Interfacial Engineering of MoS2@CoS2 Heterostructure Electrocatalysts for Effective pH-Universal Hydrogen Evolution Reaction.

The practical utilization of the hydrogen evolution reaction (HER) necessitates the creation of electrocatalysts that are both efficient and abundant in earth elements, capable of operating effectively within a wide pH range. However, this objective continues to present itself as an arduous obstacle. In this research, we propose the incorporation of sulfur vacancies in a novel heterojunction formed by MoS2@CoS2, designed to exhibit remarkable catalytic performances. This efficacy is attributed to the advantageous combination of the low work function and space charge zone at the interface between MoS2 and CoS2 in the heterojunction. The MoS2@CoS2 heterojunction manifests outstanding hydrogen evolution activity over an extensive pH range. Remarkably, achieving a current density of 10 mA cm-2 in aqueous solutions 1.0 M KOH, 0.5 M H2SO4, and 1.0 M phosphate-buffered saline (PBS), respectively, requires only an overpotential of 48, 62, and 164 mV. The Tafel slopes for each case are 43, 32, and 62 mV dec-1, respectively. In this study, the synergistic effect of MoS2 and CoS2 is conducive to electron transfer, making the MoS2@CoS2 heterojunction show excellent electrocatalytic performance. The synergistic effects arising from the heterojunction and sulfur vacancy not only contribute to the observed catalytic prowess but also provide a valuable model and reference for the exploration of other efficient electrocatalysts. This research marks a significant stride toward overcoming the challenges associated with developing electrocatalysts for practical hydrogen evolution applications.

Analysis of tumor microenvironment alterations in partially responsive rectal cancer patients treated with neoadjuvant chemoradiotherapy.

PURPOSE: Achieving a pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (NCRT) remains a challenge for most patients with rectal cancer. Exploring the potential of combining NCRT with immunotherapy or targeted therapy for those achieving a partial response (PR) offers a promising avenue to enhance treatment efficacy. This study investigated the impact of NCRT on the tumor microenvironment in locally advanced rectal cancer (LARC) patients who exhibited a PR. METHODS: This was a retrospective, observational study. Five patients demonstrating a PR after neoadjuvant treatment for LARC were enrolled in the study. Biopsy samples before treatment and resected specimens after treatment were stained with a panel of 26 antibodies targeting various immune and tumor-related markers, each labeled with distinct metal tags. The labeled samples were then analyzed using the Hyperion imaging system. RESULTS: Heterogeneity within the tumor microenvironment was observed both before and after NCRT. Notably, tumor-associated macrophages, CD4 + T cells, CD8 + T cells, CD56 + natural killer cells, tumor-associated neutrophils, cytokeratin, and E-cadherin exhibited slight increase in abundance within the tumor microenvironment following treatment (change ratios = 0.78, 0.2, 0.27, 0.32, 0.17, 0.46, 0.32, respectively). Conversely, the number of CD14 + monocytes, CD19 + B cells, CD45 + CD4 + T cells, collagen I, α-smooth muscle actin, vimentin, and ß-catenin proteins displayed significant decreases post-treatment (change ratios = 1.73, 1.92, 1.52, 1.25, 1.52, 1.12, 2.66, respectively). Meanwhile, Foxp3 + regulatory cells demonstrated no significant change (change ratio = 0.001). CONCLUSIONS: NCRT has diverse effects on various components of the tumor microenvironment in LARC patients who achieve a PR after treatment. Leveraging combination therapies may optimize treatment outcomes in this patient population.

Analysis of the efficacy and factors influencing survival of adjuvant radiotherapy for stage II-III biliary tract carcinoma.

