Comparison of MACT and 5Fu+ACT-D chemotherapy regimens in the treatment of low-risk gestational trophoblastic neoplasia.

The study aimed to compare the efficacy of methotrexate (MTX) cervical injections + actinomycin-D (ACT-D)(MACT) and 5-fluorouracil (5-Fu) + actinomycin-D (5-Fu plus ACT-D) chemotherapy regimens for low-risk gestational trophoblastic neoplasia (LR-GTN). Clinical data from 66 LR-GTN patients, admitted to the Beijing Obstetrics and Gynecology Hospital from January 2010 to April 2012, were analysed retrospectively. In total, 32 patients were treated with a MACT therapeutic regimen and the remaining 34 with a 5Fu + ACT-D therapeutic regimen. Complete remission rates (CR), duration of treatment, hospital stay and toxicity effects were compared. There was no statistical difference in CR for the MACT (90.63%) or the 5-Fu plus ACT-D (100%) therapeutic regimens (p = 0.0676) or in the duration of treatment [MACT (3.50) or 5-Fu plus ACT-D (3.71; p = 0.2021)]. Moreover, the hospital stay in the 5-Fu plus ACT-D group (32.88 days) was significantly longer than for the MACT group (22.09 days; p ï¼œ 0.001). Furthermore, the degree of myelosuppression, nausea and vomiting, diarrhoea, stomatitis and alopecia was more severe in the 5Fu + ACT-D group (p ï¼œ 0.01). However, there was no statistical difference in the severity of liver function damage between the two groups. A shorter hospital stay, lower hospitalization cost and slightly more toxic effects were observed in LR-GTN patients treated with the MACT therapeutic regimen. We suggest that the MACT regimen should be used as first-line chemotherapy for LR-GTN.

Interleukin-6-induced epithelial-mesenchymal transition through signal transducer and activator of transcription 3 in human cervical carcinoma.

Epithelial-mesenchymal transition (EMT) is an important process in the invasion and metastasis of human cervical carcinoma. The pro-inflammatory cytokine interleukin-6 (IL-6) has been shown as an EMT inducer in multiple carcinomas. However, whether the EMT program can be induced by IL-6 and the mechanisms underlying the IL-6-induced EMT in human cervical carcinoma remain to be determined. In this study, we show that IL-6 receptor (IL-6R) and signal transducer and activator of transcription 3 (Stat3) were highly expressed in human cervical squamous cell carcinoma (CSCC) tissues, and the expression of EMT markers was reversed in well-differentiated and poorly-differentiated human CSCC. Additional experiments showed that IL-6 exposure in cervical carcinoma cell lines induced IL-6R and Stat3 expression, markedly promoted cell growth, and altered cell morphology. The treatment of cervical carcinoma cell lines with IL-6 resulted in downregulation of E-Cadherin and upregulation of Vimentin. Importantly, knockdown of Stat3 significantly reversed the IL-6-induced EMT program, suggesting that Stat3 is necessary for IL-6-induced EMT in the progression of human cervical carcinoma. Moreover, Slug, a member of the Snail family of EMT regulators, was observed to be associated with the expression of Stat3. We concluded that IL-6 plays an important role through Stat3 in the EMT induction and can be a potential therapeutic target and biomarker for human cervical carcinoma.

High-risk endometrial cancer may be benefit from adjuvant radiotherapy plus chemotherapy.

OBJECTIVE: To present patterns of practice and outcomes in the adjuvant treatment of intermediate- and high-risk endometrial cancer. METHODS: Retrospective data on 224 women with intermediate-risk and high-risk endometrial cancer from 1999 to 2006 were reviewed. All patients underwent surgical staging. Patterns of adjuvant treatment, consisting of pelvic radiotherapy, chemotherapy, and radiotherapy plus chemotherapy, were assessed. The 3- and 5-year disease-specific survival (DSS) rates were calculated using the Kaplan-Meier method. RESULTS: The difference in 5-year DSS rate was statistically significant between adjuvant group and non-adjuvant group (80.65% vs. 63.80%, P=0.040). In 110 high-risk patients who underwent adjuvant treatment, both 5-year DSS rate and recurrent rate were significantly different in combined radiotherapy and chemotherapy group compared with radiotherapy alone and chemotherapy alone groups (DSS rate, P=0.049; recurrent rate, P=0.047). In 83 intermediate-risk women who underwent adjuvant treatment, there was no significant difference in 5-year DSS rate and recurrence rate among the combined radiotherapy and chemotherapy, radiotherapy alone and chemotherapy alone groups (DSS rate, P=0.776; recurrent rate, P=0.937). CONCLUSIONS: Adjuvant radiotherapy plus chemotherapy is associated with a higher 5-year DSS rate and lower recurrence rate compared with radiotherapy alone and chemotherapy alone in high-risk endometrial cancer patients. Patients with intermediate-risk endometrial cancer may be not likely to benefit from adjuvant combined radiotherapy and chemotherapy.

[Mechanistic study of radiosensitization by gemcitabine on human squamous carcinoma cell line of the cervix].

OBJECTIVE: To investigate whether gemcitabine (dFdC) at the non-cytotoxic concentration enhances the effect of irradiation on human squamous carcinoma cells of the uterine cervix (HeLa) in vitro, and to evaluate the mechanism by which dFdC at the non-cytotoxic concentration [24 h 10% inhibiting concentration (IC(10))] is able to enhance radiation-induced cytotoxicity to HeLa in vitro. METHODS: The non-cytotoxic concentration (24 h IC(10)) of dFdC was determined by methyl thiazolyl tetrazolium (MTT). After exposure to the non-cytotoxic concentration (0.01 micro mol/L) for 4, 8, 12 and 24 hours followed by immediate irradiation (4, 6 and 8 Gy), the surviving fraction was counted and the radiation enhancement ratio (RER) was evaluated. Cell cycle distribution and apoptosis were analyzed by flow cytometry. The expressions of p53, bcl-2 and bax were studied by western blot. RESULTS: After exposure to non-cytotoxic concentration (0.01 micro mol/L) for 4, 8, 12 and 24 hours followed by immediate irradiation, the RER was 1.19, 1.35, 1.72 and 1.93, respectively. After exposed to dFdC, HeLa cells showed an S phase block. The proportion of S phase cells was elevated with the increase of exposure duration (P < 0.01). The S-phase proportion increased to 51.8% at 24 hours of exposure. Meanwhile, compared with the single-agent treatments, combination of dFdC and radiation did not additionally increase the number of apoptotic cells and expression of proteins related to apoptosis such as p53, bcl-2 and bax (P > 0.05). CONCLUSIONS: HeLa cells were radiosensitive at IC(10) concentration of dFdC. The radiosensitization effect depends on the exposure duration to dFdC. There appears a strong association between the radiosensitization and the progression of cells into S-phase after dFdC treatment. Combination of dFdC and radiation did not increase apoptosis of HeLa cells.