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前沿技术与中医药创新发展 1

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Adjuvant chemotherapy versus adjuvant concurrent chemoradiotherapy after radical surgery for early-stage

《医学前沿（英文）》 2023年 第17卷 第1期   页码 93-104 doi: 10.1007/s11684-021-0892-z

摘要： We conducted a prospective study to assess the non-inferiority of adjuvant chemotherapy alone versus adjuvant concurrent chemoradiotherapy (CCRT) as an alternative strategy for patients with early-stage (FIGO 2009 stage IB–IIA) cervical cancer having risk factors after surgery. The condition was assessed in terms of prognosis, adverse effects, and quality of life. This randomized trial involved nine centers across China. Eligible patients were randomized to receive adjuvant chemotherapy or CCRT after surgery. The primary end-point was progression-free survival (PFS). From December 2012 to December 2014, 337 patients were subjected to randomization. Final analysis included 329 patients, including 165 in the adjuvant chemotherapy group and 164 in the adjuvant CCRT group. The median follow-up was 72.1 months. The three-year PFS rates were both 91.9%, and the five-year OS was 90.6% versus 90.0% in adjuvant chemotherapy and CCRT groups, respectively. No significant differences were observed in the PFS or OS between groups. The adjusted HR for PFS was 0.854 (95% confidence interval 0.415–1.757; P = 0.667) favoring adjuvant chemotherapy, excluding the predefined non-inferiority boundary of 1.9. The chemotherapy group showed a tendency toward good quality of life. In comparison with post-operative adjuvant CCRT, adjuvant chemotherapy treatment showed non-inferior efficacy in patients with early-stage cervical cancer having pathological risk factors. Adjuvant chemotherapy alone is a favorable alternative post-operative treatment.

关键词： chemotherapy     cervical cancer     lymph node metastasis     concurrent chemoradiotherapy     quality of life    

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allogeneic transplantation could be used as a salvage option for patients with relapsed acute leukemia post-chemotherapy

《医学前沿（英文）》 2021年 第15卷 第5期   页码 728-739 doi: 10.1007/s11684-021-0833-x

摘要： Relapse is the main problem after allogeneic hematopoietic stem cell transplantation (allo-HSCT). The outcome of a second allo-HSCT (HSCT2) for relapse post-HSCT has shown promising results in some previous studies. However, little is known about the efficacy of HSCT2 in patients with relapsed/refractory acute leukemia (AL) post-chemotherapy plus modified donor lymphocyte infusion (post-Chemo+m-DLI) after the first allo-HSCT (HSCT1). Therefore, we retrospectively analyzed the efficacy of HSCT2 in 28 patients with relapsed/refractory AL post-Chemo+m-DLI in our center. With a median follow-up of 918 (457–1732) days, 26 patients (92.9%) achieved complete remission, and 2 patients exhibited persistent disease. The probabilities of overall survival (OS) and disease-free survival (DFS) 1 year after HSCT2 were 25.0% and 21.4%, respectively. The cumulative incidences of nonrelapse mortality on day 100 and at 1 year post-HSCT2 were 7.1%±4.9% and 25.0%±8.4%. The cumulative incidences of relapse were 50.0%±9.8% and 53.5%±9.9% at 1 and 2 years post-HSCT2, respectively. Risk stratification prior to HSCT1 and percentage of blasts before HSCT2 were independent risk factors for OS post-HSCT2, and relapse within 6 months post-HSCT1 was an independent risk factor for DFS and relapse post-HSCT2. Our findings suggest that HSCT2 could be a salvage option for patients with relapsed AL post-Chemo+m-DLI.

