AIM:To investigate the current status of peritoneal carcinomatosis(PC) management,as well as the usage of cytoreductive surgery(CRS) and hyperthermic intraperitoneal chemotherapy(HIPEC) in China's Mainland.METHODS...AIM:To investigate the current status of peritoneal carcinomatosis(PC) management,as well as the usage of cytoreductive surgery(CRS) and hyperthermic intraperitoneal chemotherapy(HIPEC) in China's Mainland.METHODS:A potentially curative therapeutic strategy for selecting patients with PC,known as "Techniques",consists of CRS in combination with HIPEC.A systemic search of published works and clinical trials was performed.Additional papers were retrieved by crosschecking references and obtaining information from Chinese oncologists and relevant conferences.One hundred and one papers and one registered clinical trial on HIPEC were included.RESULTS:A literature review identified 86 hospitals in 25 out of all 31 areas of China's Mainland that perform HIPEC.The earliest report included in our survey was published in 1993.Different approaches to HIPEC have been utilized,i.e.palliative,prophylactic,and possiblycurative treatment.Only one center has consistently performed HIPEC according to the "Sugarbaker Protocol",which involves evaluating the extent of PC with peritoneal cancer index and the results of CRS with the completeness of cytoreduction.Positive preliminary results were reported:7 of 21 patients with PC survived,free of tumors,during an 8-43-mo follow-up period.Hyperthermic strategies that include HIPEC have been practiced for a long time in China's Mainland,whereas the "Sugarbaker Protocol/Techniques" has been only rarely implemented in China.The Peritoneal Surface Oncology Group International hosts a biannual workshop with the intent to train more specialists in this field and provide support for the construction of quality treatment centers,especially in developing countries like China,whose population is huge and has a dramatically increased incidence of cancer.CONCLUSION:To popularize Sugarbaker Protocol/Techniques in China's Mainland in PC management arising from gastric cancer or colorectal cancer will be the responsibility of the upcoming Chinese Peritoneal Surface Oncology Group.展开更多
AIM: To evaluate the influence of preoperative FOLFOX chemotherapy on CCL20/CCR6 expression in liver metastases of stage IV colorectal cancer (CRC) patients.(/7 = 53) and in patients who did not receive FOLFOX ch...AIM: To evaluate the influence of preoperative FOLFOX chemotherapy on CCL20/CCR6 expression in liver metastases of stage IV colorectal cancer (CRC) patients.(/7 = 53) and in patients who did not receive FOLFOX chemotherapy prior to liver surgery (n = 29). RESULTS: Of the 53 patients who received FOLFOX, time to liver surgery was n〈 1 mo in 14 patients, 〈 1 year in 22 patients and 〉 1 year in 17 patients, respectively. In addition, we investigated the proliferation rate of CRC cells in liver metastases in the different patient groups. Both CCL20 and CCR6 mRNA and protein ex- pression levels were significantly increased in patients who received preoperative FOLFOX chemotherapy ~〈 12 mo before liver surgery (P 〈 0.001) in comparison to patients who did not undergo FOLFOX treatment. Further, proliferation of CRLM cells as measured by Ki-67 was increased in patients who underwent FOLFOX treat- ment. CCL20 and CCR6 expression levels were significantly increased in CRLM patients who had undergone preoperative FOLFOX chemotherapy. CONCLUSION: This chemokine/receptor up-regulation could lead to increased proliferation/migration through an autocrine mechanism which might be used by surviving metastatic cells to escape cell death caused by FOLFOX.展开更多
Objective:To evaluate the ef icacy of autologous cytokine-induced kil er (CIK) cells transfusion combined with chemotherapy in patients suf ered from advanced colorectal cancer. Methods: Sixty untreated patients w...Objective:To evaluate the ef icacy of autologous cytokine-induced kil er (CIK) cells transfusion combined with chemotherapy in patients suf ered from advanced colorectal cancer. Methods: Sixty untreated patients with advanced colorectal cancer were randomly divided into two groups. The 30 patients in the control group received chemotherapy with the regimen of xeloda plus oxiplatin (XELOX). The 30 patients in the trial group were treated with chemotherapy (XELOX) in combination with autologous CIK celltransfusion. T-lymphocyte subgroups were separated and measured by flow cytometry quality of life (QOL) was determined by EORTC QLQ-C30. The short-term curative ef ect was evaluated via imaging examina-tions. The patients’ median progression free survival time was estimated by Kaplan-Meier. Results:The T-lymphocyte im-mune activity was improved in patients