SiSGC: A Drug Repositioning Prediction Model Based on Heterogeneous Simplifying Graph Convolution.

Drug repositioning plays a key role in disease treatment. With the large-scale chemical data increasing, many computational methods are utilized for drug-disease association prediction. However, most of the existing models neglect the positive influence of non-Euclidean data and multisource information, and there is still a critical issue for graph neural networks regarding how to set the feature diffuse distance. To solve the problems, we proposed SiSGC, which makes full use of the biological knowledge information as initial features and learns the structure information from the constructed heterogeneous graph with the adaptive selection of the information diffuse distance. Then, the structural features are fused with the denoised similarity information and fed to the advanced classifier of CatBoost to make predictions. Three different data sets are used to confirm the robustness and generalization of SiSGC under two splitting strategies. Experiment results demonstrate that the proposed model achieves superior performance compared with the six leading methods and four variants. Our case study on breast neoplasms further indicates that SiSGC is trustworthy and robust yet simple. We also present four drugs for breast cancer treatment with high confidence and further give an explanation for demonstrating the rationality. There is no doubt that SiSGC can be used as a beneficial supplement for drug repositioning.

[Spatio-temporal Variations in PM2.5and Its Influencing Factors in the Yangtze River Delta Urban Agglomeration].

To coordinate the contradiction between economic development and environmental pollution and achieve the sustainable development of the economy and society, the spatio-temporal variations in PM2.5 were analyzed based on PM2.5 concentration and meteorological data of the Yangtze River Delta (YRD) urban agglomeration. Wavelet transform coherence (WTC), partial wavelet coherence (PWC), and multiple wavelet coherence (MWC) were used to analyze the multi-scale coupling oscillation between PM2.5 and meteorological factors in the time-frequency domain. The results showed that:① the concentration of PM2.5 in the YRD decreased from northwest to southeast, and the spatial range with high PM2.5 concentration decreased annually. The spatial distribution characteristics of the seasonal average PM2.5 concentration were similar to those of the annual average PM2.5 concentration. PM2.5 concentration exhibited the seasonal variation characteristics of high in winter, low in summer, and transitioning between spring and autumn. ② PM2.5 concentration decreased from 2015 to 2021, and the compliance rate increased. The difference in annual average PM2.5 concentration was decreased with dynamic convergence characteristics. The convergence of PM2.5 concentration in summer was greater than that in winter. During the whole study period, the daily average PM2.5 concentration showed a "U" distribution, and the proportion of days with excellent and good PM2.5 levels were 49.72% and 41.45%, respectively. ③ The wavelet coherence between PM2.5 and meteorological factors was different in different time-frequency domains. The main factors affecting PM2.5 were different in different time-frequency scales. At all time-frequency scales, WTC and PWC showed that wind speed and temperature were the best explanatory variables of PM2.5 variation, respectively. ④ The larger the time-frequency scale, the stronger the interaction of multi-factor combinations to explain PM2.5 variations. The synergistic effect of temperature and wind speed could better explain the variation in PM2.5. These results can provide reference for air pollution control in the YRD.

Improved prediction of drug-target interactions based on ensemble learning with fuzzy local ternary pattern.

Introduction: The prediction of interacting drug-target pairs plays an essential role in the field of drug repurposing, and drug discovery. Although biotechnology and chemical technology have made extraordinary progress, the process of dose-response experiments and clinical trials is still extremely complex, laborious, and costly. As a result, a robust computer-aided model is of an urgent need to predict drug-target interactions (DTIs). Methods: In this paper, we report a novel computational approach combining fuzzy local ternary pattern (FLTP), Position-Specific Scoring Matrix (PSSM), and rotation forest (RF) to identify DTIs. More specially, the target primary sequence is first numerically characterized into PSSM which records the biological evolution information. Afterward, the FLTP method is applied in extracting the highly representative descriptors of PSSM, and the combinations of FLTP descriptors and drug molecular fingerprints are regarded as the complete features of drug-target pairs. Results: Finally, the entire features are fed into rotation forests for inferring potential DTIs. The experiments of 5-fold cross-validation (CV) achieve mean accuracies of 89.08%, 86.14%, 82.41%, and 78.40% on Enzyme, Ion Channel, GPCRs, and Nuclear Receptor datasets. Discussion: For further validating the model performance, we performed experiments with the state-of-art support vector machine (SVM) and light gradient boosting machine (LGBM). The experimental results indicate the superiorities of the proposed model in effectively and reliably detect potential DTIs. There is an anticipation that the proposed model can establish a feasible and convenient tool to identify high-throughput identification of DTIs.

