的3.54倍（Plt;0.001）。结论:TRAIL蛋白对COC1/DDP细胞生长有抑制作用，DDP与TRAIL联合使用COC1/DDP细胞生长抑制更明显，TRAIL可逆转COC1/DDP细胞对DDP的耐药性，耐药性的逆转可能与DDP导致TRAIL受体DR5水平增高促进了肿瘤细胞的凋亡有关。
Objective To observe the effect of cisplatin in bletilla hyacinthine particle chemotherapy combined with 125I brachytherapy on short-and long-term outcomes and the toxic and side effects in advanced gastric cancer. Methods One hundred seventy-six patients with stage Ⅱ or stage Ⅲ advanced gastric cancer underwent curative surgical resection were included in this study. They were randomly divided into brachytherapy and chemotherapy group (n=48), intraperitoneal chemotherapy group (n=32) and intravenous chemotherapy group (n=48), and other patients who abandoned radiotherapy and chemotherapy and signed informed consent form by themselves were considered as control group (n=48). The short-and long-term outcomes and the toxic and side effects were observed and the survival of all patients was analyzed by Kaplan-Meier method and Log-Rank test. Results For short-term outcomes, the total effective rate in 4 groups were 95.83%, 71.88%, 64.58% and 52.08% respectively, and the difference was significant (Plt;0.05). For long-term outcomes, the 3 -and 5-year mortality rate was 37.50% and 56.30%, and 5-year median survival time was (14±4.51) months (95%CI: 14.419-4.512) in brachytherapy and chemotherapy group patients. The 3- and 5-year mortality rate was 78.12%and 93.75%and 5year median survival time was (10.6±1.13) months (95%CI: 10.620-1.163) in intraperitoneal chemotherapy group patients. The 3-and 5-year mortality rate was 79.21%and 95.80%and 5-year median survival time was (11±3.10) months (95%CI: 11.130-3.162) in intravenous chemotherapy group patients. The 3-and 5-year mortality rate was 87.50%and 95.83% and 5-year median survival time was (9±2.30) months (95%CI: 10.024-1.180) in control group patients. Compared with the vein chemotherapy group, the short distance puts the chemotherapy group disgusting vomit, the marrow to suppress, the liver function harm, the kidney function harm formation rate to reduce obviously (Plt;0.05). Conclusion Cisplatin in bletilla hyacinthine particle chemotherapy combined with 125I brachytherapy can reduce the toxic and side effects of drugs and prolong survival time of patients with advanced gastric cancer.
To study the effect of intraperitoneal hyperthermic double distiled water and cis-diamminedichloro-platinum(DDP) perfusion to the peritoneal cancerous ascites,intraperitoneal injection of H22 cancer cells (2×107 tumor cell,each mouse) were performed in LACA mice. Five days after cancer cells injection, intraperitoneal perfusion of simple hypertherrnic (43℃) double distiled water(group Ⅰ) isotonic fluid (group Ⅱ ). DDP (group Ⅲ ), and hypertherrnic double distiles water perfusion combined with DDP (guoup Ⅳ ) were performed .The results showed that cancer cells in the peritoneal cavity of LACA mice were seriously damaged, the production of ascites was markedly inhibited and the survival days of LACA mice were prolonged in all groups . .The intraperitoneal hyperthermic double distilled water perfusion with DDP group showed more effective result as compared with the other groups,Only 1 peritoneal implanted dissemination was found after treatment in this group,Basing on the experimental from September 1991 through September 1993,intraperitoneal hyperthermic double distiled water perfusion with DDP was used to treat 32 advanced gastric cancer patients after radical gastrectomy with satisfactory results.
