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Objective In view of the controversy over radiotherapy target volume for patients with limited-stage small cell lung cancer ( SCLC), a prospective randomized controlled trial was conducted to compare the impact of different radiotherapy target volumes on prognosis. Methods After 2 cycles of EP chemotherapy,patients without progressive disease were randomly assigned to receive thoracic radiotherapy (TRT) to either the post-or pre-chemotherapy primary tumour extent as study arm or control. Involved field radiotherapy (IFRT) to the entire metastatic lymph node regions was applied for both arms. TRT consisted of 45 Gy/30Fx/19 d administered concurrently with cycle 3 chemotherapy. Prophylactic cranial irradiation was administered to patients achieved complete or partial remission. Kaplan-Meier method was used for survival analysis. Results Between June 2002 and December 2017,159 and 150 patients were randomly assigned to study arm and control respectively. The 1-,2-,and 5-year local/regional control rates were 79. 4%,61. 5% and 60. 1% respectively in the study arm versus 79. 8%,66. 5%,and 57. 3% in the control arm (P=0. 73). The median OS time was 22. 1 months in the study arm (95%CI,18. 2-26. 0 months) and 26. 9 months (95%CI,23. 5-30. 3 months) in the control arm,the 1-,3-,5-,and 7-year OS rates were 81. 1%,31. 6%, 23. 9% and 22. 2% respectively in the study arm versus 85. 3%,36. 6%,26. 1% and 20. 0% in the control arm (P=0. 51).Grade 2-3 acute esophagitis was developed in 32. 9% and 43. 2% of patients respectively in study arm and control arm (P=0. 01),while grade 2-3 pulmonary fibrosis was observed in 2. 0% and 10. 9% of patients ( P= 0. 01 ) respectively. Conclusions For patients with limited-stage SCLC who received induction chemotherapy,thoracic radiotherapy can be limited to post-chemotherapy tumour extent and IFRT can be routinely applied.
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<p><b>OBJECTIVE</b>This study aims to evaluate the efficacy and safety of crizotinib for advanced ALK-positive non-small cell lung cancer (NSCLC) patients.</p><p><b>METHODS</b>Twenty-eight patients with advanced ALK-positive NSCLC were given orally crizotinib 250 mg b. i.d., and were followed up to evaluate the therapeutic efficacy and safety.</p><p><b>RESULTS</b>Among the 28 patients, the objective response rate (ORR) was 71.4% (20/28) and disease control rate (DCR) was 92.9% (26/28). Three patients achieved complete response. Seventeen patients had partial response. The most common drug-related adverse events were mild flickering vision and gastrointestinal reaction. Eleven patients experienced flickering vision. Nine patients had nausea and vomiting. Eight patients had diarrhea. They were all reversible and of grade I or II. Only one patient had grade III myelosuppression. Among the 28 patients, 16 cases were disease-free and 12 cases had progressive disease, with a progression-free survival of 8.2 months.</p><p><b>CONCLUSIONS</b>Crizotinib is effective and tolerable in the treatment of advanced ALK-positive NSLCC. However, its long-term treatment efficacy requires to be further studied.</p>
Subject(s)
Humans , Antineoplastic Agents , Therapeutic Uses , Carcinoma, Non-Small-Cell Lung , Drug Therapy , Pathology , Diarrhea , Disease-Free Survival , Lung Neoplasms , Drug Therapy , Pathology , Nausea , Protein Kinase Inhibitors , Therapeutic Uses , Pyrazoles , Therapeutic Uses , Pyridines , Therapeutic Uses , Receptor Protein-Tyrosine Kinases , VomitingABSTRACT
Objective To investigate the distribution of human papillomavirus (HPV) genotypes in male patients with anogenital warts in Lishui area,Zhejiang province.Methods Tissue specimens were obtained from the lesions of 150 male patients with anogenital warts.PCR-reverse dot blot hybridization was performed to detect the presence of 3 low-risk HPV types (HPV 6,11,and 43) and 16 moderate-or high-risk HPV types (HPV 16,18,31,33,35,39,45,51,52,53,56,58,59,66,68 and CP8304) in these specimens.Chi-square test was used for statistical analysis.Results HPV was detected in 91 (60.67％) of the 150 male patients.Of the 91 positive patients,74 (81.32％) were infected by single or multiple low-risk HPV types,whereas 17 (18.68％) by single or multiple