An Ensemble Learning-Based Method for Inferring Drug-Target Interactions Combining Protein Sequences and Drug Fingerprints.

Identifying the interactions of the drug-target is central to the cognate areas including drug discovery and drug reposition. Although the high-throughput biotechnologies have made tremendous progress, the indispensable clinical trials remain to be expensive, laborious, and intricate. Therefore, a convenient and reliable computer-aided method has become the focus on inferring drug-target interactions (DTIs). In this research, we propose a novel computational model integrating a pyramid histogram of oriented gradients (PHOG), Position-Specific Scoring Matrix (PSSM), and rotation forest (RF) classifier for identifying DTIs. Specifically, protein primary sequences are first converted into PSSMs to describe the potential biological evolution information. After that, PHOG is employed to mine the highly representative features of PSSM from multiple pyramid levels, and the complete describers of drug-target pairs are generated by combining the molecular substructure fingerprints and PHOG features. Finally, we feed the complete describers into the RF classifier for effective prediction. The experiments of 5-fold Cross-Validations (CV) yield mean accuracies of 88.96%, 86.37%, 82.88%, and 76.92% on four golden standard data sets (enzyme, ion channel, G protein-coupled receptors (GPCRs), and nuclear receptor, respectively). Moreover, the paper also conducts the state-of-art light gradient boosting machine (LGBM) and support vector machine (SVM) to further verify the performance of the proposed model. The experimental outcomes substantiate that the established model is feasible and reliable to predict DTIs. There is an excellent prospect that our model is capable of predicting DTIs as an efficient tool on a large scale.

Recombinant Adenovirus-p53 Gene Therapy for Advanced Unresectable Soft-Tissue Sarcomas.

Patients with unresectable advanced soft-tissue sarcomas (STS) receiving radiotherapy or/and chemotherapy still have a poor prognosis. This study aimed to evaluate retrospectively the efficacy and safety of recombinant adenovirus-p53 (rAd-p53) gene therapy combined with radiotherapy and hyperthermia for advanced STS. A total of 71 patients with advanced unresectable STS treated at the authors' center from April 2007 to November 2014 were included. Of these 71 patients, 36 cases received rAd-p53 therapy combined with radiotherapy and hyperthermia (p53 group), while 35 cases received radiotherapy and hyperthermia alone (control group). Short-term therapeutic efficacies, long-term survival outcomes, and adverse events were evaluated and compared between groups. Compared to the control group, the p53 group had a significantly higher disease control rate (83.33% vs. 54.29%; p = 0.008) and a lower progressive disease rate (16.67% vs. 45.71%; p = 0.018). In addition, rAd-p53 treatment significantly improved the progression-free survival and overall survival of STS patients. Cox regression indicated that rAd-p53 treatment significantly reduced the risks for disease progression or death event for STS patients. Furthermore, there was no significant difference in all adverse events, except for transient fever, which occurred in 89% of patients with rAd-p53 therapy. rAd-p53 combined with radiotherapy and hyperthermia can effectively improve the therapeutic efficacy and survival outcomes in patients with advanced unresectable STS, providing a new therapeutic strategy.

Reduced serum levels of oestradiol and brain derived neurotrophic factor in both diabetic women and HFD-feeding female mice.

