Objective:Several studies have been conducted on the effects and toxicity of adding oxaliplatin to fluorouracilbased or capecitabine-based chemoradiotherapy(CRT)regimens as significantly increasing the toxic response ...Objective:Several studies have been conducted on the effects and toxicity of adding oxaliplatin to fluorouracilbased or capecitabine-based chemoradiotherapy(CRT)regimens as significantly increasing the toxic response without benefit to survival.In this study,we further explored the role of these two postoperative CRT regimens in patients with pathological stage N2 rectal cancer.Methods:This study was a subgroup analysis of a randomized clinical trial.A total of 180 patients with pathological stage N2 rectal cancer were eligible,85 received capecitabine with radiotherapy(RT),and 95 received capecitabine and oxaliplatin with RT.Patients in both groups received adjuvant chemotherapy[capecitabine and oxaliplatin(XELOX);or fluorouracil,leucovorin,and oxaliplatin(FOLFOX)]after CRT.Results:At a median follow-up of 59.2[interquartile range(IQR),34.0−96.8]months,the three-year diseasefree survival(DFS)was 53.3%and 64.9%in the control group and the experimental group,respectively[hazard ratio(HR),0.63;95%confidence interval(95%CI),0.41−0.98;P=0.04].There was no significant difference between the groups in overall survival(OS)(HR,0.62;95%CI,0.37−1.05;P=0.07),the incidence of locoregional recurrence(HR,0.62;95%CI,0.24−1.64;P=0.33),the incidence of distant metastasis(HR,0.67;95%CI,0.42−1.06;P=0.09)and grade 3−4 acute toxicities(P=0.78).For patients with survival longer than 3 years,the conditional overall survival(COS)was significantly better in the experimental group(HR,0.39;95%CI,0.16−0.96;P=0.03).Conclusions:Our results indicated that adding oxaliplatin to capecitabine-based postoperative CRT is safe and effective in patients with pathological stage N2 rectal cancer.展开更多
AIM To explore the therapeutic effect of chemoembolization in hepatic metastases in colorectal carcinoma. METHODS Forty patients underwent chemoembolization of metastatic liver lesion from colorectal carcinoma. Sel...AIM To explore the therapeutic effect of chemoembolization in hepatic metastases in colorectal carcinoma. METHODS Forty patients underwent chemoembolization of metastatic liver lesion from colorectal carcinoma. Selective angiography of the hepatic artery was performed to identify the feeding vessels of the metastatic lesion. The injected chemoemulsum consisted of 100*!mg 5 fluorouracil, 10*!mg mitomycin C and 10*!mL lipiodol ultra fluid in a total volume of 30*!mL . Gel foam embolization then followed until stagnation of blood flow was achieved. Patients were evaluated for response, over all survival, and side effects. RESULTS Overall median survival time from date of first chemoembolization was ten months. Median survival time of cirrhotic patients with class A and B by Child Pugh classification was 24 and 3 months, respectively. The difference was significant, ( P <0 01) . Patients with metastatic disease confined to the liver did better than those who also had extrahepatic disease, with median survivals of 14 and 3 months, respectively ( P <0 02) . There were significant differences in that median survival of patients with hypervascular metastases was longer than that of patients with hypovascular metastases. The most common side effects were transient fever, abdominal pain and fatigue. Three patients died within one month from the procedure. CONCLUSION The therapeutic effect of systemic chemotherapy in hepatic metastases of large intestinal carcinoma was not satisfactory and there were more side effects, whereas the therapeutic effect of selective chemoembolization was promising and there were less side effects. Selective chemoembolization may be an effective first line therapy in hepatic metastases of large intestinal carcinoma.展开更多
IM To compare the pharmacokinetic characteristics of four kinds of fluorouracil (5FU) preparations rectally administered to animals.METHODS The concentrations of 5FU in the plasma, rectal wall and lymph tissues of m...IM To compare the pharmacokinetic characteristics of four kinds of fluorouracil (5FU) preparations rectally administered to animals.METHODS The concentrations of 5FU in the plasma, rectal wall and lymph tissues of mesentery were determined by HPLC assay, and the main pharmacokinetic parameters were calculated by the data procession software package.RESULTS The 5FU concentrations in the rectal wall and lymph tissues of rats were significantly higher than that in blood of the animals administered rectally with the four kinds of preperations (P<001). The drug level in rectal wall was higher in emulsion groups than that in suppository groups (P<005). The drug level in plasma was lower in lipophilbase suppository group than that in hydrophilbase suppository group, and than in the simple (o/w) emulsion group was lower than in the complex (w/o/w) emulsion group, and the in vivo differences were found statistically significant in rabbits (P<001).CONCLUSION The lipophilbase suppository and the simple emulsion of 5FU might be more suitable for rectal administration in the treatment of the rectal cancers.展开更多