high-risk HPV types.Thirty-one (34.07％) patients harbored 2-5 HPV genotypes,including 20 (64.52％)patients infected with both low-risk and high-risk HPV types,and 6 (19.35％) patients infected with two low-risk HPV types.The coexistence of moderate-or high-risk HPV types with HPV 6 was observed in 13 (41.94％)patients,and that with HPV 11 in 6 (19.35％) patients.The most prevalent genotype was HPV 6 (28.68％,39/136),followed by HPV 11 (26.47％,36/136),16 (8.09％,11/136),52 (5.15％,7/136),53 (5.15％,7/136),51 (4.41％,6/136),58 (4.41％,6/136) and 43 (4.41％,6/136).Conclusions Low-risk HPV genotypes predominate in male patients with anogenital warts,and there are large differences in the distribution of multiple infections and HPV genotypes.
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<p><b>BACKGROUND</b>The preclinical experiments and several clinical studies showed icotinib, an oral epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, in Chinese patients with advanced non-small cell lung cancer (NSCLC) who failed previous chemotherapy. We performed a retrospective study of the efficacy and safety of icotinib monotherapy in a different and more recent sample of Chinese patients.</p><p><b>METHODS</b>The clinical data of 149 patients with advanced NSCLC who were admitted to Zhejiang Cancer Hospital from August 1, 2011 to July 31, 2012 were retrospectively analyzed. All patients were given icotinib treatment after the failure of previous chemotherapy. Univariate and multivariate analyses were conducted based on the Kaplan Meier method and Cox proportional hazards model.</p><p><b>RESULTS</b>The objective response rate was 33/149 and disease control rate was 105/149. No complete response occurred. Median progression free survival (PFS) with icotinib treatment was 5.03 months (95% CI: 3.51 to 6.55). Median overall survival was 12.3 months (95% CI: 10.68 to 13.92). Multivariate analysis showed that the mutation of EGFR and one regimen of prior chemotherapy were significantly associated with longer PFS. At least one drug related adverse event was observed in 65.8% (98/149) of patients, but mostly grade 1 or 2 and reversible and none grade 4 toxicity.</p><p><b>CONCLUSIONS</b>Icotinib monotherapy is an effective and well tolerated regimen for Chinese patients with NSCLC after the failure of chemotherapy. It is a promising agent and further study with icotinib in properly conducted trials with larger patient samples and other ethnic groups is warranted.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Antineoplastic Agents , Therapeutic Uses , Carcinoma, Non-Small-Cell Lung , Drug Therapy , Crown Ethers , Therapeutic Uses , Lung Neoplasms , Drug Therapy , Multivariate Analysis , Proportional Hazards Models , Quinazolines , Therapeutic Uses , Retrospective StudiesABSTRACT
Objective To evaluate the prognostic factors of brain metastasis from non-small cell lung cancer and suggest a individualized treatment method proposal with prognostic estimation. Methods From Dec. 2003 to Jan.2007, 183 patients received whole brain radiation therapy (WBRT) were retrospectively analyzed. Kaplan-Meier method was used to analyze the survival. Logrank test was used to evaluate the difference between the groups. Multivariate survival analysis was conducted using a Cox proportional hazard regression model with a backward stepwise procedure. Results The overall l-, 2- and 3-year survival rate was 40.6%, 16.6% and 11.3%, respectively, but with a median survival time of 10.0 months (95% CI 8.6-11.4 months). In multivariate analysis, RAP grouping, weight loss, LDH in blood serum and treatment method were independent prognostic factors. The median survival time of WBRT alone, WBRT with chemotherapy, surgery with chemoradiotherapy and WBRT with Gefitinib was 9.0, 9.0, 22.0 and 13.0 months, respectively, but their difference were statistical significant (X2 = 10.37, P = 0.016). Conclusions The main prognostic factors of brain metastasis from non-small cell lung cancer are RAP grouping, weight loss, LDH in blood serum and treatment method. The survival time is prolonged by proper multidiseiplinary management than WBRT alone. The effect of combined treatment of surgery with chemoradiotherapy is favorable for the patients operated with single region of metastasis.
