Phase II trial of gefitinib alone without radiation therapy for Japanese patients with brain metastases from EGFR-mutant lung adenocarcinoma.

BACKGROUND: Brain metastases (BM) are a common in patients with lung cancer. Although whole-brain radiation therapy (WBRT) is the standard therapy, it may have a risk of decline in cognitive function of patients. In this study, we evaluated the efficacy of gefitinib alone without radiation therapy for the treatment of patients with BM from lung adenocarcinoma. MATERIALS AND METHODS: Eligible patients had BM from lung adenocarcinoma with epidermal growth factor receptor (EGFR) mutations. Gefitinib was given at 250 mg orally once a day until tumor progression or unacceptable toxicity. RESULTS: Forty-one patients were enrolled. The response rate was 87.8%. No patient experienced grade ≥4 toxicity. The median progression-free survival time was 14.5 months (95% CI, 10.2-18.3 months), and the median overall survival time was 21.9 months (95% CI, 18.5-30.3 months). In compared with L858R, exon 19 deletion was associated with better outcome of patients after treatment with gefitinib in both progression-free (p = 0.003) and overall survival (p = 0.025). CONCLUSION: Favorable response of BM to gefitinib even without irradiation was demonstrated. Exon 19 deletion was both a predictive and prognostic marker of patients with BM treated by gefitinib.

Effects of a charcoal powder-wood vinegar compound solution in piglets for raw pigeon pea seed meal.

Histological intestinal villus alterations were studied in piglets fed a raw pigeon pea meal (PM) diet including a powder mixture of amorphous charcoal carbon and wood vinegar compound solution (CWVC). Twenty-eight male castrated piglets were divided into seven dietary groups of four piglets each. The control group was fed raw PM supplemented to the basal diet (178 g/kg crude protein, 4.23 kcal/g gross energy) at 0 g/kg (CONT), 200 g/kg (PM200) and 400 g/kg (PM400). The treatment groups were fed CWVC in both PM200 and PM400 diet groups at levels of 10 g/kg and 30 g/kg (PM200 + CWVC10, PM200 + CWVC30, PM400 + CWVC10 and PM400 + CWVC30). With increasing dietary PM levels, daily feed intake tended to increase. In contrast, daily body-weight gain tended to decrease, significantly in the PM400 group (P < 0.05), resulting in a significant decrease of feed efficiency in PM groups (P < 0.05). Body-weight gain and feed efficiency were higher in the CWVC groups compared with the PM groups. The duodenum and ileum were longer (P < 0.05) in the PM400 group than in CONT, but were similar to CONT in CWVC groups. The liver was heavier (P < 0.05), whereas the weights of the heart, kidney and stomach were decreased in the CWVC groups than in other groups. Most values for the intestinal villus height, cell area and cell mitosis number were lower in PM groups than those in CONT (P < 0.05) for each intestinal segment; however, these values were higher in CWVC groups than in PM groups (P < 0.05). The epithelial cells on the duodenal villus surface of the PM200 group showed cell morphology almost similar to CONT. However, the PM400 group had a smooth villus surface due to the presence of flat cells. The epithelial cells of the CWVC groups were protuberated, resulting in a much rougher surface than CONT. The current growth performance and histological intestinal alterations in piglets fed PM and PM + CWVC diets demonstrate that the intestinal features might be atrophied by feeding PM, resulting in decreased growth performance. CWVC might prevent the harmful effects of PM dietary toxins on intestinal function, resulting in a normal growth performance.

Intestinal villus histological alterations in piglets fed dietary charcoal powder including wood vinegar compound liquid.

To investigate the effects of dietary charcoal powder including wood vinegar compound liquid (CWVC, 4 : 1) on intestinal villus histology, piglets were fed 0, 1, 3 and 5% dietary CWVC diets for 30 days. Feed intake and body weight gain were measured during the experimental period. At the end of the experiments, intestinal villus height, epithelial cell area and cell mitosis were examined using light microscopy (LM), and the duodenal villus tip surface was observed using scanning electron microscopy (SEM). Feed efficiency tended to be improved in the CWVC group. The 3% CWVC group showed the highest value, followed by 1% CWVC group of most LM parameters in most intestinal parts, but the 5% CWVC group showed the almost similar value compared with the control. In addition, on the duodenal villus tip surface, the 3% CWVC group showed a clearer cell outline, larger cells and cells protuberated further into the lumen than those of the 1% CWVC group. However, the 5% CWVC group showed faint SEM features than the 1% CWVC group. The present trend of improved feed efficiency after feedings of dietary CWVC demonstrates that the CWVC could be incorporated into piglet diets up to 3% level, and that the CWVC might activate intestinal functions both at villus and cellular levels.