The interactions among drugs,tumor and host are critical for a response to therapy and for outcome.Anticancer herbs used in Chinese medicine are classified into 4 groups based on their target (tumor,patient and drug) ...The interactions among drugs,tumor and host are critical for a response to therapy and for outcome.Anticancer herbs used in Chinese medicine are classified into 4 groups based on their target (tumor,patient and drug) as follows:eliminating pathogenic factors,strengthening the body resistance,enhancing effects of chemotherapy and detoxication of chemotherapy. Correspondingly,anticancer drugs used in Western medicine can be classified into 4 groups as follows:cytotoxic drugs,biological response modifiers,chemosensitizers and chemoprotectants. Based on the theory of Chinese medicinal formulas,prescriptions are composed of four constituents,namely,primary constituent (main component of the formula prescription),minister constituent (second component of formula prescription),adjuvant constituent (adjuvant component of the formula prescription) and messenger constituent (component making the formula prescription targeting pathological tissues).To control the interaction among drugs and to modulate the interaction among the tumor,patient and drugs,we suggest that combined therapy for Western medicine might include 4 constituents,i.e.,primary,cooperative,adjuvant and modulatory constituent. Cytotoxic drugs frequently are used as primary and cooperative constituents,whereas biological response modifiers and biochemical modulators are usually regarded respectively as adjuvant drugs and modulatory constituents. We believe these new concepts may be helpful for the aim of appropriately designing,evaluating or providing combination therapy.展开更多
Tumors ofthe biliary tract （gallbladder tumors, cholangiocarcinomas and ampullary carcinomas） are low incidence tumors with poor prognosis. The five-year overall survival is 50% for stage I, 30% stage II, 10% stage ...Tumors ofthe biliary tract （gallbladder tumors, cholangiocarcinomas and ampullary carcinomas） are low incidence tumors with poor prognosis. The five-year overall survival is 50% for stage I, 30% stage II, 10% stage III and 0% stage IV. Treatment is based on surgery for potentially resectable tumors. Chemotherapy and chemo-radiotherapy is the treatment of choice when surgery is not amenable, however it has not achieved encouraging results. These patients use to have very few symptoms, which is the reason for the delay in diagnosis and the poor prognosis. They frequently develop biliary obstruction： obstructive jaundice, right upper quadrant pain and weight loss. Ampullary carcinomas are frequently related to steatorrhea due to malabsorption. The most effective chemotherapy drugs used in monotherapy are 5FU （response rate 20%） and gemcitabine （response rate of 13%-60%）, so they have been selected for further development in multiple phase II clinical trials to explore their efficacy and safety in combination with other agents. In a phase III clinical trial, combination of gemcitabine and cisplatin has been selected as the schedule of choice. Target therapies are also being developed in this malignancy. The present work reviews the most current knowledge of the pathogenesis, diagnosis and natural history of biliary tract tumors. Further, review of surgery, current adjuvant treatment and therapies for unresectable and advanced disease is provided. The most recent understanding for target therapies and molecular biology is also summarized.展开更多
Objective： The aim of the study was to investigate the clinical value and application of ATP based bioluminescence tumor chemosensitivity assay （ATP-TCA） in the chemotherapy for hydrothorax caused by non-small cell...Objective： The aim of the study was to investigate the clinical value and application of ATP based bioluminescence tumor chemosensitivity assay （ATP-TCA） in the chemotherapy for hydrothorax caused by non-small cell lung cancer （NSCLC）. Methods： Hydrothorax specimens from 120 NSCLC patients were analyzed by ATP-TCA and the most sensitive chemotherapeutic drugs were used in NSCLC patients （treatment group）. At the same time, 56 NSCLC patients with hydrethorax were admitted in our Hospital （Department of Oncology, The No. 2 People＇s Hospital of Yibin, China） and given chemotherapy without guidance of the ATP-TCA （control group）. Before the third chemotherapeutic cycle, clinical outcomes were analyzed in the two groups. Results： Effective rate of hydrothorax in treatment group was 67%, while 46% in control group （P 〈 0.05）. In refractory hydrothorax patients, they were 69% and 40% （P 〈 0.05）, respectively.In vitro results correlated well with clinical outcomes （P 〈 0.01）. Conclusion： Effective rate of chemotherapy for hydrothorax in NSCLC is higher in treatment group than that in control group. ATP-TCA is especially helpful for refractory hydrothorax.展开更多