基金supported by grants from Sanming Project of Medicine in Shenzhen(No.SZSM202211030)the Science and Technology Department Basic Research Project of Shanxi(No.202203021221284)。
文摘Objective:Several studies have been conducted on the effects and toxicity of adding oxaliplatin to fluorouracilbased or capecitabine-based chemoradiotherapy(CRT)regimens as significantly increasing the toxic response without benefit to survival.In this study,we further explored the role of these two postoperative CRT regimens in patients with pathological stage N2 rectal cancer.Methods:This study was a subgroup analysis of a randomized clinical trial.A total of 180 patients with pathological stage N2 rectal cancer were eligible,85 received capecitabine with radiotherapy(RT),and 95 received capecitabine and oxaliplatin with RT.Patients in both groups received adjuvant chemotherapy[capecitabine and oxaliplatin(XELOX);or fluorouracil,leucovorin,and oxaliplatin(FOLFOX)]after CRT.Results:At a median follow-up of 59.2[interquartile range(IQR),34.0−96.8]months,the three-year diseasefree survival(DFS)was 53.3%and 64.9%in the control group and the experimental group,respectively[hazard ratio(HR),0.63;95%confidence interval(95%CI),0.41−0.98;P=0.04].There was no significant difference between the groups in overall survival(OS)(HR,0.62;95%CI,0.37−1.05;P=0.07),the incidence of locoregional recurrence(HR,0.62;95%CI,0.24−1.64;P=0.33),the incidence of distant metastasis(HR,0.67;95%CI,0.42−1.06;P=0.09)and grade 3−4 acute toxicities(P=0.78).For patients with survival longer than 3 years,the conditional overall survival(COS)was significantly better in the experimental group(HR,0.39;95%CI,0.16−0.96;P=0.03).Conclusions:Our results indicated that adding oxaliplatin to capecitabine-based postoperative CRT is safe and effective in patients with pathological stage N2 rectal cancer.
文摘AIM To explore the therapeutic effect of chemoembolization in hepatic metastases in colorectal carcinoma. METHODS Forty patients underwent chemoembolization of metastatic liver lesion from colorectal carcinoma. Selective angiography of the hepatic artery was performed to identify the feeding vessels of the metastatic lesion. The injected chemoemulsum consisted of 100*!mg 5 fluorouracil, 10*!mg mitomycin C and 10*!mL lipiodol ultra fluid in a total volume of 30*!mL . Gel foam embolization then followed until stagnation of blood flow was achieved. Patients were evaluated for response, over all survival, and side effects. RESULTS Overall median survival time from date of first chemoembolization was ten months. Median survival time of cirrhotic patients with class A and B by Child Pugh classification was 24 and 3 months, respectively. The difference was significant, ( P <0 01) . Patients with metastatic disease confined to the liver did better than those who also had extrahepatic disease, with median survivals of 14 and 3 months, respectively ( P <0 02) . There were significant differences in that median survival of patients with hypervascular metastases was longer than that of patients with hypovascular metastases. The most common side effects were transient fever, abdominal pain and fatigue. Three patients died within one month from the procedure. CONCLUSION The therapeutic effect of systemic chemotherapy in hepatic metastases of large intestinal carcinoma was not satisfactory and there were more side effects, whereas the therapeutic effect of selective chemoembolization was promising and there were less side effects. Selective chemoembolization may be an effective first line therapy in hepatic metastases of large intestinal carcinoma.
文摘IM To compare the pharmacokinetic characteristics of four kinds of fluorouracil (5FU) preparations rectally administered to animals.METHODS The concentrations of 5FU in the plasma, rectal wall and lymph tissues of mesentery were determined by HPLC assay, and the main pharmacokinetic parameters were calculated by the data procession software package.RESULTS The 5FU concentrations in the rectal wall and lymph tissues of rats were significantly higher than that in blood of the animals administered rectally with the four kinds of preperations (P<001). The drug level in rectal wall was higher in emulsion groups than that in suppository groups (P<005). The drug level in plasma was lower in lipophilbase suppository group than that in hydrophilbase suppository group, and than in the simple (o/w) emulsion group was lower than in the complex (w/o/w) emulsion group, and the in vivo differences were found statistically significant in rabbits (P<001).CONCLUSION The lipophilbase suppository and the simple emulsion of 5FU might be more suitable for rectal administration in the treatment of the rectal cancers.
