Objective To investigate the mechanisms of local application of granulocyte macrophage- colony stimulating factor (GM-CSF) on healing of colonic anastomoses impaired by intraperitoneal oxaliplatin in rats. Methods Sixty 10-week-old male Wistar rats were made the colonic anastomosis model and randomized into 3 groups, 20 rats in each. The rats received intraperitoneal injection of 5% dextrose in group A, and intraperitoneal injection of 5% dextrose and 10 mL oxaliplatin (25 mg/kg) in group B at 1 day; and 50 μg GM-CSF was injected into the perianastomotic area immediately after operation and 10 mL intraperitoneal oxaliplatin (25 mg/kg) was given at 1 day. The general situation of rats was observed after operation. Anastomotic healing was tested by measuring the bursting pressure in vivo at 2, 3, 5, 7 days. Anastomotic healing score was evaluated by histological staining. Immunohistochemical staining of the anastomotic site was used to determine the amount of collagen type I content. Results All animals survived to the experiment end. There was no significant difference in the bursting pressure among 3 groups at 2 and 3 days (P gt; 0.05); the bursting pressure of group B was significantly lower than that of groups A and C (P lt; 0.05). There was no significant difference in mononuclear cells infiltration, mucosal epithelialization, submucosa-muscle layer connection degree, and granulation tissue formation between groups A and C at different time points (P gt; 0.05); groups A and C were significantly better than group B in mucosal epithelialization and granulation tissue formation (P lt; 0.05). Groups A and C were significantly better than group B in mononuclear cells infiltration at 2 and 3 days, and in submucosa-muscle layer connection degree at 5 and 7 days (P lt; 0.05). There was no significant difference in collagen type I content among 3 groups at 2 and 3 days (P gt; 0.05); the content of collagen type I in groups A and C were significantly higher than that in group B (P lt; 0.05) at 5 and 7 days. Conclusion Local administration of GM-CSF may enhance colonic anastomotic healing by early stimulating infiltration of macrophages and increasing collagen deposition.
Objective To assess clinical efficacy and safety of Oxaliplatin plus Vinorelbine in the treatment of advanced non-small cell lung cancer (NSCLC). Methods We used the methods of Cochrane reviews, electronically searched the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 3, 2008), MEDLINE (1966 to April 2008), EMbase (1984 to Dec. 2006), Cancerlit (1996 to Dec. 2005), CBM (1978 to April 2008), CNKI (1994 to April 2008), VIP (1989 to April 2008), and handsearched 15 Chinese medical core journals, to collect randomized controlled trials (RCTs) of Oxaliplatin combined with Vinorelbine in the treatment of advanced NSCLC. RCTs were included according to the inclusion and exclusion criteria, the quality of included trials was evaluated and RevMan 4.2.8 software was used for metaanalyses after the extraction of the data. Results Seventeen RCTs involving 1 399 patients with advanced NSCLC were included. All of them reported the use of a random method, but with no detailed reports of allocation concealment and whether the blind method was used. The results of meta-analyses showed that NO program (vinorelbine + oxaliplatin) and NP program (vinorelbine + cisplatin) were similar in efficient rate (RR=0.97, 95%CI 0.85 to 1.10) and 1-year survival rate (RR=0.82, 95%CI 0.66 to 1.03). Compared with NP program, NO program induced lower III-IV degree of nausea and vomiting response (RR=0.20, 95%CI 0.14 to 0.28), III-IV degree of leukopenia reaction (RR=0.64, 95%CI 0.52 to 0.79), and I-II degree of renal damage RR=0.27, 95%CI 0.11 to 0.60) after chemotherapy. No study reported treatmentrelated death. Conclusion Oxaliplatin and Cisplatin plus Vinorelbine are similar in efficacy in the treatment of advanced NSCLC. Oxaliplatin plus Vinorelbine could be used as a chemotherapy of advanced NSCLC because of its better tolerance and more liability to be accepted by patients. However, highly-potential selection bias and measurement bias would affect the demonstration level of the outcome, so more high-quality double-blind RCTs are needed.
ObjectiveTo evaluate the efficacy and safety of docetaxel (DOC) combined with oxaliplatin (OXA) regimen in the treatment of advanced gastric cancer. MethodsSixty patients with advanced gastric cancer treated in our hospital from January 2008 to January 2011 were randomly divided into two groups. The treatment group (n=30) was given DOC combined with OXA regimen. Patients in this group were treated with DOC 75 mg/m2, ivgtt, d1; OXA 130 mg/m2, ivgtt, d4; with 21 days as a cycle. The control group (n=30) was given DCF regimen. Patients in the control group were treated with DOC 75 mg/m2, ivgtt, d1; cisplatin 75 mg/m2, ivgtt, d1; calcium folinate 200/m2, ivgtt, 2 h, d1-2; fluorouracil 400 mg/m2, bolus 10 minutes, fluorouracil 600 mg/m2 civ 22 h d1-2; also with 21 days as a cycle. All patients received two cycles of chemotherapy at least. The effective rate (complete remission+partial remission), adverse reactions, median survival time and quality of life were analyzed and compared between the two groups. ResultsThe effective rates in the treatment group and the control group were 60.0% and 46.7% respectively, showing a non-significant difference (P>0.05). The appetite increasing rate (70.0% vs 43.3%), the weight gain rate (60.0% vs 33.3%), and the Karnofsky score improvement rate (63.3% vs 30.0%) of the treatment group were significantly higher than those of the control group (P<0.05). The adverse reactions were fewer in the treatment group, and most of them were between grade Ⅰ and Ⅱ. The median time of disease progression (5.8 months vs 5.6 months) and the median survival period (11.8 months vs 9.2 months) of the treatment group were longer than those in the control group. ConclusionDOC combined with OXA regimen is effective in treating advanced gastric cancer. It can significantly improve the quality of life of the patients, and it has fewer adverse reactions. Meanwhile, the median survival period is prolonged. DOC combined with OXA regimen is worth to be applied in clinic.
