The clinical significance of axillary sentinel lymph node biopsy in different clinical stages breast cancer patients after neoadjuvant chemotherapy

Objective： We aimed to study the success and false negative rate of sentinel lymph node biopsy （SLNB） in dif- ferent clinical stages breast cancer patients being carried out with neoadjuvant chemotherapy （NAC）, and the clinical signifi- cance of SLNB, we conducting this trial. Methods： One hunderd and thirty-seven cases were enrolled in this clinical research from March 2003 to March 2007. All of the patients＇ sentinel lymph nodes were detected with 99mTc-Dx and methylene blue. There were 61 patients with stage TI_2NoMo carried SLNB without NAC （group A）, 76 cases were carried out NAC 3-4 cycles before SLNB, including 39 T2_4N0_IMo cases （group B） and 27 T2-4N2_3M0 cases （group C）. The success and false negative rate of SLNB were analysed with chi-square test. Results： In group A, the successful and false negative rate of SLNB were 92.31% （36/39）, 8.57% （3/35）, and in group B and C were 92.31% （36/39）, 8.57% （3/35） and 74.07 % （20/27）, 18.52 % （5/27）, respectively. The successful rate of group C decreased and false negative rate increased significantly compared with group A and B （P 〈 0.05）, but group A and B had no significant difference （P 〉 0.05）. Conclusion： The SLNB can accurately predict lymph node status of axillary lymph node in N0-1 stage patients with NAC, but in N2-3 stage patients the success rate decreased and false rate increased negative significantly.     

The application of Meta-analysis in the latest comprehensive treatment of breast cancer

Meta-analysis is a kind of systematic review, which uses quantitative method to summarize the results. It is a comprehensive evaluation to the findings of previous studies with higher credibility. Recently, it is applied to all areas of scientific research, particularly in the integrated treatment of breast cancer. Currently, breast cancer is known one of the most common malignant tumors, and its incidence is increasing year by year. Therefore, more and more clinical doctors pay attention to the effect of comprehensive treatment for patients with breast cancer. This article mainly collects the results of comprehensive treatment of breast cancer, in which the method of Meta-analysis is applied. In addition, we discuss the latest progress in order to guide the clinical treatment.     

The effect and side effects of Gemcitabine plus Vinorelbine in patients with triple-negative metastatic breast cancer

Objective： The aim of this study was to evaluate the anti-tumor activity and safety of Gemcitabine （GEM） combined with Vinorelbine （NVB） in patients with advanced TNABC after chemotherapy. Methods： Thirty-seven patients with immunohistochemical proved TNABC were enrolled. The patients received 21-day cycles of NVB 25mg/m^2 i.v. with GEM 1000 mg/m^2 i.v. on days 1 and 8. Results： A total of 136 cycles were given to 37 patients（median 4 cycles, ranged 2-6 cycles）. The treatment response was evaluable in all patients. Of the 37 patients, 1 received complete remission （CR）, 8 received partial remission （PR）, 20 had stable disease （SD）, 9 had progressive disease （PD）. Overall objective response （CR＋ PR） were 24.3 %. The median time to progress （TTP） was 6 months （95% CI, 4-6 months）. The median overall survival was 24 months （95% CI, 11-37 months）. The median 1-year survival rate was （66.24±8.43）%. The median 3-year survival rate was （28.77±11.96）%. The major adverse events were grade Ⅰ-Ⅱ myelosuppression, peripheral neurologic toxicities, nausea and vomiting. Some patients had rash and hepatic dysfunction. A total of 40% of patients experienced flu-like symptoms. Alopecia and diarrhea were rare. Conclusion： The combination of GEM and NVB is an effective and well tolerated regimen for the patients with TNABC.     

