Publications by authors named "Hongfeng Gou"

30 Publications

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Rare DNA Mismatch Repair-Related Protein Loss in Patients with Intrahepatic Cholangiocarcinoma and Combined Hepatocellular-Cholangiocarcinoma and Their Response to Immunotherapy.

Cancer Manag Res 2021 31;13:4283-4290. Epub 2021 May 31.

Department of Abdominal Cancer, West China Medical School, Cancer Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China.

Purpose: The patients with advanced mismatch repair deficiency (dMMR) cancers can benefit from programmed cell death 1 (PD-1) pathway blockade, regardless of the tumor type. Little is known about the prevalence of dMMR in intrahepatic cholangiocarcinoma (ICC) and combined hepatocellular-cholangiocarcinoma (cHCC-CC). This study aimed to assess the mismatch repair (MMR)-related protein expression in patients with ICC and cHCC-CC.

Patients And Methods: Formalin-fixed, paraffin-embedded tumor specimens were obtained from patients undergoing surgery at the West china Hospital between 2009 and 2017. The immunoreactions for MLH1, MSH2, MSH6, and PMS2 were investigated to determine the MMR status.

Results: A total of 97 patients were evaluated, including 73 ICC patients and 24 cHCC-CC patients. The prevalence of dMMR was only found in two cases of 97 patients (2.06%). Both patients are ICC. In 24 cHCC-CC patients, no dMMR was observed. They did not receive an adjuvant chemotherapy after surgery. At the end of the follow-up, one patient was in a tumor-free state, and the other patient had local recurrence and metastasis. After receiving sintilimumab (an immune checkpoint inhibitor [ICI] for PD- 1), the patient had a partial response.

Conclusion: DMMR was detected in few patients with ICC and cHCC-CC. Thus, it is not recommended to routinely evaluate the MMR status of patients with ICC or cHCC-CC after surgery, but that of patients with advanced ICC or cHCC-CC should be assessed.
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http://dx.doi.org/10.2147/CMAR.S304281DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8183674PMC
May 2021

A randomized phase II trial comparing capecitabine with oxaliplatin or docetaxel as first-line treatment in advanced gastric and gastroesophageal adenocarcinomas.

Medicine (Baltimore) 2021 Apr;100(17):e25493

Department of Abdominal Oncology.

Background: A combination of fluoropyrimidines and platinum is widely accepted as the standard first-line treatment for advanced gastric and gastroesophageal adenocarcinomas. However, the benefit compared with platinum-free chemotherapeutic regimens remains controversial. We compared the efficacy and safety of capecitabine with oxaliplatin or docetaxel, as first-line therapy in advanced gastric cancer.

Methods: Eligible patients were randomly assigned to receive either capecitabine and oxaliplatin (XELOX) (capecitabine 1,000 mg/m2; twice daily for 14 days with oxaliplatin 130 mg/m2 on day 1, every 21 days), or DX (capecitabine 1,000 mg/m2; twice daily for 14 days with docetaxel 75 mg/m2 on day 1, every 21 days). The primary endpoint was the objective response rate (ORR). Secondary endpoints included the disease control rate (DCR), progression-free survival, overall survival, and prespecified safety endpoints.

Results: Ninety patients were enrolled in the West China Hospital from April 2012 to August 2016; a total of 83 and 66 patients were eligible for safety and efficacy analyses, respectively. Between the XELOX and DX groups, ORR (24.2% vs 24.2%, p = 1.000), DCR (90.9% vs 75.8%, p = 0.099), progression-free survival (6.1m vs 4.1m, p = 0.346), and overall survival (8.8m vs 9.0m, p = 0.973) were similar. There was no significant difference in toxicity between the two regimens. The frequent grade 3 or higher toxicities in the XELOX and DX groups were peripheral neuropathy and hematological toxicity, respectively. Toxicity was tolerable; no treatment-related deaths occurred in either group.

Conclusions: The DX regimen was not superior to XELOX, but instead, similar. The platinum-containing regimen remains the preferred first-line option for advanced gastric and gastroesophageal adenocarcinomas, and DX might be considered as an alternative for patients unsuitable for platinum-containing chemotherapy.
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http://dx.doi.org/10.1097/MD.0000000000025493DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8084035PMC
April 2021

Complete Pathologic Response After Concurrent Treatment with Pembrolizumab and Radiotherapy in Metastatic Colorectal Cancer: A Case Report.

Onco Targets Ther 2021 13;14:2555-2561. Epub 2021 Apr 13.

West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China.

Due to specific genetic characteristics, therapeutic options for colorectal cancer (CRC) with DNA mismatch repair deficient (dMMR)/microsatellite instability-high (MSI-H) are limited. Although programmed death 1 (PD-1) blockade has been shown to be highly effective therapy for dMMR/MSI-H CRC, there is a need to develop new therapeutic paradigms to further improve survival rates of patients with dMMR/MSI-H CRC. So far, there is no case report on the use of immunotherapy combined with radiotherapy (RT) for the treatment of dMMR/MSI-H metastatic CRC (mCRC). Here, we report a 64-year-old patient diagnosed with mCRC who experienced a complete pathological response (pCR) after successfully conversion treatment with pembrolizumab and RT, and remains to be tumor-free during a follow-up of 11 months while off therapy. Immunohistochemical staining for MLH1, MSH2, MSH6, and PMS2 on the intestinal biopsy samples revealed loss of MLH1 and PMS2 protein expression. The present case report adds to the limited data on the safety and effectiveness of local RT combined with immunotherapy for patients with dMMR/MSI-H mCRC. This combination therapy appears to be a potential treatment for dMMR/MSI-H mCRC and deserves further exploration.
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http://dx.doi.org/10.2147/OTT.S298333DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8053529PMC
April 2021

Survival outcome and prognostic factors for colorectal cancer with synchronous bone metastasis: a population-based study.

Clin Exp Metastasis 2021 02 9;38(1):89-95. Epub 2021 Jan 9.

Department of Abdominal Oncology, West China Hospital of Medicine, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, People's Republic of China.