The estrogen levels in the pre and post menstrual phases interact with brain-derived neurotrophic factor in a complex manner, which influences the overall state of the body. To study the role of oestradiol and brain-derived neurotrophic factor in modulating obesity related type 2 diabetes and the interactions between two factors, we enrolled 15 diabetic premenopausal women and 15 diabetic postmenopausal women respectively, the same number of healthy pre and postmenopausal women were recruited as two control groups. The fasting blood glucose, insulin, lipids, estrogen, and brain-derived neurotrophic factor levels were measured through clinical tests. Additionally, we set up obese female mouse model to mimic human trial stated above, to verify the relationship between estrogen and brain-derived neurotrophic factor. Our findings revealed that there is a moderately positive correlation between brain-derived neurotrophic factor and oestradiol in females, and decreased brain-derived neurotrophic factor may worsen impaired insulin function. The results further confirmed that high fat diet-fed mice which exhibited impaired glucose tolerance, showed lower levels of oestradiol and decreased expression of brain-derived neurotrophic factor mRNA in the ventromedial hypothalamus. The level of brain-derived neurotrophic factor reduced on condition that the level of oestradiol is sufficiently low, such as women in postmenopausal period, which aggravates diabetes through feeding-related pathways. Increasing the level of brain-derived neurotrophic factor may help to alleviate the progression of the disease in postmenopausal women with diabetes.

Two-week Course of Preoperative Radiotherapy for Locally Advanced Rectal Adenocarcinoma: 8 Years' Experience in a Single Institute.

OBJECTIVES: To evaluate local control and survival in locally advanced rectal adenocarcinoma patients who underwent a preoperative 2-week course of radiotherapy (RT) and to identify prognostic factors influencing the survival rate. METHODS: We analyzed 377 consecutively treated patients with locally advanced (T3/T4 or node positive) rectal adenocarcinoma. All patients underwent a preoperative 2-week course of RT (30 Gy in 10 fractions) followed by curative surgery. Regression model was used to examine prognostic factors for the disease-free survival (DFS) and overall survival (OS) rates. The Statistical Analysis System software package, version 9.3, was used for analysis. RESULTS: The median follow-up for all living patients was 63.8 months (range, 5.1 to 131.7). The 5-year DFS and OS rates were 64.5% (95% CI, 59.0-69.4) and 75.6% (95% CI, 70.5-80.0), respectively. The 5-year cumulative incidences of local recurrence and distant metastases were 5.4% (95% CI, 2.9-7.9) and 29.0% (95% CI, 23.9-30.1), respectively. The pathologic complete response rate was achieved in 17 patients (4.5%). The Multivariate Cox Regression model showed that factors affecting DFS were the surgical technique, pre-RT pathologic grade, ypT, ypN, and comorbidity; and factors improving OS were low anterior resection, low pre-RT grade, low ypT, and low ypN. CONCLUSIONS: Patients treated with preoperative RT with 30 Gy in 10 fractions had similar local control, 5-year DFS and OS to reported long course RT regimen. The surgical technique, pre-RT pathologic grade, ypT, and ypN seemed to affect the OS. Further study on combining a 2-week course of preoperative RT with concurrent chemotherapy would be warranted.

Effect and Safety of Recombinant Adenovirus-p53 Transfer Combined with Radiotherapy on Long-Term Survival of Locally Advanced Cervical Cancer.

Detection of exogenous p53 gene and target gene expression in cervical cancer cell lines SiHa and C33A infected by recombinant adenovirus-p53 (rAd-p53) in vitro. The rAd-p53 infection evidently increased the expression of exogenous p53 gene, p21 gene, and Bax gene. The radiosensitization rates of rAd-p53 were 1.19 in SiHa and 1.18 in C33A in vitro. To evaluate the effect and safety of rAd-p53 transfer combined with radiotherapy (RT) in patients with cervical cancer, rAd-p53 transfer combined with radiotherapy (group PRT) in 69 patients with cervical cancer was compared with a control group treated with radiotherapy alone (group RT) in 35 patients with cervical cancer. Patients were intratumorally injected with rAd-p53 (1 × 1012 virus particles) once a week for 6 weeks. Concurrent pelvic RT plus brachytherapy to take point A to 76.0 Gray units (Gy) (range 75-80 Gy). The 5-year overall survival rate of the PRT group was 17.5% higher than that of the RT group (HR = 0.551, 95% CI 0.278-1.095, p = 0.084). The 5-year progress-free survival rate of the PRT group was 17.1% higher than that of the RT group (HR = 0.485, 95% CI 0.234-1.006, p = 0.047). rAd-p53 administration did not increase the adverse events caused by radiotherapy, except for transient fever after rAd-p53 administration. rAd-p53 was safe and biologically active in improving radiotherapeutic survival rates in patients with cervical cancer.

