Objective: To explore the influence of serum vascular endothelial growth factor (VEGF) level on therapeutic outcome and diagnosis/prognostic value in patients with cervical cancer. Materials and Methods: A total of 37 patients diagnosed with cervical cancer by biopsy were selected and treated with concurrent chemoradiotherapy. Double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) was adopted before treatment to assess VEGF levels, and its relationships with clinicopathological features and short-term therapeutic effects were analyzed. Results: The median VEGF level in 37 patients before treatment was 647.15 (393.35~1125.16) pg/mL. Serum VEGF levels in patients aged <50 years, in International Federation of Gynecology and Obstetrics (FIGO) stage IIIa~IVa, with lymph node metastasis and tumor size >4 cm were significantly increased (P<0.05). The complete remission (CR) rate was 48.7% (18/37), partial remission (PR) rate was 35.1% (13/37), stable disease (SD) rate was 13.5% (5/37) and progressive disease (PD) rate was 2.70% (1/37), so the objective remission rate (ORR) after treatment was 83.8% (31/37). Logistic regression analysis showed that tumor size and serum VEGF level before treatment were independent risk factors affecting the therapeutic outcome, and the higher the level of serum VEGF, the worse the prognosis when tumor size>4 cm. Some 56.8% of patients manifested with myelosuppression, 37.8% with leucopenia, 24.3% with thrombocytopenia, 5.41% with diarrhea, 46.0% with nausea and vomiting, 21.6% with hair loss and 8.11% with hepatic and renal injury during the treatment. Conclusions: Serum VEGF level may reflect the degree of malignancy of cervical cancer and predict therapeutic effect, which is of great importance to cancer diagnosis and prognosis.
Aim: The aim of this study was to evaluate acute adverse events and efficacy of three-dimensional intensitymodulated radiotherapy (IMRT) combined with endocrine therapy for intermediate and advanced prostate cancer. Methods: Sixty-seven patients were treated with three-dimensional IMRT combined with maximum androgen blockade. The correlation between radiation-induced rectal injury and clinical factors was further analyzed. Results: After treatment, 21 patients had complete remission (CR), 37 had partial remission (PR), and nine had stable disease (SD), with an overall response rate of 86.5%. The follow-up period ranged from 12.5 to 99.6 months. Thirty-nine patients had a follow-up time of ${\geq}$ five years. In this group, three-year and five-year overall survival rates were 89% and 89.5%, respectively; three-year and five-year progression-free survival rates were 72% and 63%. In univariate analyses, gross tumor volume was found to be prognostic for survival ($X^2$ = 5.70, P = 0.037). Rates of leucopenia and anemia were 91.1% and 89.5%, respectively. Two patients developed acute liver injury, and a majority of patients developed acute radiation proctitis and cystitis, mainly grade 1/2. Tumor volume before treatment was the only prognostic factor influencing the severity of acute radiation proctitis (P < 0.05). Conclusions: IMRT combined with endocrine therapy demonstrated promising efficacy and was well tolerated in patients with intermediate and advanced prostate cancer.
The death of cattle from acute bracken poisoning has been recognized for many years. Acute bracken poisoning is characterized by mucoidal nasal and anal hemorrhage, severe anorexia. pyrexia, gastric ulcer and myocardial damage. In 1958 Evans first suggested that clinical picture of bracken poisoning was very much similar to that of radiation injuries such as aplastic anemia, leucopenia, thrombocytopenia and increased capillary fragility. Bracken has been clearly demonstrated to contain a carcinogen as well as thiaminase. However, the nature of carcinogen in bracken has not definetely elucidated. Also it was warned by several workers that bracken could be a causative factor for stomach cancer in Korean and Japanese. It appears that little is known on the e(feet of bracken on the function of cardiovascular system. Therefore the present study was designed to explore effects of ethanol extract of raw and toiled bracken (RBEE:BBEE) on blood pressure in cats. Also studied was the mechanism underlying changed in blood pressure of cats by bracken. The result obtained were as follows; 1) Mean arterial blood pressure was invariably decreased following administration of either RBEE or BBEE. Tn general depressor responses to RBEE persisted longer than that to BBEE. Generally, depressor responses were proportional to debases of RBEE and BBEE administered. 2) After administration of 60 mg/kg RBEB and BBEE, blood Pressure decreased by $62.1{\pm}1.7mmHg$ and $68.0{\pm}3.0mmHg$, respectively. No change was observed between depressor responses to RBEE and that to BBEE. 3) Depressor responses to BBEE and RBEE were not affected by vagotomy, propranolol and regitine. 4) In atropinized animal depressor responses to BBEE and RBEE were reduced by 30-40% showing part of depressor response was resulted from cholinergic effect of bracken.