received autologous CIK celltransfusion than those treated with chemotherapy alone. The subgroup of CD3+CD56+T lymphocyte was significantly increased (4.28 ± 0.45 vs 10.14 ± 1.02, P=0.01). Short-term ef icacy evaluation revealed that there was no significant dif erence in terms of objective response rate (ORR) between the two groups, but the disease control rate (DCR) was markedly increased (86.7%vs 56.7%, P=0.020) in the group treated by chemotherapy plus CIK cells compared to the group treated with chemotherapy alone. The progression free survival time was 8.64 months ( 95%CI 6.25-9.75 months) in control group and 10.15 months ( 95%CI 7.48-12.52 months) in trial group. Compared to patients in control group, the patients in trial group had significantly longer progression-free survival (P=0.046). The QOL assessment suggested the QOL in trial group was obviously improved than that in the control group. Compared with the control group, patients treated with autologous CIK celltransfusion scored more in the area of physical function and general health status, while the symptomatic scores in terms of pain, fatigue, nausea and vomiting and diarrhea were significantly reduced. Conclusion:Autologous CIK celltransfusion combined with chemotherapy can ef ectively enhance the immune activity of T-lymphocytes, prevent disease progression and improve the progression-free survival and QOL in patients with advanced colorectal cancer.展开更多
OBJECTIVE To estimate effects, survival rate after the short-time efficacy, side the treatment of combining chemotherapy of oxaliplatin or 5-fluorouracil/leucovorin with hydroxycamptothecine (HCPT) for the patients ...OBJECTIVE To estimate effects, survival rate after the short-time efficacy, side the treatment of combining chemotherapy of oxaliplatin or 5-fluorouracil/leucovorin with hydroxycamptothecine (HCPT) for the patients with advanced colorectal cancer. METHODS From January 2002 to November 2005, 59 patients with advanced colorectal cancer confirmed by pathology were enrolled into this study in the department of medical oncology, in the Sixth People's Hospital of Shanghai Jiaotong University, Shanghai. Patients' characteristics in two groups were similarly confirmed by statistic. All 37 patients in OH group received oxalip21atin (130 mg/m^2 d1) plus hydroxycamptothecine (6 mg/m d1-4), and all 22 patients in the HLF group received hydroxycamptothecine (6 mg/m^2 d1-4) plus leucovorin (300 mg d1-5) and 5-fluorouracil (0.375 g/m^2 d1-5). The regimens in both groups were 21-day cycle that was repeated three weeks. The side effects were evaluated. The efficacy was estimated after two cycles of chemotherapy for each patient. RESULTS The efficacy of the treatment in the OH group with 37 patients and in the HLF group with 22 patients was estimated. The overall response rate (CR + PR) was 32.4% in the OH group and 22.7% in the HLF group. There was no complete response (CR) and there was no statistical significantly difference (%2= 0.876, P = 0.704) in two groups. The 1-year survival rate was 30.98% in the OH group and 15.02% in the HLF group, and it had no significant difference between the two groups. The median PSF and OS were 5.83 months and 11.17 months in the OH group vs. 7.40 months and 10.48 months in the HLF group, and it had no significant differences between the two groups (P 〉 0.05). The major side effects of grade III and IV in the two groups were myelosuppression and gastrointestinal reactions. The statistically significant difference in side effects appeared in leukopenia (χ^2= 17.173, P = 0.001), nausea/vomiting (χ^2= 6.426, P = 0.039), diarrhea (χ^2= 16.245, P = 0.000) and peripheral neuropathy. CONCLUSION The efficacy was almost equal between the OH and the HLF groups, and the two regimens can be used as the second-line treatments for the patients with colorectal cancer. Leucopenia, nausea, diarrhea and peripheral neuropathy appeared more in OH group, and anemia and thrombocytopenia were almost equal between the OH and the HLF groups.展开更多
Objective: The combination of hepatic arterial chemotherapy(HAIC) and systemic chemotherapy(SYC) has potential effect on colorectal cancer(CRC) patients with unresectable hepatic metastasis. The aim of this retrospect...Objective: The combination of hepatic arterial chemotherapy(HAIC) and systemic chemotherapy(SYC) has potential effect on colorectal cancer(CRC) patients with unresectable hepatic metastasis. The aim of this retrospective study was to investigate the efficacy and safety of this combined therapeutic regimen on Chinese patients based on single institute experiences. Methods: All 54 patients of this retrospective analysis were diagnosed with CRC with unresectable liver metastasis and received combined HAIC and SYC. Among the patients, 