目的 分析晚期食管鳞癌疾病采用卡瑞利珠单抗、化疗联合方案治疗的效果与安全性.方法 选择2019年9月-2022年9月本院收治的晚期食管鳞癌患者40例作为研究对象,随机分作对照组(20例)与观察组(20例),对照组治疗方案为常规放疗联合化疗;观察组治疗方案为常规放疗、化疗联合卡瑞利珠单抗;观察治疗效果,对两组患者治疗前后肿瘤标志物指标进行检测,对比结果差异.比较各组患者治疗期间不良反应总发生概率.结果 观察组患者治疗后客观缓解率、疾病控制率均高于对照组(P<0.05).两组患者治疗前检测肿瘤标志物指标比较差异无统计学意义(P>0.05),治疗后观察组相应测定结果均低于对照组(P<0.05),两组患者出现不良反应的总概率比较差异无统计学意义(P>0.05).结论 临床治疗晚期食管鳞癌疾病可在常规放疗、化疗基础上联合卡瑞利珠单抗,能够有效提高疾病控制率,同时不增加患者不良反应,值得运用推广.

Objective:To study effective carriers that can enhance the antitumor effect of paclitaxel (PTX).Methods:PTX-loaded polylactic-co-glycolic acid (PLGA) nanoparticles (NPs) (PTX-PLGA NPs), constructed using the emulsification solvent evaporation method, were characterized by scanning electron microscopy and dynamic light scattering. Non-small-cell lung carcinoma (NSCLC) cells were divided into the dimethyl sulfoxide (DMSO) group, PLGA NPs group, PTX group, and PTX-PLGA NPs group. Cell viability was detected by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), cell apoptosis was determined by flow cytometry, and cell migration and invasion were assessed using Transwell assay.Results:PTX-PLGA NPs were smooth in the surface and spherical in shape, with a particle size of 268 ± 1.3 nm. Both PTX and PTX-PLGA NPs could effectively inhibit the activity of A549 and H1650 cells. At 12 and 24 h, PTX-PLGA NPs presented weaker inhibition on the activity of NSCLC cells than PTX, but at 48 and 72 h, PTX-PLGA NPs presented stronger inhibition. Compared with PTX, PTX-PLGA NPs were more effective in enhancing apoptosis and inhibiting migration and invasion of NSCLC cells.Conclusion:With good sustained release and the ability to promote cellular uptake, PTX-PLGA NPs can strongly inhibit the malignant activities of NSCLC cells, which can be used as a promising drug carrier.

Objective. To study effective carriers that can enhance the antitumor effect of paclitaxel (PTX). Methods. PTX-loaded polylactic-co-glycolic acid (PLGA) nanoparticles (NPs) (PTX-PLGA NPs), constructed using the emulsification solvent evaporation method, were characterized by scanning electron microscopy and dynamic light scattering. Non-small-cell lung carcinoma (NSCLC) cells were divided into the dimethyl sulfoxide (DMSO) group, PLGA NPs group, PTX group, and PTX-PLGA NPs group. Cell viability was detected by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), cell apoptosis was determined by flow cytometry, and cell migration and invasion were assessed using Transwell assay. Results. PTX-PLGA NPs were smooth in the surface and spherical in shape, with a particle size of 268 ± 1.3 nm. Both PTX and PTX-PLGA NPs could effectively inhibit the activity of A549 and H1650 cells. At 12 and 24 h, PTX-PLGA NPs presented weaker inhibition on the activity of NSCLC cells than PTX, but at 48 and 72 h, PTX-PLGA NPs presented stronger inhibition. Compared with PTX, PTX-PLGA NPs were more effective in enhancing apoptosis and inhibiting migration and invasion of NSCLC cells. Conclusion. With good sustained release and the ability to promote cellular uptake, PTX-PLGA NPs can strongly inhibit the malignant activities of NSCLC cells, which can be used as a promising drug carrier.