Prognostic factors of synchronous bone metastatic colorectal cancer (CRC) are still undetermined. We aimed to investigate survival outcome and prognostic factors of patients with synchronous bone metastatic CRC. Information of patients with synchronous bone metastatic CRC were obtained from the Surveillance, Epidemiology, and End Results (SEER) and West China Hospital (WCH) databases. Cases from SEER database composed construction cohort, while cases from WCH database were used as validation cohort. A novel nomogram was constructed to predict individual survival probability based on Cox regression model. The performance of the nomogram was internally and externally validated using calibration curves and concordance index (C-index). Three hundred and eighty-one patients from SEER database were eligible. The median disease specific OS was 9.0 months (95% confidence interval [CI]: 7.3-10.7 months). Multivariate Cox analysis identified seven independent prognostic factors including histological type, differentiation grade, T stage of primary tumor, CEA level, systemic chemotherapy, combined with liver metastasis and combined with lung metastasis. A novel nomogram was established based on these variables. In the internal validation, the C-index (0.72, 95% CI 0.69-0.75) and calibration curve indicated well performance of this nomogram at predicting survival outcome in bone metastatic CRC. In the external validation, the C-index was 0.57 (95% CI 0.46-0.68). The prognosis of synchronous bone metastatic CRC is very poor. Histological type, differentiation grade, T stage of primary tumor, CEA level, systemic chemotherapy, combined with liver metastasis and combined with lung metastasis are independent prognostic factors. Further study is warranted to confirm the practicality of the prognostic nomogram.
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http://dx.doi.org/10.1007/s10585-020-10069-5DOI Listing
February 2021

Third-line sunitinib treatment in a -mutated metastatic intrahepatic cholangiocarcinoma: a case report and literature review.

Cancer Biol Ther 2020 09 18;21(9):785-789. Epub 2020 Jun 18.

Department of Abdominal Oncology, West China Hospital, Sichuan University, Chengdu, P.R. China.

Intrahepatic cholangiocarcinoma (iCCA) is a highly aggressive malignancy with a poor prognosis. There is no standard treatment beyond first-line chemotherapy and no molecular-targeted drug approved for advanced iCCA. We herein present a case of a 46-y-old Asian iCCA patient with multiple metastases in lung, bone, and liver. The patient progressed rapidly after first- and second-line chemotherapy. According to next-generation sequencing result of somatic Von Hippel-Lindau () gene mutation, the patient was administered third-line sunitinib and obtained a relatively longer survival of 9 months after taking sunitinib. Additionally, we briefly summarized the current targeted treatment of iCCA. To our knowledge, this is the first report of mutation and sunitinib usage in metastatic iCCA patient. As a highly heterogeneous and aggressive malignancy, we strongly recommend making clinical decisions based on precision medicine concept in advanced iCCA.
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http://dx.doi.org/10.1080/15384047.2020.1769418DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7515542PMC
September 2020

Transarterial strategies for the treatment of unresectable hepatocellular carcinoma: A systematic review.

PLoS One 2020 19;15(2):e0227475. Epub 2020 Feb 19.

School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, P.R. China.

Conventional transarterial chemoembolization (cTACE), drug-eluting beads (DEB-TACE) and transarterial radioembolization (TARE) are alternative strategies for unresectable hepatocellular carcinoma (HCC). However, which of these strategies is the best is still controversial. This meta-analysis was performed to evaluate the effects of DEB-TACE, TARE and cTACE in terms of overall survival (OS), tumor response and complications. A literature search was conducted using the EMBASE, PubMed, Google Scholar, and Cochrane databases from inception until July 2019 with no language restrictions. The primary outcome was overall survival, and the secondary outcomes included complete response and local recurrence. The comparison of DEB-TACE with cTACE indicated that DEB-TACE has a better OS at 1 year (RR 0.79, 95% CI 0.67-0.93, p = 0.006), 2 years (RR 0.89; 95% CI 0.81-0.99, p = 0.046), and 3 years (RR 0.89; 95% CI 0.81-0.99, p = 0.035). The comparison of TARE with cTACE indicated that TARE has a better OS than cTACE at 2 years (RR 0.87; 95% CI 0.80-0.95, p = 0.003) and 3 years (RR 0.90; 95% CI 0.85-0.96, p = 0.001). The comparison of DEB-TACE with TARE indicated that DEB-TACE has a better OS than TARE at 2 years (RR 0.40; 95% CI 0.19-0.84, p = 0.016). The current meta-analysis suggests that DEB-TACE is superior to both TARE and cTACE in terms of OS. TARE has significantly lower complications than both DEB-TACE and cTACE for patients with HCC. Further multicenter, well-designed randomized controlled trials are needed, especially for evaluating DEB-TACE versus TARE.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0227475PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7029952PMC
April 2020

S-1 or gemcitabine adjuvant therapy in resected pancreatic cancer: a cost-effectiveness analysis based on the JASPAC-01 trial.

Expert Rev Pharmacoecon Outcomes Res 2020 Feb 10;20(1):133-138. Epub 2019 Oct 10.

Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.

: This study aimed to investigate the cost-effectiveness of adjuvant treatments in resected pancreatic cancer.: A Markov model was developed to mimic the disease process of postoperative pancreatic cancer, encompassing three health states (relapse-free survival, recurrent disease, and death). Health outcomes and utility scores were derived from the phase III trial and available literature. Cost data were calculated using standard fee data from the West China Hospital for 2017. One-way sensitivity analyses and probabilistic sensitivity analyses were developed to explore model uncertainty.: Treatment with S-1 was estimated to yield 1.61 quality-adjusted life-years (QALYs) at a cost of $25,696, whereas treatment with gemcitabine yielded 1.27 QALYs at a cost of $28,930. The incremental cost-effectiveness ratio of S-1 versus gemcitabine was $-9,490 per QALY. Based on the willingness-to-pay threshold of $25,841 per QALY, the net monetary benefit (NMB) was $15,786 for S-1 and $3,727 for gemcitabine, generating the incremental NMB of $12,059. A probabilistic sensitivity analysis revealed that the probabilities of S-1 and gemcitabine being cost-effective were 92% and 8%, respectively. Results were robust to changes in parameters.: Adjuvant therapy using S-1 is a cost-effective alternative compared to gemcitabine in patients with postoperative pancreatic cancer from the Chinese societal perspective.
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http://dx.doi.org/10.1080/14737167.2020.1677155DOI Listing
February 2020

Prognostic factors and treatment outcomes in patients with non-ampullary small bowel adenocarcinoma: Long-term analysis.