23 of them received HAIC plus SYC when they developed liver metastases as first-line treatment(Group 1), and 31 patients received HAIC plus SYC as non-first-line treatment(Group 2). The different efficacy in two groups was analyzed by SPSS 19.0. Results: The overall response rate(ORR) were 52.2% and 25.8% respectively in Groups 1 and 2(P = 0.047), and the disease control rate(DCR) were 65.2% and 35.5% respectively in Groups 1 and 2(P = 0.031). The median progression-free survival(PFS) were 6.8 and 3.3 months(P = 0.002), the median hepatic progression-free survival(H-PFS) were 8.8 and 3.7 months(P = 0.001), and the median overall survival(OS) were 18.8 and 13.7 months(P = 0.121) in Groups 1 and 2, respectively. No fatal reaction was observed and no significant difference of adverse reaction was found in two groups. Grade 3/4 toxic effects included neutropenia(9.7% in Group 2 only), gastrointestinal reaction(8.7% in Group 1 and 6.5% in Group 2), stomatitis(6.5% in Group 2 only) and hyperbilirubinemia(4.3% in Group 1 only). Conclusion: HAIC combined with SYC showed promising efficacy and safe profiles on CRC patients with unresectable liver metastases.展开更多
Objective: To assess whether the polymorphism of ERCC1 Asn118Asn (C → T) had effects on cancer response to chemotherapy and outcome in Chinese patients treated with oxaliplatin as first-line chemotherapy regimen f...Objective: To assess whether the polymorphism of ERCC1 Asn118Asn (C → T) had effects on cancer response to chemotherapy and outcome in Chinese patients treated with oxaliplatin as first-line chemotherapy regimen for advanced colorectal cancer. Methods: ERCC1 Asn 118Asn polymorphism was analyzed in 99 patients with stages Ⅲ and Ⅳ advanced colorectal cancer treated with oxaliplatin-based chemotherapy, For all of the patients, ERCC1 Asnl18Asn genotype was analyzed for associations with treatment response and time to disease progress (TTP). Results: The allele frequencies of the ERCC1 gene codon 118 were C/C 50.51% (50/99), C/T 41.41% (41/99), T/T 8.08% (8/99), respectively. Patients with C/C genotype showed higher response rate than those with C/T + T/T (OR = 3.764, 95% CI: 1.310-10.813). The median TTP of all patients was 7 months (95% CI: 5.569--8.431). Patients with C/C genotype showed a median TTP of 10 months (95% CI: 8.924-11.076), which was longer than 5 months (95% CI: 4.424-5.576) in patients with C/T + T/T genotypes. Conclusion: Our results showed a link between ERCC1 Asn118Asn genetic polymorphism and cancer response to oxaliplatin-based chemotherapy and time to disease progress in Chinese patients with advanced colorectal cancer. ERCC1 Asn 118Asn genotyping may be of predictive benefit in selecting treatment regimen for advanced colorectal cancer.展开更多
文摘AIM:To investigate the current status of peritoneal carcinomatosis(PC) management,as well as the usage of cytoreductive surgery(CRS) and hyperthermic intraperitoneal chemotherapy(HIPEC) in China's Mainland.METHODS:A potentially curative therapeutic strategy for selecting patients with PC,known as "Techniques",consists of CRS in combination with HIPEC.A systemic search of published works and clinical trials was performed.Additional papers were retrieved by crosschecking references and obtaining information from Chinese oncologists and relevant conferences.One hundred and one papers and one registered clinical trial on HIPEC were included.RESULTS:A literature review identified 86 hospitals in 25 out of all 31 areas of China's Mainland that perform HIPEC.The earliest report included in our survey was published in 1993.Different approaches to HIPEC have been utilized,i.e.palliative,prophylactic,and possiblycurative treatment.Only one center has consistently performed HIPEC according to the "Sugarbaker Protocol",which involves evaluating the extent of PC with peritoneal cancer index and the results of CRS with the completeness of cytoreduction.Positive preliminary results were reported:7 of 21 patients with PC survived,free of tumors,during an 8-43-mo follow-up period.Hyperthermic strategies that include HIPEC have been practiced for a long time in China's Mainland,whereas the "Sugarbaker Protocol/Techniques" has been only rarely implemented in China.The Peritoneal Surface Oncology Group International hosts a biannual workshop with the intent to train more specialists in this field and provide support for the construction of quality treatment centers,especially in developing countries like China,whose population is huge and has a dramatically increased incidence of cancer.CONCLUSION:To popularize Sugarbaker Protocol/Techniques in China's Mainland in PC management arising from gastric cancer or colorectal cancer will be the responsibility of the upcoming Chinese Peritoneal Surface Oncology Group.