目的 观察晚期肺癌患者接受姑息性放疗联合阿帕替尼治疗的临床近期疗效及安全性.方法 回顾性分析40例晚期肺癌患者的临床资料,按照治疗方法的不同将患者分为对照组和观察组,每组20例.对照组患者单纯接受姑息性放疗,观察组患者在此基础上联用阿帕替尼治疗.比较治疗后2组的临床近期总有效率、临床症状评分和毒副反应发生率.结果 观察组近期客观缓解率为70.00％、疾病控制率为90.00％,分别高于对照组的30.00％、60.00％,差异有统计学意义(P＜0.05);观察组疼痛评分、气喘评分和胸水评分均低于对照组,差异有统计学意义(P＜0.05);观察组高血压发生率高于对照组,差异有统计学意义(P＜0.05),2组其他毒副反应发生率差异无统计学意义(P＞0.05).结论 相较于单纯姑息性放疗,姑息性放疗联合阿帕替尼治疗晚期肺癌的近期疗效更佳,可明显改善患者临床症状,且安全性较好.

目的 探讨食管癌术后纵隔淋巴结转移中大体肿瘤体积(GTV》＞40 cm3患者对同步放化疗的疗效.方法 选择2016年12月-2017年12月我院经筛查出现纵隔淋巴结转移且GTV＞40 cm3的食管癌术后患者66例,根据治疗方式不同分为对照组和治疗组,每组33例.对照组接受单纯三维调强放疗,治疗组接受同步化疗联合三维调强放疗,比较两组治疗疗效、生存情况及不良反应发生情况.结果 治疗组有效率高于对照组(78.79％ vs 54.55％),差异有统计学意义(P＜0.05);两组疾病控制率比较(87.88％ vs 84.85％),差异无统计学意义(P＞0.05).治疗组3年生存率高于对照组,差异有统计学意义(P＜0.05);两组1年生存率、2年生存率比较,差异无统计学意义(P＞0.05).两组不良反应主要为放射性气管炎、放射性肺炎、胃肠道反应和骨髓抑制,均为1、2级,无3、4级不良反应发生.两组放射性气管炎、放射性肺炎、胃肠道反应和骨髓抑制发生率比较,差异无统计学意义(P＞0.05).结论 同步放化疗联合三维调强放疗可提高食管癌术后纵隔淋巴结转移中GTV＞40 cm3者的局部控制率及生存率,不良反应小,患者可耐受.