Medicine (Baltimore) 2019 Apr;98(17):e15381

Department of Abdominal Oncology, Cancer Center.

Small bowel adenocarcinoma (SBA) is a relatively rare malignancy in gastrointestinal tumors. In addition, the difficulty of early diagnosis, its poor prognosis compared to large bowel adenocarcinoma, and inadequate treatment experiences due to lack of prospective randomized trials make it necessary to explore the characteristics of the disease for early diagnosis and treatment.Patients diagnosed with primary malignant tumor of small intestine in West China Hospital of Sichuan University between January 2001 and 2013 were reviewed retrospectively. A total of 208 patients with SBA were selected and 160 patients with duodenal periampullary tumor were excluded. Forty-two cases of patients were finally enrolled for statistical analysis as 6 patients were lost of follow-up. The clinical characteristics, the response to treatment and their overall survival (OS) time were reviewed and analyzed.Of the 42 patients, 11 (26.2%) primary tumors were originated from duodenum, 29 (69.0%) from jejunum, and 2 (4.8%) from ileum. All patients (64.3% male; median age, 54.7 years) included in this study underwent primary resection of the tumor to confirm final diagnosis. Three-year survival rate is 21% and 5-year survival rate is 9%. Median OS were 24.2 months (95% CI: 4.0-72.0). The univariate predictors for prognosis of SBA were as follows: age (P = .021), severe intestinal symptoms at first diagnosis (P < .001), T4 of tumor stage (P = .011), tumor size (P = .004), relatively late clinical stage (P < .001), peritoneal metastasis (P < .001), and no chemotherapy (P = .011). The multivariate predictors for poor prognosis were age of more than 60 years old (P = .035), intestinal obstruction or perforation at first diagnosis (P = .026), relatively late clinical stage (P = .000), and no chemotherapy (P = .027).SBA was a relatively rare malignancy that was difficult for early diagnosis and treatment. Intestinal obstruction was the common clinical manifestation at first diagnosis, with a tendency of early peritoneal metastasis. Precaution of the disease in early phase, radical resection of the primary tumor while resectable, followed with in-time chemotherapy might improve prognosis and survival of patients with SBA.
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http://dx.doi.org/10.1097/MD.0000000000015381DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6831280PMC
April 2019

Tumor calcification as a prognostic factor in cetuximab plus chemotherapy-treated patients with metastatic colorectal cancer.

Anticancer Drugs 2019 02;30(2):195-200

Department of Medical Oncology, Cancer Center.

This study aimed to explore the correlation between survival and tumor calcification in patients with metastatic colorectal cancer who received cetuximab combined with chemotherapy. The study was a single-center retrospective analysis that enrolled 111 patients who had received therapy between April 2011 and October 2016. Tumor calcification and treatment efficacy were evaluated independently by radiologists on the basis of computed tomography scans. Clinical characteristics and follow-up data were collected from electronic medical records. Correlations between tumor calcification and clinical characteristics, tumor response rate, and patient survival were analyzed. Among the 111 enrolled patients, 27 had tumor calcification [27/111 (24.3%)]. The median progression-free survival was significantly longer for patients with tumor calcification than for those without calcification (9.3 vs. 6.2 months, P=0.022). Patients with tumor calcification also had a higher objective response rate (55.6 vs. 31%, P=0.021) and better overall survival (21.9 vs. 16.5 months, P=0.084). The correlation between calcification features and prognosis showed that patients with an increasing number of calcifications after treatment had a significantly longer median overall survival (22.9 vs. 9.1 months, P=0.033). Simultaneously, new liver metastases and multiple calcifications also showed a trend toward better overall survival. There were also no significant correlations between clinical characteristics (sex, age, gene mutation, primary tumor location, pathological type, blood test result) and survival (Supplementary Table 1, Supplemental digital content 1, http://links.lww.com/ACD/A280). Tumor calcification is associated with a better treatment outcome and is a potential prognostic marker.
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http://dx.doi.org/10.1097/CAD.0000000000000726DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365256PMC
February 2019

Total neoadjuvant treatment (CAPOX plus radiotherapy) for patients with locally advanced rectal cancer with high risk factors: A phase 2 trial.

Radiother Oncol 2018 11 28;129(2):300-305. Epub 2018 Oct 28.

Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China. Electronic address:

Background And Purpose: To evaluate the safety and efficacy of Total neoadjuvant treatment (TNT) in patients with rectal cancer with high risk factors.

Methods And Materials: We did this phase 2 trial in patients who were diagnosed with stage II-III rectal cancer with at least one of the high risk factors. Three cycles of induction CAPOX were followed by pelvic radiotherapy of 50.4 Gy/28 fractions and two cycles of concurrent CAPOX. Three cycles of consolidation CAPOX were delivered after radiotherapy. Primary endpoints were pathological complete response (pCR) and R0 resection.

Results: Fifty patients were enrolled and 47 patients were evaluable. A total of 34 patients (72.3%) completed 6 to 8 cycles of chemotherapy and 46 patients (98%) completed the planned radiotherapy. 17 patients (36%) achieved a pCR or clinical complete response (cCR). Three cCR patients (6.4%) refused the operation and selected a watch-and-wait approach. The most common grade 3 or worse adverse events were leucopenia (10.6%) and radiation dermatitis (6.4%). The major surgical complications included pelvic abscesses/infection in 2 patients (4.3%), anastomotic leakage and hemorrhage in1 patient (2.2%), respectively, which were all addressed with conservative management.

Conclusions: TNT is effective and safe in patients with locally advanced rectal cancer with high risk factors. Long-term efficacies of TNT need to be further evaluated. This trial is registered with Chinese Clinical Trial Registry, number ChiCTR-OIN-17012284.
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http://dx.doi.org/10.1016/j.radonc.2018.08.027DOI Listing
November 2018

Gemcitabine plus S-1 for metastatic pancreatic cancer.

Medicine (Baltimore) 2018 Oct;97(41):e12836

Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, PR China.