Combination of Recombinant Adenovirus-p53 with Radiochemotherapy in Unresectable Pancreatic Carcinoma.

OBJECTIVE: To assess the safety and efficacy of the combination of recombinant adenovirus-p53 (rAd-p53) with radiochemotherapy for treating unresectable pancreatic carcinoma. METHODS: The eligible patients received concurrent rAd-p53 intratumoral injection and radiochemotherapy. Intratumoral injection of rAd-p53 was guided by B ultrasound. Radiochemotherapy consisted of intensity-modulated radiotherapy (IMRT) at two dose levels and intravenous gemcitabine (Gem). For radiotherapy, gross target volume (GTV) and clinical target volume (CTV) were 55-60 Gy and 45-55 Gy in 25-30 fractions, respectively. Concurrent intravenous gemcitabine was administered at 350 mg/m(2), weekly, for 6 weeks. The primary end points included toxicity, clinical benefit response (CBR) and disease control rate (DCR). The secondary end points included progression-free survival (PFS) and overall survival (OS). RESULTS: Fifteen eligible patients were enrolled. Eight patients (53.3%) were evaluated as CBR and 12 (80%) achieved DCR. The median PFS and OS were 6.7 and 13.8 months, respectively. One-year PFS and OS were 40.0% and 51.1%, respectively. There were 8 (53.3%) patients reported grade 3 toxicities including neutropenia (6 patients, 40%), fever (1 patient, 6.7%) and fatigue (1 patient, 6.7%). There was no grade 4 toxicity reported. CONCLUSION: Combination of rAd-p53 in unresectable pancreatic carcinoma showed encouraging efficacious benefit and was well tolerated. Long-term follow-up is needed to confirm the improvement of PFS and OS.

A method of tumor classification based on wavelet packet transforms and neighborhood rough set.

Tumor classification is an important application domain of gene expression data. Because of its characteristics of high dimensionality and small sample size (SSS), and a great number of redundant genes not related to tumor phenotypes, various feature extraction or gene selection methods have been applied to gene expression data analysis. Wavelet packet transforms (WPT) and neighborhood rough sets (NRS) are effective tools to extract and select features. In this paper, a novel approach of tumor classification is proposed based on WPT and NRS. First the classification features are extracted by WPT and the decision tables are formed, then the attributes of the decision tables are reduced by NRS. Thirdly, a feature subset with few attributes and high classification ability is obtained. The experimental results on three gene expression datasets demonstrate that the proposed method is effective and feasible.

Tumor Classification Using High-Order Gene Expression Profiles Based on Multilinear ICA.

Motivation. Independent Components Analysis (ICA) maximizes the statistical independence of the representational components of a training gene expression profiles (GEP) ensemble, but it cannot distinguish relations between the different factors, or different modes, and it is not available to high-order GEP Data Mining. In order to generalize ICA, we introduce Multilinear-ICA and apply it to tumor classification using high order GEP. Firstly, we introduce the basis conceptions and operations of tensor and recommend Support Vector Machine (SVM) classifier and Multilinear-ICA. Secondly, the higher score genes of original high order GEP are selected by using t-statistics and tabulate tensors. Thirdly, the tensors are performed by Multilinear-ICA. Finally, the SVM is used to classify the tumor subtypes. Results. To show the validity of the proposed method, we apply it to tumor classification using high order GEP. Though we only use three datasets, the experimental results show that the method is effective and feasible. Through this survey, we hope to gain some insight into the problem of high order GEP tumor classification, in aid of further developing more effective tumor classification algorithms.

Effect of recombinant adenovirus-p53 combined with radiotherapy on long-term prognosis of advanced nasopharyngeal carcinoma.