Experimental radiation nephritis was produced in 15 rabbits by X-irradiation. About $2,000{\gamma}$ (tissue doses) were given to both kidneys of a rabbit in 5 days. Other tissues and organs except both kidneys were protected with 2mm thickened lead plates. 5 weeks after the last irradiation, blood pictures, blood pressures, B.U.N., serum creatinine, Ca, Mg, Fe levels and serum erythropoietin activity of the irradiated rabbits were studied. After finishing above studies, rabbits were sacrificed and both kidneys were removed and examined histopathologically. Same laboratory and pathological studies were performed in 6 control rabbits. In this study, the author obtained following results. 1) Both kidneys of rabbitis with experimental raditation nephritis showed marked histopathological changes, i.e.: renal tubules showed diffuse cloudy swelling, impacted intraluminal hyaline casts and focal precipitations of lime salts on the tubular epithelium. Diffuse interstitial fatty necrosis and various degrees of fibrotic infiltrations on the interstitium were also seen in association with focal lymphocytic infiltrations. Hyaline degenerations were observed on the glomeruli and small vessels. 2) Experimental radiation nephritis rabbits showed marked lowering in R.B.C. counts, decreased hemoglobin levels, low hematocrit values and leucopenia in comparison with those of control rabbits. (P<0.01). (Table 1 & 2). 3) Mild proteinuria were observed in experimental radiation nephritis in rabbits. 4) The levels of B.U.N. and serum creatinine increased in experimental radiation nephritis. (P<0.01). (Table 1,3 & 4) 5) The levels of serum Ca and Mg Showed no statistical difference in comparison with those of control rabbits. (P>0.05) (Table 3 & 4). 6) No statistical correlations were observable between the levels of B.U.N. and Hb. values. (${\gamma}=-0.223$) No close correlations (${\gamma}=-0.328$) were noticed between the levels of B.U.N. and serum iron levels. 7) Erythropoietin activity (R.B.C. $^{59}Fe$ Incorporation) was measured by the modified Fried method. No change in its activity was noticed in radiation nephritis group comparing with that of the control group. (P>0.05). (Table 1,3 & 5). 8) Carotid artery blood pressures showed also no difference. (P>0.05). (Table 1 & 2).
The effects of X-ray irradiation and the thyroid gland on the erythropoietic system were studied in the white male rabbits. The total body irradiation was done in doses of 250 r and 500 r to each of 5 rabbits for 10days. The factors were 220KV, 10mA, FLI/4 Cu+1 mmAI(HVL:2.0 mm Cu) 50 cm F.S.D. The thyroid dysfunction was experimentally induced, by giving 2mg of thyroid tablets per kg body weight for 15 days in 5 rabbits for hyperthyroidism and by giving 1.5 mC of $^{131}I$ per kg body weight in another 5 rabbits for hypothyroidism. Fourteen healthy rabbits were used as control. The hematologic changes and ferrokinetic data obtained from $^{59}Fe$ and apparent half survival of the red blood cells obtained from $^{51}Cr$ were compared. Following were the results: A. X-ray irradiated group; 1. There were no significant changes in hematologic findings except for leucopenia. A slight decrease of red blood cells was observed in 500 r irradiated animals. 2. The decreases in the iron turnover rates of the plasma and red blood cells as well as in the red cell renewal rate were found in both groups. A :significant decrease of the red cell iron utilization rate was observed in the 500 r irradiated animals. 3. The apparent half survival times of the red blood cells were slightly, in the 250 r ($12.1{\pm}0.80$ days), and markedly shortened in the 500 r irradiated animals ($9.8{\pm}1.38$ days), the normal being $14.0{\pm}1.6$ days. 4. It appears, therefore, that the anemia caused by X-ray irradiation is due to the inhibition of hemopoietic function and the excess destruction of the red blood cells. B. Thyroid dysfunction group; 1. The slight increases of the red blood cell count and circulating blood volume with the normal serum iron level were observed in the hyperthyroid group, while the decreases of the red and white blood cell counts, hemoglobin and hematocrit values with a marked decrease of the serum iron level in the hypothyroid group. 2. A marked decrease of the plasma iron disappearance rate with increases of plasma iron turnover, red cell iron utilization and red cell iron turnover were observed in the hyperthyroid group, while the marked delay and decreases in the hypothyroid group. 3. The apparent half survival times of the red blood cells were almost the same with the control in the hyperthyroid group, ($14.0{\pm}1.58$ while a marked shortening in the hypothyroid group $10.6{\pm}0.30$. 4. It was reconfirmed that the thyroid hormones bear a close relationship with the erythropoietic system, namely, the latter is stimulated by the former. The lack of the thyroid hormones thus induces the bone marrow depression leading to anemia the major cause of which, therefore, is not hemolysis.