To investigate the treatment effects of gemcitabine plus S-1 (GS) for metastatic pancreatic cancer in our institution.Data from 41 patients with metastatic pancreatic cancer treated with GS regimen in West China Hospital, Sichuan University were reviewed. The therapeutic efficacy and toxicity were evaluated. The influencing factors of progression-free survival (PFS) and overall survival (OS) were also explored.At the last follow-up, all patients had died. The objective response rate was 22.0% (9/41) and the disease control rate was 65.9% (27/41). The median PFS and OS times were 5.1 (range, 1.5-21) and 10.6 months (range, 1.5-40), respectively. The 0.5-, 1-, and 2-year OS rates were 65.9%, 41.5%, and 9.8%, respectively. In multivariate analysis, body mass index and carbohydrate antigen 19-9 change were the significant influencing factors of PFS, compared to tumor site and chemotherapy cycles for OS. The adverse effects were moderate and tolerable.The effects of GS for metastatic pancreatic cancer in our institution were good. The adverse effects were moderate and tolerable. However, further investigation in future prospective clinical studies is warranted.
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http://dx.doi.org/10.1097/MD.0000000000012836DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6203537PMC
October 2018

Tumoral cavitation in colorectal cancer patients with unresectable lung metastasis treated with bevacizumab and chemotherapy.

J Cancer Res Clin Oncol 2018 Jul 17;144(7):1339-1346. Epub 2018 May 17.

Department of Abdominal Cancer, The State Key Laboratory of Biotherapy, West China Medical School, Cancer Center, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China.

Purpose: Efficacy and the frequency of tumor cavitation have not been investigated in patients with metastatic colorectal cancer (mCRC) and lung metastases (LMs) treated with chemotherapy in combination with bevacizumab. This study was aimed to evaluate the efficacy and safety of bevacizumab for unresectable mCRC with LM and to determine the frequency of tumor cavitation, and its correlation with clinical outcomes in patients receiving bevacizumab plus chemotherapy.

Methods: Patients with mCRC and LMs treated with bevacizumab as first- or second-line therapy at West China Hospital, Sichuan University Cancer Center from September 2010 to November 2016 were included in this retrospective study. Data on clinicopathological characteristic were collected and overall survival (OS), progression-free survival (PFS), objective response rate (ORR) and disease control rate (DCR) were determined.

Results: Among 60 patients included in the study, response rate (RR), stable disease (SD), and DCR were 43.6% (17/39), 51.3% (20/39) and 94.9% (37/39) in patients receiving bevacizumab as first-line treatment. Median OS and PFS of the first-line treatment group were 32.4 and 15.5 months, respectively. Among 60, 12 patients (20%) developed cavitation after bevacizumab therapy initiation. Median OS was longer in patients with cavitation than those without cavitation (42.1 vs 30.8 months; p = 0.042) in the first-line treatment group.

Conclusion: Bevacizumab in combination with chemotherapy exhibited promising efficacy in mCRC patients LMs. Moreover, our findings reveal that OS might be affected by new tumor cavitation during antiangiogenic agent treatment.
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http://dx.doi.org/10.1007/s00432-018-2656-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6002465PMC
July 2018

Clinicopathological Characteristics, Treatment, and Prognosis of 21 Patients with Primary Gastric Squamous Cell Carcinoma.

Gastroenterol Res Pract 2016 5;2016:3062547. Epub 2016 Jul 5.

Cancer Center, West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu, Sichuan 610041, China.

We performed a retrospective analysis of 21 patients with primary gastric squamous cell carcinoma (PGSCC) who were admitted to our hospital from October 2008 to October 2014. The median age was 67 years and male predominance was observed, the most common tumor locations were the upper third of the stomach, most of the clinical manifestations were identical to those of other types of gastric tumors, and the tumor cells had positive immunoreactivity for p63 and CK5/6. In terms of treatments, surgery (R0 resection) is the main treatment; the effect of other treatments is unclear. The median survival time for the surgery group and nonsurgery group was 46 and 4.5 months, respectively. Probably due to limited number of cases, no significant difference in median survival time was observed between the surgery alone group and the surgery plus adjuvant therapy group (46 versus 51 months, P = 0.310). A standard chemotherapy regimen for this disease has not yet been established; the choice of its chemotherapy regimens tends to follow the principle of the treatment of gastric adenocarcinoma or esophageal cancer. PGSCC generally had a poor prognosis, and early detection, early diagnosis, and early surgical treatment are beneficial to patients.
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http://dx.doi.org/10.1155/2016/3062547DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4949341PMC
August 2016

A phase I study of adjuvant intensity-modulated radiotherapy with concurrent paclitaxel and cisplatin for cervical cancer patients with high risk factors.

Med Oncol 2015 Nov 3;32(11):247. Epub 2015 Oct 3.

Department of Abdominal Oncology, Cancer Center, West China Hospital, Sichuan University, No. 37 of WainanGuoxue Lane, Chengdu, Sichuan Province, China.

The aim of the study is to determine the maximum tolerated dose (MTD) and acute dose-limiting toxicities (DLTs) of adjuvant concurrent paclitaxel and cisplatin (TP) with pelvic intensity-modulated radiotherapy (IMRT) for early-stage cervical cancer patients with high risk factors. Women who underwent radical hysterectomy and pelvic lymphadenectomy for stages IB-IIA cervical cancer and had high risk factors were enrolled. One cycle of TP was delivered before and after concurrent chemoradiotherapy, respectively. Then 3 weeks after the start of the initial cycle of the chemotherapy, patients received IMRT in a total dose of 50-50.4 Gy in 25-28 fractions with two cycles of concurrent TP, which was administered with escalating doses. Eighteen patients were enrolled at three dose levels. At dose level 1 (paclitaxel 90 mg/m(2), cisplatin 40 mg/m(2)) and level 2 (paclitaxel 90 mg/m(2), cisplatin 50 mg/m(2)), DLT (grade 3 leukopenia) was observed in one patient, respectively. At level 3 (paclitaxel 105 mg/m(2), cisplatin 50 mg/m(2)), two DLTs (grade 3 leukopenia) were observed in two patients. The MTD of paclitaxel and cisplatin was then defined as 90 and 50 mg/m(2), respectively. Pelvic IMRT and concurrent TP is a safe and tolerable adjuvant treatment regimen for cervical cancer patients with high risk factors. The MTD of concurrent chemotherapy is paclitaxel 90 mg/m(2) and cisplatin 50 mg/m(2). Trial registration Current controlled trials ChiECRCT-2014025.
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http://dx.doi.org/10.1007/s12032-015-0689-5DOI Listing
November 2015

An Apela RNA-Containing Negative Feedback Loop Regulates p53-Mediated Apoptosis in Embryonic Stem Cells.

