Persistent high-risk human papillomavirus (HR-HPV) infection may increase the risk of malignancies in males, including penile, rectal, anal, prostate, bladder, and oropharyngeal cancers. However, few studies focused on the epidemiology of human papillomavirus (HPV) in male patients. This study aims to retrospectively investigate the trends of HPV molecular epidemiology in males residing in the plateau region of Southwest China from 2014 to 2024. This retrospective study investigated the trends of HPV molecular epidemiology in 3580 males residing in the plateau region of southwest China from 2014 to 2024. Samples were collected for DNA extraction, and detection of 27 HPV genotypes by Luminex xMAP technology. HPV prevalence fluctuated between 43.17

目的:比较使用重组人血小板生成素(rhTPO)与重组人白细胞介素-11(rhIL-11)预防卵巢癌化疗相关血小板减少症(CIT)的疗效和安全性.方法:入组Ⅱ度以上卵巢癌CIT患者68例,随机分为预防性注射rhTPO治疗组(34例)和预防性注射rhIL-11治疗组(34例),化疗后第一天、第二天用药.剂量:rhTPO 300 U/kg,rhIL-11 25～50 μg/kg.观察两组患者血小板下降情况、血小板开始恢复时间、血小板输注次数、治疗延迟及不良反应情况.结果:两组患者血小板下降程度均较本组预防性用药前有所改善,rhTPO组患者Ⅲ-Ⅳ度血小板下降比例较rhIL-11组患者明显减少,使用rhTPO的促血小板增殖效果明显高于rhIL-11.rhTPO治疗组血小板开始恢复时间与血小板恢复至100×109/L以上所需要时间较rhIL-11治疗组明显缩短,统计学差异显著.rhIL-11治疗组有1例患者化疗后输入外源性血小板,rhTPO治疗组无患者输注血小板.应用rhTPO及rhIL-11对患者凝血功能无明显影响.与rhIL-11相比,rhTPO较少发生不良反应,患者耐受性较好.结论:既往化疗出现Ⅱ度以上CIT的患者,预防性应用rhTPO和rhIL-11对CIT有积极的预防作用,rhTPO的疗效优于rhIL-11,并且具有良好的耐受性.

Although the prognosis of locally advanced cervical cancer has improved dramatically, survival for those with stage IIIB-IVA disease or lymph nodes metastasis remains poor. It is believed that the incorporation of intensity-modulated radiotherapy into the treatment of cervical cancer might yield an improved loco-regional control, whereas more cycles of more potent chemotherapy after the completion of concurrent chemotherapy was associated with a diminished distant metastasis. We therefore initiated a non-randomized prospective phaseII study to evaluate the feasibility of incorporating both these two treatment modality into the treatment of high risk locally advanced cervical cancer. To determine whether the incorporation of intensity-modulated radiotherapy and the addition of adjuvant paclitaxel plus cisplatin regimen into the treatment policy for patients with high risk locally advanced cervical cancer might improve their oncologic outcomes. Patients were enrolled if they had biopsy proven stage IIIA-IVA squamous cervical cancer or stage IIB disease with metastatic regional nodes. Intensity-modulated radiotherapy was delivered with dynamic multi-leaf collimators using 6MV photon beams. Prescription for PTV ranged from 45.0 50.0 Gy at 1.8 Gy 2.0 Gy/fraction in 25 fractions. Enlarged nodes were contoured separately and PTV-nodes were boosted simultaneously to a total dose of 50.0–65 Gy at 2.0- 2.6 Gy/fraction in 25 fractions. A total dose of 28 35 Gy high-dose- rate brachytherapy was prescribed to point A in 4 5 weekly fractions using an iridium- 192 source. Concurrent weekly intravenous cisplatin at 30 mg/m2 was initiated on the first day of radiotherapy for over 1-h during external-beam radiotherapy. Adjuvant chemotherapy was scheduled within 4 weeks after the completion of concurrent chemo-radiotherapy and repeated 3 weeks later. Paclitaxel 150 mg/m2 was given as a 3-h infusion on day1, followed by cisplatin 35 mg/m2 with 1-h infusion on day1-2 (70 mg/m2 in total). Fifty patients achieved complete response 4 weeks after the completion of the treatment protocol, whereas 2 patients had persistent disease. After a median follow-up period of 66 months, loco-regional (including 2 persistent disease), distant, and synchronous treatment failure occurred in 4,5, and 1, respectively. The 5-year disease-free survival, loco-regional recurrence-free survival, distant-metastasis recurrence-free survival was 80.5

