Nowadays, one of the most challenging aspects of retinoblastoma (RB) therapy is how to control the resistant or recurrent viable vitreous seeds, for which intravenous chemotherapy appears to be ineffective. Recently, intravitreal chemotherapy offers another option to control advanced stage and vitreous seeds of RB, and may be a promising new approach to RB therapy. However, intravitreal injection for RB patients raises considerable controversy due to concerns of possible extraocular extension along the injection route, and should not replace the primary standard of care for bilateral RB or group E eyes of RB. Close follow-up and further studies are needed to determine appropriate indications, to determine the effective drugs and concentrations, to optimize RB therapy protocols and to investigate the relationship between long-term efficacy and toxicities.
ObjectiveTo systematically review the efficacy and safety of crizotinib in the treatment of non-small cell lung cancer (NSCLC).MethodWe electronically searched databases including the Cochrane Library (Issue 5, 2017), PubMed, Embase, China Biology Medicine Database, China National Knowledge Internet Database, VIP Database and Wangfang Data from the establishment to May 2017. The randomized controlled trials (RCTs), non-RCTs, case series and case reports on crizotinib for NSCLC were included. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, assessed the methodological quality of included studies, then make Meta-analysis and descriptive analysis.ResultA total of 15 studies were included, including 4 RCTs, 1 non-RCT, 4 case series and 6 case reports. The results indicated that the progression-free survival time of crizotinib group was 8 months, which was better than chemotherapy group (4.6 months). The results of Meta-analysis showed that the response rate in the crizotinib group was higher than that in the chemotherapy group [RR=2.35, 95%CI (1.59, 3.46), P<0.000 1]. The one year survival rate in the crizotinib group was 74.5%-78.6%. The incidences of adverse reactions including dysopsia, dysgeusia, diarrhea, vomiting, constipation, transaminase lifts, upper respiratory tract infection, edema and dizziness in the crizotinib group were higher than those in the chemotherapy group (P<0.05), while the incidences of adverse reactions including leukopenia, thrombocytopenia, alopecia and fatigue in crizotinib group were lower than those in the chemotherapy group (P<0.05). Subgroup analysis under precision treatment showed the progression-free survival time of anaplastic lymphoma kinase (ALK)-positive group was 8 months, and it was longer than ALK-negative group of 4 months.ConclusionsBased on current evidence, crizotinib is better than chemotherapy for NSCLC. Due to limited quality of the included studies, the above conclusion needs to be verifed by more high quality studies.
Drugs may induce hepatitis B virus (HBV) reactivation (HBV-R). Here we have reviewed the definition and harm of HBV-R, the risk drugs and their underlying mechanism, the influence factors, as well as the early intervention measures. It is shown that multiple drugs, including chemotherapy drugs, immunotherapy drugs, directly acting antivirals, cell therapy, etc., can induce HBV-R by affecting host immunity or directly activating HBV transcription factors. HBV-R could cause severe liver damage, even interruption of treatment of original diseases, affecting the prognosis of patients. Through precisely identifying risk drugs, monitoring the influence factors, and prescribing preventive anti-HBV regimen if necessary, the incidence of HBV-R can be significantly reduced. It is also suggested that clinical physicians should not only pay attention to the early identification and intervention of HBV-R, but also further study the mechanism of HBV-R in depth, especially the underlying mechanism between host, HBV and risk factors. This will help to promote the discovery of more valuable markers for risk prediction and targets for early intervention, and to further reduce the risk of HBV-R and improve the prognosis of patients.
Objective To review the research progress of the treatment of osteosarcoma, and to thoroughly understand its current state of research and prospect so as to lay a sol id foundation for the cl inical treatment. Methods The cl inical and experimental research l iteratures about treatment of osteosarcoma were extensively reviewed and analyzed. Results The present treatment of osteosarcoma is still need to comprehensive therapy which combine chemotherapy and surgical treatment. There are some progresses in gene therapy and molecular targeting therapy which can improve survival rate. Furthermore, well-designed studies and cl inical trials are needed to evaluate the potential therapeutic impact before they are used in cl inical. Conclusion Advancement in chemotherapeutic regimens has improved survival and l imb-sparing surgery in the treatment of osteosarcoma, but the progress of gene therapy and molecular targeting therapy gives new hope for osteosarcoma patients.