Objective To screen the critical genes related to the development of esophageal squamous cell carcinoma ( ESCC ) by weighted gene co-expression network analysis ( WGCNA ) and to verify by experiments.Methods Gene expression data of ESCC were downloaded from gene expression omnibus (GEO) database based on gene chip platform ( GPL) 570, GPL571, GPL96/97 or GPL14613 platform, respectively. Meanwhile, the obtained differentially expressed genes together with gene expression data of 81 ESCC patients from the cancer genome atlas ( TCGA ) and clinical data were analyzed by WGCNA to set up co-expression networks including mRNA and microRNA ( miRNA ) . The expression of miRNA in ESCC tissues and paracancerous tissues was examined by quantitative real-time polymerase chain reaction ( RT-PCR ) .And the expression of target protein Kruppel like factor 4 ( KLF4 ) and desmocollin 2 ( DSC2 ) were detected by immunohistochemistry .After ESCC cell line ECA-109 cells were transfected with miRNA-92b-3p mimic, cell cycle was tested by flow cytometry ,the cell invasion and migration ability was measured by Transwell chamber assay and scratch-wound assay.The expression of KLF4 and DSC2 was observed by confocal laser scanning microscopy and Western blotting .The target genes were verified by luciferase assay .T-test, rank sum test, chi-square test and Pearson correlation analysis were performed for statistical analysis .Results A total of 4023 differential expression gene ( DEG) and 328 differential expression miRNA ( DEM) were screened and 11 gene modules were set up by WGCNA .Among them, the brown modules were negatively associated with tumor grade and T stage (r=-0.340 and -0.268, P=0.002 and 0.016).Meanwhile, has-miR-92b and the potential target genes KLF4 and DSC2 were all in the brown module .Furthermore, the results of RT-PCR showed the expression of miRNA-92b-3p in ESCC tissues was higher than that in paracancerous tissues (3.052(1.652, 5.371) vs.0.985(0.558, 2.032)), and the difference was statistically significant (Z=-4.021,P<0.01). The results of immunohistochemistry demonstrated that the positive rates of KLF 4 and DSC2 in ESCC tissues were 43.3％(13/30) and 20.0％(6/30), respectively, which were lower than those of paracancerous tissues (70.0％(21/30) and 63.3％(19/30)), and the differences were statistically significant (χ2 =4.344 and 1.589, both P<0.05).After ECA-109 cells were transfected with miRNA-92b-3p mimics, the percentage of cells at G0/G1 phase decreased ((63.71 ±2.83)％vs.(54.62 ±4.00)％) and the percentage of cells at the S phase and G2/M phase increased ((31.81 ±2.88)％vs.(41.20％±2.87)％, and (3.87 ±1.75)％vs. (8.10 ±1.71)％, respectively), and the differences were statistically significant (t =3.215, 4.000 and 2.998;P=0.032, 0.016 and 0.040).The invasion and migration ability of the cells were significantly improved (79.67 ±27.54 vs.280.33 ±46.18, (69.72 ±3.91)％ vs.(84.90 ±5.25)％), and the differences were statistically significant (t=6.465 and 4.019, P=0.003 and 0.016).The results of Western blotting indicated that, compared with control mimic group , the expression of KLF4 and DSC2 was both dramatically downregulated after transfected with miRNA-92b-3p mimics transfected (1.00 ±0.23 vs.0.42 ±0.03, 1.00 ±0.20 vs.0.55 ± 0.21), and differences were statistically significant (t=4.470 and 5.493, P=0.042 and 0.032).The results of luciferase assay demonstrated that miRNA-92b-3p could directly bind KLF4 and DSC2. Conclusion WGCNA is an efficient systemic biological approach by which miRNA-92b-3p is identified as a new cancer-promoting gene .

BACKGROUND:Esophageal squamous cell carcinoma (ESCC) is a highly aggressive malignancy. The aims of the present study were to screen the critical miRNA and corresponding target genes that related to development of ESCC by weighted gene correlation network analysis (WGCNA) and investigate the functions by experimental validation. METHODS:Datasets of mRNA and miRNA expression data were downloaded from GEO. The R software was used for data preprocessing and differential expression gene analysis. The differentially expressed protein-coding genes (DEGs) and miRNAs (DEMs) were selected (FDR <0.05 or |Fold Change (FC)| >1.5). Meanwhile, 81 expression data of ESCC patients in TCGA combined with clinic information were applied by WGCNA to create networks. The correlational analyses between each module and clinical parameters were conducted, and enrichment analyses of GO and KEGG were subsequently performed. Then, a series of experiments were conducted in ESCC cells by use of miRNA mimics. RESULTS:In total, 4,023 DEGs and 328 DEMs were screened. After checking good genes and samples, 3,841 genes (3,696 DEGs and 145 DEMs) were used for WGCNA. As a consequence, altogether 11 gene modules were found. Among them, the brown modules were found to be strongly inversely associated with pathological grade. Meanwhile, has-mir-92b, the only miRNA in brown module, had a positive correlation with grade and negatively correlated with potential target gene (KFL4 and DCS2) in the same module. Furthermore, an increased expression of miR-92b-3p and down-regulated KLF4 and DSC2 protein was detected in the ESCC clinical samples. Up-regulated miR-92b-3p shortened G0/G1 phase and promote ESCC cells invasion and migration. Furthermore, we verified that DSC2 and KFL4 was target genes of miR-92b-3p by luciferase report assay. CONCLUSION:WGCNA is an efficient approach to system biology. By this procedure, miR-92b-3p was identified as an ESCC-promoting gene by target KLF4 and DCS2.