Cell Stem Cell 2015 Jun 30;16(6):669-83. Epub 2015 Apr 30.

Cancer and Stem Cell Epigenetics, Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute, Bethesda, MD 20892, USA. Electronic address:

Maintaining genomic integrity is of paramount importance to embryonic stem cells (ESCs), as mutations are readily propagated to daughter cells. ESCs display hypersensitivity to DNA damage-induced apoptosis (DIA) to prevent such propagation, although the molecular mechanisms underlying this apoptotic response are unclear. Here, we report that the regulatory RNA Apela positively regulates p53-mediated DIA. Apela is highly expressed in mouse ESCs and is repressed by p53 activation, and Apela depletion compromises p53-dependent DIA. Although Apela contains a coding region, this coding ability is dispensable for Apela's role in p53-mediated DIA. Instead, Apela functions as a regulatory RNA and interacts with hnRNPL, which prevents the mitochondrial localization and activation of p53. Together, these results describe a tri-element negative feedback loop composed of p53, Apela, and hnRNPL that regulates p53-mediated DIA, and they further demonstrate that regulatory RNAs add a layer of complexity to the apoptotic response of ESCs after DNA damage.
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http://dx.doi.org/10.1016/j.stem.2015.04.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4458197PMC
June 2015

Enhancing the anti-colon cancer activity of quercetin by self-assembled micelles.

Int J Nanomedicine 2015 16;10:2051-63. Epub 2015 Mar 16.

Department of Pathophysiology, West China College of Preclinical Medicine and Forensic Medicine, Sichuan University, Chengdu, Sichuan, People's Republic of China.

Colorectal cancer, a type of malignant neoplasm originating from the epithelial cells lining the colon and/or rectum, has been the third most frequent malignancy and one of the leading causes of cancer-related deaths in the US. As a bioflavonoid with high anticancer potential, quercetin (Qu) has been proved to have a prospective applicability in chemotherapy for a series of cancers. However, quercetin is a hydrophobic drug, the poor hydrophilicity of which hinders its clinical usage in cancer therapy. Therefore, a strategy to improve the solubility of quercetin in water and/or enhance the bioavailability is desired. Encapsulating the poorly water-soluble, hydrophobic agents into polymer micelles could facilitate the dissolution of drugs in water. In our study, nanotechnology was employed, and quercetin was encapsulated into the biodegradable nanosized amphiphilic block copolymers of monomethoxy poly(ethylene glycol)-poly(ε-caprolactone) (MPEG-PCL), attempting to present positive evidences that this drug delivery system of polymeric micelles is effective. The quercetin-loaded MPEG-PCL nanomicelles (Qu-M), with a high drug loading of 6.85% and a minor particle size of 34.8 nm, completely dispersed in the water and released quercetin in a prolonged period in vitro and in vivo. At the same time, compared with free quercetin, Qu-M exhibited improved apoptosis induction and cell growth inhibition effects in CT26 cells in vitro. Moreover, the mice subcutaneous CT26 colon cancer model was established to evaluate the therapy efficiency of Qu-M in detail, in which enhanced anti-colon cancer effect was proved in vivo: Qu-M were more efficacious in repressing the growth of colon tumor than free quercetin. In addition, better effects of Qu-M on inducing cell apoptosis, inhibiting tumor angiogenesis, and restraining cell proliferation were observed by immunofluorescence analysis. Our study indicated that Qu-M were a novel nanoagent of quercetin with an enhanced antitumor activity, which could serve as a promising potential candidate for colon cancer chemotherapy.
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http://dx.doi.org/10.2147/IJN.S75550DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4368034PMC
October 2016

A phase II trial of concurrent 3D-CRT/IMRT and oxaliplatin, 5-fluorouracil and leucovorin (FOLFOX) in gastric cancer patients with R0 gastrectomy and D2 lymph node dissection.

Gastric Cancer 2016 Jan 22;19(1):245-54. Epub 2015 Jan 22.

Department of Abdominal Oncology, Cancer Center, West China Hospital, Sichuan University, No. 37 of Wainan Guoxue Lane, Wuhou District, Chengdu, 610041, Sichuan Province, People's Republic of China.

Background: To evaluate the safety and efficacy of a concurrent three-dimensional conformal radiotherapy (3D-CRT) or intensity-modulated radiotherapy (IMRT) plus oxaliplatin, 5-fluorouracil and leucovorin (FOLFOX) regimen in completely resected gastric cancer patients with D2 lymph node dissection.

Materials And Methods: Patients with stage IB-IIIC gastric cancer (per the AJCC, 7th edition) who had undergone R0 and D2 gastrectomy were recruited. Two cycles of FOLFOX with concurrent 3D-CRT or IMRT (50.4 Gy/28f) were administered. One and an additional five cycles of FOLFOX were delivered before and after concurrent chemoradiotherapy, respectively. Primary endpoints were relapse-free survival (RFS) and overall survival (OS), with adverse events as secondary endpoints.

Results: From 2008 to 2011, 110 patients were evaluable. The 1-, 2- and 3-year RFS and OS were 86.2, 72.2, 67.8 and 94.7, 87.2, 77.6%, respectively. On multivariate analysis, stage (≤ IIIA vs. >IIIA) was a statistically significant factor affecting both RFS and OS. Additionally, the T-category (≤ T4a vs. = T4b) was a statistically significant factor affecting only the RFS. The most commonly observed grade 3 or 4 adverse events were nausea and vomiting, decreased appetite, leukopenia/neutropenia and fatigue, each of which occurred in 14.5, 11.8, 9.1 and 6.4% patients, respectively.

Conclusions: Adjuvant 3D-CRT/IMRT to a dose of 50.4 Gy/28f with concurrent FOLFOX is safe and effective in patients following radical gastrectomy with D2 lymph node dissection.
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http://dx.doi.org/10.1007/s10120-015-0461-8DOI Listing
January 2016

p53 loss increases the osteogenic differentiation of bone marrow stromal cells.