Objective To evaluate the efficacy and toxicity of the combination of S-1 and oxaliplatin in the first-line chemotherapy of patients with advanced gastric cancer. Methods From March 2012 to April 2013, 57 patients in the First Affiliated Hospital of Guangxi Medical University were enrolled in this study. Oxaliplatin was administered at 130 mg/m2 on day 1, while S-1 was administered orally (< 1.25 m2: 40 mg twice per day; 1.25-1.50 m2: 50 mg twice per day; > 1.50 m2: 60 mg twice per day) for 14 days. The response was evaluated every two chemotherapy cycles. Results The objective response rate was 52.6%, and the disease control rate was 84.2%. The median time to progression was 5.8 months, and the median survival time was 13.5 months. The major grade 3/4 hematological toxic effects were neutropenia (12.3%) and thrombocytope nia (12.3%), and the grade 3/4 non-hematological toxic effects were vomiting, fatigue and sensory neuropathy. The rate of clinical benefit response was 71.9% (41/57). Conclusion The regimen of oxaliplatin and S-1 shows precise efficacy and good tolerance against advanced gastric cancer, and it is worthy of promotion and application in the future.
Objective To investigate the efficacy of Docetaxel injection and Capecitabine tablets combined with Oxaliplatin injection in chemotherapy for patients after esophageal cancer surgery. Methods We retrospectively analyzed the clinical data of 101 patients with esophageal cancer who underwent radical surgery from June 2010 to December 2012, including 58 males and 43 females. According to the different treatment methods they were divided into a study group (58 patients, 32 males and 26 females, postoperatively receiving Docetaxel injection, Capecitabine tablets, Oxaliplatin injection and chemotherapy) and a control group (43 patients, 26 males and 17 females, taking Docetaxel injection and Capecitabine tablets for 4 consecutive courses). We compared the difference in the outcomes between the two groups. Results There was no significant difference in the level of serum anticancer antigen (CEA), carbohydrate antigen 125 (CA125), carbohydrate antigen 199 (CA199) and squamous cell carcinoma antigen (SCC) before chemotherapy between two groups (P>0.05). After chemotherapy, the level of serum CEA, CA125, CA199, SCC in the study group was significantly lower than that in the control group (P<0.05). The 1-year survival rate of the study group was 92.59% and the 2-year survival rate was 70.37%, which were not significantly different from those of the control group (P>0.05). The 3-year survival rate of the study group was significantly higher than that of the control group (57.41 %vs. 32.43%, P<0.05). The mean survival time of the study group was longer than that of the control group (31 monthsvs. 22 months, P=0.001). Conclusion Docetaxel injection and Capecitabine tablets combined with Oxaliplatin injection for the treatment of esophageal cancer surgery can significantly reduce levels of tumor markers in serum after esophageal cancer surgery, and is favorable for the long-term survival of patients, but adverse reactions should be noted.
ObjectiveTo systematically review the efficacy and safety of capecitabine combined with irinotecan (CAPIRI) versus capecitabine combined with oxaliplatin (CAPOX) for patients with advanced/metastatic colorectal cancer.MethodsPubMed, EMbase, The Cochrane Library, VIP, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) on CAPIRI versus CAPOX for patients with advanced/metastatic colorectal cancer from inception to August 2018. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 12 RCTs involving 1 049 patients were included. The results of meta-analysis showed that: there were no significant differences in complete response (CR), partial response (PR), stable disease (SD), progression disease (PD), overall respond rate (ORR), median progression-free survival (mPFS), and median overall survival (mOS) between two groups (P>0.05). However, CARIRI group was lower on the disease control rate (RR=0.93, 95%CI 0.86 to 1.00, P=0.04) than CAPOX group. Incidence of diarrhea was higher in CAPIRI group (RR=1.83, 95%CI 1.37 to 2.45, P<0.000 1). However, the incidence rate of peripheral neurotoxicity in CAPOX group was higher (RR=0.13, 95%CI 0.05 to 0.35, P<0.000 1). There were no significant differences between two groups in the incidence rates of nausea and vomiting, hand-foot syndrome, anemia, thrombocytopenia, leukocytopenia and alopecia (P>0.05).ConclusionsCurrent evidence shows that two groups are equivalent in terms of curative effects. CAPIRI has a higher incidence rate of diarrhea, while CAPOX has a higher risk of peripheral neurotoxicity. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.