目的 比较多西紫杉醇周剂量化疗同步放疗与单纯放疗治疗老年食管鳞癌的疗效.方法 选取2016年9月至2017年9月收治的老年食管鳞癌患者共80例,年龄≥70岁,随机分为研究组及对照组,各40例.对照组单纯应用调强适形放疗,肿瘤量DT:60 Gy/30f,单次分割剂量:2 Gy/f.研究组在对照组三维适形调强放疗基础上联合多西紫杉醇周剂量同步化疗,放疗期间予多西紫杉醇40 mg/次,每周1次,共4周;对比患者临床疗效[完全缓解(CR)、部分缓解(PR)、稳定(SD)、进展(PD)]和毒副反应.结果 研究组CR 19例,PR 15例,SD 3例,PD 3例;对照组CR 14例,PR 11例,SD 9例,PD 6例.研究组临床总有效率(CR+ PR)为85.0％,明显高于对照组的62.5％ (P ＜0.05).研究组1年疾病无进展生存率80.0％明显高于对照组的55.0％ (P ＜0.05).同步放化疗组1～2级白细胞减少、血小板减少及放射性食管炎较单纯放疗组有所增加,但经临床处理后均顺利完成治疗.结论 多西紫杉醇周剂量化疗同步放疗与单纯放疗治疗老年性食管癌,疗效较高,毒副反应能耐受,可提高患者近期生存率,远期生存是否得益尚需继续随访观察.

目的 探讨经一线化疗失败的晚期非小细胞肺癌(NSCLC)患者使用培美曲塞二钠单药治疗的近远期效果及毒副作用,为晚期NSCLC患者二线治疗药物选择提供参考.方法 共收集84例经一线化疗失败的晚期NSCLC患者,临床分期Ⅲb-Ⅳ期.采用单盲随机数表法将其分为对照组和观察组,两组各42例.其中对照组接受多西他赛单药化疗,剂量75 mg/m2;观察组采用培美曲塞二钠化疗,500 mg/m2,两组均21天/周期.持续4个周期后采用实体瘤评价标准(RECIST)判定疗效,采用美国国家癌症研究院(NCI)制定的毒性评价标准(CTC)评估两组毒性作用情况.结合1年随访统计两组远期生存情况.结果 对照组肿瘤治疗有效率(RR)(完全缓解是CR,部分缓解是PR;RR是CR+PR例数占总例数比例)和疾病控制率(DCR)分别为14.29％(6/42)、64.29％(27/42),观察组RR和DCR分别为16.67％(7/42)、69.05％(29/42),两组间差异均无统计学意义(P>0.05).观察组白细胞下降、恶心呕吐、脱发、肝功能损伤发生率均显著低于对照组,差异有统计学意义(χ2=4.421、4.613、4.459、5.126,P均<0.05).对照组和观察组6个月、1年生存率和总生存期(OS)比较,差异均无统计学意义(P均>0.05).结论 一线化疗失败的晚期NSCLC患者采用培美曲塞二钠治疗,化疗近远期效果同多西他赛,但毒性作用明显减轻,未出现严重不良反应,安全性良好,可作为晚期NSCLC患者二线治疗药物的优先选择.

目的:探讨单纯放疗与放疗联合多西他赛周剂量化疗治疗原发性食管癌的临床疗效与风险.方法:以2014年2月-2017年8月笔者所在医院放疗科68例原发性食管癌患者为研究对象,依据治疗方法不同分为试验组(放疗联合多西他赛周剂量化疗,34例)和对照组(单纯放疗,34例).对比观察两组疗效,统计毒副反应.结果:试验组肿瘤客观缓解率(73.53％)、疾病控制率(94.12％)、进食受阻改善率(91.18％)均高于对照组,差异有统计学意义(P<0.05).试验组消化道症状(29.41％)、骨髓抑制(70.59％)、放射性食管炎(58.82％)、食管瘘(2.94％)与对照组比较差异均无统计学意义(P>0.05).结论:放疗联合多西他赛周剂量化疗治疗原发性食管癌疗效优于单纯放疗,可有效控制肿瘤进展,改善进食受阻症状,而且不明显增加毒副反应,应用安全有效,值得临床推广.