Stem Cells 2015 Apr;33(4):1304-19

Cancer and Stem Cell Epigenetics Section, Laboratory of Cancer Biology and Genetics.

The tumor suppressor, p53, plays a critical role in suppressing osteosarcoma. Bone marrow stromal cells (BMSCs, also known as bone marrow-derived mesenchymal stem cells) have been suggested to give rise to osteosarcomas. However, the role of p53 in BMSCs has not been extensively explored. Here, we report that p53 regulates the lineage choice of mouse BMSCs (mBMSCs). Compared to mBMSCs with wild-type p53, mBMSCs deficient in p53 have enhanced osteogenic differentiation, but with similar adipogenic and chondrogenic differentiation. The role of p53 in inhibiting osteogenic lineage differentiation is mainly through the action of Runx2, a master transcription factor required for the osteogenic differentiation of mBMSCs. We find that p53 indirectly represses the expression of Runx2 by activating the microRNA-34 family, which suppresses the translation of Runx2. Since osteosarcoma may derive from BMSCs, we examined whether p53 has a role in the osteogenic differentiation of osteosarcoma cells and found that osteosarcoma cells with p53 deletion have higher levels of Runx2 and faster osteogenic differentiation than those with wild-type p53. A systems biology approach reveals that p53-deficient mBMSCs are more closely related to human osteosarcoma while mBMSCs with wild-type p53 are similar to normal human BMSCs. In summary, our results indicate that p53 activity can influence cell fate specification of mBMSCs, and provide molecular and cellular insights into the observation that p53 loss is associated with increased osteosarcoma incidence.
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http://dx.doi.org/10.1002/stem.1925DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4376591PMC
April 2015

Synergistic Effect of Subtoxic-dose Cisplatin and TRAIL to Mediate Apoptosis by Down-regulating Decoy Receptor 2 and Up-regulating Caspase-8, Caspase-9 and Bax Expression on NCI-H460 and A549 Cells.

Iran J Basic Med Sci 2013 May;16(5):710-8

Department of Medical Oncology, Cancer Center of West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.

Unlabelled: Objective(s) : Although tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) can selectively induce apoptosis in tumor cells, more than half of tumors including non-small cell lung cancer (NSCLC) exhibit TRAIL-resistance. The purpose of this study was to determine whether subtoxic-dose cisplatin and TRAIL could synergistically enhance apoptosis on NSCLC cells and investigate its underlying mechanisms.

Materials And Methods: NCI-H460 and A549 cells were treated with TRAIL alone, cisplatin alone or combination treatment in this study. The cytotoxicity was evaluated according to Sulforhodamine B assay, and apoptosis was examined using Hoechst 33342 staining and flow cytometry. The mRNA and protein levels of TRAIL receptors and apoptotic proteins including caspase-8, caspase-9, Bcl-2 and Bax were determined by RT-PCR and Western blotting, respectively.

Results: Our results showed that NCI-H460 cells were sensitive to TRAIL, whereas A549 cells were resistant. However, subtoxic-dose cisplatin could enhance the both cells to TRAIL-mediated cell proliferation inhibition and apoptosis. The underlying mechanisms might be associated with the down-regulation of DcR2 and up-regulation of Caspase-8, Caspase-9 and Bax.

Conclusion: Subtoxic-dose cisplatin could enhance both TRAIL- sensitive and TRAIL- resistant NSCLC cells to TRAIL-mediated apoptosis. These findings motivated further studies to evaluate such a combinatory therapeutic strategy against NSCLC in the animal models.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3700047PMC
May 2013

Clinical significance of Cox-2, Survivin and Bcl-2 expression in hepatocellular carcinoma (HCC).

Med Oncol 2011 Sep 17;28(3):796-803. Epub 2010 Apr 17.

Department of Medical Oncology, Cancer Center of West China Hospital, Sichuan University, Chengdu, China.

Cox-2, Survivin and Bcl-2 are frequently overexpressed in numerous types of cancers. They are known to be the important regulators of apoptosis. This study was designed to investigate the correlation between the clinical characteristics and the expression of Cox-2, Survivin and Bcl-2 in hepatocellular carcinoma. A total of 63 postoperative hepatocellular carcinoma (HCC) samples, 10 adjacent non-tumor samples and 10 normal liver samples were immunochemically detected for the expression of Cox-2, Survivin and Bcl-2. A median follow-up of 4 years for the 63 HCC patients was conducted. Univariate tests and multivariate Cox regression were performed for statistical analysis. The Kaplan-Meier method was used to analyze the survival. Positive expression of Cox-2 (84.3%) and Survivin (77.8%) was detected significantly more frequently in the HCC samples than in the normal liver tissues (30% and 0, respectively). Bcl-2 was highly expressed in the adjacent non-tumor tissue. Cox-2 was positively correlative to Survivin. Survivin and Bcl-2 were significantly associated with the pathological grade of HCC (P<0.05). Expression of both Cox-2 and Survivin was significantly associated with the poor overall survival (OS) (P=0.0141, P=0.0039). Furthermore, multivariate analysis confirmed the independent prognostic value of Survivin expression, along with tumor size and hepatic function. Cox-2 and Survivin were highly expressed in the HCC tissue. Survivin and Bcl-2 were significantly associated with the pathological grade of HCC. The expression of Survivin was an independent prognostic factor for HCC after a hepatectomy. Treatment that inhibits Survivin may be a promising targeted approach in HCC.
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http://dx.doi.org/10.1007/s12032-010-9519-yDOI Listing
September 2011

[Clinical analysis of 8 cases of tracheal adenoid cystic carcinoma].

Zhongguo Fei Ai Za Zhi 2007 Jun;10(3):237-9

Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R.China.

Background: Tracheal adenoid cystic carcinoma (TACC) is a rare, low malignant and primary tracheal carcinoma, which is easily misdiagnosed and missedly diagnosed. The aim of this study is to increase the knowledge about TACC.

Methods: Data including clinical manifestations and treatment were retrospectively analyzed for 8 cases of TACC confirmed by pathology and follow-up was carried out.