关键词： second hematopoietic stem cell transplantation     acute leukemia     relapse     chemotherapy     modified donor lymphocyte infusion    

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Effect of pEGFP-survivin on GBC-SD cell growth and chemotherapy sensitivity

Hanbin SHEN MD, Bin ZHANG MBA, Song ZHAO BM, Qichang ZHENG MD, Jianping GONG MD, Xiaotang CAI BM,

《医学前沿（英文）》 2009年 第3卷 第4期   页码 485-490 doi: 10.1007/s11684-009-0089-3

摘要： This paper is aimed to investigate the effect of survivin shRNA on chemotherapy resistance in human gallbladder carcinoma GBC-SD cells. The viability of human gallbladder carcinoma GBC-SD, GBC-SD/enhanced green fluorescent protein (EGFP), and GBC-SD/survivin cells was detected by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, and mRNA and protein of survivin were tested by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot. After the cells were treated with cisplatin (DDP) (3.0 μg/mL) for the same time, cell survival rate and IC was detected with MTT, cell apoptosis was detected with fluorescence-activated cell sorting (FACS), and the nuclear alteration was observed by TdT-mediated deoxyuridine triphosphate nick end labeling (TUNEL). In addition, caspase-3 activity was detected by using colorimetric method. Cell viability was decreased significantly in GBC-SD/survivin cells, and survivin expression was decreased significantly (mRNA and protein of survivin were decreased by 74.7% and 71.5%, respectively). After treatment with DDP, cell survival rate and IC was decreased significantly (2.03±0.24 μg/mL) in GBC-SD/survivin cells, while apoptotic rate (84.3%) was elevated significantly as compared with the other two groups. There were brown apoptotic nuclei in all the cells. Caspase-3 activity in all the cells was increased at first and then decreased, but the caspase-3 activity in GBC-SD/survivin cells was significantly higher than the other two groups. The survivin shRNA could down-regulate the expression of survivin in GBC-SD cells significantly and improve the sensibility to chemotherapy.

关键词： survivin     shRNA     chemotherapy     sensibility     GBC-SD    

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Clinical outcomes of ATP-tumor chemosensitivity assay directed chemotherapy in hepatocellular carcinoma

RAO Rongsheng, CHEN Wenxue, ZHOU Xinwen, ZHOU Zheng, LI Xiaojun, ZENG Zhiping

《医学前沿（英文）》 2007年 第1卷 第2期   页码 157-160 doi: 10.1007/s11684-007-0029-z

摘要： This study aims to investigate the clinical response of ATP tumor chemosensitivity assay (ATP-TCA) directed chemotherapy regimens delivered via hepatic artery infusion in 104 cases of primary liver carcinoma (PLC). Tumor tissue was obtained via laparotomy and cultivated in vitro. This tissue was put through the assay to determine chemosensitivity. A single drug regimen of either 5-FU, MMC and ADM and a combination drug regimen were used. The treatment assigned was dependent on the result of the ATP-TCA. In the control group, 30 cases of diagnosed PLC were given the conventional three-combination drug. The two groups were evaluated after three courses of chemotherapy. The results are as follows. The overall response rate of sensitivity test ranged from 36% to 44% in the single drug therapy groups and 81% in the combination drug group. The clinical overall response rate was 75% in the treatment group and 56% in control group. The treatment group had better results than the control group as survival period over six months was 80% and over one year 44%. In the control group, survival period over six months was 60% and 30% over one year. In short, ATP-TCA directed chemotherapy shows better results for terminal stages of PLC in that you can decrease the dose of drugs thereby reducing the side-effects with possible improvements in therapeutic effects.
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Clinical risk score for invasive fungal diseases in patients with hematological malignancies undergoing chemotherapy

Ling Wang, Ying Wang, Jiong Hu, Yuqian Sun, He Huang, Jing Chen, Jianyong Li, Jun Ma, Juan Li, Yingmin Liang, Jianmin Wang, Yan Li, Kang Yu, Jianda Hu, Jie Jin, Chun Wang, Depei Wu, Yang Xiao, Xiaojun Huang