目的 比较食管癌术后两种同步放化疗方案治疗纵隔淋巴结转移的疗效.方法 有纵隔淋巴结转移食管癌手术患者60例均分为两组:观察组术后采用放疗同步多西他赛+顺铂(T P)化疗方案,对照组采用放疗同步顺铂+5氟尿嘧啶(PF)化疗.比较两组疗效和不良反应发生情况.结果 观察组和对照组客观有效率相仿(36.7％vs.23.3％)(P>0.05).观察组患者4年生存率高于对照组(26.7％vs.6.7％)(P<0.05),复发率低于对照组(36.7％vs.66.7％)(P<0.05).两组不良反应发生率相仿(P>0.05).结论 与放疗同步PF化疗方案比较,放疗同步TP化疗可延迟或抑制肿瘤复发,提高患者的远期生存率,且不良反应无明显加重.

Dendritic cells (DC) are highly efficient antigen-presenting cells. DC may be used to create DC vaccines against cancer, but the optimal strategies remain to be elucidated. This study aimed to examine the benefits and adverse effects of using esophageal cancer cell antigens to stimulate DC to trigger the specific immune response in patients with esophageal cancer undergoing radiotherapy. This was an observational cohort study performed at Lianshui County People’s Hospital between September 2010 and June 2012. Forty patients with esophageal cancer planned to receive radiotherapy were selected, and 28 received the DC vaccine. DC were isolated, loaded with antigens, and intradermally injected after being cultured for 1 week. One week after injection, the patients underwent a delayed-type hypersensitivity test. Serum Th1 cytokines [interleukin (IL)-2, IL-12, and interferon (IFN)-γ] and antigen-specific IFN-γ+CD8+ T cells were tested before and after vaccination. Patients were followed up for 2 years. Adverse events were monitored. Patients in the vaccine group tolerated the DC vaccine. Levels of serum IL-2 (+92.4%), IL-12 (+70.9%), and IFN-γ (+214.3%) as well as the proportion of IFN-γ+CD8+ T cells (3.0–16.4-fold) were significantly increased compared with baseline and the control group (all P<0.05). The 1- (82.1% vs. 50.0%, P=0.04) and 2-year survival (67.8% vs. 33.3%, P=0.04) was improved by vaccination. Only 2 patients showed mild fever. In conclusion, the DC vaccine triggered the specific immune response and induced the secretion of Th1 cytokines. The vaccine may lead to better survival, but this have to be confirmed. Adverse events were rare and mild.

目的 研究热休克凋亡自体食管癌肿瘤细胞抗原负载的树突状细胞(dendritic cell,DC)对激发食管癌患者特异性免疫应答的影响及治疗的临床疗效.方法 选择2010年11月至2013年6月就诊的手术治疗后食管鳞癌患者40例,随机分为研究组(28例)与对照组(12例).对照组行常规放疗,研究组采用放疗联合DC免疫治疗:(1)留取自体食管癌组织,经热休克处理(42℃,3h)后获得热休克凋亡食管癌抗原;(2)分离、培养外周血单个核细胞,其中贴壁细胞经过重组人粒细胞-单核细胞集落刺激因子(rhGM-CSF)、白细胞介素(IL)-4联合诱导为DC;(3)负载热休克抗原,培养1周后经患者腹股沟皮内注射,1周注射1次,共注射4次.在治疗后1周进行迟发型超敏反应(DTH)检测;在患者治疗前后进行血清中细胞因子和抗原特异性IFN-γ+ CD8+T细胞检测,并进行免疫学疗效评价.治疗后跟踪随访2年,对远期疗效进行评价.结果28例研究组食管癌患者对DC治疗耐受良好,治疗后患者血清中Th1型细胞因子(IL-2、IL-12、INF-γ)水平较治疗前和对照组治疗后均有显著提高(P均＜0.01).治疗后研究组IFN-γ+ CD8+T细胞比例较对照组有显著提高(P＜0.01),其中10例患者IFN-γ+CD8+T细胞比例升高2倍以上.12例食管癌患者DTH试验呈阳性反应,其中9例IFN-γ+ CD8+T细胞比例升高2倍以上.定期随访2年,两组均无脱落病例.研究组1年内死亡5例,存活82.14％;2年内共死亡9例,存活67.86％.对照组1年内死亡6例,存活50.00％;2年内共死亡8例,存活33.33％.研究组随访2年时生存比例大于对照组(P＜0.05).结论 负载食管癌肿瘤细胞热休克凋亡抗原的DC能激发患者的特异性免疫应答、诱导Th1型细胞因子的分泌,联合放疗远期疗效良好,是一种安全的治疗方法.

