A 23-year-old male presented with a three-week-history of crampy abdominal pain and melaena.Colonoscopy revealed a friable mass filling the entire lumen of the cecum;histologically,it was classified as perivascular ep...A 23-year-old male presented with a three-week-history of crampy abdominal pain and melaena.Colonoscopy revealed a friable mass filling the entire lumen of the cecum;histologically,it was classified as perivascular epithelioid cell tumor(PEComa).An magnetic resonance imaging scan showed,in addition to the primary tumor,two large mesenteric lymph node metastases and four metastatic lesions in the liver.The patient underwent right hemicolectomy and left hemihepatectomy combined with wedge resections of metastases in the right lobe of the liver,the resection status was R0.Subsequently,the patient was treated with sirolimus.After 4 mo of adjuvant mammalian target of rapamycin inhibition he developed two new liver metastases and a local pelvic recurrence.The visible tumor formations were again excised surgically,this time the resection status was R2 with regard to the pelvic recurrence.The patient was treated with 12 cycles of doxorubicin and ifosfamide under which the disease was stable for 9 mo.The clinical course was then determined by rapid tumor growth in the pelvic cavity.Second line chemotherapy with gemcitabine and docetaxel was ineffective,and the patient died 23 mo after the onset of disease.This case report adds evidence that,in malignant PEComa,the mainstay of treatment is curative surgery.If not achievable,the effects of adjuvant or palliative chemotherapy are unpredictable.展开更多
Objective: A pilot study to test the feasibility and efficacy of high dose IFO and standard dose ADR and DTIC with G-CSF support in treatment of advanced soft tissue sarcoma (STS). Methods: 35 patients of no prior che...Objective: A pilot study to test the feasibility and efficacy of high dose IFO and standard dose ADR and DTIC with G-CSF support in treatment of advanced soft tissue sarcoma (STS). Methods: 35 patients of no prior chemotherapy with metastatic or locally advanced unresectable STS were treated by this regimen, including 18 rhabdomyosarcomas, 7 malignant fibrous histiocytomas, 2 neurofibrosarcomas, 2 fibrosarcomas, 2 leiomyosarcomas, 2 synoviosarcomas, and 2 malignant hemangiopericytomas. IFO dose was 2 g/m2 on day 1–5 (with mesna uroprotection), ADR 50mg/m2 on day 1 and DTIC 250 mg/m2 on day 1–5. G-CSF (2 μg/kg/d) was administered on day 6 to 15 or until recovery of leukocytes account. The cycles were repeated every 3 weeks. Result: There were five complete responses (CR including pathologic CR) and eleven partial responses for overall 46% objective response rate. Most responses were observed within two cycles. The median survival was 15 months. Following CR, two patients remain disease free at 45 and 28 months, respectively. 6/120 (5%) cycles were complicated by grade IV neutropenia, 46/120 (38%) cycles had grade III neutropenia. No patients had treatment-related deaths. Nonhematologic toxicity consisted predominantly of anorexia and vomiting. No other severe toxicities were seen, especially no severe cardiotoxicity. Conclusion: This regimen is well tolerated and has substantial benefits for patients with advanced soft tissue sarcomas.展开更多
Objective： To evaluate the efficacy of ifosfamide and etoposide （VP-16） in patients with small cell lung cancer （SCLC）, and investigate the correlation between microvessel count （MVC） in tumor and chemotherapeu...Objective： To evaluate the efficacy of ifosfamide and etoposide （VP-16） in patients with small cell lung cancer （SCLC）, and investigate the correlation between microvessel count （MVC） in tumor and chemotherapeutic sensitivity. Methods： Forty-one consecutive cases of SCLC received chemotherapy of ifosfamide plus VP-16, and underwent investigation retrospectively. Immunohistochemistry using anti-human blood type H monoclonal antibody was conducted and MVC was recorded under light microscope. Results： There were 27 limited-disease and 14 extensive-disease patients. The overall response rate was 92.7% （38/41） with 28 cases （68.3%） of complete response （CR）, 10 （24.4%） with partial response （PR）, 3 （7.3%） with progressive disease （PD）. The 1-, 2-, 3-, and 5-year survival rates were 68.3% （28/41）, 48.3% （20/41）, 23.7% （9/38） and 11.1% （3/27）, respectively, with the median survival of 26.8 months. The principal toxicities were grade 3-4 neutropenia in 8 cases （19.5%）, grade 3-4 thrombocytopenia in 6 cases （14.6%）, mild liver toxicity in 7 cases （17.0%） and mild renal function damage in 4 cases （9.8%）. The mesenchymal vasculature was clearly visualized, with the mean value of 34.7 under each high microscopic power field. Of SCLC with more MVC （n=26）, CR accounted for 84.6%; while in cancers with less MVC （n=l 5）, CR took up 40.0%, with significant difference （P〈0.05）. Conclusion： Administrating ifosfamide and VP-16 is in accordance with the biological features of SCLC and results in beneficial results as well as acceptable side effects. The MVC is positively correlated with the chemotherapeutic sensitivity, and serves as a vital factor contributing to chemosensitivity.展开更多
