Inter-annual variations of vegetation dynamics to climate change in Ordos, Inner Mongolia, China.

To reveal the characteristics of climate change and the controlling factors for vegetation dynamics in the Ordos, Inner Mongolia, China, 34 years (1982-2015) of regional climate variables and vegetation dynamics were investigated. The results show that: Annual mean air temperature (TMP) significantly increased with a linear slope of 0.473°C/10yr. Annual precipitation (PRE) had a non-significant positive trend nearly 5 times lower than the trend of potential evapotranspiration (PET). The average Normalized Difference Vegetation Index (NDVI) computed for the region was found to show a significant positive trend (6.131×10-4/yr). However, all climate variables displayed non-significant correlations with NDVI at annual scale. The reduction of desert and the increase of grassland over the past decades were accountable for the increased NDVI. Principal components analysis revealed that the regional climate change can be characterized as changes in temperature, humidity and the availability of radiant energy. Based on principal components regression coefficients, NDVI was mostly sensitive to humidity component, followed by growing season warmth (WMI). Spatially, 93.1% of the pixels displayed positive trend and 61.8% of the pixels displayed significant change over the past decades. Both principal regression analysis and partial correlation analysis revealed that NDVI in eastern part of Ordos was sensitive to TMP, whereas, NDVI in southern and western areas of Ordos displayed the high sensitivity to combined effects of PRE and cloud coverage (CLD). Partial correlation analyses also revealed that TMX was a surrogate for aridity, TMN was a representative of humidity, and temperature variations below the threshold of 5°C (CDI) were less important than WMI. We conclude that regional climate change can be characterized by warming and increased aridity. The significant positive trend of regional NDVI and the non-significant correlations between NDVI and climate variables at annual scale suggests the hidden role of the human activities.

Phase III study of dulanermin (recombinant human tumor necrosis factor-related apoptosis-inducing ligand/Apo2 ligand) combined with vinorelbine and cisplatin in patients with advanced non-small-cell lung cancer.

Background Dulanermin is a recombinant soluble human Apo2 ligand/tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) that activates apoptotic pathways by binding to proapoptotic death receptor (DR) 4 and DR5. The purpose of this study was to evaluate the efficacy and safety of dulanermin combined with vinorelbine and cisplatin (NP) as the first-line treatment for patients with advanced non-small-cell lung cancer (NSCLC). Experimental design Patients were randomly assigned to receive NP chemotherapy (vinorelbine 25 mg/m2 on days 1 and 8 and cisplatin 30 mg/m2 on days 2 to 4) for up to six cycles plus dulanermin (75 µg/kg on days 1 to 14) or placebo every three weeks until disease progression, intolerable toxicity, or withdrawal of consent. The primary end point was progression-free survival (PFS), and the secondary end points included objective response rate (ORR), overall survival (OS), and safety evaluation. Results Between October 2009 and June 2012, 452 untreated patients with stage IIIB to IV NSCLC were randomly assigned to receive dulanermin plus NP (n = 342) and placebo plus NP (n = 110). Median PFS was 6.4 months in the dulanermin arm versus 3.5 months in the placebo arm (hazard ratio (HR), 0.4034; 95% CI, 0.3181 to 0.5117, p < 0.0001). ORR was 46.78% in the dulanermin arm versus 30.00% in the placebo arm (p = 0.0019). Median OS was 14.6 months in the dulanermin arm versus 13.9 months in the placebo arm (HR, 0.94; 95% CI, 0.74 to 1.21, p = 0.64). The most common grade ≥ 3 adverse events (AEs) were oligochromemia, leukopenia, neutropenia, and oligocythemia. Overall incidence of AEs, grade ≥ 3 AEs, and serious AEs were similar across the two arms. Conclusion Addition of dulanermin to the NP regimen significantly improved PFS and ORR. However, our results showed that the combination of dulanermin with chemotherapy had a synergic activity and favorable toxic profile in the treatment of patients with advanced NSCLC.

Pegylated filgrastim is comparable with filgrastim as support for commonly used chemotherapy regimens: a multicenter, randomized, crossover phase 3 study.