PURPOSE: To centrally assess the safety, efficacy, and 6-year follow-up of recombinant adenovirus-p53 (rAd-p53) combined with radiotherapy (RT) for patients with nasopharyngeal carcinoma (NPC). PATIENTS AND METHODS: A randomized controlled clinical study on rAd-p53 combined with RT in 42 patients with NPC was compared with a control group of 40 patients with NPC treated with RT alone. In the group receiving rAd-p53 combined with RT, rAd-p53 was intratumorally injected once a week for 8 weeks. Concurrent RT (70 Gy in 35 fractions) was given to the nasopharyngeal tumor and neck lymph node. Patients and tumors were monitored for adverse events and responses. RESULTS: rAd-p53-specific p53 mRNA was detected in postinjection of rAd-p53 biopsies from 16 (94.1%) of 17 patients. Upregulation of p21/WAF1 and Bax and downregulation of vascular endothelial growth factor were observed in postinjection tumor biopsy. Complete response rate in the group receiving rAd-p53 combined with RT was observed at 2.73 times that of the group receiving RT alone (66.7% v 24.4%). Six-year follow-up data showed that rAd-p53 significantly increased the 5-year locoregional tumor control rate by 25.3% for patients with NPC treated with irradiation (P = .002). The 5-year overall survival rate and 5-year disease-free survival rate of the group receiving rAd-p53 combined with RT were 7.5% (P = .34) and 11.7% (P = .21) higher than those of the group receiving RT alone. No dose-limiting toxicity or adverse events appeared, except for transient fever after rAd-p53 administration. CONCLUSION: In patients with NPC, rAd-p53 was safe and biologically active. Our results indicated that rAd-p53 improves radiotherapeutic tumor control and survival rate in patients with NPC.

[Whole brain irradiation for non-small-cell lung cancer with brain metastasis].

OBJECTIVE: To investigate the time of whole brain irradiation and the prognostic factors for non-small lung cancer patients with brain metastasis. METHODS: From August 1996 to December 2003, 147 patients with brain metastasis from non-small cell lung cancer received whole brain irradiation. The patients were divided into two groups: with or without symptoms caused by brain metastasis, each group was then divided into two sub-groups, early whole brain irradiation group (the interval between the diagnosis of brain metastasis and the brain irradiation < or = one month) and late group ( the interval > one month ). Univariate and multivariate analysis (Cox regression) as well as Kaplan-Meier method in SPSS software package 11.5 was used to analyze the data of the 147 patients including 72 with brain metastasis symptom and 75 without. RESULTS: The median survival time (MS) of patients with or without extracranial metastasis was 9.9 months and 11.3 months (P = 0.0002). Multivariate analysis indicated that extracranial metastasis was an independent prognostic factor (P = 0.0004). For 72 patients with brain metastasis symptom, the MS of the patients with and without extracranial metastasis was 9.3 months and 11.3 months (P = 0.0036). The MS of patients with early and late whole brain irradiation was 11.4 months and 9.2 months (P = 0.001). Multivariate analysis showed that extracranial metastasis, the interval between the diagnosis of brain metastasis and the whole brain irradiation were independent prognostic factors. However, for 75 patients without brain metastasis symptom, the MS difference of those with early or late whole brain irradiation was not statistically significant (P = 0.1643). CONCLUSION: The extracranial metastasis in non-small cell lung cancer patients with brain metastasis is an independent prognostic factors. Early whole brain irradiation may improve the survival for those with brain metastasis symptoms.

[Inhibitory effect of Adp53 and F56 on growth and metastasis of transplantation of the breast tumor in mice].