Results: The main manifestations were cough, stridor, hemoptysis and progressive inspiratory dyspnea. Fiberoptic bronchoscope and computerized tomography were reliable examinations for final diagnosis. Five cases underwent operative treatment, and three cases underwent interventional treatment by fiberoptic bronchoscope in which 1 case accepted a second operation after recurrence and 2 cases accepted chemotherapy after operation. One case was lost, 1 case treated by interventional treatment died after 11 months and other 6 cases were followed-up from 2 months to 34 months who were alive.

Conclusions: TACC is low malignancy and has good prognosis. The best treatment is operation. The better palliative treatment is interventional treatment by fiberoptic bronchoscope which can relieve symptoms and improve the patient's living quality.
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http://dx.doi.org/10.3779/j.issn.1009-3419.2007.03.18DOI Listing
June 2007

[Randomized clinical trial of paclitaxel plus cisplatin versus gemcitabine plus cisplatin in the treatment of patients with advanced non-small cell lung cancer].

Zhongguo Fei Ai Za Zhi 2007 Apr;10(2):141-3

Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R.China.

Background: Cisplatin-based chemotherapy is the standard regimens in the treatment of advanced non-small cell lung cancer (NSCLC). The aim of this trial is to evaluate the efficacy and toxicity of paclitaxel or gemcitabine combined with cispltin for patients with advanced NSCLC.

Methods: Seventy-seven advanced NSCLC patients were randomly divided into 2 groups, 39 in TP group and 38 in GP group. TP group: paclitaxel 135 mg/m², on day 1; cisplatin 30 mg/m², on days 1-3. GP group: gemcitabine 1000 mg/m², on days 1, 8; cisplatin 30 mg/m², on days 1-3.

Results: Patients' characteristics were similar between the two groups. The overall response rate was 46.2% in the TP group and 42.1% in the GP group. There was no statistically significant difference in response rate between the two groups (P > 0.05). The major cytotoxicity was leukopenia in the TP group and thrombocytopenia in the GP group.

Conclusions: Both TP and GP regimens are effective for advanced NSCLC and have no significant difference. The side effects of the two regimens are different but all adverse reactions are tolerable.
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http://dx.doi.org/10.3779/j.issn.1009-3419.2007.02.14DOI Listing
April 2007

[Clinical analysis of sarcomatoid carcinoma of the lung].

Zhongguo Fei Ai Za Zhi 2006 Dec;9(6):547-9

Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R.China.

Background: Sarcomatoid carcinoma (SC) is a rare malignant cancer with mixed tumor and sarcomatoid tissues. The aim of this study is to investigate the clinical manifestations and pathological findings of sarcomatoid carcinoma of the lung.

Methods: Data including clinical manifestations, pathological findings, treatment were retrospectively analysed from fourteen patients with lung sarcomatoid carcinoma confirmed by pathology and follow-up was carried out.

Results: Mean age at onset was 62 years old and gender ratios (M/F) in these patients was 6:1. The clinical manifestations of lung sarcomatoid carcinoma were similar to that of other types of lung cancer while there were characteristic findings on the enhancement CT scan. Bronchofiberscopy was not a reliable examination for final diagnosis. Cells with endothelial phenotype could be detected by immunohistochemical method.

Conclusions: The final diagnosis of this disease depends on histopathological observation, while the diagnosis may be missed among patients without surgical intervention. Immunohistochemical examination is helpful for diagnosis and differential diagnosis. The therapeutic strategy is coincident with that for non-small cell lung cancer.
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http://dx.doi.org/10.3779/j.issn.1009-3419.2006.06.15DOI Listing
December 2006

[Hyperthermia combined with intracavitary injection of drug for malignant pleural effusion].

Zhongguo Fei Ai Za Zhi 2006 Jun;9(3):286-8

Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R.China.

Background: Malignant pleural effusion is one of the common complications in patients with advanced lung cancer. Intracavitary injection of drug is a usual method, but it also exhibits unstable efficacy and obvious adverse reaction. The aim of this study is to evaluate the efficacy of hyperthermia combined with intracavitary injection of drug for malignant pleural effusion.

Methods: Fifty patients with malignant pleural effusion caused by lung cancer were randomized into two groups after puncture or closed drainage. Group A was treated with hyperthermia combined with intrapleural injection of cisplatin and interleukin-2. Group B was treated only with intrapleural injection of cisplatin and interleukin-2.

Results: The response rate of pleural effusion was 88% in group A and 60% in group B (P=0.024). The quality of life in group A was significantly better than that in group B (P=0.013).

Conclusions: Hyperthermia combined with intracavitary injection is effective and secure in treatment of malignant pleural effusion.
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http://dx.doi.org/10.3779/j.issn.1009-3419.2006.03.18DOI Listing
June 2006

[Randomly clinical study of vinorelbine/cisplatin and vinorelbine/oxaliplatin regimens in the treatment of advanced non-small cell lung cancer].

Zhongguo Fei Ai Za Zhi 2006 Feb;9(1):71-3

Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R.China.

Background: vinorelbine/cisplatin is an important regimen for advanced non-small lung cancer (NSCLC), but the side effect is severe . This study aims to compare the efficacy and toxicity of vinorelbine/cisplatin and vinorelbine/oxaliplatin regimens in the treatment of advanced NSCLC.

Methods: One hundred and twenty six inoperatable or recurrent patients with stage III and IV NSCLC were randomized into vinorelbine/cisplatin group and vinorelbine/oxaliplatin group. All of them were treated by the two regimens responsively for 2 or 3 cycles.

Results: The overall response rate was 48.4%(30/62) for vinorelbine/cisplatin group and 42.2% (27/64) for vinorelbine/oxaliplatin group, the partial response rate was 45.2% (28/62) and 40.6% (26/64) respectively. There was no statistically significant difference of overall response rate between two groups (P > 0.05). The major side effects were leukopenia and gastrointestinal reaction, 25 patients (40.3%) in vinorelbine/cisplatin group and 10 patients (15.6%) in vinorelbine/oxaliplatin group had grade III+IV leucopenia (P < 0.05). Eleven patients (17.7%) in vinorelbine/cisplatin group and 3 patients (4.7%) in vinorelbine/oxaliplatin group had grade III+IV gastrointestinal reaction (P < 0.05). Seven patients (11.7%) in vinorelbine/cisplatin group and 60 patients (93.8%) in vinorelbine/oxaliplatin group had neurotoxicity (P < 0.05).