Objective:To explore the curative effect of operation,radiotherapy and photodynamic therapy in combi-nation with small dose of chemotherapy in the treatment of early glottic cancer.Methods:A retrospective analysis was performed on clinical data of 122 patients with early glottic cancer,and were divided into operation group(83 cases), radiotherapy group(20 cases),photodynamic therapy group(19 cases)according to treatment methods,were given joint of small dose chemotherapy.3,5 years survival rate and 2 years tumor free survival rate and local control rate at 2 years of the three groups were observed and compared.Results:Eight patients were lost to follow up,destined for death or recurrence.In 3 groups total of 6 patients died of laryngeal carcinoma,1 patient died in second primary malig-nant tumor,1 patient died of other diseases.Three patients of the 3 groups,the 5 years survival rate and 2 years tumor free survival rate and local control rate after 2 years were not significantly different(P >0.05).Complications oc-curred in 13 cases in operation group,2 cases occurred complications of photodynamic therapy group,radiotherapy group 7 cases with complications.A total of 27 cases developed recurrence and metastasis,including 4 cases of cervi-cal lymph node metastasis,23 cases of recurrence in primary lesion.Photodynamic therapy group and radiotherapy group,operation group were 5 cases,3 cases,15 cases relapsed.Conclusion:It have similar clinical efficacy of surger-y,radiotherapy and photodynamic therapy combined with low -dose chemotherapy in the treatment of early glottic car-cinoma.

Neoplatin plus 5-fluorouracil (5-FU) is the routine method to treat nasopharyngeal carcinoma. The present study aims to investigate the potential drug-drug interaction for this therapy regimen, and the therapeutic mechanism towards nasopharyngeal carcinoma. The inhibition of neoplatin + 5-FU towards human liver microsomes (HLMs)-catalyzed SN-38 (the active metabolite of irinotecan) glucuronidation was investigated. Metabolomics-based serum analysis was used to elucidate the therapeutic mechanism of neoplatin + 5-FU towards nasopharyngeal carcinoma. The results showed that neoplatin + 5-FU can inhibit HLMs-catalyzed SN-38 glucuronidation, indicating the potential drug-drug interaction between this treatment regimen with irinotecan. The treatment of neoplatin + 5-FU towards nasopharyngeal carcinoma was attributed to the prevention of neoplatin + 5-FU towards alteration of amino acids glutamine and glutamic acid. In conclusion, potential drug-drug interaction existed for the clinical application of neoplatin + 5-FU to treat nasopharyngeal carcinoma in which prevention of nasopharyngeal carcinoma-induced alteration of glutamine and glutamic acid is the potential mechanism.

目的 探讨紫杉醇加顺铂(TP)方案与顺铂加氟尿嘧啶(PF)方案化疗同步放疗对局部晚期喉癌的效果和毒性.方法 随机选取2011年3月-2014年10月南京医科大学附属淮安第一医院耳鼻喉科收治的局部晚期喉癌患者80例,依据治疗方法将这些患者分为TP组(n=40)和PF组(n=40),给予二组患者化疗同步放疗,然后对二组患者的近期疗效、毒性反应发生情况及生存情况进行统计分析.结果 TP组患者治疗的总有效率92.5％(37/40)显著高于PF组60.0％(24/40)(P＜0.05),Ⅲ～Ⅳ度放射性咽喉炎、胃肠道反应、骨髓抑制发生率均显著高于PF组(P＜0.05).结论 在局部晚期喉癌的治疗中,TP方案较PF方案化疗同步放疗具有较好的效果和较小的毒性.