Objective:The aim of our study was to evaluate the clinical efficacy and side effects of docetaxel as single chemotherapy for elderly patients with advanced non-small-cell lung cancer (NSCLC). Methods: Forty-two elder...Objective:The aim of our study was to evaluate the clinical efficacy and side effects of docetaxel as single chemotherapy for elderly patients with advanced non-small-cell lung cancer (NSCLC). Methods: Forty-two elderly patients with advanced NSCLC who were chemotherapy-naive were enrolled in this study. Docetaxel at the doses of 70 mg/m2 was administrated intravenously every 21 days as a cycle, each patient received 2-4 cycles. All patients were followed up until disease progressed or patients died. Results: Among 42 patients, 40 could be evaluated, 1 complete response (CR), 9 partial response (PR), 13 stable disease (SD), 17 progress disease (PD). The overall response rate (CR+PR) was 35% and disease control rate (CR+PR+SD) was 57.5%. The median time to progress (TTP) was 4.2 months, median survival time was 6.1 months and 1-year survival rate was 35.8%. The main toxicity was myelosuppression and decreasing platelet. Conclusion: Single agent docetaxel for elderly patients with advanced NSCLC is an efficient and well-tolerated chemotherapeutic approach with a low toxicity level.展开更多
Radiation recall phenomenon is a tissue reaction that develops throughout a previously irradiated area,precipitated by the administration of certain drugs.Radiation recall is uncommon and easily neglected by physician...Radiation recall phenomenon is a tissue reaction that develops throughout a previously irradiated area,precipitated by the administration of certain drugs.Radiation recall is uncommon and easily neglected by physicians;hence,this phenomenon is underreported in literature.This manuscript reports two cases of radiation recall.First,a 44-year-old man with nasopharyngeal carcinoma was treated with radiotherapy in 2010 and subsequently developed multi-site bone metastases.A few days after the docetaxel-based chemotherapy,erythema and papules manifested dermatitis,as well as swallowing pain due to pharyngeal mucositis,developed on the head and neck that strictly corresponded to the previously irradiated areas.Second,a 19-year-old man with recurrent nasal NK/T cell lymphoma initially underwent radiotherapy followed by chemotherapy after five weeks.Erythema and edema appeared only at the irradiated skin.Both cases were considered chemotherapeutic agents that incurred radiation recall reactions.Clinicians should be knowledgeable of and pay attention to such rare phenomenon.展开更多
Clinical pharmacists specialized in oncology contributed to the safe and effective chemotherapy treatment for advanced esophageal carcinoma patients complicated with hypertension by participating in medication practic...Clinical pharmacists specialized in oncology contributed to the safe and effective chemotherapy treatment for advanced esophageal carcinoma patients complicated with hypertension by participating in medication practice. Optimal therapeutic regimen was proposed, and pharmaceutical care and health education were provided based on the condition of each patient. By providing pharmaceutical care for cancer patients with their pharmacy knowledge, clinical pharmacists specialized in oncology can not only reduce the potential risks of chemotherapy, but also take into account of other accompanying diseases, thus improving the comprehensive treatment of patients. Furthermore, it deepened the understanding of the role of clinical pharmacy practice by patients and other medical workers. Involvement of clinical pharmacist in therapeutic practice could improve the outcome of pharmacotherapy.展开更多
文摘The interactions among drugs,tumor and host are critical for a response to therapy and for outcome.Anticancer herbs used in Chinese medicine are classified into 4 groups based on their target (tumor,patient and drug) as follows:eliminating pathogenic factors,strengthening the body resistance,enhancing effects of chemotherapy and detoxication of chemotherapy. Correspondingly,anticancer drugs used in Western medicine can be classified into 4 groups as follows:cytotoxic drugs,biological response modifiers,chemosensitizers and chemoprotectants. Based on the theory of Chinese medicinal formulas,prescriptions are composed of four constituents,namely,primary constituent (main component of the formula prescription),minister constituent (second component of formula prescription),adjuvant constituent (adjuvant component of the formula prescription) and messenger constituent (component making the formula prescription targeting pathological tissues).To control the interaction among drugs and to modulate the interaction among the tumor,patient and drugs,we suggest that combined therapy for Western medicine might include 4 constituents,i.e.,primary,cooperative,adjuvant and modulatory constituent. Cytotoxic drugs frequently are used as primary and cooperative constituents,whereas biological response modifiers and biochemical modulators are usually regarded respectively as adjuvant drugs and modulatory constituents. We believe these new concepts may be helpful for the aim of appropriately designing,evaluating or providing combination therapy.
