Clinical study of Photofrin photodynamic therapy for the treatment of relapse nasopharyngeal carcinoma.

OBJECTIVES: To evaluate the clinical response and adverse effects of Photofrin photodynamic therapy (PDT) in patients with relapse nasal pharyngeal cancer. METHODS: Thirty patients with relapse nasal pharyngeal cancer were randomly divided into PDT group and chemotherapy group. In PDT group, patients received intravenous administration of Photofrin (2mg/kg b.w.) and 48h later light (200-300J/cm) was delivered by a 630nm diode laser through a cylinder diffuser under endoscopic assistance. Two days after PDT the necrotic tissues were removed and newly identified sites were subject to another round of light irradiation. In chemotherapy group, the routine cisplatin and 5-fluorouracil (DDP/5-FU) remedy was used. Endoscopic and radiological examinations were performed during 6 months follow-up. The Karnofsy Score was used to evaluate the quality of life. RESULTS: The local response and nasal cavity obstruction remission rate in PDT group were better than that in chemotherapy group. The Karnofsy Score was also improved in PDT group. CONCLUSION: This pilot study suggests that Photofrin PDT is effective and safe in treatment of advanced nasal pharyngeal cancer and management of nasal obstruction.

[Effect of Herceptin combined with Taxol on patients with Her-2/neu overexpressing metastatic breast cancer].

OBJECTIVE: To investigate the efficacy and toxicity of recombinant humanized anti-Her-2/neu antibody (Herceptin) and Taxol for patients with Her-2/neu overexpressing metastatic breast cancer. METHODS: Sixty patients with Her-2/neu overexpressing metastatic breast cancer were investigated. Of the 60 cases, 22 were treated with Herceptin and Taxol and 38 with Taxol and doxorubicin. RESULTS: The total response rate (RR) of Herceptin and Taxol was 68.2%, and that of Taxol and doxorubicin was 44.7%. The RR of patients with Her-2/neu(+++) was 75%, while that of patients with Her-2/neu(++) was 50%. The major adverse effects were gastro-intestinal tract reactions, myopathy, bone marrow suppression and alopecia. CONCLUSION: The treatment with Herceptin and Taxol is effective and safe for patients with Her-2/neu overexpressing metastatic breast cancer. The therapeutic effect is related to the degree of Her-2/neu overexpression.

[Clinical study of the effects of radiotherapy in combination with traditional Chinese medicine on non-small cell lung cancer].

OBJECTIVE: To study the therapeutic effects of radiotherapy combined with traditional Chinese medicine (TCM) on non-small cell lung cancer (NSCLC). METHODS: Ninety-two patients with NSCLC were randomly divided into combined treatment group (n=50) and radiotherapy group (n=42). The former group was given TCM in combination with radiotherapy, and the latter group received radiotherapy only. The adverse effects and quality-of-life (QOL) of all the patients were observed after the treatments. RESULTS: The incidence of adverse effects was much lower in combined treatment group than in radiotherapy group, and significantly greater improvement in QOL of the patients was observed in the former group (P<0.01). CONCLUSION: TCM in the combined treatment for patients with NSCLC can reduce the adverse effects of radiotherapy, and improve the life quality of the patients.

[Clinical study of Photofrin photodynamic therapy for advanced cancers].

OBJECTIVE: To evaluate the clinical efficacy and adverse effects of Photofrin photodynamic therapy (PDT) in patients with advanced cancers. METHODS: Forty patients with advanced cancers in stage IV with lumen obstruction, who failed to respond positively to other treatment regimens, received intravenous administration of Photofrin as the photosensitizer at the dose of 2 mg/kg.b.w. 48 h before PDT by 630 nm light (DIOMED) delivered through cylinder diffusing tip quartz fibers that passed through the biopsy channel of a flexible endoscope. PDT endoscopy was repeated, the necrotic tissue removed and, if necessary, the primary sites and other newly identified sites were subjected to a second exposure 8 h later. Two days after the second exposure, endoscopy was again performed and the necrotic tissue removed. Endoscopy was repeated one month after PDT and periodically thereafter as needed to treat symptomatic residual tumor. RESULTS: The total rate of response to the treatment was 74% in these patients, and the rate of lumen obstruction due to the tumors decreased from 90% to 10% after PDT, with significantly improved Karnofsky performance score. CONCLUSION: Photofrin PDT is effective and safe in the treatment of advanced cancer, which may relieve lumen obstruction and improve patient quality of life.

[Association between the survival time and high-expression of EGFR and HER-2 in breast cancer].

OBJECTIVE: To investigate the relationship between the survival time and the high-expression of epidermal growth factor receptor (EGFR) and human epidermal receptor 2 (HER2) in breast cancer patients, and assess the feasibility of using the two markers either alone or in combination for predicting the prognosis of the patients. METHODS: Breast cancer samples were obtained from 185 patients and measured for the expressions of EGFR and HER-2 by way of immunohistochemistry, and 120 patients (64.9%) were followed up and their survival time recorded. Sixty-five patients (35.1%) failed to be followed for various reasons. RESULTS: Of the 120 patients followed up, death occurred in 28 (15%). Positive HER2 expression was detected in 57.8% and EGFR expression in 40.5% of the all the samples examined. The over-expression of either HER2 or EGFR was in inverse correlation with the survival time (P<0.05 and P<0.01, respectively), and the over-expression of both related to the survival time in similar manner (P<0.05 and P<0.01). CONCLUSION: The high expression of HER2 or/and EGFR suggests a short survival time and an unfavorable prognosis.