OBJECTIVE: To investigate the effects of Adp53 and F56 on the growth and lung metastasis of breast cancer. METHODS: The BICR-H1 cells were inoculated into the mammary fatty pad of BALB/C nude mice and NOD/SCID mice to establish breast cancer model. Then the nude mice with xenograft tumor were randomized into group Adp53+F56, Adp53, F56 and control. The NOD/SCID mice with xenograft tumor were randomized into group Adp53+F56, Adp53, F56, Adlacz and control. They were treated for 3 weeks according to the plan, diversity of the volume and histopathology of xenograft tumor of nude mice was observed and the expressions of p53 and VEGF gene, and microvessel density (MVD) were detected by immunohistochemistry. Lung metastasis of breast cancer in NOD/SCID mice was observed. RESULTS: (1) Intratumoral injections of Adp53, F56, and their combination resulted in an inhibition on the growth of xenograft tumor of BICR-H1 cells. The ultimate relative growth volumes of groups Adp53+F56, Adp53, F56 and control were 2.47,4.37,4.69 and 12.49 respectively. (2) After treatment, P53 positive rate of group Adp53+F56, Adp53 increased 9.4%, 6.3% than before respectively, but compared with control group, the difference is not significant (P=0.693); VEGF protein of group Adp53+F56, Adp53 and F56 decreased 21.9%, 9.4% and 3.1% than before respectively, but compared with control group, the difference was not significant (P=0.284). Necrosis and decrease of vessel in the tumor and morphological change of endothelium were observed under light microscope in the groups Adp53+F56, Adp53 and F56. MVD estimated by FVIII-RA staining of group Adp53+F56, Adp53 and F56 were 14.50+/-2.54, 16.28+/-3.44 and 18.06+/-7.66, compared with control group(24.93+/-6.53), the difference is significant (P=0.000). (3) The average number of lung metastasis of NOD/SCID mice in group Adp53+F56, Adp53 and F56 were 1.143+/-0.378, 2.750+/-0.886 and 3.375+/-0.518 respectively, lower than Adlacz group(5.000+/-0.816) and control group (5.670+/-0.817) obviously (P=0.000). CONCLUSION: Adp53 combined with F56 can greatly inhibit growth and metastasis of breast cancer in vivo. The mechanism of anti-tumor effects of Adp53 and F56 may be related to the anti-angiogenesis effect on malignant tumor through inhibiting the expression and activity of VEGF.

[Survival status of stage IV non-small cell lung cancer patients after radiotherapy--a report of 287 cases].

BACKGROUND & OBJECTIVE: The patients with stage IV non-small cell lung cancer (NSCLC) usually need radiotherapy and have good responses, particularly in those with brain or bone metastases. This study was to evaluate the influence of radiotherapy on the survival of stage IV NSCLC patients. METHODS: Clinical data of 287 patients with stage IV NSCLC were retrospectively analyzed. Whole brain was treated with two parallel fields irradiation; bone metastases were treated with one local field irradiation. Primary tumors, regional lymph nodes and other distant metastases were treated by conventional fractionation radiotherapy or 3-dimensional conformal radiotherapy. Whole brain and bone radiotherapy was delivered with a total dose of 40 Gy in 20 fractions in 4 weeks or with a total dose of 30 Gy in 10 fractions in 2 weeks. The median dose for primary tumors and regional lymph nodes was 50 Gy (20-70 Gy), and the median dose for other distant metastases was 46 Gy (40-60 Gy). RESULTS: The median survival time of the 287 patients was 9 months (8-10 months). The 1- and 2-year overall survival rates were 30.2% and 8.9%. The median survival time was significantly longer in the patients received chemotherapy than in the patients didn't (10 months vs. 8 months, P = 0.049). In the patients with brain, bone, or other distant metastases, the median survival time was 8, 9, and 10 months, respectively; the 1-year survival rates were 24.8%, 28.7%, and 37.5%, respectively; the 2-year survival rates were 6.7%, 7%, and 15.3%, respectively. By unitivariate analysis, histological type and patients' age were prognostic factors of NSCLC. The median survival time was significantly longer in adenocarcinoma patients than in squamous cell carcinoma patients and other carcinoma patients (10 months vs. 7 and 9 months, P = 0.046), longer in the patients of < or =60 years old than in those of >60 years old (11 months vs. 8 months, P = 0.012), and longer in the patients with only bone metastases than in the patients with concomitant other distant metastases (10 months vs. 6 months, P = 0.033), but there was no significant difference between the patients with only brain metastases and those with concomitant other distant metastases (9 months vs. 8 months, P = 0.374). Radiotherapy for primary tumors and lymph nodes, complications of other chronic diseases, and irradiation dose and pattern had no effect on the survival. CONCLUSIONS: Histological type and patients' age may affect the efficacy of radiotherapy on stage IV NSCLC. The irradiation patterns of 40 Gy in 20 fractions in 4 weeks or 30 Gy in 10 fractions in 2 weeks have no effect on the survival of patients with brain or bone metastases.