文摘AIM: To evaluate the influence of preoperative FOLFOX chemotherapy on CCL20/CCR6 expression in liver metastases of stage IV colorectal cancer (CRC) patients.(/7 = 53) and in patients who did not receive FOLFOX chemotherapy prior to liver surgery (n = 29). RESULTS: Of the 53 patients who received FOLFOX, time to liver surgery was n〈 1 mo in 14 patients, 〈 1 year in 22 patients and 〉 1 year in 17 patients, respectively. In addition, we investigated the proliferation rate of CRC cells in liver metastases in the different patient groups. Both CCL20 and CCR6 mRNA and protein ex- pression levels were significantly increased in patients who received preoperative FOLFOX chemotherapy ~〈 12 mo before liver surgery (P 〈 0.001) in comparison to patients who did not undergo FOLFOX treatment. Further, proliferation of CRLM cells as measured by Ki-67 was increased in patients who underwent FOLFOX treat- ment. CCL20 and CCR6 expression levels were significantly increased in CRLM patients who had undergone preoperative FOLFOX chemotherapy. CONCLUSION: This chemokine/receptor up-regulation could lead to increased proliferation/migration through an autocrine mechanism which might be used by surviving metastatic cells to escape cell death caused by FOLFOX.
基金Supported by a grant from the Key Project of National 12th Five-year Research Program of China(No.2012ZX0903016-002)
文摘Objective:To evaluate the ef icacy of autologous cytokine-induced kil er (CIK) cells transfusion combined with chemotherapy in patients suf ered from advanced colorectal cancer. Methods: Sixty untreated patients with advanced colorectal cancer were randomly divided into two groups. The 30 patients in the control group received chemotherapy with the regimen of xeloda plus oxiplatin (XELOX). The 30 patients in the trial group were treated with chemotherapy (XELOX) in combination with autologous CIK celltransfusion. T-lymphocyte subgroups were separated and measured by flow cytometry quality of life (QOL) was determined by EORTC QLQ-C30. The short-term curative ef ect was evaluated via imaging examina-tions. The patients’ median progression free survival time was estimated by Kaplan-Meier. Results:The T-lymphocyte im-mune activity was improved in patients received autologous CIK celltransfusion than those treated with chemotherapy alone. The subgroup of CD3+CD56+T lymphocyte was significantly increased (4.28 ± 0.45 vs 10.14 ± 1.02, P=0.01). Short-term ef icacy evaluation revealed that there was no significant dif erence in terms of objective response rate (ORR) between the two groups, but the disease control rate (DCR) was markedly increased (86.7%vs 56.7%, P=0.020) in the group treated by chemotherapy plus CIK cells compared to the group treated with chemotherapy alone. The progression free survival time was 8.64 months ( 95%CI 6.25-9.75 months) in control group and 10.15 months ( 95%CI 7.48-12.52 months) in trial group. Compared to patients in control group, the patients in trial group had significantly longer progression-free survival (P=0.046). The QOL assessment suggested the QOL in trial group was obviously improved than that in the control group. Compared with the control group, patients treated with autologous CIK celltransfusion scored more in the area of physical function and general health status, while the symptomatic scores in terms of pain, fatigue, nausea and vomiting and diarrhea were significantly reduced. Conclusion:Autologous CIK celltransfusion combined with chemotherapy can ef ectively enhance the immune activity of T-lymphocytes, prevent disease progression and improve the progression-free survival and QOL in patients with advanced colorectal cancer.
文摘OBJECTIVE To estimate effects, survival rate after the short-time efficacy, side the treatment of combining chemotherapy of oxaliplatin or 5-fluorouracil/leucovorin with hydroxycamptothecine (HCPT) for the patients with advanced colorectal cancer. METHODS From January 2002 to November 2005, 59 patients with advanced colorectal cancer confirmed by pathology were enrolled into this study in the department of medical oncology, in the Sixth People's Hospital of Shanghai Jiaotong University, Shanghai. Patients' characteristics in two groups were similarly confirmed by statistic. All 37 patients in OH group received oxalip21atin (130 mg/m^2 d1) plus hydroxycamptothecine (6 mg/m d1-4), and all 22 patients in the HLF group received hydroxycamptothecine (6 mg/m^2 d1-4) plus leucovorin (300 mg d1-5) and 5-fluorouracil (0.375 g/m^2 d1-5). The regimens in both groups were 21-day cycle that was repeated three weeks. The side effects were evaluated. The efficacy was estimated after two cycles of chemotherapy for each patient. RESULTS The efficacy of the treatment in the OH group with 37 patients and in the HLF group with 22 patients was estimated. The overall response rate (CR + PR) was 32.4% in the OH group and 22.7% in the HLF group. There was no complete response (CR) and there was no statistical significantly difference (%2= 0.876, P = 0.704) in two groups. The 1-year survival rate was 30.98% in the OH group and 15.02% in the HLF group, and it had no significant difference between the two groups. The median PSF and OS were 5.83 months and 11.17 months in the OH group vs. 7.40 months and 10.48 months in the HLF group, and it had no significant differences between the two groups (P 〉 0.05). The major side effects of grade III and IV in the two groups were myelosuppression and gastrointestinal reactions. The statistically significant difference in side effects appeared in leukopenia (χ^2= 17.173, P = 0.001), nausea/vomiting (χ^2= 6.426, P = 0.039), diarrhea (χ^2= 16.245, P = 0.000) and peripheral neuropathy. CONCLUSION The efficacy was almost equal between the OH and the HLF groups, and the two regimens can be used as the second-line treatments for the patients with colorectal cancer. Leucopenia, nausea, diarrhea and peripheral neuropathy appeared more in OH group, and anemia and thrombocytopenia were almost equal between the OH and the HLF groups.
