Alterations in Serum Lipids and Lipoproteins Induced by Neoadjuvant Chemotherapy in Patients with Osteosarcoma around the Knee Joint:A Retrospective Analysis

Objective To investigate the serum lipid profiles of patients with localized osteosarcoma around the knee joint before and after neoadjuvant chemotherapy.Methods After retrospectively screening the data of 742 patients between January 2007 and July 2020,50 patients aged 13 to 39 years with Enneking stage II disease were included in the study.Serum lipid levels,including total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),lipoprotein-α[Lp(a)],and apolipoprotein A1,B,and E(ApoA1,ApoB,and ApoE),and clinicopathological characteristics were collected before and after neoadjuvant chemotherapy.Results The mean levels of TC,TG,and ApoB were significantly increased following neoadjuvant chemotherapy(16%,38%,and 20%,respectively,vs.pretreatment values;P<0.01).The mean levels of LDL-C and ApoE were also 19%and 16%higher,respectively(P<0.05).No correlation was found between the pretreatment lipid profile and the histologic response to chemotherapy.An increase in Lp(a)was strongly correlated with the Ki-67 index(R=0.31,P=0.023).Moreover,a trend toward longer disease-free survival(DFS)was observed in patients with decreased TG and increased LDL-C following chemotherapy,although this difference was not statistically significant(P=0.23 and P=0.24,respectively).Conclusion Significant elevations in serum lipids were observed after neoadjuvant chemotherapy in patients with localized osteosarcoma.There was no prognostic significance of pretreatment serum lipid levels on histologic response to neoadjuvant chemotherapy.The scale of increase in serum Lp(a)might have a potential prognostic role in osteosarcoma.Patients with increased LDL-C or reduced TG after chemotherapy seem to exhibit a trend toward favorable DFS.

Cancer gene therapy targeting angiogenesis:An updated review

Since the relationship between angiogenesis and tumor growth was established by Folkman in 1971, scientists have made efforts exploring the possibilities in treating cancer by targeting angiogenesis. Inhibition of angiogenesis growth factors and administration of angiogenesis inhibitors are the basics of anti- angiogenesis therapy. Transfer of anti-angiogenesis genes has received attention recently not only because of the advancement of recombinant vectors, but also because of the localized and sustained expression of therapeutic gene product inside the tumor after gene transfer. This review provides the up-to-date information about the strategies and the vectors studied in the field of anti-angiogenesis cancer gene therapy.

Comparison between preadolescent and adolescent patients with high-grade osteosarcoma in China

Objective:The aim of this study was to assess the differences in clinical appearance and prognosis of osteosarcoma between preadolescent and adolescent in Chinese patients and investigate whether age at diagnosis is a prognostic indicator.Methods:Between May 2002 and May 2009,ninety-six children with high-grade osteosarcoma treated at our institute were stratified according to the age of 10.There were 19 preadolescents(≤ 10 years) and 77 adolescents(10 years < age ≤ 19 years),and their medical records were reviewed and compared using Fisher exact tests.Overall survival and disease-free survival was estimated by Kaplan-Meier methods and compared using log-rank tests.The prognostic significance of the various factors on survival was examined by Cox regression analysis.Results:There were no significant differences in terms of Karnofsky Performance Status(KPS) score,Enneking stage,tumor location,histologic type,pathologic fracture,tumor necrosis rate,tumor size,relapse and frequencies of adjuvant chemotherapy between the two groups.A high proportion of preadolescent patients was treated with amputation(78.9% vs.44.2%;P = 0.01).The 5-year survival of the preadolescent and adolescent groups was(38 ± 14)% and(33 ± 10)%,and the 2-year disease free survival for each group was(45 ± 12)% and(44.4 ± 6.3)%,respectively.Our study showed that age did not have any statistical significance for survival(P = 0.803).Univariate analysis indicated that KPS score;frequencies of adjuvant chemotherapy,tumor size and relapse were significantly related to overall survival.Multivariate Cox regression analysis revealed that both frequencies of adjuvant chemotherapy and relapse were independently prognostic factors for survival.Conclusion:Clinical characteristics and survival between the preadolescents and adolescents with osteosarcoma in China were compatible.So we suggested that there did not need to treat preadolescents patients by alternative and/or aggressive therapies compared with adolescent patients.

