Pharmacokinetics, micro-SPECT/CT imaging and therapeutic efficacy of Re-DXR-liposome in C26 colon carcinoma ascites mice model

The pharmacokinetics and internal radionuclide therapy of intraperitoneally administrated ¹⁸⁸Re-N,N-bis(2-mercaptoethyl)-N′,N′-diethylethylenediamine (BMEDA)-labeled pegylated liposomal doxorubicin (¹⁸⁸Re-DXR-liposome) were investigated in the C26 murine colon carcinoma ascites mouse model. After intraperitoneal administration of the nanotargeted bimodality ¹⁸⁸Re-DXR-liposome, the ascites and tumor accumulation of the radioactivity were observed, the levels of radioactivity within the ascites were maintained at relatively higher levels before 48 h and the levels of radioactivity in the tumor were maintained at steady levels after 4 h. The AUC_(o→∞) of ¹⁸⁸Re-DXR-liposome in blood, ascites and tumor was 9.3-, 4.2- and 4.7-fold larger than that of ¹⁸⁸Re-BMEDA, respectively. The maximum tolerated dose of intraperitoneally administrated ¹⁸⁸Re-DXR-liposome was determined in normal BALB/c mice. The survival, tumor and ascites inhibition of mice after ¹⁸⁸Re-DXR-liposome (22.2 MBq of ¹⁸⁸Re, 5 mg/kg of DXR) treatment were evaluated. Consequently, radiochemotherapeutics of ¹⁸⁸Re-DXR-liposome attained better survival time, tumor and ascites inhibition (decreased by 49% and 91% at 4 days after treatment; P<.05) in mice than radiotherapeutics of ¹⁸⁸Re-liposome or chemotherapeutics of Lipo-Dox did. Therefore, intraperitoneal administration of novel ¹⁸⁸Re-DXR-liposome could provide a benefit and promising strategy for delivery of passive nanotargeted bimodality radiochemotherapeutics in oncology applications.     

热放疗、放化疗和单纯放疗治疗食管癌的临床疗效比照分析

目的探讨热放疗、放化疗和单纯放疗治疗食管癌的临床效果,为日后选择治疗方案提供指导。方法回顾分析自2012年1月—2014年6月期间该院收治的晚期食管癌患者75例,75例患者随机分为热放疗组（n=25）、放化疗组（n=25）和纯放疗组（n=25）。3组患者均接受常规性放射治疗,放化疗组患者在放射治疗基础上采用化疗治疗,热放疗组患者在放射治疗的基础上采用热疗治疗。比较3组患者治疗4周后的临床效果和不良反应。结果经治疗结束4周后,热放疗组的治疗总有效率为68.00%,放化疗组的治疗总有效率为84.00%,纯放疗组的治疗总有效率为56.00%。放化疗组和纯放疗组的治疗效果,差异有统计学意义（P〈0.05）。放化疗组患者的不良反应发生率高于纯放疗组和热放疗组,差异有统计学意义（P〈0.05）。结论放疗结合化疗治疗食管癌的临床效果佳,但不良反应发生率高,应根据患者的病情及需要采用合适的治疗方法。     

The role of diffusion-weighted MRI and 18F-FDG PET/CT in the prediction of pathologic complete response after radiochemotherapy for rectal cancer: A systematic review

After neoadjuvant radiochemotherapy (RCT) for locally advanced rectal cancer, 15–27% of the patients experience a pathological complete response (pCR). This observation raises the question as to whether invasive surgery could be avoided in a selected cohort of patients who obtain a clinical complete response after preoperative RCT. In this respect, there has been growing interest in functional imaging techniques to improve clinical response assessment. This systematic review focuses on the role of diffusion-weighted imaging (DWI) and ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) in the prediction of pCR after RCT for rectal cancer.A total of 14 publications on DWI and 25 on ¹⁸F-FDG PET/CT were retrieved. Pooled analysis of individual patient data shows both imaging modalities have a low positive predictive value in the prediction of pCR (mean PPV of 54% and 39% for DWI- and ¹⁸F-FDG PET/CT-based parameters respectively). Especially pre-RCT imaging is unable to predict pCR with overall accuracies of 68–72% for DWI and 44% for ¹⁸F-FDG PET/CT. Qualitative DWI assessment 5–10 weeks after the end of RCT may outperform apparent diffusion coefficient (ADC)-based DWI-parameters (overall accuracy of 87% vs. 74–78%). Although few data are available, early changes in FDG-uptake seem promising in the prediction of pCR and the role of ¹⁸F-FDG PET/CT during RCT should be further investigated. Quantitative and qualitative ¹⁸F-FDG PET/CT measurements are equally effective in the assessment of pCR after RCT.The major strength of DWI and ¹⁸F-FDG PET/CT lies in the identification of non-responders who are not candidates for organ preservation. Up to now, DWI and ¹⁸F-FDG PET/CT are not accurate enough to safely select patients for organ-sparing strategies. Future research must focus on the integration of functional imaging with clinical data and molecular biomarkers.     