基金Supported by grants of National Natural Science Foundation of China(No.81302141)Administration of Traditional Chinese Medicine of Guangdong Province,China(No.20111169)+1 种基金Science and Technology Planning Project of Guangdong Province,China(No.2010B031600317)the Sun Yat-sen University Young Teacher Training Project(No.12ykpy56)
文摘Objective: The combination of hepatic arterial chemotherapy(HAIC) and systemic chemotherapy(SYC) has potential effect on colorectal cancer(CRC) patients with unresectable hepatic metastasis. The aim of this retrospective study was to investigate the efficacy and safety of this combined therapeutic regimen on Chinese patients based on single institute experiences. Methods: All 54 patients of this retrospective analysis were diagnosed with CRC with unresectable liver metastasis and received combined HAIC and SYC. Among the patients, 23 of them received HAIC plus SYC when they developed liver metastases as first-line treatment(Group 1), and 31 patients received HAIC plus SYC as non-first-line treatment(Group 2). The different efficacy in two groups was analyzed by SPSS 19.0. Results: The overall response rate(ORR) were 52.2% and 25.8% respectively in Groups 1 and 2(P = 0.047), and the disease control rate(DCR) were 65.2% and 35.5% respectively in Groups 1 and 2(P = 0.031). The median progression-free survival(PFS) were 6.8 and 3.3 months(P = 0.002), the median hepatic progression-free survival(H-PFS) were 8.8 and 3.7 months(P = 0.001), and the median overall survival(OS) were 18.8 and 13.7 months(P = 0.121) in Groups 1 and 2, respectively. No fatal reaction was observed and no significant difference of adverse reaction was found in two groups. Grade 3/4 toxic effects included neutropenia(9.7% in Group 2 only), gastrointestinal reaction(8.7% in Group 1 and 6.5% in Group 2), stomatitis(6.5% in Group 2 only) and hyperbilirubinemia(4.3% in Group 1 only). Conclusion: HAIC combined with SYC showed promising efficacy and safe profiles on CRC patients with unresectable liver metastases.
文摘Objective: To assess whether the polymorphism of ERCC1 Asn118Asn (C → T) had effects on cancer response to chemotherapy and outcome in Chinese patients treated with oxaliplatin as first-line chemotherapy regimen for advanced colorectal cancer. Methods: ERCC1 Asn 118Asn polymorphism was analyzed in 99 patients with stages Ⅲ and Ⅳ advanced colorectal cancer treated with oxaliplatin-based chemotherapy, For all of the patients, ERCC1 Asnl18Asn genotype was analyzed for associations with treatment response and time to disease progress (TTP). Results: The allele frequencies of the ERCC1 gene codon 118 were C/C 50.51% (50/99), C/T 41.41% (41/99), T/T 8.08% (8/99), respectively. Patients with C/C genotype showed higher response rate than those with C/T + T/T (OR = 3.764, 95% CI: 1.310-10.813). The median TTP of all patients was 7 months (95% CI: 5.569--8.431). Patients with C/C genotype showed a median TTP of 10 months (95% CI: 8.924-11.076), which was longer than 5 months (95% CI: 4.424-5.576) in patients with C/T + T/T genotypes. Conclusion: Our results showed a link between ERCC1 Asn118Asn genetic polymorphism and cancer response to oxaliplatin-based chemotherapy and time to disease progress in Chinese patients with advanced colorectal cancer. ERCC1 Asn 118Asn genotyping may be of predictive benefit in selecting treatment regimen for advanced colorectal cancer.