Retrospective clinical analysis of MAID protocol as first-line treatment on 137 metastatic soft-tissue sarcomas patients

Objective:The aim of this study was to evaluate the efficacy,adverse reaction and survival of MAID protocol as first-line treatment on 137 metastatic soft tissue sarcomas patients.Methods:One hundredand thirty-seven patients with metastatic soft tissue sarcoma were given MAID protocol chemotherapy which consists of ifosfamide at a total dose of 8-10 g/m2 in 4-5 days,adriamycin at a dose of 60 mg/m2 on first day and dacarbazine at a dose of 200 mg/m2/d in 4-5 days.Twenty one days were regarded as a cycle and 2-6 cycles were completed.The median cycle number was 4.Results:Four cases had complete remission(CR)(2.9%),thirteen cases achieved partial remission(PR)(9.5%),eighty-eight cases maintained a stable disease(SD)(64.2%),and thirty-two cases had progressive disease(PD)(23.4%).The overall response rate(RR) was 12.4%,disease control rate(DCR) was 76.6%.The progression-free survival(PFS) was 2-14 months and median PFS was 5.00 ± 1.12 months.The overall survival(OS) was 3-19 months and median OS was 8.00 ± 1.32 months.Three months PFS rate was 56.9%,six months PFS rate was 27.2% and one year PFS rate was 7.8%.Three months OS rate was 100.0%,six months OS rate was 41.5% and one year OS rate was 10.7%.The main adverse reactions were bone marrow supression,nausea/vomiting and alopecia.Other adverse reactions were seldom observed.Conclusion:The effect of MAID protocol as first-line treatment on metastatic soft tissue sarcomas patients was exact,the treatment can control disease progression effectively and the side effects can be tolerable.It was obviously very worthy in clinical use as one of the first-line chemotherapy protocols on advanced soft tissue sarcomas.

Retrospective analysis of prognostic factors for sixty osteosarcoma patients with local recurrence

Objective:The aim of this study was to identify prognostic factors and imply the appropriate management for local recurrent osteosarcoma.Methods:The clinical records of 60 patients with local recurrence osteosarcoma were reviewed between January 2002 and December 2010.The mean followed-up time for these patients was 49.1 months(range 13 to 143 months).The factors of age,gender,tumor site,tumor size,surgical procedure,neoadjuvant chemotherapy,frequency of primary postoperative adjuvant chemotherapy,lung metastasis,metastasis of other sites(except for lung) and treatment after local recurrence were selected as the measurements for this analysis.Kaplan-Meier method was used to measure the overall survival and post-recurrence survival.The univariate analysis was used to determine the prognostic factors related with survival by Log-rank test.The COX proportional-hazard regression model was used to analyze the correlation between the prognostic factor and the survival.Results:The median post-recurrence survival and overall survival of 60 patients were 32 months(95% confidence interval:16.2-47.8) and 55 months(95% confidence interval:39.3-70.7) respectively.The 2and 3-year cumulative survival rates were 81.7% and 55.4%,respectively.The Log-rank univariate analysis showed that age,gender,tumor size,metastasis of other sites(except for lung) and treatment after local recurrence were associated with the prognosis of osteosarcoma with local recurrence(P < 0.05).The Cox regression analysis revealed that gender(P = 0.016),metastasis of other sites(except for lung,P = 0.017) and treatment after local recurrence(P = 0.028) were the independent prognostic factors of osteosarcoma with local recurrence.On the other hand,the prognosis of local recurrent osteosarcoma was not associated with tumor site,surgical procedure,frequency of primary postoperative adjuvant chemotherapy,neoadjuvant chemotherapy and lung metastasis(P > 0.05).Conclusion:The independent prognostic factors for local recurrent osteosarcoma were the metastasis of other site(except for lung) and the treatment after local recurrence.The aggressive surgical treatment for local recurrence and distant metastasis could effectively improve the survival of local recurrent osteosarcoma.