CT image fusion in the evaluation of radiation treatment planning for non-small cell lung cancer

Objective: We studied the application of CT image fusion in the evaluation of radiation treatment planning for non-small cell lung cancer (NSCLC). Methods: Eleven patients with NSCLC, who were treated with three-dimensional con-formal radiation therapy, were studied. Each patient underwent twice sequential planning CT scan, i.e., at pre-treatment, and at mid-treatment for field reduction planning. Three treatment plans were established in each patient: treatment plan A was based on the pre-treatment planning CT scans for the first course of treatment, plan B on the mid-treatment planning CT scans for the second course of treatment, and treatment plan F on the fused images for the whole treatment. The irradiation doses received by organs at risk in the whole treatment with treatment A and B plans were estimated by the plus of the parameters in treatment plan A and B, assuming that the parameters involve the different tissues (i.e. V20=AV20+BV20), or the same tissues within an organ (i.e. Dmax=ADmax+BDmax). The assessment parameters in the treatment plan F were calculated on the basis of the DVH of the whole treatment. Then the above assessment results were compared. Results: There were marked differ-ences between the assessment results derived from the plus of assessment parameters in treatment plan A and B, and the ones derived from treatment plan F. Conclusion: When a treatment plan is altered during the course of radiation treatment, image fusion technique should be performed in the establishment of a new one. The estimation of the assessment parameters for the whole treatment with treatment plan A and B by simple plus, is inaccurate.

Qing Dai, a traditional Chinese medicine for the treatment of chronic hemorrhagic radiation proctitis

Objective： To evaluate the efficacy and safety of Qing Dai （indigo naturalis）, a traditional Chinese medicine, in the treatment for chronic hemorrhagic radiation proctitis. Methods： Ten patients with chronic hemorrhagic radiation proctitis between January 2005 to January 2008 were treated with Qing Dai. Qing Dai was administered orally at a dose of 1.5 g, bid for 5 consecutive days, every 2 weeks for two courses. Patients were followed up every 3 months. The clinical response and side-effects were evaluated. Results： Six patients showed improvement of rectal bleeding to grade 0-1 after 1 course of Qing Dai therapy. Four patients had reduced rectal bleeding to grade 0-1 after 2 courses of the therapy. The median follow-up time was 10 months （range： 6-24）. During the follow-up period, 1 patient experienced recurrent rectal bleeding and was managed with topical formalin dabbing, which controlled the symptom. No treatment toxicity was observed. Conclusion： Qing Dai may be a safe and effective treatment for chronic hemorrhagic radiation proctitis.

A new lever-type variable friction damper for freight bogies used in heavy haul railway

To overcome defects caused by the complex structure and unstable damping performance of the wedge- type damper, a new lever-type friction damper has been developed for use in freight bogies; the design allows the advantages of traditional three-piece bogies to be retained. A detailed description of the structure and mechanism of the lever-type damper is provided, followed by a stress analysis using the finite element method. Dynamic per- formance characteristics of the lever-type damper and the wedge-type damper are compared in terms of the nonlinear critical speed, riding index, and curve negotiation. The results indicate that the maximum stress of the lever remains below its yield limit. The lever-type car has higher running performance reliability, and achieves similar nonlinear critical speed, riding index, and curve negotiation when compared with the wedge-type car.

Mechanisms of radioresistance in hepatocellular carcinoma

Hepatocellular carcinoma(HCC), one of the most common cancers in the world, is characterized by poor prognosis and recurrence after resection. Its prevalence is highest in developing countries, particularly where there is high incidence of hepatitis B virus infection. Several curative treatments are available for early stage HCC; however, these options are not available for advanced disease. New techniques allowing the specific delivery of high-dose radiotherapy enable their use in the treatment of HCC, which has been avoided in the past due to low hepatic tolerance for radiation. This presents a new challenge—the development of resistance to radiotherapy and subsequent disease recurrence. Recently, the mechanisms controlling radioresistance have begun to be elucidated. Understanding the molecular basis of radioresistance is key to developing new strategies with better treatment response and increased patient survival.

