Objective To assess the effectiveness and safety of nedaplatin combined with 5-fluorouracil (5-Fu) for advanced esophageal cancer. Methods Such databases as PubMed, The Cochrane Library, EMbase, CBM, CNKI, VIP and WanFang Data were searched from the date of their establishment to May 4th, 2012 to collect the randomized controlled trials (RCTs) about nedaplatin combined with 5-Fu versus cisplatin combined with 5-Fu for advanced esophageal cancer. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data and assessed the quality of the included studies. Then meta-analysis was conducted using RevMan 5.1 software. Results A total of 15 RCTs invloving 863 patients were included. The results of meta-analysis suggested that, compared with cisplatin combined with 5-Fu, nedaplatin combined with 5-Fu could improve short-term effects (RR=1.31, 95%CI 1.14 to 1.52, P=0.000 2) and reduce gastrointestinal reaction and renal function impairment, but it was associated with aggravated myelosuppression, increase of thrombocytopenia and leukopenia, and decrease of hemoglobin. There were no significant differences between the two groups in liver function impairment, diarrhea and peripheral neurovirulence. Conclusion Nedaplatin combined with 5-fluorouracil can increase short-term effects and reduce gastrointestinal reaction and renal function impairment. However, nedaplatin is associated with aggravated myelosuppression, so it should be applied in clinic with cautious. Nedaplatin combined with 5-fluorouracil can be used as a replacement chemotherapy regimen for advanced esophageal cancer, but the evidence about long-term effects and safety is still required. For the quality and quantity limitation of the included studies which decreases the level of evidence, so the conclusion of this systematic review only provides some references for clinical practice and research.
Objective To investigate the patient’s psychological anticipation and occurrence of chemotherapy-induced nausea and vomiting (CINV), and to assess the influence of CINV on quality of life, so as to provide evidence for clinical doctors to recognize and pay attention to CINV. Methods The patients in the Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology who took either moderately emetogenic chemotherapy (MEC) or highly emetogenic chemotherapy (HEC) were randomly sampled with a questionnaire for two circles. Patients were asked to record the following indexes before chemotherapy, on the second day and the sixth day of chemotherapy: acute and delayed nausea and vomiting, independently taking antiemetics, and functional living index-emesis (FLIE). Then, descriptive analysis and multiple linear regression analysis were adopted for the outcomes of investigation. Results A total of 344 patients were investigated, of which 303 fulfilled the questionnaire finally. For the single-day chemotherapy, the acute nausea and vomiting, delayed nausea vomiting and overall complete remission in the MEC group were 86.1%, 76.6%, and 71.5%, respectively; while those of the HEC group were 84.1%, 71.0%, and 66.7%, respectively. For the multi-day chemotherapy, the acute nausea and vomiting, delayed nausea vomiting and overall complete remission were 93.8%, 64.9%, and 64.9%, respectively. Patients’ expectation of nausea and anticipatory anxiety was closely related to the delayed nausea in their prior circle of chemotherapy. Based on the FLIE assessment, about 30% of all patients reported reduced daily living function. Conclusion CINV remains a significant problem among patients in China, especially in controlling the reaction during delayed phase and nausea as well. It requires that more attention should be paid to CINV and more effective prophylaxis should be adopted in clinical practice.
Objective To assess the effectiveness and safety of hyperthermia combined with chemotherapy for advanced colorectal cancer. Methods Databases such as CNKI, VIP, WanFang Data, CBM, EMbase, PubMed and The Cochrane Library (Issue 3, 2012) were electronically searched from the date of their establishment to June, 2012, and the relevant literature and conference proceedings were also manually searched to include randomized controlled trials (RCTs) on comparison of chemotherapy with hyperthermia plus chemotherapy for advanced colorectal cancer. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies. Then the meta-analysis was performed by using RevMan 5.1 software. Results A total of 11 RCTs involving 708 patients with advanced colorectal cancer were included. The results of meta-analysis showed that: a) as for effectiveness, the chemotherapy combined with hyperthermia group was superior to the chemotherapy group in the partial improve rate (OR=1.65, 95%CI 1.39 to 1.97, Plt;0.000 01) and the total effective rate (OR=3.59, 95%CI 2.51 to 5.12, Plt;0.000 01), with significant differences; b) as for safety, the chemotherapy combined with hyperthermia group was lower than the chemotherapy group in the incidence of neurotoxicity (OR=0.50, 95%CI 0.33 to 0.75, P=0.000 8). Conclusion Compared with chemotherapy, chemotherapy combined with hyperthermia can increase partial improve rate and total effective rate and reduce the incidence of neurotoxicity. Due to the limitation of the included studies, large sample size, multicenter, high quality studies are needed to verify the above conclusion. We recommend that chemotherapy combined with hyperthermia therapy could be applied to clinic combining individual conditions of patients.