Background: Lymph node metastasis (LNM) accounts for the most important route of metastasis for cervical cancer. Yet, the status of LNM is different in patients with similar clinico-pathological variables. It has been revealed that microRNAs are widely involved in the occurrence and development of various malignancies, and the tumor-suppressive or promoting effects of microRM-99 (miR-99) family have been previously reported. This study sought to investigate the predictive value of miR-99a for lymphogenous spread and its effect on the survival of patients with early-stage cervical squamous cell cancer (CSCC). Methods: Patients with stage IB squamous cervical cancer who were treated surgically between October 2015 and November 2018 were enrolled. A total of 21 formalin-fixed paraffin-embedded tissues of pathologically confirmed positive lymph nodes were retrieved, and an additional 21 tissues of negative lymph nodes from patients well-matched on baseline characteristics were collected as the control group. TaqMan real-time quantitative polymerase chain reaction was used to examine the expression levels of miR-99a in the samples. Differential expression levels of miR-99a were compared between the 2 groups using independent sample t-test. Furthermore, the associations between miR-99a expression level and clinico-pathological parameters of these 42 patients was evaluated by Chi-square test or Fisher's exact-probability method, and their effects on survival were assessed using Kaplan-Meier product-limit method. Results: There were no significant differences in baseline clinico-pathological parameters between the 2 groups (P>0.05). The expression levels of miR-99a in the node-positive group and control group were 1.61 +/- 3.09 and 16.77 +/- 30.40, respectively (P=0.029). Downregulated expression of miR-99a was dosely related to depth of invasion (DOI) and lymph-vascular space invasion (P<0.05). Univariate analysis revealed that downregulated miR-99a and deeper DOI were associated with worse 5-year disease-free survival, while multivariate analysis showed that only the expression level of miR-99a was an independent factor for disease-free survival (HR =0.120; 95% CI: 0.015-0.979; P=0.048). Patients with downregulated miR-99a tended to have more unfavorable overall survival, but the difference did not reach statistical significance. Conclusions: MiR-99a plays an inhibitory role in the pathogenesis of lymph node metastasis and may serve as a novel prognostic biomarker for patients with CSCC.

To investigate whether the Warburg effect is a key modulator on the resistance mechanism of photodynamic therapy (PDT). Glycolysis was examined by the test of lactate product and glucose uptake at different post-PDT time points. Cell viability was detected by the CCK-8 assay and cell proliferation was detected by colony formation assay. The expression of glycolysis and related proteins were examined by western blotting. Target gene was silenced by RNAi. In the present study, we assessed the effect of PDT on cancer cell glycolysis. Our team has demonstrated that pyruvate kinase M2 (PKM2), a key speed-limiting enzyme of glycolysis, was significantly overexpressed in patients with esophageal cancer. Our results in the present study showed that PKM2 was downregulated, and lactate product and glucose uptake were inhibited in cells exposed to 5-aminolevulinic acid (5-ALA)–mediated PDT at 4 h after treatment. However, at 24 h after PDT, we observed a substantial increase in PKM2 expression, lactate product, and glucose uptake. Moreover, silencing of PKM2 gene abrogated the upregulatory effect of PDT on glycolysis at late post-PDT period. 2-Deoxy-D-glucose (2-DG) is a recognized chemical inhibitor of glycolysis. The combined treatment of 2-DG and PDT significantly inhibited tumor growth in vitro at 24 h. These results demonstrate that PDT drives the Warburg effect in a time-dependent manner, and PKM2 plays an important role in this progress, which indicated that PKM2 may be a potential molecular target to increase the sensitivity of esophageal cancer cells to PDT.