《医学前沿（英文）》 2019年 第13卷 第3期   页码 365-377 doi: 10.1007/s11684-018-0641-0

摘要： Invasive fungal disease (IFD) is a major infectious complication in patients with hematological malignancies. In this study, we examined 4889 courses of chemotherapy in patients with hematological diseases to establish a training dataset ( =3500) by simple random sampling to develop a weighted risk score for proven or probable IFD through multivariate regression, which included the following variables: male patients, induction chemotherapy for newly diagnosed or relapsed disease, neutropenia, neutropenia longer than 10 days, hypoalbuminemia, central-venous catheter, and history of IFD. The patients were classified into three groups, which had low (0–10, ~1.2%), intermediate (11–15, 6.4%), and high risk (>15, 17.5%) of IFD. In the validation set ( =1389), the IFD incidences of the groups were ~1.4%, 5.0%, and 21.4%. In addition, we demonstrated that anti-fungal prophylaxis offered no benefits in low-risk patients, whereas benefits were documented in intermediate (2.1% vs. 6.6%, =0.007) and high-risk patients (8.4% vs. 23.3%, =0.007). To make the risk score applicable for clinical settings, a pre-chemo risk score that deleted all unpredictable factors before chemotherapy was established, and it confirmed that anti-fungal prophylaxis was beneficial in patients with intermediate and high risk of IFD. In conclusion, an objective, weighted risk score for IFD was developed, and it may be useful in guiding antifungal prophylaxis.

关键词： invasive fungal diseases     hematological malignancies     chemotherapy     risk score     prophylaxis    

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Clinical outcomes and prognostic factors of patients with epithelial ovarian cancer subjected to first-line treatment: a retrospective study of 251 cases

null

《医学前沿（英文）》 2014年 第8卷 第1期   页码 91-95 doi: 10.1007/s11684-014-0305-7

摘要：

A total of 251 patients with epithelial ovarian cancer (EOC) treated between 2002 and 2008 was retrospectively analyzed to investigate the long-term outcomes and prognostic factors of these patients, particularly those who underwent primary debulking surgery followed by platinum-based chemotherapy. Clinico-pathological parameters, including progression-free survival (PFS) and overall survival (OS), were also analyzed. The median follow-up period from the end of initial treatment to June 2010 was 58 months. The three-year PFS rate was 61.7% for International Federation of Gynecology and Obstetrics (FIGO) I–II, 19.9% for FIGO III–IV, and 33.9% for all stages. By comparison, the five-year PFS rate was 44.6% for FIGO I–II, 17.7% for FIGO III–IV, and 28.3% for all stages. The three-year OS rate was 67.9% for FIGO I–II, 41.7% for FIGO III–IV, and 50.2% for all stages. The five-year OS rate was 52.7% for FIGO I–II, 30.8% for FIGO III–IV, and 39.2% for all stages. Univariate analysis revealed that advanced FIGO stage, serum CA125, and suboptimal debulking were significant factors affecting PFS and OS. In multivariate analysis, PFS was significantly influenced by FIGO stage and suboptimal debulking. However, OS was significantly influenced by advanced FIGO stage only. Our study confirms the efficacy of surgery followed by platinum-based chemotherapy for EOC. FIGO stage is considered as one of the most reliable predictors of the prognosis of patients with EOC.

关键词： ovarian carcinoma     prognostic factors     surgery     chemotherapy     survival    

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Improved local control without elective nodal radiotherapy in patients with unresectable NSCLC treated by 3D-CRT