Conclusions: Both vinorelbine/cisplatin and vinorelbine/oxaliplatin regimens are effective for advanced NSCLC. Compared with vinorelbine/cisplatin regimen, vinorelbine/oxaliplatin regimen has less bone marrow toxicity and gastrointestinal toxicity but higher neurotoxicity.
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http://dx.doi.org/10.3779/j.issn.1009-3419.2006.01.18DOI Listing
February 2006

[A randomized clinical trial of chemotherapy combined with oxaliplatin and cisplatin plus navelbine in the treatment of advanced non-small cell lung cancer].

Zhongguo Fei Ai Za Zhi 2005 Dec;8(6):538-41

Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R.China.

Background: Cisplatin plus navelbine (NO) is a standard combination chemotherapy regimen for non-small cell lung cancer (NSCLC), but severe toxicities due to cisplatin often influence the quality of life in the patients, such as nausea and vomiting. The aims of this study are to evaluate the efficacy and toxicity of combined chemotherapy of oxaliplatin and cisplatin plus navelbine in treatment of advanced NSCLC.

Methods: A total of 168 patients were randomly divided into NO group (n=83) and NP group (n=85).

Results: The overall response rate was 38.6% in NO group and 40.0% in NP group respectively. 1-year survival rate was 33.7% in NO group and 31.8% in NP group. There was no significant difference in response rate and 1-year survival between the two groups (P > 0.05). The major side effects were myelosuppression, nausea/vomiting and neurotoxicity in the two groups. Incidences of leukopenia and nausea/vomiting were significantly lower in NO group than those in NP group (P < 0.05), but neurotoxicity in NO group was more obvious than that in NP group (P < 0.001).

Conclusions: The efficacy and 1-year survival of combined chemotherapy of oxaliplatin and cisplatin plus navelbine are similar in the treatment of advanced NSCLC. However, the side effects of oxaliplatin plus navelbine are lower except for neurotoxicity.
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http://dx.doi.org/10.3779/j.issn.1009-3419.2005.06.12DOI Listing
December 2005

[A randomized study of small bore catheter thoracostomy closed drainage versus conventional pleural aspiration in the treatment of malignant pleural effusions].

Zhongguo Fei Ai Za Zhi 2005 Oct;8(5):459-61

Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R.China.

Background: Malignant pleural effusions commonly occur in patients with advanced cancer. Treatment is often palliative, such as pleural aspiration or tube thoracostomy with large bore chest tube. Tube thoracostomy with large bore chest tube can cause significant discomfort of patients. The aim of this study is to evaluate the efficacy of small bore catheter for drainage and administration of sclerosing agent in the treatment of malignant pleural effusions.

Methods: Sixty patients with malignant pleural effusions were randomly assigned to small bore catheter thoracostomy closed drainage group or conventional pleural aspiration group. Cisplatin and interleukin-2 were infused into the thoracic cavity in eligible patients after drainage. Responses were evaluated 30 days later.

Results: Overall response rate (complete response plus partial response) was 80.00% in small bore catheter thoracostomy closed drainage group and 36.67% in conventional pleural aspiration group respectively (P < 0.01). And the side effects in small bore catheter thoracostomy closed drainage group were obviously less than that in conventional pleural aspiration group.

Conclusions: Small bore intercostal catheter for drainage and administration of sclerosing agent is a valid and safe option for malignant pleural effusions.
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http://dx.doi.org/10.3779/j.issn.1009-3419.2005.05.23DOI Listing
October 2005

[A randomized clinical trial of cisplatin solution and cisplatin powder combination regimens in the treatment of patients with lung cancer].

Zhongguo Fei Ai Za Zhi 2004 Jun;7(3):243-6

Department of Chemotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R.China.

Background: To compare the efficacy and side effects between cisplatin solution and cisplatin powder combination regimens for lung cancer.

Methods: A total of 223 patients were enrolled into this study. EP protocol was given to patients with small cell lung cancer (SCLC), and NP protocol to non small cell lung cancer (NSCLC). The 223 patients were randomly divided into cisplatin solution group and cisplatin powder group, and the same drugs and dosage were used in the two groups for the same type of lung cancer.

Results: Response rates of the cisplatin solution group and the cisplatin powder group were 84.8% and 82.4% for SCLC ( P > 0.05), and 31.6% and 29.9% for NSCLC ( P > 0.05), respectively. The major side effects were gastrointestinal reactions and myelosuppression. Significantly higher incidence of nausea/vomiting was found in cisplatin solution group than that in cisplatin powder group for either SCLC or NSCLC ( P < 0.05). There was a remarkable difference in cost of hospitalization between the two groups ( P < 0.05).

Conclusions: Cisplatin solution is as effective as cisplatin powder in the treatment of lung cancer. However, the more severe nausea/vomiting reactions and higher cost of cisplatin solution should be considered in its clinical application.
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http://dx.doi.org/10.3779/j.issn.1009-3419.2004.03.15DOI Listing
June 2004

[Randomly clinical study of ITP and NP regimens in the treatment of non-small cell lung cancer].

Zhongguo Fei Ai Za Zhi 2004 Feb;7(1):64-6

Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R.China.

Background: To evaluate the efficacy and toxicity of ITP (ifosfamide + perarubicin + cisplatin) and NP (vinorelbine + cisplatin) regimens in the treatment of advanced non small cell lung cancer (NSCLC).

Methods: One hundred inoperatable or recurrent patients with stage III and IV NSCLC were randomized into ITP group and NP group treated by the two regimens responsively for 2 or 3 cycles.

Results: The overall response rate was 51.5% for ITP group and 50.9% for the NP group, respectively. There was no statistically significant difference of the overall response rate between the two groups ( P > 0.05). The major side effects were leukopenia and gastrointestinal reaction. The leukopenia incidence was higher in ITP group than that in NC group ( P < 0.05).

Conclusions: Both ITP and NP regimens are effective for the advanced NSCLC. Compared with ITP regimen, NP regimen has less bone marrow toxicity than ITP regimen.
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http://dx.doi.org/10.3779/j.issn.1009-3419.2004.01.16DOI Listing
February 2004
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