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Pharmacology Teaching and Research Office,Pharmaceutical Department,Heze Medical College has effectively adjusted the curriculum setup and established a framework of 5-2-3.Based on the new teaching mode,the teaching methods have been improved,Pharmacological experiments renewed and the traditional examination formula reformed.What's more,a new kind of extracurricular activity has been formed,which guides students to write literature summaries.All of these improved teaching,experimental and testing methods are very popular with students,which have brought about satisfactory teaching effects.
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Objective: To observe the safety and clinical efficacy of tumor antigen-pulsed dendritic cell(DC) vaccine in treatment of advanced malignant tumor.Methods: Ninety-one patients with non-small cell lung cancer,colon and rectal cancer,melanoma,renal carcinoma,breast cancer and other malignant tumors were enrolled in this study.All patients met the selecting standard and signed informed consent.Human dendritic cells were obtained from peripheral blood monocytes by culturing them with granulocyte macrophage-colony stimulating factor and interleukin-4.DC vaccine was prepared from tumor antigen pulsed immature dendritic cells in vitro.Patients received the vaccine therapy once every week and one cycle was defined as once every week for 3 weeks.Results: All the patients received 96 cycles of DC vaccine treatment.Symptoms of toxicity included fever,shivering,aching pain of muscle,asthenia,itching,stifle and transient fatigue;most of the symptoms automatically recovered.Clinical efficacy of the treatment was evaluated in 76 patients.Thirty-one of the 76 patients were stable after treatment and 45 were in progressive situation,with the clinical benefiting rate being 40.8%.Eighty-five patients were followed up.The median time for progression was 2.6 months;the overall survival time was 0.9-30.6 months;and the median survival period was 4.5 months,with the one year survival rate being 9.2%.Conclusion: The results suggest that the DC vaccine therapy is well tolerated in treating patients with advanced malignant tumors and has satisfactory clinical benefit;the clinical value of DC vaccine therapy needs to be further observed.
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The article explores the significant role supervisor system plays in the credit system in medical college,the scientific selection of supervisors,their management,duty and directions in order to guide the supervisor system in correct and scientific orbit so as to train constantly new type of medical talents.
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Objective:To evaluate the safety and clinical efficacy of antigen-pulsed dendritic cell (APDC) vaccine combined hyperthermia in treating advanced non-small cell lung cancer (NSCLC). Methods: Fourteen patients with advanced NSCLC were enrolled in this study. All patients met the selecting standard and signed informed consent. Human dendritic cells were derived from peripheral blood monocytes by co-culturing them with granulocyte macrophage-colony stimulating factor and interleukin-4. DCs vaccine was prepared from antigen pulsed immature dendritic cells in vitro. The vaccine therapy was given once every week following local hyperthermia by NRL-001 Double RF Tumor Hyperthermia system (39.5 ℃-41 ℃ for 60-120 min). Every three-week was defined as a treatment cycle. Results: All patients received 16 cycles of combined treatment. The main adverse effect included fever, chill, myalgia, transient fatigue, itching, chest distress, local rashes, and blister. Seven of 14 patients had stable condition after treatment and another seven had a progressing condition, with a clinical beneficial rate of 50%. Median time to progress was 2.7 months in the patients and the overall survival period was 2.5 to 29.3 months, with the median survival time being 4.9 months; the one year survival rate was 21.4% in our group. Conclusion: The results suggest that combination of APDC vaccine therapy and local hyperthermia is well tolerated by NSCLC patients and is clinically beneficial to the patients; the clinical value of this therapy needs to be further studied.