[Effect of hypoxic radiosensitizer sodium glycididazole on long-term result of radiotherapy for nasopharyngeal carcinoma].

OBJECTIVE: To evaluate the long-term effect of sodium glycididazole (CMNa) as a hypoxic radiosensitizer on the radiotherapy for nasopharyngeal carcinoma. METHODS: Between May 1999 and May 2002, 211 patients with pathologically confirmed nasopharyngeal carcinoma were randomized into group-A treated by radiotherapy plus CMNa or group-B by radiotherapy alone. The staging was determined according to 92' Fuzhou staging systerm. The type, procession and dosage of radiotherapy were identical in both groups. The early adverse effect grade was assessed based on the CTC2.0 criteria and the late adverse effects were evaluated according to the RTOG/EORTC criteria. The median follow-up time was 52 months. All the data was analyzed by the SPSS 13.0 software. Characteristics and adverse events of these patients were compared between the two groups using t-test and the Wilcoxin rank sum test. Time-to-event curves were estimated using the Kaplan-Meier method. The prognostic parameters were analyzed using univariate analysis and the Cox multivariate regression analysis. RESULTS: The clinical data of the two groups were comparable. The 3-year survival was 88.4% in group-A, while 75.2% in group-B, with a statistically significant difference between two groups (P = 0.010). Univariate analysis showed that the 3-year survival was statistically correlated with N-staging ((N0-1, 86.9%, N2-3 73.8%, P < 0.001), T-staging (T1-2 85.6%, T3-4 79.3%, P = 0.014), TNM staging (P = 0.039), and whether using CMNa or not during rediotherapy (Group-A 88.4%, Group-B 75.2%, P = 0.010). The 5-year recurrence-free survival, 5-year metastasis-free survival and 5-year overall survival were 75.8%, 74.9% and 77.7% in Group-A, while 63.0%, 63.0% and 62.4% in Group-B with a statistically significant difference between two groups (0.013, 0.022 and 0.010, respectively). If stratified in the subgroups, the overall survival of stage III - IV patients was statistically different between group A and B (P = 0.009), however, not of stage I - II patients (P = 0.502). Cox multivariate regression analysis showed that the independent prognostic parameters for survival were N-stage (RR = 3.288) , T-stage (RR = 2.147) and use of CMNa during rediotherapy (RR = 0.407). However, there was no statistically significant difference between two groups in acute or late adverse effects on nervous system or heart, which suggested that use of CMNa during radiotherapy would not aggravate the toxicity caused by radiotherapy. CONCLUSION: Sodium glycididazole is well tolerable effective as a hypoxic radiosensitizer, which can improve the efficacy of radiotherapy and the long-term result of nasopharyngeal carcinom a patients, especially for the stage III - IV patients.

[Recombinant adenovirus-p53 gene therapy combined with radiotherapy for head and neck squamous-cell carcinoma].

OBJECTIVE: To evaluate the efficacy and safety of recombinant adenovirus-p53 gene (Gendicine) therapy combined with radiotherapy for head and neck squamous-cell carcinoma (HNSCC). METHODS: From Oct. 2001 to May 2003, a randomized controlled clinical trial on Gendicine combined with radiation in 36 patients (gene therapy + radiotherapy, GTRT) vs. radiotherapy alone in 33 patients (RT) with HNSCC was completed. In the GTRT group, Gendicine 1 x 10(12) VP (virus particle) was injected intratumorally once a week for eight weeks, and concurrently followed by irradiation. For both groups, the conventional fractionation 2 Gy/f, five fractions a week to a total dose of 70 Gy, was given to either primary tumor or neck lymph nodes. Tumor response was assessed by CT image at 40 Gy, 70 Gy, 2 months after treatment to evaluate the response rate of CR, PR, SD and PD. RESULTS: Wild-type p53 gene significantly enhanced radiotherapeutic effectiveness in patients with HNSCC (P < 0.05). The CR rate of tumors treated by GTRT was increased by nearly 2.31 times more than that of tumors treated by RT alone. No dose-limiting toxicity and adverse events were noted, except transient fever after Gendicine administration. CONCLUSION: Intratumoral injection of Gendicine to HNSCC patients is safe and effective. The apparent improved results of combined therapy with Gendicine and radiation suggest that p53 gene therapy has promising therapeutic potential in cancer treatment.