吉西他滨联合奈达铂同期放化疗治疗局部晚期鼻咽癌的疗效观察

目的评价吉西他滨加奈达铂(GN组)和氟尿嘧啶加顺铂(PF组)同期放化疗治疗Ⅲ、Ⅳa期鼻咽癌的疗效,毒副作用和生存率。方法经病理确诊的Ⅲ、Ⅳa期鼻咽癌120例随机分为2组,GN组(治疗组)60例,PF组(对照组)60例。吉西他滨800 mg/m2,d1,d8;奈达铂70 mg/m2,d1;氟尿嘧啶500 mg/m2,d1～d5;顺铂80 mg/m2,d1,均是静脉滴入,在放疗第1,5周给予,一共2周期。结果 GN组同期放化疗的有效率为100%,PF组96.7%。3年生存率分别为GN组81.7%,PF组78.3%,消化道反应发生率分别为GN组53.3%,PF组76.7%。结论同期GN化放组和PF化放组的近期疗效和3年生存率相近。GN化放组的不良反应较轻,患者耐受好。     

高级别胶质瘤放射及化学治疗后假性进展

目的 探讨高级别胶质瘤患者放射、化学治疗后假性进展的临床特点、诊断与处理.方法 分析2008年6月-2009年6月接受综合治疗的31例高级别胶质瘤患者临床资料,对假性进展的患者进行回顾分析,按照实体瘤疗效评判标准应用磁共振进行疗效评价.结果 31例术后病理诊断为高级别胶质瘤的患者,替莫唑胺(TMZ)同期放射、化学治疗后...     

磁共振扩散加权成像预测、监测直肠癌放化疗效果的价值

目的探讨MR扩散加权成像(diffusion-weighted imaging,DWI)在预测、监测直肠癌放、化疗效果中的应用价值。资料与方法动态监测15例行放、化疗的直肠癌患者,于放化疗前、放化疗结束和放化疗后4~5周行3次常规MRI及DWI。测量直肠癌的长度、肿瘤侵犯直肠壁厚度和表观扩散系数(apparent diffusion coefficient,ADC)值在放化疗前、后各时间点的变化,并分别进行比较;依据实体瘤疗效评价标准(RECIST)分组,比较各组在放化疗前ADC值之间的差异。结果直肠癌放化疗结束时,肿瘤侵犯肠壁的厚度较放化疗前差异有统计学意义(0.010.05);而对于放化疗结束与放化疗后4~5周,三者的变化差异均无统计学意义。放化疗前部分缓解(PR)与病灶稳定(SD)组之间的ADC值差异无统计学意义(P=0.222>0.05)。结论 DWI可优先、准确评价直肠癌放化疗的疗效相对于肿瘤形态学变化;而放化疗前ADC值对于预测直肠癌放化疗的疗效无明显意义...     

热疗联合同步放化疗治疗中晚期宫颈癌的临床观察

目的 观察热疗（Hyperthermia,HT）联合同步放化疗在中晚期宫颈癌治疗中的临床疗效及毒副反应.方法 将2007-2011年我院收治的78例中晚期宫颈癌患者随机分为对照组和试验组,每组各39例.对照组采用三维适形放疗及后装放疗同步顺铂化疗（40mg/m2,每周一次,共6次）,试验组在对照组基础上加用热疗（每次60 min,2次/周,共12次）,观察两种治疗方法近期疗效和毒副反应.结果 试验组近期有效率为92.3％,对照组为74.4％,两组比较差异有统计学意义（x2=4.52,P＜0.05）.治疗组副反应稍高于对照组,但差异无统计学意义（P＞0.05）.结论 热疗联合同步放化疗治疗宫颈癌近期疗效较好,毒副反应轻,值得推广.     