Irradiation-induced EMT is associated with activation of TGF-β and restriction of BMP signaling in esophageal cancer cells

Objective: Irradiation may enhance migration and/or invasiveness of cancer cells in vitro and in vivo, the mechanism of which may be associated with epithelial-mesenchymal transition (EMT). The present study explored the mechanisms of EMT induced by irradiation in esophageal cancer cells. Methods: Human esophageal cancer cell line EC109 was treated with increased doses of irradiation (0 Gy, 20 Gy, 40 Gy and 60 Gy). Cell morphology was observed. Expressions of E-cadherin and vimentin were determined by immunofluorescence assay or western blot. Secretion of transforming growth factor-β1 (TGF-β1) by cells was determined by enzyme-linked immunosorbent assay (ELISA), and the expressions of Smad2/3 and phosphorated Smad2 (p-Smad2) were also examined by Western blot. The mRNA expressions of BMP-4, a bone morphogenetic protein (BMP) ligand, and two secreted BMP antagonists (Chordin and Gremlin), were detected with reverse transcription-polymerase chain reaction (RT-PCR). Cell migratory capacity was evaluated. Results: Irradiation induced EMT in EC109 cells in a dose-dependent manner as evidenced by morphological changes, decreased expression of E-cadherin and increased expression of vimentin, and increased cell motility. The secretion of TGF-β1 and expression of p-Smad2 were gradually increased in an irradiation dose-dependent manner, but the Smad2/3 protein levels remained stable. The mRNA expression of BMP-4 was gradually down-regulated, but the expressions of Chordin and Gremlin were gradually up-regulated in cells treated with increased doses of irradiation. Conclusion: Irradiation can induce EMT in esophageal cancer cells in a dose-dependent manner, and the mechanism may be associated with activation of TGF-β and restriction of BMP signaling.

Whole-brain radiation therapy alone vs. combined therapy with stereotactic radiosurgery for the treatment of limited brain metastases: A systematic review

Objective The aim of the study was to compare the efficacy and safety of whole brain radiotherapy(WBRT) used alone and combined with stereotactic radiosurgery(SRS) in the treatment of limited(1–4)brain metastases. Methods We searched for randomized controlled and matched-pair analysis trials comparing WBRT plus SRS versus WBRT alone for brain metastases. The primary outcomes were the overall survival(OS), intracranial control(IC), and localcontrol(LC). The secondary outcome was radiation toxicity. The log hazard ratios(lnHRs) and their variances were extracted from published Kaplan-Meier curves and pooled using the generic inverse variance method in the RevMan 5.3 software. The non-pooled outcome measures were evaluated using descriptive analysis. Results Three randomized controlled trials and two matched-pair analysis studies were included. There was no difference in the OS for limited brain metastases between the two groups [lnHR 0.91(95% CI 0.76–1.09, P = 0.32) vs. 0.72(95% CI 0.44–1.19, P = 0.20)]. The LC and IC were significantly higher in the combined treatment group [lnHR 0.69(95% CI 0.55–0.86, P = 0.001) vs. 0.41(95% CI 0.29–0.58, P < 0.0001)]. For patients with a single lesion, one trial showed a higher survival in the combined treatment group(median OS: 6.5 months vs. 4.9 months, P = 0.04). The combined treatment was not associated with significantly higher incidence of radiation toxicity. Conclusion Combined treatment with WBRT plus SRS should be recommended for patients with limited brain metastases based on the better LC and IC without increased toxicity. It should also be considered a routine treatment option for patients with solitary brain metastases based on the prolonged OS.

Selective partial salivary glands sparing during intensity-modulated radiation therapy for nasopharyngeal carcinoma

Objective This study evaluated the dosimetric consequences of selective partial salivary gland sparing during intensity-modulated radiotherapy(IMRT) for patients with nasopharyngeal carcinoma(NPC).Methods Ten patients with NPC were enrolled in the study.Two IMRT plans were produced for each patient:conventional(control) and partial salivary glands-sparing(treatment),with dose constraints to the entire parotid glands or partial salivary glands(including the parotid and submandibular glands,delineated with the adjacent distance of at least 0.5 cm between the glands and PTV,the planning target volume) in planning,respectively.Dosimetric parameters were compared between the two plans,including the V_(110%),V_(100%),V_(95%)(the volume covered by more than 110%,100%,or 95% of the prescribed dose),Dmin(the minimum dose) of PTV,homogeneity index(HI),conformity index(CI),and the mean dose and percentage of the volume receiving 30 Gy or more(V_(30)) for the parotid glands and submandibular glands.Results Treatment plans had significantly lower mean doses and V_(30) to both the entire parotid glands and partial parotid glands than those in control plans.The mean doses to the partial submandibular glands were also significantly lower in treatment plans than in control plans.The PTV coverage was comparable between the two plans,as indicated by V_(100%),V_(95%),Dmin,CI,and HI.The doses to critical structures,including brainstem and spinal cord,were slightly but not significantly higher in treatment plans than in control plans.Conclusion A selective partial salivary gland-sparing approach reduces the doses to parotid and submandibular glands during IMRT,which may decrease the risk of post-radiation xerostomia while not compromising target dose coverage in patients with NPC.