[Detection of p53 gene change and serum antibody level in phase II clinical trial of ad p53 gene therapy].

OBJECTIVE: To determine the alteration of p53 gene in tumor tissues and to monitor the immunoresponsiveness to anti adenovirus in patients following treatment of recombinant adenovirus-p53 (Adp53, SBN-1) combined with radiation. METHODS: Tumor tissues were collected from 22 patients with malignant tumors at advanced stage before and after treatment with recombinant adenovirus-p53 (Adp53, SBN-1) combined with radiation. Immunohistochemistry was used to detect the p53 expression. Microdissection, PCR, and denaturation high performance liquid chromatography (DHPLC), and DNA sequencing were used to detect the mutation of p53 gene. The levels of the anti-adenovirus antibody SBN-1, IgG and IgM in the serum were detected by using ELISA. RESULTS: p53 positive staining was shown in the nuclei of tumor cells in 6 of 15 tumor samples showing the increase of stability of protein caused by gene mutation. DHPLC and DNA sequencing showed point mutation in 7 of 22 tumor samples. Six of the 7 cases with p53 gene mutation showed complete and partial remission at the degree > 50%, and the 8 cases without p53 gene mutation only showed partial remission or stability of condition. The IgG positive rate was 50% (8/ 16), showing that 50% of the patients had been infected by adenovirus (mainly the types 3, 7, and 11) before. The IgM positive rate was 6% (1/16), showing that most of the patients had not been infected by adenovirus (mainly the types 3, 7, and 11) at that time. The anti-SBN-1 antibody was negative in all patients before the rAd-53 therapy and became positive since the 4th week after the beginning of treatment and the intensity of positivity increased along with the time. CONCLUSION: An effective gene diagnosis system for detecting the p53 gene alteration has been developed.

[Treatment of head and neck squamous cell carcinoma by recombinant adenovirus-p53 combined with radiotherapy: a phase II clinical trial of 42 cases].

OBJECTIVE: To evaluate the efficacy and safety of recombinant adenovirus-p53 (Adp53, SBN-1) combined with radiotherapy in treatment of head and neck squamous cell carcinoma (HNSCC). METHODS: Forty-two patients with HNSCC were randomly divided into 2 groups: gene therapy + radiotherapy group (GTRT group. n = 20, SBN-1 solution 1 x 10(12) VP was injected intratumorally once a week for 8 weeks and radiotherapy was begun since the 3rd day of gene therapy 5 fractions a week with the with the fraction dosage of 2 Gy and total dosage of 70 GY) and radiotherapy group (RT group. n = 22, the above regimen of radiotherapy was conducted). CT was conducted 5 weeks and 8 weeks after the beginning of treatment and 2 months after the finish of treatment (validation point) to calculate the size of tumor. Patients were monitored for adverse event and serum level of anti-adenoviral antibody. A comparative study was also performed on the immediate response rate by CT at the times when the dosages of 40 Gy and 70 Gy had been given. RESULTS: The average tumor reduction rates were (63 +/- 17)%, (82 +/- 18)%, and (90 +/- 16)% at the 40 Gy time point, 70 Gy time point, and validation point respectively in the GTRT group, all higher than those in the RT group (37 +/- 26)%, (62 +/- 39)%, and (70 +/- 34)% respectively, all P < 0.05. Random control study showed that the radio-sensitized enhancement rate was 1.72 at 40 Gy time point and the CR rate of the GRTR group at the validation point was 1.68 times higher than that of the RT group. Self-controlled study showed that the SBN-1 radio-sensitized enhancement ratio in the 4 GTRT group was 1.69 at 40 Gy time point and the CR rate of the GTRT group at validation point was 253% that of the RT group (P < 0.01). No dose-limiting toxicity and adverse events were noted, except transient fever after SBN-1 administration. CONCLUSION: A potentially effective gene therapeutic agent for HNSCC treatment, intratumoral injection of SBN-1 is safe.