YANG Kunyu, LIU Li, ZHANG Tao, WU Gang, CAO Fengjun, WANG Jianhua

《医学前沿（英文）》 2007年 第1卷 第4期   页码 381-385 doi: 10.1007/s11684-007-0074-7

摘要： To investigate the influence of prophylactic elective nodal irradiation on the therapeutic results of definitive radiotherapy for patients with stage IIIA or stage IIIB unresectable non-small-cell lung cancer, 55 patients with clinically inoperable advanced non-small-cell lung cancer were studied. After four cycles of induction chemotherapy, the patients were divided into two groups at random. In one group, the elective nodal irradiation was included in clinical tumor volume (CTV) of definitive radiotherapy (ENI group); and in the other group, elective nodal irradiation was not included in CTV (non-ENI group). For the patients in the ENI group, the mean prescription dose for gross tumor volumes was 58.4 Gy, while for the patients in the non-ENI group, it was 65.8 Gy (<0.05). The responsive rates were 45.8% and 74.0% (<0.05), and the rate of the elective nodal failure (ENF) was 4.2% and 11.1%, respectively. Kaplan-Meier analysis showed that the mean local-progression-free survival time was 11.0 and 15.0 months, and one-year local-failure rates were 51.9% and 24.5% (<0.05). The median overall survival time was 13.0 and 15.0 months, respectively ( = 0.084). The one-year survival rates were 55.7% and 72.5%, and two-year survival rates were 0% and 19.9%. There was no significant difference in the occurrences of radiation-associated complications between the two groups. Our results showed that omitting elective nodal irradiation did not result in a high incidence of elective nodal failure. On the contrary, it decreased local failure by increasing prescription doses to the primary diseases and lymphadenopaphy, and thereby it may further prolong the patients survival.

关键词： significant difference     irradiation     unresectable non-small-cell     induction chemotherapy     influence    

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Chemotherapy initiation with single-course methotrexate alone or combined with dactinomycin versus multi-course

《医学前沿（英文）》 2022年 第16卷 第2期   页码 276-284 doi: 10.1007/s11684-021-0855-4

摘要： We aimed to evaluate the effectiveness and safety of single-course initial regimens in patients with low-risk gestational trophoblastic neoplasia (GTN). In this trial (NCT01823315), 276 patients were analyzed. Patients were allocated to three initiated regimens: single-course methotrexate (MTX), single-course MTX+ dactinomycin (ACTD), and multi-course MTX (control arm). The primary endpoint was the complete remission (CR) rate by initial drug(s). The primary CR rate was 64.4% with multi-course MTX in the control arm. For the single-course MTX arm, the CR rate was 35.8% by one course; it increased to 59.3% after subsequent multi-course MTX, with non-inferiority to the control (difference –5.1%, 95% confidence interval (CI) –19.4% to 9.2%, P=0.014). After further treatment with multi-course ACTD, the CR rate (93.3%) was similar to that of the control (95.2%, P=0.577). For the single-course MTX+ACTD arm, the CR rate was 46.7% by one course, which increased to 89.1% after subsequent multi-course, with non-inferiority (difference 24.7%, 95% CI 12.8%–36.6%, P<0.001) to the control. It was similar to the CR rate by MTX and further ACTD in the control arm (89.1% vs. 95.2%, P=0.135). Four patients experienced recurrence, with no death, during the 2-year follow-up. We demonstrated that chemotherapy initiation with single-course MTX may be an alternative regimen for patients with low-risk GTN.

关键词： gestational trophoblastic neoplasia (GTN)     methotrexate (MTX)     dactinomycin (ACTD)    

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Anlotinib as third- or further-line therapy for short-term relapsed small-cell lung cancer: subgroup analysis of a randomized phase 2 study (ALTER1202)

《医学前沿（英文）》 2022年 第16卷 第5期   页码 766-772 doi: 10.1007/s11684-021-0916-8

摘要： Patients with small-cell lung cancer (SCLC) relapse within months after completing previous therapies. This study aimed to investigate the efficacy and safety of anlotinib as third- or further-line therapy in patients with short-term relapsed SCLC from ALTER1202. Patients with short-term relapsed SCLC (disease progression within 3 months after completing ≥ two lines of chemotherapy) in the anlotinib (n = 67) and placebo (n = 34) groups were analyzed. The primary endpoint was progression-free survival (PFS). The secondary endpoints included overall survival, objective response rate (ORR), disease control rate, and safety. Anlotinib significantly improved median PFS/OS (4.0 vs. 0.7 months, P < 0.0001)/(7.3 vs. 4.4 months, P = 0.006) compared with placebo. The ORR was 4.5%/2.9% in the anlotinib/placebo group (P = 1.000). The DCR in the anlotinib group was higher than that in the placebo group (73.1% vs. 11.8%, P < 0.001). The most common adverse events (AEs) were hypertension (38.8%), loss of appetite (28.4%), and fatigue (22.4%) in the anlotinib group and gamma-glutamyl transpeptidase elevation (20.6%) in the placebo group. No grade 5 AEs occurred. For patients with short-term relapsed SCLC, third- or further-line anlotinib treatment was associated with improved survival benefit. Further studies are warranted in this regard.