The purpose of this study was to compare the efficacy and safety of a single subcutaneous injection of pegylated filgrastim with daily filgrastim as a prophylaxis for neutropenia induced by commonly used chemotherapy regimens. Fifteen centers enrolled 337 chemotherapy-naive cancer patients with normal bone marrow function. All patients randomized into AOB and BOA arms received two cycles of chemotherapy. Patients received a single dose of pegylated filgrastim 100 µg/kg in cycle 1 (AOB) or cycle 2 (BOA) and daily doses of filgrastim 5 µg/kg/day in cycle 1 (BOA) or cycle 2 (AOB). Efficacy and safety parameters were recorded. The primary end point was the rate of protection against grade 4 neutropenia after chemotherapy [defined as the rate at which the absolute neutrophil count (ANC) remained >0.5×10(9)/l throughout the entire cycle]. Ninety-four percent of patients receiving pegylated filgrastim or filgrastim did not develop grade 4 neutropenia. The incidence of ANC<1.0×10(9)/l was 16.0% (50/313) after support with either pegylated filgrastim or filgrastim. The incidences of febrile neutropenia and antibiotic administration were similar in both groups. Notably, faster ANC recovery was observed with pegylated filgrastim support. The ANC nadir was also earlier with pegylated filgrastim (day 7) support than with filgrastim support (day 9), although the depth of nadir was not significantly different. A single subcutaneous injection of pegylated filgrastim 100 µg/kg provided adequate and safe neutrophil support comparable with daily subcutaneous injections of unmodified filgrastim 5 µg/kg/day in patients receiving commonly used standard-dose mild-to-moderate myelosuppressive chemotherapy regimens.

[Preliminary result of multi-center clinical trial on the docetaxel, 5-Fu and DDP in the treatment of advanced, recurrent or metastatic nasopharyngeal carcinoma].

OBJECTIVE: This clinical study was designed to evaluate the efficacy and toxicity of the combined regimen of docetaxel, 5-Fu and DDP (TPF) in the treatment of advanced or relapsed nasopharyngeal carcinoma (NPC). METHODS: Fifty-six patients with newly diagnosed or recurrent/metastatic NPC following chemotherapy or radiotherapy were enrolled. Both docetaxel and DDP were administered intravenously for 6 hours at the dose of 70 mg/m2 on D1. 5-Fu was given at a dose of 400-500 mg/m2 for 6 hours from D1 to D5. Dexamethasone was routinely administered before injection of docetaxel. This combination was repeated every 3 to 4 weeks, and continued for 4-6 cycles or until PD for the responders. RESULTS: Fifty-one (91.1%) patients were evaluable for response assessment. The response rate for whole group was 72.5% (37/51) with a CR rate of 9.8% (5/51). The stable disease accounted for 17.6% (9/51). There were 17(30.4%) chemotherapy-naïve patients. The overall response rate in those was 82.4% with a CR rate of 29.4%. However, the response rate for previously treated patients was 64.7% without CR. Twelve patients had progressed disease, including 5 (8.9%) died of disease progression with a median follow-up of 11 month (ranged from 1 to 19 months). Totally, 196 courses of chemotherapy were administered. The major toxicity was myelosupression, nausea/vomiting. The incidence of leucopenia was 48% with 22.2% of these in NCI grade II or IV. But only 2 patients (3.6%) experienced leucopenia with a fever. Other mild toxicities including alopecia, asthenia, mucositis and diarrhea were also observed. CONCLUSION: Our preliminary outcome shows docetaxel, 5-Fu and DDP combination is effective and safe for the patients with advanced or relapsed nasopharyngeal carcinoma. But further clinical study is warranted.

[Effect of informing the diagnosis on depressive state in patients with non-small cell lung cancer of stage III.].