文摘Tumors ofthe biliary tract （gallbladder tumors, cholangiocarcinomas and ampullary carcinomas） are low incidence tumors with poor prognosis. The five-year overall survival is 50% for stage I, 30% stage II, 10% stage III and 0% stage IV. Treatment is based on surgery for potentially resectable tumors. Chemotherapy and chemo-radiotherapy is the treatment of choice when surgery is not amenable, however it has not achieved encouraging results. These patients use to have very few symptoms, which is the reason for the delay in diagnosis and the poor prognosis. They frequently develop biliary obstruction： obstructive jaundice, right upper quadrant pain and weight loss. Ampullary carcinomas are frequently related to steatorrhea due to malabsorption. The most effective chemotherapy drugs used in monotherapy are 5FU （response rate 20%） and gemcitabine （response rate of 13%-60%）, so they have been selected for further development in multiple phase II clinical trials to explore their efficacy and safety in combination with other agents. In a phase III clinical trial, combination of gemcitabine and cisplatin has been selected as the schedule of choice. Target therapies are also being developed in this malignancy. The present work reviews the most current knowledge of the pathogenesis, diagnosis and natural history of biliary tract tumors. Further, review of surgery, current adjuvant treatment and therapies for unresectable and advanced disease is provided. The most recent understanding for target therapies and molecular biology is also summarized.
文摘Objective： The aim of the study was to investigate the clinical value and application of ATP based bioluminescence tumor chemosensitivity assay （ATP-TCA） in the chemotherapy for hydrothorax caused by non-small cell lung cancer （NSCLC）. Methods： Hydrothorax specimens from 120 NSCLC patients were analyzed by ATP-TCA and the most sensitive chemotherapeutic drugs were used in NSCLC patients （treatment group）. At the same time, 56 NSCLC patients with hydrethorax were admitted in our Hospital （Department of Oncology, The No. 2 People＇s Hospital of Yibin, China） and given chemotherapy without guidance of the ATP-TCA （control group）. Before the third chemotherapeutic cycle, clinical outcomes were analyzed in the two groups. Results： Effective rate of hydrothorax in treatment group was 67%, while 46% in control group （P 〈 0.05）. In refractory hydrothorax patients, they were 69% and 40% （P 〈 0.05）, respectively.In vitro results correlated well with clinical outcomes （P 〈 0.01）. Conclusion： Effective rate of chemotherapy for hydrothorax in NSCLC is higher in treatment group than that in control group. ATP-TCA is especially helpful for refractory hydrothorax.
文摘Objective:The aim of our study was to evaluate the clinical efficacy and side effects of docetaxel as single chemotherapy for elderly patients with advanced non-small-cell lung cancer (NSCLC). Methods: Forty-two elderly patients with advanced NSCLC who were chemotherapy-naive were enrolled in this study. Docetaxel at the doses of 70 mg/m2 was administrated intravenously every 21 days as a cycle, each patient received 2-4 cycles. All patients were followed up until disease progressed or patients died. Results: Among 42 patients, 40 could be evaluated, 1 complete response (CR), 9 partial response (PR), 13 stable disease (SD), 17 progress disease (PD). The overall response rate (CR+PR) was 35% and disease control rate (CR+PR+SD) was 57.5%. The median time to progress (TTP) was 4.2 months, median survival time was 6.1 months and 1-year survival rate was 35.8%. The main toxicity was myelosuppression and decreasing platelet. Conclusion: Single agent docetaxel for elderly patients with advanced NSCLC is an efficient and well-tolerated chemotherapeutic approach with a low toxicity level.
文摘Radiation recall phenomenon is a tissue reaction that develops throughout a previously irradiated area,precipitated by the administration of certain drugs.Radiation recall is uncommon and easily neglected by physicians;hence,this phenomenon is underreported in literature.This manuscript reports two cases of radiation recall.First,a 44-year-old man with nasopharyngeal carcinoma was treated with radiotherapy in 2010 and subsequently developed multi-site bone metastases.A few days after the docetaxel-based chemotherapy,erythema and papules manifested dermatitis,as well as swallowing pain due to pharyngeal mucositis,developed on the head and neck that strictly corresponded to the previously irradiated areas.Second,a 19-year-old man with recurrent nasal NK/T cell lymphoma initially underwent radiotherapy followed by chemotherapy after five weeks.Erythema and edema appeared only at the irradiated skin.Both cases were considered chemotherapeutic agents that incurred radiation recall reactions.Clinicians should be knowledgeable of and pay attention to such rare phenomenon.
基金Zhejiang Provincial Program for the Cultivation of High-level Innovative Health Talents(Grant No.2010-190-4)
文摘Clinical pharmacists specialized in oncology contributed to the safe and effective chemotherapy treatment for advanced esophageal carcinoma patients complicated with hypertension by participating in medication practice. Optimal therapeutic regimen was proposed, and pharmaceutical care and health education were provided based on the condition of each patient. By providing pharmaceutical care for cancer patients with their pharmacy knowledge, clinical pharmacists specialized in oncology can not only reduce the potential risks of chemotherapy, but also take into account of other accompanying diseases, thus improving the comprehensive treatment of patients. Furthermore, it deepened the understanding of the role of clinical pharmacy practice by patients and other medical workers. Involvement of clinical pharmacist in therapeutic practice could improve the outcome of pharmacotherapy.