Objective To compare and evaluate the effectiveness and safety of irinotecan (IRI) versus oxaplatin (OXA), in combination with 5-FU/LV for patients with advanced colorectal cancer. Methods The literature search, study selection and assessment, data collection and analysis were undertaken by two reviewers according to the Cochrane Handbook for Systematic Reviews of Interventions. Randomised controlled trials (RCTs) or quasi-RCTs comparing IRI versus OXA, in combination with 5-FU/LV in the treatment of advanced colorectal cancer were collected. Results Seven studies involving 2107 patients were included. The OXA/5-FU/LV regimen was superior or at least equal to the IRI/5-FU/LV regimen in prolonging overall survival and time to progression. The OXA/5-FU/LV regimen showed a higher response rate and was associated with lower toxicities. Conclusion Compared with IRI, OXA is more appropriate for the treatment of advanced colorectal cancer when combined with 5-FU/LV.
Objective To investigate the sensitivity of 5 kinds of chemotherapeutic drugs on human colorectal cancer in vivo. Methods Xenografts in nude mice were set up by tumor tissues from 9 patients with colorectal cancer and nude mice were divided into 6 groups randomly， receiving saline （control group）， 5-fluorouracil （5-FU group）， doxorubicin（ADM group）， mitomycin （MMC group）， oxaliplatin （LOHP group）， and irinotecan （CPT-11 group）， respectively. The inhibitive rates （IR） of xenografts in 5 groups for each patient were calculated. Results The lowest and highest IR of 5 groups were 23.6% and 54.9% in 5-FU group， 23.7% and 69.5% in LOPH group， 23.6% and 82.6% in CPT-11group， 24.1% and 48.1% in MMC group， 5.8% and 20.7% in ADM group， respectively. The IR exceeded 40.0% in 7 patients of LOHP group， 6 patients of CPT-11 group， 4 patients of 5-FU group， and 1 patient of MMC group， respec-tively. Of 9 patients， the IR exceeded 40.0% to 3 kinds of drugs in 3 patients， to 2 kinds of drugs in 4 patients， the IR didn’t exceed 30.0% to 4 kinds of drug （IR was 82.6% to CPT-11） in 1 patient， and the IR didn’t exceed 31.0% to all 5 kinds of drugs in 1 patient. There were statistical differences on the IR of 5 kinds of drugs （H=24.061 2， P=0.000 1）. IR of ADM group was statistical lower than 5-FU group， MMC group， LOHP group， and CPT-11 group （P＜0.05），but there were no statistical differences between 5-FU group， MMC group， LOHP group， and CPT-11 group （P＞0.05）. Conclusions The xenografts from same patient have different sensitivity to different chemotherapy drugs， and the same chemotherapy drug corresponds to different IR in different patients. The IR of LOHP and CPT-11 are the highest， following by 5-FU and MMC.
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.
Objective To detect the characteristic of multidrug resistance gene products expressions in gastric cancer tissues, including glutathione-s-transferase π (GST-π), P-glycoprotein (P-gp), topoisomerase Ⅱ (Topo-Ⅱ), thymidylate synthase (TS), and multidrug resistance related protein (MRP), and analyze their clinical significance for the therapy of gastric cancer. Methods SP immunohistochemical stain was used to detect GST-π, P-gp, Topo-Ⅱ, TS and MRP expressions in sample of 48 gastric cancer tissues and 10 normal gastric mucosa. And their corresponding clinical data were comprehensive analyzed. Results The expressions of GST-π, P-gp, Topo-Ⅱ, TS and MRP had notable differences between the gastric cancer tissues and normal gastric mucosa (GST-π： P＜0.01； P-gp： P＜0.01； Topo-Ⅱ： P＜0.01； TS： P＜0.05； MRP： P＜0.05). Positive expression rates of GST-π, P-gp, Topo-Ⅱ, TS and MRP in gastric cancer tissues were 72.9% (35/48), 56.3% (27/48), 83.3% (40/48), 41.7% (20/48) and 39.6% (19/48), and positive expression rates of them in normal gastric mucosa were 10.0% (1/10), 0 (0/10), 0 (0/10), 0 (0/10) and 0 (0/10) corresponding. Their positive expression rates were closely relevant to the degree of differentiation (P＜0.01), but not to the patients’ sex, age, tumour site, size of tumour, invasive depth and lymph node metastasis (Pgt;0.05). Conclusions The expressions of GST-π, P-gp, Topo-Ⅱ, TS and MRP in gastric cancer tissues exist obvious heterogeneity. Their overexpression underlie the multidrug resistance of gastric cancer. The joint detection of GST-π, P-gp, Topo-Ⅱ, TS and MRP can be looked as an important symbol for guiding its chemotherapy.