Long non-coding RNAs in cancer

Long non-coding RNAs （IncRNAs）, gradually being paid attention to, have been found playing a critical role in regulation of cellular processes such as cell growth and apoptosis, what is more, accumulating evidence indicates that IncRNAs also play a critical role in regulation of carcinogenesis and cancer progression. Here, we will summarize the recent researches about some IncRNAs in the development of cancers, hoping to give a new view about the study in the mechanisms involved in carcinogenesis and tumor progression.

Lipid disorders and lipid peroxidation associated with the malignant transformation of colorectal adenoma

Objective:The aim of this study was to investigate lipid disorders and lipid peroxidation associated with the malignant transformation of colorectal adenoma.Methods:Analyses were based on data from 100 subjects with histologically confirmed adenomas(cases) and 50 adenoma-free control subjects,all of whom had colonoscopy.The subjects were divided into two groups:those with no adenoma and those with adenoma.According to subsite of adenomas the subjects with adenoma were divided into group of distal adenoma and group of proximal adenoma.According to histology of adenomas the subjects with adenoma were divided into group of villiform adenoma and group of tubular + tubulo-villous adenoma.Among the groups,the serum levels of triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),lowdensity lipoprotein cholesterol(LDL-C),and lipid peroxidation product malondialdehyde(MDA) were compared in all the patients.Results:Plasma total cholesterol and MDA level in group of adenomas were significantly higher than that in group of control subjects,but plasma HDL-C level was low in group of adenomas(P<0.05).Plasma total cholesterol and MDA levels were positively related to distal and villiform adenomas(P<0.05).Conclusion:The findings suggest that altered lipid metabolism may be differentially associated with colorectal adenomas.

Cytokine-induced killer cell combination with TACE in the treatment of hepatocellular cancers:a meta-analysis

Objective：The aim of the study was to evaluate the ef icacy and safety of cytokine-induced kil er （CIK） cellcombined with transcatheter arterial chemoembolization （TACE） therapy in the treatment of hepatocellular carcinoma （HCC）. Methods：Randomized control ed trials （RCTs） on CIK cells combination with TACE based-therapy were identified by elec-tronic searches in the Cochrane Library, MEDLINE, Pubmed, Wanfang, VIP, CNKI and other electronic databases. We in-cluded any RCTs evaluating CIK cellcombination with TACE for the treatment of hepatocellular cancers. The quality of RCTs meeting inclusion criteria was evaluated and data on short-term and long-term curative ef ects, quality of life, liver function and immunologic function were extracted. For quantitative data, we conducted meta-analysis with ReMan 5.1 software and the GRADE System was used to rate the level of evidence and strength of recommendation. For qualitative data, data mainly adopted descriptive methods. Results：The 9 RCTs involving 870 cases meeting the inclusion criteria were included. The meta-analysis showed significant survival benefit on 0.5-year survival rate （RR=1.51, 95%CI, 1.35-1.69, P〈0.00001） in fa-vor of CIK based therapy. This ef ect was consistent at other prospective dates, including 1-year survival rate （RR=2.30, 95%CI, 1.94-2.72, P〈0.00001）, 2-year survival rate （RR=7.03, 95%CI, 3.83-12.91, P〈0.0001）. Meanwhile, the CIK-based group also demonstrated a significantly prolonged time-to-progression （TTP） （SD=1.62, 95%CI, 1.30-1.94, P〈0.0001） and overal survival （OS） （SD=20.6, 95%CI, 20.2-21.18, P〈0.0001）. Moreover, a favored response rate （RR=CR＋PR） （RR=2, 95%CI, 1.65-2.43, P〈0.00001） and the quality of life improvement rate （KPS） （RR=1.76, 95%CI, 1.26-2.45, P=0.0008） were also observed in patients receiving CIK cells and TACE therapy. Furthermore, patients in the CIK group showed lower AFP （SD=-165.23, 95%CI,-178.51--151.94, P〈0.00001）, ALT （SD=-33.14, 95%CI,-40.30--36.37, P〈0.00001）, and AST （SD=-15.57, 95%CI,-17.05--14.09, P〈0.00001） levels. In terms of T-lymphocyte subsets in peripheral blood, the analysis also showed the percentage of CD3＋, CD4＋cells and the ratio of CD4＋/CD8＋cells in the CIK group increased compared with the non-CIK group. Based on GRADE, the level of evidence was GRADE 2C, and the strength of recommen-dation was 2. Conclusion：CIK cells combined with TACE therapy demonstrated a significant superiority in improving recent and forward curative ef ects, immunity function, quality of life and liver function of HCC patients. Based on GRADE, the level of evidence was GRADE 2C, and the strength of recommendation was 2. In the light of the limitations of this study, large-scale, high-quality clinical trials should be carried out to further confirmed the above conclusion.