Jeong, Songmi;Yoo, Eun Jung;Kim, Ji Yoon;Han, Chi Wha;Kim, Ki Jun;Kay, Chul Seung
Radiation Oncology Journal
/
v.31
no.4
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pp.206-215
/
2013
Purpose: Re-irradiation (re-RT) is considered a treatment option for inoperable locoregionally recurrent head and neck cancer (HNC) after prior radiotherapy. We evaluated the efficacy and safety of re-RT using Helical Tomotherapy as image-guided intensity-modulated radiotherapy in recurrent HNC. Materials and Methods: Patients diagnosed with recurrent HNC and received re-RT were retrospectively reviewed. Primary endpoint was overall survival (OS) and secondary endpoints were locoregional control and toxicities. Results: The median follow-up period of total 9 patients was 18.7 months (range, 4.1 to 76 months) and that of 3 alive patients was 49 months (range, 47 to 76 months). Median dose of first radiotherapy and re-RT was 64.8 and 47.5 $Gy_{10}$. Median cumulative dose of the two courses of radiotherapy was 116.3 $Gy_{10}$ (range, 91.8 to 128.9 $Gy_{10}$) while the median interval between the two courses of radiation was 25 months (range, 4 to 137 months). The response rate after re-RT of the evaluated 8 patients was 75% (complete response, 4; partial response, 2). Median locoregional relapse-free survival after re-RT was 11.9 months (range, 3.4 to 75.1 months) and 5 patients eventually presented with treatment failure (in-field failure, 2; in- and out-field failure, 2; out-field failure, 1). Median OS of the 8 patients was 20.3 months (range, 4.1 to 75.1 months). One- and two-year OS rates were 62.5% and 50%, respectively. Grade 3 leucopenia developed in one patient as acute toxicity, and grade 2 osteonecrosis and trismus as chronic toxicity in another patient. Conclusion: Re-RT using Helical Tomotherapy for previously irradiated patients with unresectable locoregionally recurrent HNC may be a feasible treatment option with long-term survival and acceptable toxicities.
Background: Malignant serous effusions (MSE) are one complication in patients with advanced cancer. Endostar is a new anti-tumor drug targeting vessels which exerts potent inhibition of neovascularization. This study aimed to systematically evaluate the efficacy and safety of intraperitoneal perfusion therapy of Endostar combined with platinum chemotherapy for malignant serous effusions (MSE). Materials and Methods: Randomized controlled trials (RCTs) on intraperitoneal perfusion therapy of Endostar combined with platinum chemotherapy for malignant serous effusions were searched in the electronic data of PubMed, EMBASE, Web of Science, CNKI, VIP, CBM and WanFang. The quality of RCTs was evaluated by two independent researchers and a meta-analysis was performed using RevMan 5.3 software. Results: The total of 25 RCTs included in the meta-analysis covered 1,253 patients, and all literature quality was evaluated as "B" grade. The meta-analysis showed that Endostar combined with platinum had an advantage over platinum alone in terms of response rate of effusions (76% vs 48%, RR=1.63, 95%CI: 1.50-1.78, P<0.00001) and improvement rate in quality of life (69% vs 44%, RR=1.57, 95%CI: 1.42-1.74, P<0.00001). As for safety, there was no significant difference between the two groups in the incidences of nausea and vomiting (35% vs 34%, RR=1.01, 95%CI: 0.87-1.18, P=0.88), leucopenia (38% vs 38%, RR=1, 95%CI: 0.87-1.15, P=0.99), and renal impairment (18% vs 20%, RR=0.86, 95%CI: 0.43-1.74, P=0.68). Conclusions: Endostar combined with platinum by intraperitoneal perfusion is effective for malignant serous effusions, and patient quality of life is significantly improved without the incidence of adverse reactions being obviously increased.