Forty-six patients with advanced gastric cancer were investigated. 25 patients were randomized to receive intraperitoneal hyperthermic (43℃) hypotonic perfusion with high dose cis-diamminedichloroplatinum (60-200mg/m2 body surface) and sodium thiosulfate intraveneously (7.5g/m2 body surface). The time of the intraperotineal perfusion was 30 minutes with the total volume of the perfusate of 2500-3000ml. 21 patients were only operated. The sex ,age macro-or microscopic serosal invasion, and histologic type of two groups were similar and comparatible. We found no cancer cell in nine paients with positive intraperitoneal free cancer cell in the treated group. The postoperative 1-year survival rate of patients in the treated group (96.00%) was significantly higher than that of the random control group (48.54%), Ｐ＜0.01. The postoperative 1 1/2year survival rate in the treated group (68.88%) was also higher than that of the control group (40.00%), however, with no significant difference (Ｐ＞0.05). No serious myelosuppression, kindley,liver, and peripheral nerve damage, and other complications were found. The results indicated that this therapy is reasonably safe and could be a prophylactic theapy for the peritoneal recurrence after radical gastrectomy, which should be further investigated.
Objective Non-small cell lung cancer ( NSCLC) cells are relatively resistant to chemotherapy, and the outcomes are not always satisfactory. This study was designed to explore the relationship between the content of Ku80 protein of human lung cancer cells and their sensitivity to cisplatin.Methods The lung cancer cells isolated frommalignant pleural effusion samples frompatients with primary lung cancer were cultured in vitro. The sensitivity to cisplatin was tested with the method of CCK-8 expressed as half maximal inhibitory concentration ( IC50 ) . The relative content of Ku80 protein was determined by Western blot. The correlation between sensitivity to cisplatin of lung cancer cells and the relative content of Ku80 protein was analyzed. Results The IC50 of NSCLC group was significantly higher than that of SCLCgroup [ ( 4. 40 ±3. 39) mg/L vs. ( 1. 02 ±0. 54) mg/L, P lt; 0. 001] . The relative content of Ku80 protein of NSCLC group was statistically higher than that of SCLC group [ ( 0. 80 ±0. 45) vs. ( 0. 48 ±0. 25) , P lt;0. 05] . The correlation coefficient between content of Ku80 protein and IC50 was 0. 618 ( P lt; 0. 001) .Conclusions The content of Ku80 protein of NSCLC patients is higher than that of SCLC patients. Itmay be one of the mechanisms contributing to chemotherapeutic resistance of NSCLC. There is a negative relationship between Ku80 protein content of cancer cells and their sensitivity to cisplatin suggesting that the content of Ku80 protein may be served as a candidate index for predicting sensitivity of lung cancer cells to cisplatin.
Objective To observe the influence of cisplan on the expression of B7-H1 in retinoblastoma (RB) cells，and to investigate its mechanism. Methods Human RB cell line HXO-Rb44 cells were treated by 6 different concentrations of cisplan (0.000, 0.375, 0.750, 1.500, 3.000, 6.000 mu;g/ml), and their B7-H1 mRNA expression was determined by the reversetranscription polymerase chain reaction (RT-PCR) and fluorescence quantitative PCR (FQ-PCR); the B7-H1 protein expression was determined by immunofluorescence and flow cytometry. HXO-Rb44 cells were treated by 1.5 mu;g/ml cisplan for 0, 15, 30, 60, 120 min, then the phosphorylation of extracellular signal-regulated kinase 1/2 (ERK1/2) was detected by Western blot.Results The expression of B7-H1 mRNA and protein in the 0.375, 0.750, 1.500, 3.000, 6.000 mu;g/ml group were significantly higher than that of the blank control group (F=395.478，112.03; P=0.000）. Western blot showed that cisplan (1.5 mu;g/ml) could activate ERK1/2 by increasing its phosphorylation in HXO-Rb44 cells. After cisplan treatment, the phosphorylation of ERK1/2 increased gradually and reached its peak at 30 min, and then went down gradually.Conclusion Cisplan can promote the expression of B7-H1 and activate ERK1/2 in RB cells.