Construction of the human miRNA-451 expression vector and its expression in gastric carcinoma cell line SGC-7901

Objective： The aim of the study was to construct miRNA-451 expression vector pLMP-miRNA-451 which could help identify the functions of miRNA-451 in SGC-7901 cell. Methods： Total RNA was extracted from SGC-7901 cells to synthesized cDNA. The synthesized cDNA encoding pre-miRNA-451 was amplified by polymerase chain reaction （PCR）. The PCR product was separated by electrophoresis on 1% agarose gel and then recovered and purified. The purified cDNA fragments of miRNA-451 precursor sequence was then ligated with vector pLMP for 1 h by using DNA ligase to form pLMP- miRNA-451 plasmid. After that, the pLMP-miRNA-451 plasmid was transformed into E. coli DH5a strain expression system to clone and amplificate. The purified pLMP-miRNA-451 extracted from E. coli DH5a via transformation and clone screening was identificatied with restriction enzyme digestion and DNA sequencing. At last, pLMP-miRNA-451 was transfected into SGC-7901 cells with lip2000. Real-time PCR was used for detection of the miRNA-451, the transfection efficiency was ob- served under fluorescence microscopy and cell counting kit-8 assay was conduced to evaluate the effect of miRNA-451 on SGC-7901 cell proliferation. Results： Our results showed that pLMP-miRNA-451 expression vector was not only constructed successfully and effectively infected SGC-7901 cells, but also could repress the SGC-7901 cell proliferation. Conclusion： The constructed plasmid pLMP-miRNA-451 could used for further studies of miRNA-451 in SGC-7901 cell lines.

Dosimetric consequences of tumor volume changes after kilovoltage cone-beam computed tomography for non-operative lung cancer during adaptive intensity-modulated radiotherapy or fractionated stereotactic radiotherapy

Objective The aim of this study was to investigate tumor volume changes with kilovoltage cone-beam computed tomography （kV-CBCT） and their dosimetric consequences for non-operative lung cancer during intensity-modulated radiotherapy （IMRT） or fractionated stereotactic radiotherapy. Methods Eighteen patients with non-operative lung cancer who received IMRT consisting of 1.8-2.2 Gy/fraction and five fractions per week or stereotactic radiotherapy with 5-8 Gy/fraction and three fractions a week were studied, kV-CBCT was performed once per week during IMRT and at every fraction during stereotactic radiotherapy. The gross tumor volume （GTV） was contoured on the kV-CBCT images, and adaptive treatment plans were created using merged kV-CBCT and primary planning computed tomogra- phy image sets. Tumor volume changes and dosimetric parameters, including the minimum dose to 95% （D95） or 1% （D1） of the planning target volume （PTV）, mean lung dose （MLD）, and volume of lung tissue that received more than 5 （Vs）, 10 （Vl0）, 20 （V20）, and 30 （V30） Gy were retrospectively analyzed. Results The average maximum change in GTV observed during IMRT or fractionated stereotactic radio- therapy was -25.85% （range, -13.09% --56.76%）. The D95 and Dr of PTV for the adaptive treatment plans in all patients were not significantly different from those for the initial or former adaptive treatment plans. In patients with tumor volume changes of 〉20% in the third or fourth week of treatment during IMRT, adap- tive treatment plans offered clinically meaningful decreases in MLD and V5, V10, V20, and V30; however, in patients with tumor volume changes of 〈 20% in the third or fourth week of treatment as well as in patients with stereotactic radiotherapy, there were no significant or clinically meaningful decreases in the dosimetric parameters. Conclusion Adaptive treatment planning for decreasing tumor volume during IMRT may be beneficial for patients who experience tumor volume changes of 〉20% in the third or fourth week of treatment.