Alici, Suleyman;Buyukberber, Suleyman;Alkis, Necati;Benekli, Mustafa;Ozkan, Metin;Bilici, Ahmet;Demirci, Umut;Karaca, Halit;Arpaci, Erkan;Gumus, Mahmut;Altunbas, Mustafa;Dane, Faysal;Turk, H. Mehmet;Anatolian Society of Medical Oncology
Asian Pacific Journal of Cancer Prevention
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v.14
no.1
/
pp.423-427
/
2013
Background: Phase II and III trials of docetaxel, cisplatin and fluorouracil (DCF) have shown superior efficacy versus cisplatin and fluorouracil alone but with high rates of hematologic toxicity in metastatic gastric cancer cases. To reduce toxicity while maintaining the efficacy of DCF, we investigated low dose docetaxel (D), cispatin (C) - leucovorin and fluorouracil (De Gramont regimen). Patient and methods: Chemotherapy-naïve patients with metastatic gastric cancer (MGC) received D 60 mg/$m^2$ on day 1 and cisplatin 30 mg/$m^2$ on day 1-2 and the De Gramont regimen (Folinic acid 400 mg/m2 on day 1 and 5-FU 2400 mg/$m^2$/46h continuous infusion) every 3 weeks. The primary endpoint was response rate. Results: One hundred twenty patients with a median age of 52.5 years (range, 32-78) received a median of 6 cycles (range, 2-12 cycles). Of the 120 evaluable patients, 4 showed complete remission and 36 achieved a partial response. The overall response rate was 56.6%. Twenty eight patients (23.3%) showed stable disease and 52 (43.3%) progression. The median time to progression was 7 months (95%CI 6-7.9). The median overall survival was 15 months (95%CI 13.7-16.2). The most frequent hematological toxicity was leucopenia, which occurred at grade 3/4 intensity in 24 patients (20%). Conclusions: Low-dose DC-De Gramont regimen is active in MGC with a tolerable toxicity profile.
An 8-years-old intact female shih tzu was referred to the Veterinary Medical Teaching Hospital Chungnam National University for treatment of suspected pyometra. This dog had clinical symptoms of vaginal bleeding, vulvar discharge, polyphagia, polyuria/polydipsia and vomiting. In hematologic examinations, complete blood count (CBC) revealed mild leucopenia and a serum biochemistry profile revealed increased ALP, decreased GLU values. Diagnosis was made by radiographic examination, ultrasonographic examination, abdominocentesis. Peritonitis secondary to pyometra was tentative diagnosed. Surgical treatment was proceeding for ovariohysterectomy and peritoneal saline irrigation. It was confirmed that severe necrotized enteritis and pus leakage to ovarian bursa with pyometra. In this report, secondary severe disease also must be considered in diagnosis of pyometra because septic peritonitis could be occurred by pus leakage from uterus with pyometra.
For patients with neck and upper thoracic esophageal carcinoma, it is difficult to control lymph node metastases with conventional dose therapy. In this study, we assessed the feasibility of simplified intensity-modulated radiotherapy (sIMRT) and concurrent chemotherapy for 44 patients and boosted high-dose to metastatic lymph nodes. Three radiation treatment volumes were defined: PGTVnd, with which 68.1Gy was delivered in high dose group (hsIMRT group), and 60Gy in the conventional dose group (csIMRT group); PTV1, featuring 63.9Gy in the hsIMRT group and 60Gy in the csIMRT group; PTV2, with 54Gy given to both groups. The sIMRT plan included 5 equi-angular coplanar beams. All patients received the cisplatin and 5-FU regimen concurrently with radiotherapy. The treatment was completed within six weeks and one case with grade three acute bronchitis was observed in hsIMRT group. For esophageal lesions, 80% complete response (CR) and 20% partial response (PR) rates were found in the hsIMRT group, and 79.2% CR, with 20.8% PR, in the csIMRT group; for lymph node lesions, 75% CR and 25% PR rates were observed in the hsIMRT group, with 45.8% and 37.5% respectively in the csIMRT group (P<0.05). The differences in 1-, 2- and 3-year relapse-free survival rates were all statistically significant (P<0.05). The major toxicity observed in both groups was Grade I~II leucopenia. sIMRT can generate a desirable dose distribution in treatment of neck and upper thoracic esophageal carcinoma with a better short-term efficacy. Boosted high dosing to metastatic lymph nodes can increase the relapse-free survival rate.
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