BACKGROUND: As other tumors, unresectabe lung cancer can cause many psychological problems to the patients, such as depression and anxiety. The present paper aims to evaluate the status of depression before and after knowing the state of illness in patients with non-small cell lung cancer of stage III. METHODS: 43 cases of newly diagnosed non-small cell lung cancer (NSCLC) with stage III were enrolled in the study. All the patients were distributed into three groups and given different intervention, that was completely unknowing the state of illness (group A), partly knowing the state of illness (group B) and completely knowing the state of illness (group C). Before and after knowing the state of illness, the depression status was assessed with the Hamilton depression rating scale for depression (HAMD). RESULTS: The mean total score of HAMD was unchanged both in group A and C, while significantly reduced in group B. The scores of anxiety somatization, cognitive disorder, retardation and feeling of despair were all significant lower in the group B after the patients partly knowing the state of illness, while the scores of sleep disorder was obviously higher in group C after the patients completely knowing the state of illness. The hypochondriasis was much severer in the group A, and in the group C, the score of suicidal idea became significantly higher after the patient knowing the diagnosis. CONCLUSIONS: Depression is very common in the NSCLC patients with stage III. Partly knowing the state of illness can obviously ameliorate the symptoms of depression, while completely knowing or completely unknowing the state of illness have no effect on relieving the patients' depression.

[Therapeutic efficacy of chemotherapy combined with radiotherapy in 527 patients with stage III and IV non-small cell lung cancer].

BACKGROUND: Chemotherapy is very important in treatment of advanced non-small cell lung cancer (NSCLC), and the third-generation cisplatin-based chemotherapy regimens have been the standard treatment for advanced NSCLC. The aim of this study is to compare the efficacy and toxicity among four different chemotherapeutic regimens combined with radiotherapy in patients with stage III/IV NSCLC. METHODS: A total of 527 patients with stage III/IV NSCLC were enrolled, among whom there were 243 patients received cisplatin/vinorelbine (NP group), 163 patients for cisplatin/paclitaxel (TP group), 65 patients for cisplatin/gemcitabine (GP group) and 56 patients for cisplatin/docetaxel (DP group). The efficacy, side effects, median time to progression (TTP), median survival time (MST), 1- and 2-year survival rate were compared. RESULTS: The response rate was 46.9% in the NP arm, 44.8% in the TP arm, 47.7% in the GP arm and 42.9% in the DP arm (P > 0.05). The response rate of patients with radiochemotherapy was 69.9%, and 40.8% for those with chemotherapy alone (P < 0.05). In group NP, TP, GP and DP, median TTP was 5.7, 5.3, 5.9 and 5.5 months (P > 0.05) respectively, MST was 10.4, 10.6, 11.5 and 10.4 months (P > 0.05) respectively, 1-year survival rate was 41.9%, 41.1%, 43.1% and 42.9% (P > 0.05) respectively, and 2-year survival rate was 21.3%, 19.4%, 23.1% and 23.2% (P > 0.05) respectively. CONCLUSIONS: The third-generation cisplatin-based chemotherapy regimens may be the standard treatment for advanced NSCLC, and their combination with radiotherapy may improve the therapeutic efficacy and prolong the survival of patients.

[Randomized clinical trial of IEP and EP regimens in the treatment of patients with small cell lung cancer].

BACKGROUND: To observe and compare the efficacy and safety of IEP and EP regimens for small cell lung cancer (SCLC). METHODS: Sixty-four patients with SCLC pathologically proved were randomly divided into IEP group ( n =32) and EP group ( n =32). RESULTS: All the 64 patients were evaluable for response and toxicity. In IEP group, the total responsive rate, responsive rates of limited-stage patients and extensive-stage patients were 84.4%(27/32), 100.0%(15/15) and 70.6%(12/17) respectively; while in EP group, those were 75.0%(24/32), 85.7%(12/14) and 66.7% (12/18) respectively. The median duration of remission was 6 months and 1-year survival rate was 62.5% in IEP group, and 5 months and 56.2% in EP group. There was no significant difference in response rate, median duration of remission and 1-year survival between the two groups ( P > 0.05). The main toxicity was myelosuppression. Incidences of leukopenia at grade III-IV, nausea, vomiting and alopecia were significantly higher in the IEP arm than those in the EP arm ( P < 0.01 ). CONCLUSIONS: High response rates and tolerable toxicities are attainable for small cell lung cancer treated with IEP and EP. IEP regimen shows a similar response rate compared with EP regimen. They might be considered as relevant regimens in initial patients with small cell lung cancer.