BACKGROUND Unclear pathogenesis existed for nasopharyngeal carcinoma. AIMS to analyze the role of bile acids in the pathogenesis of nasopharyngeal carcinoma. METHODS 20 healthy volunteers and 20 patients with nasopharyngeal carcinoma were enrolled between January 1(st), 2013 and December 31(st), 2014. ESI-QTOF-MS analysis of serum was performed to find altered bile acids components. The biological function of changed bile acids was investigated using in vitro experiment. RESULTS Compared with healthy volunteers, the level of DCA and GDCA exhibited higher abundance in patients with nasopharyngeal carcinoma (p<0.01). Furthermore, the biological function was investigated for the inhibition of DCA and GDCA towards the secretion of IL-10 by CD4+CD25- T cells. Both DCA and GDCA significantly inhibited the secretion of IL-10 by CD4+CD25- T cells. Furthermore, DCA+GDCA can show stronger inhibition towards the secretion of IL-10 than DCA and GDCA. CONCLUSION The inhibition of IL-10 secretion by elevated DCA and GDCA components in nasopharyngeal carcinoma patients is the inducer for nasopharyngeal carcinoma.

Lasiodin-related potential drug-drug interaction and clinical therapy of lasiodin towards nasopharyngeal carcinoma were investigated in this study. In vitro inhibition of lasiodin towards the metabolism of irinotecan was investigated. Metabolomics-based analysis of serum was carried out towards healthy volunteers, treated and untreated nasopharyngeal carcinoma with lasiodin-containing Rabdosia serra tea. The results showed that lasiodin inhibited 30% activity of SN-38 glucuronidation. Metabolomics analysis showed that treatment with lasiodin-containing R. serra tea treatment presented the elevation of glutamic acid and reduction of glutamine in patients with nasopharyngeal carcinoma. In conclusion, lasiodin-related potential drug-drug interaction and clinical therapy of lasiodin towards nasopharyngeal carcinoma were demonstrated in the present study.

OBJECTIVE:The efficacy of postoperative concurrent radiochemotherapy (POCRT) on IIIA-pN2 non-small cell lung cancer (NSCLC) is still unclear. The aim of this randomized controlled trial was to compare POCRT with postoperative chemotherapy (POCT) alone in terms of survival and relapse patterns. METHODS:Patients with completely resected IIIA-pN2 NSCLC were randomized into POCRT or POCT groups. Chemotherapy consisted of paclitaxel (175 mg/m(2)) and cisplatin (60 mg/m(2)) administered intravenously for four cycles on day 1, 22, 43, and 64. Patients in the POCRT group received radiotherapy (50.4 Gy/28 fractions) concurrently with the first 2 cycles of chemotherapy. RESULTS:This study recruited 140 participants and was closed early because of slow accrual. Data were analyzed for 135 of them including 66 cases in the POCRT group and 69 cases in the POCT group. Patients were followed-up for a median period of 45 months. The POCRT group had a median survival (MS) of 40 months and a 5-year overall survival (OS) rate of 37.9%. The POCT group had a MS of 28 months and a 5-year OS rate of 27.5%. The hazard ratio for death in the POCRT group was 0.69 (95% CI: 0.457-1.044, P=0.073). We observed a disease-free survival (DFS) of 28 months and a 5-year DFS rate of 30.3% in the POCRT group. Likewise, we observed a DFS of 18 months and a 5-year DFS rate of 18.8% in the POCT group. The recurrence hazard ratio in the POCT group was 1.49 (95% CI: 1.008-2.204, P=0.041). Subgroup analysis revealed that POCRT significantly increased the OS rate of the patients with ≥2 pN2 lymph nodes (P=0.021). The POCRT group had a significantly lower local relapse (P=0.009) and distant metastasis (P=0.05) rates as compared to that of the POCT group. One case died of pyemia and 9 cases suffered from grade 3 and 4 acute radiation esophagitis. The two groups had similar and tolerable hematologic toxicities. CONCLUSIONS:Compared with POCT, POCRT increased both local/regional and distant DFS rate of the patients with IIIA-pN2 NSCLC, but not the OS rate. Considering the relatively small sample size of the current study, caution should be taken when adopting the conclusions.