BACKGROUND: To determine the efficacy of adjuvant radiotherapy for stage II-III biliary tract carcinoma. METHODS: We retrospectively analyzed the data of 37 patients who underwent radical resection of biliary tract carcinomas at the Affiliated Hospital of Inner Mongolia Medical University between 2016 and 2020. We analyzed survival differences between patients who did (n = 17) and did not (n = 20) receive postoperative adjuvant radiotherapy by using Kaplan-Meier analysis. The log-rank test and Cox univariate analysis were used. The Cox proportional risk regression model was used for the multifactorial analysis of factors influencing prognosis. RESULTS: The median survival time (28.9 vs. 14.5 months) and the 1-year (82.40% vs. 55.0%) and 2-year survival rates (58.8% vs. 25.0%) were significantly higher among patients who received adjuvant radiotherapy than among those who did not (χ2 = 6.381, p = 0.012). Multifactorial analysis showed that pathological tumor type (p = 0.004), disease stage (p = 0.021), and adjuvant radiotherapy (p = 0.001) were independent prognostic factors in biliary tract carcinoma. Subgroup analyses showed that compared to no radiotherapy, adjuvant radiotherapy significantly improved median survival time in patients with stage III disease (21.6 vs. 12.7 months; p = 0.017), positive margins (28.9 vs. 10.5 months; p = 0.012), and T3 or T4 tumors (26.8 vs. 16.8 months; p = 0.037). CONCLUSION: Adjuvant radiotherapy significantly improved the survival of patients with biliary tract carcinoma, and is recommended especially for patients with stage III disease, positive surgical margins, or ≥ T3.

Advances and applications of genetically modified pig models in biomedical and agricultural field.

Compared with rodents, pigs are closer to humans in terms of anatomy, metabolism and physiology, so they are ideal animal models of human diseases and xenotransplantation donors. In addition, as one of the most important livestock in China, pigs are closely related to our lives in terms of breeding improvement, disease prevention and animal welfare. In this review, we mainly summarize the research progress and future application of genetically modified pig models in the fields of xenotransplantation, molecular breeding and human disease models. We wish to take this opportunity to raise the awareness of researchers in related fields on cutting-edge technologies such as gene editing and understand the significance of genetically modified pig models in life science research.

Clinical Efficacy of Potato Extract for Alleviating Chemoradiotherapy-Related Leukopenia: a Randomized, Single-Blind, Placebo-Controlled Trial.

BACKGROUND: Leukopenia is the most common adverse event in chemotherapy, which natural products can prevent and treat. The aim of this study was to investigate the clinical efficacy of potato extract for alleviating chemoradiotherapy-induced leukopenia in cancer patients. METHODS: This was a single-blinded randomized placebo-controlled trial that enrolled 184 cancer patients. The participants were scheduled to undergo chemoradiotherapy in two hospitals, where they were randomized to receive potato extract or a placebo in a 1:1 ratio for a period of 49 days. Change in leukocyte value was considered the primary outcome of this clinical trial. Secondary outcomes included tumor response rate, blood test, and quality of life score. RESULTS: The leukopenia was relieved in the potato extract group compared with the placebo group. Of note, a significant difference in leukopenia between the two groups was found after 14 days (p = 0.04). In addition, there was no statistically significant difference in leucocyte levels in the potato extract group (before and after potato extract treatment; p = 0.13), but in the placebo group, the leukocyte value significantly decreased compared to before treatment (p = 0.06). CONCLUSIONS: Potato extract can alleviate chemoradiotherapy-induced leukopenia in cancer patients. These results show the potential function of potato extract as a protective agent in management of cancer chemoradiotherapy.

Axillary channel-assisted TOETVA: An effective way to prevent mental nerve from iatrogenic injury?