The roles of micro RNAs and epithelial-mesenchymal transition in colorectal cancer metastasis

Colorectal cancer(CRC) is the second most common cause of cancer death worldwide. Distant metastasis is the major cause of death in patients with CRC. During progression to metastasis in which malignant cells disseminate from the primary tumor to seeding other organs, a multistep process is involved. Cancer cells proliferate, invade microenvironment, enter into the blood circulation, then survive and colonize into distant organs. Micro RNAs(mi RNAs) and epithelial-mesenchymal transition(EMT) are key regulators and mechanism in tumorigenesis and cancer metastasis. We review the roles of EMT and micro RNAs, especially EMT related micro RNAs in the metastatic pathway of CRC. Micro RNAs provide us a set of potential therapeutic applications and molecular target for CRC.

Characteristics of small bowel tumors detected by double balloon endoscopy:A Chinese single-center study

Objective： Small intestinal tumors （SBTs） were difficult to be discovered before surgery. The emergence of dou- ble-balloon enteroscopy （DBE） and capsule endoscopy （CE） have greatly improved the evaluation of SBTs and facilitated a more precise preoperative diagnosis. Yet little data exist in China regarding clinical efficacy of DBE and clinical characteristics of SBTs. The aim of our study was to clarify the clinical characteristics of SBTs and analyze the efficacy of DBE examination in the detection and diagnosis of SBTs. Methods： We retrospectively reviewed patients who underwent DBE in our hospital between June 2011 and July 2014. Patients who were diagnosed with SBTs by DBE were included in the study. Results： A total of 316 patients underwent 321 DBE procedures, 80 （25.3%） of whom were suspected to have an SBT. And 59 of the 80 subjects were diagnosed with SBT finally. The majorities （59.3%, 35/59） of the patients diagnosed with SBT were males, whose average age was 61.8 years （SD _＋11.0 years）. DBE were frequently performed in patients with obscure gastrointes- tinal bleeding （66.1%）, abdominal pain （16.9%）. The common SBTs identified were： gastrointestinal stromal tumors （GISTs） （24/59, 40.7%）, adenocarcinomas （13/59, 22.0%）, lymphomas （6/59, 10.2%） and benign polyps （6/59, 10.2%）. Jejunum had the highest detection rate （47.5%, 29/61）. During the follow-up period （3 months to 3 years）, 14 patients were submitted to chemotherapy and two patients died of tumor. Conclusion： The most high frequency type and location of SBTs detected in our hospital were different from western countries. DBE is a valuable and safe examination for SBIs.

Comparison of plastic and self-expandable metal stents in the palliative treatment of malignant biliary obstruction: a meta-analysis

Objective： Stent placement is one of the main methods in the palliative treatment of malignant biliary obstruc- tion, including plastic and self-expandable metal stents. The comparison of stent patency between self-expandable metal and plastic stents in palliation of malignant biliary obstruction is meaningful. We carried out a meta-analysis to summarize current evidence for clinical efficacy of self-expandable metal and plastic stents in the treatment of malignant biliary obstruc- tion. Methods： A comprehensive search of several databases including CNKI, Wanfang Data, Sino MED. A fixed-effects or random-effects model was used to pool data of aU study endpoint. Sensitivity analysis was also performed. Results： Eight randomized clinical trials were identified, including 633 patients. These results suggested that the self-expandable metal stents were associated with a significantly longer stent patency （OR = 8.15; 95% CI： 2.80-23.76; 12 = 85%）. No publication bias was observed. Conclusion： Self-expanding metal stents have a longer patency than plastic stents and offer adequate palliation in patients with malignant bUiary obstruction.

TACE combined with liver resection versus liver resection alone in the treatment of resectable HCC:a meta-analysis

Objective: The efficacy of preoperative transarterial chemoembolization(TACE) for hepatectomy on hepatocelluar carcinoma(HCC) is still controversial. This study aims to evaluate the efficacy of preoperative TACE on resectable HCC. Methods: Pubmed, SCI, Medline, EMBASE, Cochrane Datebase, CNKI were searched. The articles that focused on preoperative TACE for resectable HCC, published from 1990 to 2012, were collected by computerized search of literatures and manual search of bibliographies. The relevant clinical trials' data were reviewed by meta-analysis using the random effects model or fixed effect model by heterogeneity. The outcomes were expressed as odds ratio(OR) with 95% confidence intervals(CIs). Results: A total of 1347 patients were included in these 7 studies, the cases were divided into the preoperative TACE group and the non-preoperative TACE group, and there was no difference between the two groups in the 3-year disease-free survival rate, with an odds ratio of 1.14(95% CI = 0.90–1.45, P = 0.27); the 5-year disease-free survival rate in the preoperative TACE group was better than that in the non-TACE group with an odds ratio of 1.35(95% CI = 1.07–1.74, P = 0.02); the 5-year overall survival rate in the preoperative TACE group was higher than that in the non-TACE group with an odds ratio of 0.59(95% CI = 0.46–0.77, P < 0.0001). Conclusion: The present data suggests that preoperative TACE has no different in improving the 3-year disease-free survival rate with non-TACE group for resectable HCC, while it can improve the 5-year disease-free survival rate and the 5-year overall survival rate. More randomized controlled trials using large sample size are needed to provide sufficient evidence to confirm current conclusion.