关键词： anlotinib     chemotherapy     short-term relapsed     small-cell lung cancer    

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Ozonation of the 5-fluorouracil anticancer drug and its prodrug capecitabine: Reaction kinetics, oxidation mechanisms, and residual toxicity

Siyu Chen, Lee Blaney, Ping Chen, Shanshan Deng, Mamatha Hopanna, Yixiang Bao, Gang Yu

《环境科学与工程前沿（英文）》 2019年 第13卷 第4期 doi: 10.1007/s11783-019-1143-2

摘要：

Specific second-order rate constants were determined for 5-FU and CAP with ozone.

Reaction sites were confirmed by kinetics, Fukui analysis, and products.

The olefin moiety was the main ozone reaction site for 5-FU and CAP.

Carboxylic acids comprised most of the residual TOC for 5-FU.

Ozonation removed the toxicity associated with 5-FU and products but not CAP.

关键词： Ozone     5-fluorouracil     Capecitabine     Hydroxyl radicals     Chemotherapy agents     Toxicity    

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标题 作者 时间 类型 操作

Adjuvant chemotherapy versus adjuvant concurrent chemoradiotherapy after radical surgery for early-stage

期刊论文

allogeneic transplantation could be used as a salvage option for patients with relapsed acute leukemia post-chemotherapy

期刊论文

Effect of pEGFP-survivin on GBC-SD cell growth and chemotherapy sensitivity

Hanbin SHEN MD, Bin ZHANG MBA, Song ZHAO BM, Qichang ZHENG MD, Jianping GONG MD, Xiaotang CAI BM,

期刊论文

Clinical outcomes of ATP-tumor chemosensitivity assay directed chemotherapy in hepatocellular carcinoma

RAO Rongsheng, CHEN Wenxue, ZHOU Xinwen, ZHOU Zheng, LI Xiaojun, ZENG Zhiping

期刊论文

Clinical risk score for invasive fungal diseases in patients with hematological malignancies undergoing chemotherapy

Ling Wang, Ying Wang, Jiong Hu, Yuqian Sun, He Huang, Jing Chen, Jianyong Li, Jun Ma, Juan Li, Yingmin Liang, Jianmin Wang, Yan Li, Kang Yu, Jianda Hu, Jie Jin, Chun Wang, Depei Wu, Yang Xiao, Xiaojun Huang

期刊论文

Clinical outcomes and prognostic factors of patients with epithelial ovarian cancer subjected to first-line treatment: a retrospective study of 251 cases

null

期刊论文

Improved local control without elective nodal radiotherapy in patients with unresectable NSCLC treated by 3D-CRT

YANG Kunyu, LIU Li, ZHANG Tao, WU Gang, CAO Fengjun, WANG Jianhua

期刊论文

Chemotherapy initiation with single-course methotrexate alone or combined with dactinomycin versus multi-course

期刊论文

Anlotinib as third- or further-line therapy for short-term relapsed small-cell lung cancer: subgroup analysis of a randomized phase 2 study (ALTER1202)

期刊论文

Ozonation of the 5-fluorouracil anticancer drug and its prodrug capecitabine: Reaction kinetics, oxidation mechanisms, and residual toxicity

Siyu Chen, Lee Blaney, Ping Chen, Shanshan Deng, Mamatha Hopanna, Yixiang Bao, Gang Yu

期刊论文

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