Aim: To evaluate the protective effect of axillary channel-assisted (ACA) transoral endoscopic thyroidectomy vestibular approach on mental nerve. Materials and Methods: From August 2018 to December 2020, 126 cases of thyroid micro-carcinoma patients who underwent endoscopic thyroidectomy were recruited retrospectively. Of those, 74 cases were performed with ACA trans-oral endoscopic thyroidectomy vestibular approach (ACA_TOETVA) (V and A group), 52 cases received standard TOETVA (V group). On postoperative day 1 (POD1), nylon monofilament test and numbness visual analogue scale score were conducted to evaluate the severity of numbness within the mental area, facial expression was tested to determine the motor function of lower mandible and the thickness of cutaneous and subcutaneous layers was measured with ultrasound. The other observation parameters including the time for operation and intraoperative blood loss were carefully collected. Results: On POD1, nylon monofilament test showed that scores in the V and A group (2.9 ± 0.3) were significantly higher than V group (1.7 ± 0.5), P < 0.01, u = 254. The completion percentage of facial expression in the V and A group was 90.5% (67/74) and significantly higher than in V group (21.2%, 11/52), P < 0.01, χ2 = 62.35. The thickness increment of cutaneous and subcutaneous layer was 2.2 ± 1.2 mm in the V and A group, which was significantly less than in the V group (4.0 ± 1.2 mm), P < 0.01, u = 605. Compared with V group, the operation time (113.4 ± 22.3 min vs. 127.7 ± 25.6 min, u = 1262) and intraoperative blood loss (43.5 ± 13.4 ml vs. 51.0 ± 14.1 ml, u = 1355) were also significantly less in the V and A group. Conclusions: The ACA transoral endoscopic thyroidectomy possesses the protective effect on mental nerve and motor function of lower mandible and facilitates the operative procedures of TOETVA.

Self-assembled nanoparticles of reduction-sensitive poly (lactic-co-glycolic acid)-conjugated chondroitin sulfate A for doxorubicin delivery: preparation, characterization and evaluation.

In this study, reduction-sensitive self-assembled polymer nanoparticles based on poly (lactic-co-glycolic acid) (PLGA) and chondroitin sulfate A (CSA) were developed and characterized. PLGA was conjugated with CSA via a disulfide linkage (PLGA-ss-CSA). The critical micelle concentration (CMC) of PLGA-ss-CSA conjugate is 3.5 µg/mL. The anticancer drug doxorubicin (DOX) was chosen as a model drug, and was effectively encapsulated into the nanoparticles (PLGA-ss-CSA/DOX) with high loading efficiency of 15.1%. The cumulative release of DOX from reduction-sensitive nanoparticles was only 34.8% over 96 h in phosphate buffered saline (PBS, pH 7.4). However, in the presence of 20 mM glutathione-containing PBS environment, DOX release was notably accelerated and almost complete from the reduction-sensitive nanoparticles up to 96 h. Moreover, efficient intracellular DOX release of PLGA-ss-CSA/DOX nanoparticles was confirmed by CLSM assay in A549 cells. In vitro cytotoxicity study showed that the half inhibitory concentrations of PLGA-ss-CSA/DOX nanoparticles and free DOX against A549 cells were 1.141 and 1.825 µg/mL, respectively. Therefore, PLGA-ss-CSA/DOX nanoparticles enhanced the cytotoxicity of DOX in vitro. These results suggested that PLGA-ss-CSA nanoparticles could be a promising carrier for drug delivery.

Multi-parametric MRI in cervical cancer: early prediction of response to concurrent chemoradiotherapy in combination with clinical prognostic factors.