Research of the relationship between radiotherapy and microRNAs

MicroRNAs(miRNAs) are endogenous short non-coding RNAs,and play a pivotal role in regulating a variety of cellular processes,including proliferation and apoptosis,both of which are cellular responses to radiation treatment.In response to radiation,multiple miRNAs show altered expression,which act as oncogenes or tumor suppressors.Recent evidence has also shown that some miRNAs have radiotherapy sensitization or radiation resistance role in malignant tumors.This review focuses on analysis of these characteristics and mechanisms of miRNAs,and will provide some insight into the therapeutic application of radiation.

DNA repair genes BRCA1 and DNA-PKcs have great potential in radiation therapy

Radiotherapy is a part of the front-line treatment regime for many cancers. The mechanisms of radiation-induced effects in cancers mainly involves double-strand breaks (DBS) which plays very important role in maintaining the stability of gene. As DNA repair gene breast cancer 1 (BRCA1) and DNA-dependent protein kinase catalytic subunit (DNA-PKcs) can act to maintain genetic stability though two distinct and complementary mechanisms for DNA DSB repair-homologous recombination (HR) and non-homologous end joining (NHEJ). Therefor, BRCA1 and DNA-PKcs are closely associated with radiation sensitivity, which means that they may be used as a useful tool to predict radio sensitivity in human tumour cells.

Induction of epithelial-mesenchymal transition (EMT) in human hepatocellular carcinoma after radiotherapy

Objective: Epithelial-mesenchymal transition (EMT) is a critical early event for the invasion and metastasis of many carcinomas. In the present study, we examined EMT markers in the residual cancer cells of hepatocellular carcinoma (HCC) after radiotherapy. Methods: Eight patients with large HCC who underwent hepatectomy with preoperative radiothera- py were studied. The expressions of E-cadherin and vimentin were determined immunohistochemically in the residual cancer cells of HCC following radiotherapy, and also in the pre-radiotherapy biopsy cancer cells. Results: Histological analysis showed that some residual cancer cells of HCC displayed an elongated spindle or fibroblast-like shape. The expression of E- cadherin was markedly reduced or negative in the spindle residual cancer cells, but the expression of vimentin significantly in- duced. However, the above changes were not found in the pre-radiotherapy biopsy cancer cells. Conclusion: EMT is induced in the residual cancer cells of HCC following radiotherapy, which may facilitate the systemic dissemination of cancer cells.

Effects of Aidi injection on vinorelbine plus cisplatin chemotherapy for advanced non-small cell lung cancer

Objective： To evaluate the effects of Aidi injection on vinorelbine plus cisplatin （NP） chemotherapy for advanced non-small cell lung cancer （NSCLC）. Methods： Ninety eight patients with advanced NSCLC were randomized to receive either NP alone or NP plus Aidi injection every 3 weeks. The primary endpoint was overall survival; secondary endpoints included overall response rate, time to progression, and safety. Results： The median overall survival time was 11.6 months in NP plus Aidi-treated patients and 10.1 months in NP alone-treated ones, and 1- and 2-year survival rates were higher in the former （47% and 22%） than the latter （42% and 15%）. The overall response rates in Aidi injection plus NP-treated patients tended to be higher but not statistically significant compared with NP alone-treated ones. The occurrence rates of grades 3 or 4 toxicities, e.g. fatigue, nausea, vomiting, appetite loss, leucopenia, thrombocytopenia and anemia, were lower in Aidi injec- tion plus NP-treated patients than NP alone-treated ones, although not significantly different between them. Con^lusion：Aidi injection promotes NP chemotherapeutic effects, reduces the toxicities, and improves the patients＇ tolerance to chemotherapy as well. It may be an effective adjunct to chemotherapy in patients with NSCLC.