Objective To investigate the effect of recombinant human growth hormone (hGH) on growth situation and bone marrow hematopoietic function in rats under chemotherapy. Methods A total of 136 10-week-old SD rats were included in the study. The rats were randomly assigned into five groups: normal control group (n=8), normal saline control group (NS group, n=32), human growth hormone group (hGH group, n=32), chemotherapeutic drug treated group (CT group, n=32), and chemotherapeutic drug plus hGH treated group (CT+hGH group, n=32). The body weight, bone marrow differential count, and the expression of proliferating cell nuclear antigen (PCNA) in bone marrow were measured before treatment and weekly in four weeks after treatment. Results Weight loss occurred in both CT group and CT+hGH group (P＜0.05), but the weight loss in CT+hGH group was significantly smaller (P＜0.05) on day 7 after treatment. In myeloid morphology, myeloid cell was hypoplastic excessively in CT group, and it was hypoplastic obviously in CT+hGH group on day 7 after treatment. Day 14, weight gain appeared in CT+hGH group, while weight loss remained in CT group; In myeloid morphology, myeloid cell was hyperplastic actively excessively in CT+hGH group, and myeloid karyote count was increased significantly in CT+hGH group (P＜0.05). Day 7, 14 and 21, PCNA positive cells count in CT group was lower than that in hGH group and CT+hGH group (P＜0.05). There was no significant different of every index among normal control group, NS group, and hGH group (Pgt;0.05), except weight between normal control group and hGH group on day 7 (P＜0.05). Conclusion hGH has a protective effect on myeloid hematopoietic function and growth situation in rats after intraperitoneal chemotherapy.
Objective To investigate the relationship between single nucleotide polymorphism (SNP) and therapy response of some conventional chemotherapy drugs in breast cancer, and to explore the value of SNP in guiding individualized treatment. Methods Pub-Medline and Chinese CHKD periodical electronic databases were searched. Representative researches in this field were sorted out and concluded. Results Varied genes related to drug metabolism have SNP phenomenon, which are closely associated with interindividual diversity in drug response. Race, section, environment, and drug-drug or gene-gene interactions may have effect on the association.Conclusion The study on SNP has important application prospect in optimizing the individual drug-delivery. However, the combinatorial analyses of multi-SNPs and multi-genes and the prospective studies with large-scale samples and random controls are still needed.
【Abstract】Objective To analyze the function of BAG3 in antiapoptosis and chemotherapy resistance induction process of pancreatic cancer.Methods The expressions of BAG-3 in pancreatic cancerous tissues of patients with chemotherapy and those without chemotherapy before resection were determined by immunohistochemistry. The expression difference of BAG-3 protein 18 hours after cultured with chemotherapy drugs (concentration of drugs: 5-FU 50 μg/ml, MMC 0.5 μg/ml, EADM 1.5 μg/ml) of 3 pancreatic cancer cell lines （MIACaPa-2, PANC-1, SW1990） was measured through Western blotting method.Results The median positive rate of pancreatic cancer tissue from patients accepted chemotherapy before resection was higher than those not accepted chemotherapy, but there wasn’t significant difference. Eighteen hours after cultured with drugs, the level of BAG-3 of this three cell lines had significant increased compared with control group (P＜0.05). Conclusion Chemotherapy induces elevation of BAG-3 expression of pancreatic cancer. The upregulate of BAG-3 may associate with the chemotherapy resistance induced by drugs.