OBJECTIVE: To investigate the prediction of response to concurrent chemoradiotherapy (CCRT) through a combination of pretreatment multi-parametric magnetic resonance imaging (MRI) with clinical prognostic factors (CPF) in cervical cancer patients. METHODS: Sixty-five patients underwent conventional MRI, diffusion-weighted imaging (DWI), and dynamic contrast-enhanced MRI (DCE-MRI) before CCRT. The patients were divided into non- and residual tumour groups according to post-treatment MRI. Pretreatment MRI parameters and CPF between the two groups were compared and prognostic factors, optimal thresholds, and predictive performance for post-treatment residual tumour occurrence were estimated. RESULTS: The residual group showed a lower maximum slope of increase (MSIL) and signal enhancement ratio (SERL) in low-perfusion subregions, a higher apparent diffusion coefficient (ADC) value, and a higher stage than the non-residual tumour group (p < 0.001, p = 0.003, p < 0.001, and p < 0.001, respectively). MSIL and ADC were independent prognostic factors. The combination of both measures improved the diagnostic performance compared with individual MRI parameters. A further combination of these two factors with CPF exhibited the highest predictive performance. CONCLUSIONS: Pretreatment MSIL and ADC were independent prognostic factors for cervical cancer. The predictive capacity of multi-parametric MRI was superior to individual MRI parameters. The combination of multi-parametric MRI with CPF further improved the predictive performance. KEY POINTS: • Pretreatment MSI L and ADC were independent prognostic factors for post-treatment residual tumours. • The residual groups showed lower MSI L , higher ADC and higher stage. • The predictive capacity of multi-parametric MRI was superior to individual MRI parameters. • The combination of multi-parametric MRI with CPF exhibited the highest predictive performance.

Minimum apparent diffusion coefficient for predicting lymphovascular invasion in invasive cervical cancer.

PURPOSE: To investigate the diagnostic performance of minimum apparent diffusion coefficient (mini-ADC) for predicting lymphovascular invasion (LVI) in invasive cervical cancer. MATERIALS AND METHODS: Ninety-six patients with pathologically confirmed invasive cervical cancer (CC) underwent conventional preoperative magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) on a 3.0T MRI system. Tumor ADC, mini-ADC and mini-ADC ratio (mini-ADC value / tumor ADC value) were obtained and compared between LVI-positive and LVI-negative invasive CC, and correlation between LVI status and Ki-67, p16, p63, and clinical prognostic factors were analyzed. ADC thresholds and diagnostic performance were determined by receiver operating characteristic (ROC) analysis. RESULTS: Tumor ADC showed no significant difference (P = 0.300) between LVI-positive invasive CC (n = 27) and LVI-negative invasive CC (n = 69); the mini-ADC and mini-ADC ratio were significantly lower in LVI-positive invasive CC than in LVI-negative invasive CC ([0.712 ± 0.078 × 10-3 mm2 /s] vs. [0.867 ± 0.099 × 10-3 mm2 /s], P < 0.001; and [0.772 ± 0.062] vs. [0.917 ± 0.052], P < 0.001, respectively). ROC curve analysis yielded a cutoff mini-ADC value of 0.837 in the differentiation of LVI-positive and LVI-negative invasive CC, with a sensitivity of 65%, specificity of 100%, and area under the curve (AUC) of 0.885; a cutoff mini-ADC ratio of 0.875 with a sensitivity of 78%, specificity of 100%, AUC of 0.970, positive predictive value of 100%, and negative predictive value of 64%. There was a positive correlation between LVI status and Ki-67 (r = 0.241, P = 0.014) and a negative correlation between mini-ADC and LVI status (r = -0.582, P < 0.001); mini-ADC and Ki-67 (r = -0.587, P < 0.001). CONCLUSION: Mini-ADC value appears to be a simple and effective tool for the prediction of LVI status in invasive CC, and the mini-ADC ratio may be the best parameter in discriminating between LVI-positive and LVI-negative invasive CC. LEVEL OF EVIDENCE: 1 Technical Efficacy: Stage 4 J. MAGN. RESON. IMAGING 2017;45:1771-1779.

Genome editing technologies drive the development of pig genetic improvement.

Nuclease-mediated genome editing technologies contribute to the rapid advances in life sciences via the ability to edit the genomes within living cells, and present a new era for porcine genetic improvement. In this review, we introduce the development of various genomic editing technologies, particularly CRISPR/Cas9 strategies and characteristics of various naturally occurring and artificially engineered CRISPR enzymes. Also, we summarize progress in pig genetic improvement mediated by genome editing, especially those associated with meat quality traits and anti-virus resistance. We highlight the challenges in the implementation of pig genetic improvement and the prospects of pig genetic breeding based on genome editing technologies.