[Treatment of moderate-grade and high-grade malignant lymphoma with autologous hematopoietic stem cell transplantation].

BACKGROUND & OBJECTIVE: High dose chemotherapy (HDCT) supported by autologous hematopoietic stem cell transplantation (ASCT) is one of the most effective approaches for the chemo-sensitive lymphoma. The purpose of this study was to investigate the effectiveness of HDCT combined with radiotherapy supported by HSCT in treatment of poor- prognostic moderate-grade and high-grade malignant lymphoma. METHODS: Eleven patients [11 cases of non-Hodgkin's lymphoma (NHL) and 2 cases of recurrent Hodgkin's lymphoma (HD)] were enrolled from December 1995 to May 2001. Status on ASCT was 8 cases with 1st complete remission (CR(1)), 4 cases with second complete remission (CR2), 1 case with second partial remission (PR2). The preparative regimens consisted of HDCT alone (4 patients), HDCT with involved-field (IF) radiotherapy (6 patients), total body irradiation (TBI) with HDCT (3 patients). Two patients were supported by bone marrow transplantation (ABMT) and 11 by autologous peripheral blood stem cell transplantation (APBSCT). RESULTS: The numbers of mono-nuclear cell (MNC) and granulocyte- macrophage colony-forming cells (CFU-GM) reinfused were 2.55 (range, 2.07-3.31) x 10(9)/L, 1.43 (range, 0.6-2.36) x 10(9)/L in this study, respectively. Hematopoietic reconstitution was observed in all patients when they were followed-up on October 2001. WBC>or=1.0 x 10(9)/L and Platelet >50 x 10(9)/L were at day 6 (range,7-35) and day 8 (range,6-32), respectively. The median CR duration was 16 months (range, 4-57 months). The 1- and 3-year survival rates were 76.9% and 46.2%, respectively. CONCLUSION: HDCT with ASCT is valuable to treatment in patients with chemo-sensitive moderate-grade and high-grade NHL and recurrent HD.

[Clinical trial on exemestane in the treatment of postmenopausal women with advanced breast cancer].

OBJECTIVE: To evaluate the response rate and adverse reactions of exemestane (a new aromatase inactivator) in the treatment of postmenopausal women with advanced breast cancer. METHODS: One hundred and seventy-three patients with advanced breast cancer entered this study with two patients excluded because of postmenopausal time being less than one year. Therefore, 173 patients could be evaluated for adverse events and 171 patients could be evaluated for efficacy. Exemestane, 25 mg orally daily for 4 weeks as one cycle was given. RESULTS: In the 171 patients evaluated for efficacy, 4 (2.3%) experienced a complete response (CR) and 40 (23.4%) a partial response (PR), with the overall response rate of 25.7%. Ninety patients (52.6%) had stable disease (SD), with 25 having SD for at least 24 weeks. The clinical benefit (CR + PR + SD > or = 24 weeks) was shown in 69 (40.4%) patients. Progressive disease (PD) was shown in 37 (21.6%) patients. The untreated patients had a higher objective response rate (33.8%) than the retreated ones (18.1%) with significant difference (P = 0.019 7). The response rates for soft-tissue, bone involvement and visceral metastasis were 32.8%, 23.9%, and 12.4% (P = 0.002). There was no significant difference in different ages, time of menopause, disease-free interval or receptor status (P > 0.05). Drug-related adverse events were gastric discomfort (17.9%), malaise (17.9%), nausea (13.9%), hot flushes (11.0%) and dysphoria (5.8%). Other side reactions and abnormal laboratory parameters were observed occasionally which were irrelevant. CONCLUSION: Exemestane can be used to treat postmenopausal women with advanced breast cancer giving only mild adverse reactions which are well tolerated.