Primary vitreoretinal lymphoma (PVRL) is a rare type of non-Hodgkin's lymphoma with poor prognosis and the optimal treatment has yet to be determined. Its treatment has evolved from enucleation to ocular radiotherapy, systemic chemotherapy and intravitreal chemotherapy. Radiotherapy can effectively eradicate tumor cells but ocular recurrences are common. Systemic chemotherapy has become the mainstream option but there are problems with only-partial response of PVRL and high rate of recurrence. Intravitreal chemotherapy, primarily used as adjunctive to systemic chemotherapy, has achieved high remission rate and low rate of recurrence as well as with limited ocular complications. The tumor cells were cleared and the visual function preserved. However, issues about the drug applied, treatment protocols and goals of intravitreal chemotherapy, whether for visual preservation or survival improvement, are worthy for further study.
ObjectiveTo evaluate the effect of ZnPP Ⅸ on the expressions of heme oxygenase-1 (HO-1) and glutathione-Stransferase-π （GST-π） and the chemosensitivity of drug-resistant hepatic carcinoma cell line Bel/Fu, and explore it’s possibility to reverse drug-resistance and the relevant regulating mechanism. Methods①MTT assay was adopted to detect the drug sensitivity for adriamycin, mitomycin, and 5-fluorouracil of Bel/Fu cell after ZnPP Ⅸ being induced for 24 h. ②RTPCR was carried out to detect the expressions of HO-1 and GST-π mRNA after Bel/FU cells being treated with different concentrations ZnPP Ⅸ for 24 h. ResultsAfter Bel/Fu cells being treated with ZnPP Ⅸ for 24 h, the 50% inhibiting concentration (IC50) for drugs was decreased dramatically （Plt;0.05）. Meanwhile, the expressions of HO-1 and GST-π mRNA in the treated cells also decreased dose-dependently (Plt;0.01). ConclusionsZnPP Ⅸ can increase the chemosensitivity of Bel/FU cells by down-regulation of HO-1 and GST-π expression. ZnPP Ⅸ is a potential agent to reverse multidrug resistance of hepatic carcinoma cells.
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.
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 study the risk factors for contralateral breast cancer (CBC) in women after regular treatment of the primary breast cancer. Methods Between January 1997 to December 2002, the clinical data of 340 breast cancer patients at our institution were retrospectively analyzed. In all the patients a detailed analysis was carried out with respect to age, operation type, radiation therapy technique and dose, the use of chemotherapy or hormone therapy, and other clinicopathologic characteristics. The KaplanMeier method was used to estimate the actuarial rate of CBC. The Cox proportional hazard regression model was used to estimate the relative risk factors of CBC. Results Fourteen cases were diagnosed to be CBC, thus overall incidence of CBC was 4.1%. Ten-year CBC incidence (2.7%) was higher than 5-year incidence of CBC (1.4%). Univariate analysis showed that the risk factors of CBC at 5-year and 10-year included: ≤45 years old, medullary carcinoma, family history of breast cancer and being taken without endocrine therapy (P＜0.05), while chemotherapy and radiotherapy were not risk factors of CBC (P＞0.05). Mutivariate analysis showed that ≤ 45 years old and being internal breast radiotherapy were independent risk factors of CBC at 5-year and 10-year (P＜0.05). Conclusions CBC may occur in these primary breast cancer patients with age ≤45 years old, medullary carcinoma, family history of breast cancer. In order to reduce the incidence of CBC, endocrine therapy rather than internal breast radiotherapy should be performed in early breast cancer patients.
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.