文摘A 23-year-old male presented with a three-week-history of crampy abdominal pain and melaena.Colonoscopy revealed a friable mass filling the entire lumen of the cecum;histologically,it was classified as perivascular epithelioid cell tumor(PEComa).An magnetic resonance imaging scan showed,in addition to the primary tumor,two large mesenteric lymph node metastases and four metastatic lesions in the liver.The patient underwent right hemicolectomy and left hemihepatectomy combined with wedge resections of metastases in the right lobe of the liver,the resection status was R0.Subsequently,the patient was treated with sirolimus.After 4 mo of adjuvant mammalian target of rapamycin inhibition he developed two new liver metastases and a local pelvic recurrence.The visible tumor formations were again excised surgically,this time the resection status was R2 with regard to the pelvic recurrence.The patient was treated with 12 cycles of doxorubicin and ifosfamide under which the disease was stable for 9 mo.The clinical course was then determined by rapid tumor growth in the pelvic cavity.Second line chemotherapy with gemcitabine and docetaxel was ineffective,and the patient died 23 mo after the onset of disease.This case report adds evidence that,in malignant PEComa,the mainstay of treatment is curative surgery.If not achievable,the effects of adjuvant or palliative chemotherapy are unpredictable.
文摘Objective: A pilot study to test the feasibility and efficacy of high dose IFO and standard dose ADR and DTIC with G-CSF support in treatment of advanced soft tissue sarcoma (STS). Methods: 35 patients of no prior chemotherapy with metastatic or locally advanced unresectable STS were treated by this regimen, including 18 rhabdomyosarcomas, 7 malignant fibrous histiocytomas, 2 neurofibrosarcomas, 2 fibrosarcomas, 2 leiomyosarcomas, 2 synoviosarcomas, and 2 malignant hemangiopericytomas. IFO dose was 2 g/m2 on day 1–5 (with mesna uroprotection), ADR 50mg/m2 on day 1 and DTIC 250 mg/m2 on day 1–5. G-CSF (2 μg/kg/d) was administered on day 6 to 15 or until recovery of leukocytes account. The cycles were repeated every 3 weeks. Result: There were five complete responses (CR including pathologic CR) and eleven partial responses for overall 46% objective response rate. Most responses were observed within two cycles. The median survival was 15 months. Following CR, two patients remain disease free at 45 and 28 months, respectively. 6/120 (5%) cycles were complicated by grade IV neutropenia, 46/120 (38%) cycles had grade III neutropenia. No patients had treatment-related deaths. Nonhematologic toxicity consisted predominantly of anorexia and vomiting. No other severe toxicities were seen, especially no severe cardiotoxicity. Conclusion: This regimen is well tolerated and has substantial benefits for patients with advanced soft tissue sarcomas.
基金This work was supported by a grant from the Education Department of P.R.China (No. 2004[527]).
文摘Objective： To evaluate the efficacy of ifosfamide and etoposide （VP-16） in patients with small cell lung cancer （SCLC）, and investigate the correlation between microvessel count （MVC） in tumor and chemotherapeutic sensitivity. Methods： Forty-one consecutive cases of SCLC received chemotherapy of ifosfamide plus VP-16, and underwent investigation retrospectively. Immunohistochemistry using anti-human blood type H monoclonal antibody was conducted and MVC was recorded under light microscope. Results： There were 27 limited-disease and 14 extensive-disease patients. The overall response rate was 92.7% （38/41） with 28 cases （68.3%） of complete response （CR）, 10 （24.4%） with partial response （PR）, 3 （7.3%） with progressive disease （PD）. The 1-, 2-, 3-, and 5-year survival rates were 68.3% （28/41）, 48.3% （20/41）, 23.7% （9/38） and 11.1% （3/27）, respectively, with the median survival of 26.8 months. The principal toxicities were grade 3-4 neutropenia in 8 cases （19.5%）, grade 3-4 thrombocytopenia in 6 cases （14.6%）, mild liver toxicity in 7 cases （17.0%） and mild renal function damage in 4 cases （9.8%）. The mesenchymal vasculature was clearly visualized, with the mean value of 34.7 under each high microscopic power field. Of SCLC with more MVC （n=26）, CR accounted for 84.6%; while in cancers with less MVC （n=l 5）, CR took up 40.0%, with significant difference （P〈0.05）. Conclusion： Administrating ifosfamide and VP-16 is in accordance with the biological features of SCLC and results in beneficial results as well as acceptable side effects. The MVC is positively correlated with the chemotherapeutic sensitivity, and serves as a vital factor contributing to chemosensitivity.