Amarogentin secoiridoid inhibits in vivo cancer cell growth in xenograft mice model and induces apoptosis in human gastric cancer cells (SNU-16) through G2/M cell cycle arrest and PI3K/Akt signalling pathway.

PURPOSE: To investigate the in vitro and in vivo antitumor effects of amarogentin in SNU-16 human gastric cancer cells as well as in nude mice xenograft model. The effects of this compound on cell apoptosis, cell cycle phase distribution and PI3K/Akt and m-TOR signalling pathways were also studied in detail. METHODS: MTT assay was used to study the effect of amarogentin on SNU-16 cell viability while clonogenic assay indicated the effect of the compound on colony formation tendency of these cells. Phase contrast microscopy revealed the effect on cellular morphology while flow cytometry was engaged to study the effects on cell apoptosis and cell cycle arrest. SNU-16 cancer cells were subcutaneously inoculated into nude mice to investigate the in vivo antitumor effects of amarogentin. RESULTS: Amarogentin induced potent, dose-dependent as well as time-dependent cytotoxic effects on the growth of SNU-16 human gastric cancer cells. Amarogentin also inhibited the colony forming capability of these tumor cells and its treatment led to morphological alterations in these cells in which the cells became withered and rounded, detached from one another and adopted irregular shapes while floating freely in the culture medium. In comparison to untreated control cells, the amarogentin treated cells with 10, 50 and 75 µM exhibited 32.5, 45.2 and 57.1 % apoptotic cells, respectively. Amarogentin induced potent and dose-dependent G2/M cell cycle arrest in these cells and led to downregulation of m-TOR, p-PI3K, PI3K, p-Akt and Akt and upregulation of cyclin D1 and cyclin E protein expressions. The tumor tissues obtained from the amarogentin-treated mice were much smaller than the tumor tissues derived from the control group. CONCLUSION: Amarogentin exerts potent in vitro and in vivo antitumor effects in SNU-16 cell model as well as in nude mice xenograft model. These antitumor effects were found to be mediated through apoptosis induction, G2/M cell cycle arrest and downregulation of PI3K/Akt/m-TOR signalling pathways.

Erratum: Amarogentin secoiridoid inhibits in vivo cancer cell growth in xenograft mice model and induces apoptosis in human gastric cancer cells (SNU-16) through G2/M cell cycle arrest and PI3K/Akt signalling pathway.

In the version of this article initially published, in Volume 21, issue 3, the first affiliation (affiliation number 1) was incorrectly stated as "Department of Pathology, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey". The correct affiliation is "Department of Oncology, Shaoxing People's Hospital ,Shaoxing Hospital of Zhejiang University, Shaoxing 312000,China'. This error appeared only in the PubMed database and not in the print form of the Journal.

Facile preparation of graphene by high-temperature electrolysis and its application in supercapacitor.

Graphene is well known owing to its astonishing properties: stronger than diamond, more conductive than copper and more flexible than rubber. Because of its potential uses in industry, researchers have been searching for less toxicity ways to make graphene in large amount with lower cost. We demonstrated an efficient method to prepare graphene by high temperature electrolysis technique. High resolution scanning electron microscopy and raman spectroscopy were used to characterize the microstructure of graphene. Graphene was assembled into the supercapacitor and its performance of electrochemical capacitor was investigated by constant current charge and discharge, cyclic voltammetry and AC impedance. The results showed that the micro-morphology of the prepared graphene was multilayer and it was favorable when the electrolytic voltage was 1.5 V. When the current density is 1 mA/cm(2), the specific capacitance of the graphene supercapacitor can reach 78.01 F/g in 6 mol/L KOH electrolyte, which was an increase of 114% compared with 36.43 F/g of conventional KOH electrolyte.

Genetically modified pigs: Emerging animal models for hereditary hearing loss.