[Inhibitory effect of ZD6474 combined with adriamycin on MCF-7 human breast cancer cells in vitro].

OBJECTIVE: To investigate the killing effect of ZD6474 combined with adriamycin (ADM) on MCF-7 human breast cancer cells. METHODS: The inhibitory effects of ZD6474 and ADM alone and in combination on the proliferation of MCF-7 cells were assessed by MTT assay. The cell cycle and cell apoptosis were detected by flow cytometry. RESULTS: ZD6474 and ADM both significantly inhibited the proliferation of MCF-7 cells, showing a synergistic effect of their reactions in combined use (P<0.05). ZD6474 or ADM alone caused cell cycle arrest at G0/G1 and S phases, respectively. Combined use of the two drugs resulted in significant reduction of the M-phase cell percentage and cell cycle arrest at G0/G1 and S phases. The coadministration of the drugs significantly increased the apoptosis rate of the cells as compared with ZD6474 or ADM treatment alone (P<0.05). CONCLUSIONS: ZD6474 and ADM show a synergistic effect in inhibiting the proliferation and inducing apoptosis of MCF-7 cells.

[Topical dimethyl sulfoxide and intralesional hyaluronidase administration for vinorelbine extravasation-induced rat skin injury].

OBJECTIVE: To evaluate the effects of topical DMSO and intralesional hyaluronidase administration, used alone or in combination, on skin injury due to vinorelbine extravasation in rats. METHODS: Skin injury due to vinorelbine extravasation was induced in the lower extremities of 30 SD rats, which were treated subsequently with topical DMSO, intralesional hyaluronidase, their combination, topical saline, and intralesional saline, with the rats without any treatment as the control. The wound area on 1, 4, 8, 12, 18, 24, 30 days and the time of healing were observed and compared. RESULTS: The wound area on 1, 4, 8, 12, 18, and 24 days were significantly smaller in topical DMSO group than in topical saline and control groups (P<0.05), and so in intralesional hyaluronidase group than in intralesional saline and control groups (P<0.05), but there was no significant difference between single agent (hyaluronidase and DMSO) treatment group and the combined treatment group. The healing time was significantly shorter in topical DMSO and intralesional hyaluronidase groups than in topical and intralesional saline groups and control group ( 24.9-/+3.2 and 21.9-/+3.0 days vs 29.8-/+2.6, 28.6-/+4.1 and 30.6-/+3.0 days, P<0.01), but comparable between the two single agent groups and combined treatment group (23.3-/+3.8 days). CONCLUSION: Intralesional hyaluronidase and topical DMSO application are effective therapies for skin damage due to vinorelbine extravasation, and their combination does not improve the therapeutic effect.

[Killing effect of sequential Herceptin and adriamycin treatment on breast cancer cell line in vitro].

OBJECTIVE: To observe the killing effect of Herceptin and adriamycin sequentially applied on breast cancer cell line in vitro. METHODS: BT-474 human breast cancer cells in exponential growth phase were treated with Herceptin alone, adriamycin alone and their sequential administration (Herceptin before adriamycin and vice versa), respectively. Under optical microscope, the morphological changes of the cells were observed before and after drug administration. The expression rate and mean fluorescence intensity (MFI) of HER-2/neu and cell death rate were detected by flow cytometry. RESULTS: Microscopically, the cells treated with different protocols all exhibited such changes as darkening and increase of cellular debris with irregular cell morphology. Flow cytometry revealed no significant difference in the expression rate of HER-2/neu in each group before and after treatment, but the MFI of HER-2/neu and death rate of the treated cells were significant different from those of the control group (P<0.05). The cell death rate of Herceptin-pretreated cells was significantly higher than that of adriamycin-pretreated ones (P<0.05). CONCLUSION: Herceptin pretreatment enhances the killing effect of adriamycin on breast cancer cell line BT-474, which provides experimental evidence for designing clinical sequential biochemotherapy of breast cancer.

[Role of the cut-off value of serum neuron-specific enolase in differentiating small cell lung cancer from non-small cell lung cancer].

OBJECTIVE: To determine the cut-off value of serum neuron-specific enolase (NSE) level for distinguishing small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). METHODS: Serum NSE levels were measured by enzyme-linked immunosorbent assay in 137 patients with NSCLC or SCLC, and the best cut-off value was analyzed using ROC curve. RESULTS: The positivity rate of serum NSE was significantly higher in patients with SCLC than in those with NSCLC (P<0.01). The best cut-off value was 15.45 microg/L using ROC curve, which gave a sensitivity of 66.7% and specificity of 65.7%. CONCLUSION: Serum NSE level may allow simple and cost-effective differentiation of SCLC and NSCLC.