The efficacy of bevacizumab in Chinese patients with metastatic colorectal cancer and its effect in different line setting

Objective： We aimed to evaluate the effect of bevacizumab in the palliative treatment of Chinese metastatic colorectal cancer （mCRC） and its efficacy in different lines. Methods： Patients of mCRC treated with bevacizumab or not at Sun Yat-sen University Cancer Center from 2005 to 2013 were recruited as the study group and control group. The endpoints were objective response rate （ORR）, disease control rate （DCR）, overall survival （OS） and progression free survival （PFS）. The OS and PFS of first-, second- and third-line treatment groups were compared between study group and control group. Re- sults： The median PFS of the study and the control group were 8.2 months （7.0-9.4 months）, 5.7 months （4.7-6.6 months）, P = 0.001; OS were 26 months （5.4-130.5 months）, 18 months （16.6-19.4 months）, P 〈 0.001, respectively. The ORR and DCR of first-, second- and third-line were 30.3% （20/66）, 20% （6/30）, 17.6% （3/17） and 97% （64/66）, 86.7% （26/30）, 100% （17/17）. In the first-line chemotherapy group, the OS of the study group and the control group were 22.9 （5.4-96.7） months and 18 （16.6-19.4） months （P 〈 0.001）; PFS were 9.4 （8.4-10.4） months and 5.7 （4.7-6.6） months （P 〈 0.001）, respectively. While in the second- and third-line setting, only OS were statistically different, PFS had no significant difference. Conclusion： The combination of bevacizumab and chemotherapy had a promising short-term and long-term efficacy in Chinese mCRC patients than those without bevacizumab regimens, and the effect could be better reflected in the first-line treatment.     

Concurrent gemcitabine and cisplatin combined with 3D conformal radiotherapy for stage III non-small cell lung cancer

Objective： To study the toxicities and efficacy of concurrent gemcitabine plus cisplatin combined with three-dimensional conformal radiotherapy for stage Ⅲ non-small cell lung cancer （NSCLC）. Methods： Thirty-six patients with pathologically diagnosed NSCLC received radiotherapy and concurrent chemotherapy. There were 22 patients with stage Ilia and 14 patients with IIIb. Radiotherapy was given a total of 60-70 Gy in conventional fractionation. Chemotherapy included gemcitabine （600 mg/m^2） and cisplatin （20 mg/m^2）, once per week. Results： Thirty-two patients received a total dose of 60-72 Gy. Two patients received 56 Gy and another two patients received 58 Gy. Thirty-four patients received 4-6 weeks of chemotherapy, while two patients received only 2 weeks of chemotherapy. The overall response rate （CR ＋ PR）, complete response rate （CR）, partially response rate （PR） were 83.3% （30/36）, 11.1% （4/36） and 72.2% （26/36） respectively. The median follow-up duration was 18.4 months. The 1- and 2-year overall survival rates were 77.8% （28/36） and 55.6% （20/36）, respectively. Conclusion： Concurrent gemcitabine and cisplatin combined with three-dimensional conformal radiotherapy for stage III non-small cell lung cancer is effective and well tolerated. Lone-term results need further study.     

Comparison of vinorelbine plus cisplatin with vinorelbine plus capecitabine in patients with anthracyclines- and taxanes-refractory advanced breast cancer

Objective： The aim of our study was to compare the efficacy and toxicities of vinorelbine plus cisplatin （NP） regimen with that of vinorelbine plus capecitabine （NX） regimen in the treatment of anthracycline- and taxane-refractory advanced breast cancer. Methods： Forty-six patients with anthracycline- and taxane-refractory advanced breast cancer were equally randomized into a NP group （n = 23） and a NX group （n = 23）. Response rates and toxicities were evaluated after 2 cycles of chemotherapy. Results： The overall response rate were 48.0% in both groups. There were no significant differences in disease control rates （78.0% vs. 83%） or 1-year survival rates （54.6% vs. 55.9%）. The main adverse events were bone marrow depression and gastrointestinal reaction, and no significant difference was found in toxicities between the groups. Conclusion： For anthracycline- and taxane-refractory advanced breast cancer, NP and NX regimens exerted similar curative effects with acceptable toxicity.