Hereditary hearing loss (HHL), a genetic disorder that impairs auditory function, significantly affects quality of life and incurs substantial economic losses for society. To investigate the underlying causes of HHL and evaluate therapeutic outcomes, appropriate animal models are necessary. Pigs have been extensively used as valuable large animal models in biomedical research. In this review, we highlight the advantages of pig models in terms of ear anatomy, inner ear morphology, and electrophysiological characteristics, as well as recent advancements in the development of distinct genetically modified porcine models of hearing loss. Additionally, we discuss the prospects, challenges, and recommendations regarding the use pig models in HHL research. Overall, this review provides insights and perspectives for future studies on HHL using porcine models.

Comparative analysis of primate and pig cells reveals primate-specific PINK1 expression and phosphorylation.

PTEN-induced putative kinase 1 (PINK1), a mitochondrial kinase that phosphorylates Parkin and other proteins, plays a crucial role in mitophagy and protection against neurodegeneration. Mutations in PINK1 and Parkin can lead to loss of function and early onset Parkinson's disease. However, there is a lack of strong in vivo evidence in rodent models to support the theory that loss of PINK1 affects mitophagy and induces neurodegeneration. Additionally, PINK1 knockout pigs ( Sus scrofa) do not appear to exhibit neurodegeneration. In our recent work involving non-human primates, we found that PINK1 is selectively expressed in primate brains, while absent in rodent brains. To extend this to other species, we used multiple antibodies to examine the expression of PINK1 in pig tissues. In contrast to tissues from cynomolgus monkeys ( Macaca fascicularis), our data did not convincingly demonstrate detectable PINK1 expression in pig tissues. Knockdown of PINK1 in cultured pig cells did not result in altered Parkin and BAD phosphorylation, as observed in cultured monkey cells. A comparison of monkey and pig striatum revealed more PINK1-phosphorylated substrates in the monkey brain. Consistently, PINK1 knockout in pigs did not lead to obvious changes in the phosphorylation of Parkin and BAD. These findings provide new evidence that PINK1 expression is specific to primates, underscoring the importance of non-human primates in investigating PINK1 function and pathology related to PINK1 deficiency.

Knockdown of UCHL5IP causes abnormalities in γ-tubulin localisation, spindle organisation and chromosome alignment in mouse oocyte meiotic maturation.

UCHL5IP is one of the subunits of the haus complex, which is important for microtubule generation, spindle bipolarity and accurate chromosome segregation in Drosophila and human mitotic cells. In this study, the expression and localisation of UCHL5IP were explored, as well as its functions in mouse oocyte meiotic maturation. The results showed that the UCHL5IP protein level was consistent during oocyte maturation and it was localised to the meiotic spindle in MI and MII stages. Knockdown of UCHL5IP led to spindle defects, chromosome misalignment and disruption of γ-tubulin localisation in the spindle poles. These results suggest that UCHL5IP plays critical roles in spindle formation during mouse oocyte meiotic maturation.

[The spinous process tenderness syndrome--a new naming of a series of common symptoms].

The rheumatoid activity on any part of the spine may affect the surrounding nerves, causing a series of symptoms at the related region of the innervations. By pressing corresponding parts on spinous processes of patient spine, tenderness of various degrees occurs. We named this kind of symptoms as "the spinous process tenderness syndrome". Meanwhile, we borrowed laboratory and imaging examinations to diagnose and differential identify. The symptoms could be alleviated by eliminating pathogenic reasons, local resting, and anti-rheumatic drugs.

The usefulness and utilization of Gold-finger retractor for endoscopic thyroid surgery.