Combined-Modality Treatment and Organ Preservation in Bladder Cancer

Purpose: In invasive bladder cancer, several groups have reported the value of organ preservation by a combined-treatment approach, including transurethral resection (TUR-BT) and radiochemotherapy (RCT). As more experience is acquired with this organ- sparing treatment, patient selection needs to be optimized. Clinical factors are limited in their potential to identify patients most likely to respond to RCT, thus, additional molecular markers for predicting treatment response of individual lesions are sorely needed. Patients and Methods: The apoptotic index (AI) and Ki-67 index were evaluated by immunohistochemistry on pretreatment biopsies of 134 patients treated for bladder cancer by TUR-BT and RCT. Expression of each marker as well as clinicopathologic factors were then correlated with initial response, local control and cancer-specific survival with preserved bladder in univariate and multivariate analysis. Results: The median AI for all patients was 1.5% (range 0.2–7.4%). The percentage of Ki-67-positive cells in the tumors ranged from 0.2% to 85% with a median of 14.2%. A significant correlation was found for AI and tumor differentiation (G1/2: AI = 1.3% vs. G3/4: AI = 1.6%; p = 0.01). A complete response at restaging TUR-BT was achieved in 76% of patients. Factors predictive of complete response included T-category (p < 0.0001), resection status (p = 0.02), lymphovascular invasion (p = 0.01), and Ki-67 index (p = 0.02). For local control, AI (p = 0.04) and Ki-67 index (p = 0.05) as well as T-category (p = 0.005), R-status (p = 0.05), and lymphatic vessel invasion (p = 0.05) reached statistical significance. Out of the molecular markers only high Ki-67 levels were associated to cause-specific survival with preserved bladder. On multivariate analysis, T-category was the strongest independent factor for initial response, local control and cancer-specific survival with preserved bladder. Conclusion: The indices of pretreatment apoptosis and Ki-67 predict a favorable outcome in bladder cancer patients treated with TUR-BT and RCT. Molecular markers may help to select patients for an organ-sparing approach.     

Results of adjuvant radiochemotherapy for gastric adenocarcinoma in Slovenia.

AIMS: To analyze the results of postoperative concomitant radiochemotherapy with 5-florouracil (5-FU) and leucovorin (LV) in patients with gastric carcinoma treated in a single institution. METHODS: During 2001-2004, 123 patients with the mean age of 60 years, were treated for adenocarcinoma of the stomach, stage Ib-IV, with postoperative concomitant radiochemotherapy. Radical (R0) and non-radical (R1) resection of the tumor was performed in 107 and 16 patients, respectively. Adjuvant treatment consisted of five cycles of five-day chemotherapy with 5-FU (425 mg/m(2)) and LV (20 mg/m(2)) and concomitant radiotherapy with the total dose of 45 Gy. RESULTS: The treatment was completed according to the protocol in 101 patients. Stomatitis, dysphagia, and nausea and vomiting of grade three occurred in 32, 27, and 23 patients, respectively. The median follow-up time of 87 survivors was 30.4 months (range 17.4-58.3 months). At two years, locoregional control (LRC), disease-free survival (DFS), disease-specific survival (DSS) and overall survival (OS) rates were 86%, 65%, 74%, and 73%, respectively. In the multivariate analysis, the initial Hb level was identified as independent prognostic factor for all survival four endpoints, the involvement of whole stomach with cancer for LRC, the total dose of 5-FU per five-day cycle for DFS, and pT stage for DSS. CONCLUSIONS: In operable gastric carcinoma, postoperative concomitant radiochemotherapy with 5-FU and LV is feasible and its toxicity acceptable. Its potential to improve the treatment outcome compared to the surgery alone is yet to be tested in well designed prospective randomized studies.