Aims: In endoscopic surgery, the visual field is frequently obstructed by muscles, blood, and even smoke. To overcome this problem, we have developed a new detachable Gold-finger retractor for narrow-space surgery. Methods: Gold-finger retractor was used in 30 patients to facilitate surgical field exposure and smoke discharge, while in 27 patients, percutaneous silk thread suspension was employed for the same purpose. Both groups underwent endoscopic unilateral thyroidectomy and unilateral central lymph node dissection via oral vestibular microincision combined with the axillary-assisted approach. A comparative analysis was conducted to evaluate the efficacy of the Gold-finger retractor and silk thread suspension in relation to intraoperative exposure effect, surgical fluency, surgeon's comfort, operation time, postoperative complications, and length of hospital stay. This analysis was based on surgical video recordings and postoperative indicators. Results: With Gold-finger retractor support, surgeons were able to perform meticulous operations. Complication rates were similar between the two groups, and no serious complications occurred. The number of lymph nodes dissected in the Gold-finger group was significantly greater than that in the routine group (12.43 ± 6.18 and 5.7 ± 2.95, respectively). Further analysis of surgeons' comfort (visibility and convenience in peeling) revealed that the Gold-finger group was significantly better. Electrosurgery smoke was removed effectively with Gold-finger, and the operation time was significantly reduced. Conclusion: In thyroid surgery, Gold-fingers enhance visual field resolution, avoid muscle cutting, save time, and improve the surgical experience.

A phase II study of modified FOLFOX as first-line chemotherapy in advanced small bowel adenocarcinoma.

This study aimed at assessing the efficacy and safety of biweekly oxaliplatin in combination with continuous infusional 5-fluorouracil and leucovorin (modified FOLFOX regimen) in patients with advanced small bowel adenocarcinoma (SBA). Thirty-three eligible patients with previously untreated SBA received 85 mg/m(2) of oxaliplatin intravenously over a 2-h period on day 1, together with 400 mg/m(2) of leucovorin over 2 h, followed by a 46-h infusion of 5-FU 2600 mg/m(2) every 2 weeks. All patients were evaluable for efficacy and toxicity. A median of nine cycles (range 3-18) was administered. The objective response rate was 48.5% [95% confidence interval (95% CI): 31-67%], with one complete response, 15 partial responses, 12 stable diseases, and five progressions. The median time to progression was 7.8 months (95% CI: 6.0-9.6) and the median overall survival was 15.2 months (95% CI: 11.0-19.4). Toxicity was fairly mild. Grade 3 toxicities included neutropenia (12.1%), thrombocytopenia (3.0%), nausea (6.1%), vomiting (3.0%), diarrhea (3.0%), peripheral neuropathy (9.1%), and fatigue (3.0%), and grade 4 toxicities occurred in none of the patients. The modified FOLFOX regimen is highly active and well tolerated as first-line chemotherapy for advanced SBA patients.

A phase II study of capecitabine plus oxaliplatin as first-line chemotherapy in elderly patients with advanced gastric cancer.

OBJECTIVE: This study aimed at assessing the efficacy and safety of oxaliplatin plus oral capecitabine (XELOX regimen) as first-line chemotherapy in elderly patients with advanced gastric cancer (AGC). PATIENTS AND METHODS: Forty-six eligible patients aged ≥70 years with previously untreated AGC received oxaliplatin 130 mg/m(2) intravenously over a 2-hour period on day 1 plus oral capecitabine 850 mg/m(2) twice daily on days 1-14, every 3 weeks. RESULTS: All patients were evaluable for toxicity and 45 patients for efficacy. A median of 6 cycles (range 1-8) was administered. The overall response rate was 48.9% (95% CI 34-64) with 1 complete response, 21 partial responses, 15 stable diseases and 8 progressions. Median time to progression was 6.0 months (95% CI 3.9-8.1), and the median overall survival was 10.0 months (95% CI 8.6-11.4). Toxicity was fairly mild. Grade 3 toxicities included neutropenia (6.5%), thrombocytopenia (2.2%), nausea (2.2%), vomiting (4.3%), diarrhea (4.3%) as well as peripheral neuropathy (2.2%); grade 4 toxicities occurred in none of the patients. CONCLUSION: The XELOX regimen with capecitabine at a lower dose of 850 mg/m(2) is active, fairly tolerable and conveniently delivered as first-line chemotherapy for elderly AGC patients.