Esophageal cancer, especially esophageal squamous cell carcinoma (ESCC) threatens so many lives in China every year. Traditional treatment of ESCC has usually been disappointing. The development of novel therapy is worth investigation. We have previously demonstrated that dihydroartemisinin (DHA) has anticancer effect on esophageal cancer. However, the mechanism has not been completely known. In this present study, we explored the effect of DHA on cancer cell glycolysis, also known as Warburg effect. Pyruvate kinase M2 (PKM2) is a key regulatory factor of glycolysis, and our results showed that it is significantly overexpressed in patients with ESCC and ESCC cell lines. In DHA treatment cells, PKM2 was down-regulated and lactate product and glucose uptake were inhibited. Overexpression of PKM2 by lentiviral transfection abrogated the inhibition effect of DHA. These results suggested that DHA might repress esophageal cancer glycolysis partly by down-regulating PKM2 expression. We believe that DHA might be a prospective agent against esophageal cancer.

Eukaryotic elongation factor 2 kinase (eEF-2K) is known as calcium/calmodulin-dependent protein kinase III and identified as a calcium/calmodulin (Ca2+/CaM)-dependent protein kinase (CaM-PK) that phosphorylates its only substrate eukaryotic elongation factor-2 (eEF-2) and blocks the ability of eEF-2 to bind the ribosome and translation elongation and inhibits global protein synthesis. The activators of eEF-2K include allosteric activator Ca/CaM, Ca/CaM-independent activator cAMP-dependent protein kinase (PKA) and H+. On the other hand, eEF-2K is inactivated by the mammalian target of rapamycin complex 1 (mTORC1) signaling pathway. However, the role of eEF-2K in cancer is not well understood. To provide opinion for the diagnosis and treatment of cancer, we summarized the role of eEF-2K in cancer. Based on the fundamental research on eEF-2K, scientists further investigated the role of eEF-2K in cancer and have reported its different effects in many kinds of cancer. eEF-2K involves in many signal pathways, including proliferation, apoptosis, autophagy, invasion and glycolysis, and promotes the development of cancer as an oncogene. Inhibition of eEF-2K by eEF-2K siRNA and little molecular inhibitors resulted in the suppression of proliferation, autophagy, invasion and glycolysis, and accelerate apoptosis to play an antitumor role. In this review, we summarize the regulation and role of eEF-2K in cancer as an oncogene and the exploitation of the inhibitor of eEF-2K. Combined treatment of eEF-2K inhibitor and chemotherapeutics should be a potential tool in cancer therapy.

Objective: To evaluate the significance of different clinicopathologic features on prognosis of patients with squamous cell carcinoma of vulva. Methods: We retrospectively analyzed the prognostic relevance of different clinicopathological variables of 201 patients with squamous cell carcinoma of vulva treated in Cancer Hospital, Chinese Academy of Medical Sciences. The data including age, initial symptoms, stage, location, tumor size, histological grade, number and size of metastatic lymph nodes, treatment mode, and presence of leukoplakia vulva was used to evaluate the prognosis of vulvar squamous cell carcinoma. Results: The median age of onset was 62.0 years old, with 74 patients in stage Ⅰ, 27 in stage Ⅱ, 55 in stage Ⅲ and 9 in stage Ⅳ. The median progression-free survival was 90.0 months. The 5-year progression-free survival rate of the total patients was 55.5%, while the 10-year progression-free survival rate was 48.5%. Univariate analysis showed statistically significant prognostic parameters included clinical stage, number of metastatic lymph nodes, tumor size and treatment mode (all P<0.001). Multivariate analysis showed that number of metastatic lymph nodes (P<0.05) was an independent prognostic factor for progression-free survival. Conclusion: The study illustrates that number of metastatic lymph nodes represents important independent factor for progression-free survival of patients with vulvar squamous cell carcinoma.

目的 分析ⅠA1期宫颈癌患者的临床特征及宫颈冷刀锥切治疗的有效性及安全性.方法 选取采用宫颈冷刀锥切初次治疗的74例ⅠA1期宫颈癌患者的病历资料进行回顾性分析,分析其临床特征、预后及生育情况.结果 74例采用宫颈冷刀锥切治疗患者中,35例(47.3％)患者术前阴道镜下活检病理提示宫颈微小浸润癌,而13例患者锥切术后病理未发现浸润性病变;活检病理为CIN而锥切术后病理诊断为ⅠA1期宫颈癌的患者有39例(52.7％).冷刀锥切术后病理诊断显示,35例(47.3％)为多灶性浸润,39例(52.7％)为单灶性浸润;62例(83.8％)患者病变浸润深度≤2 mm;2例(2.7％)有淋巴脉管间隙受侵.本组患者的中位随访时间为70.3个月,5年无复发生存率为95.1％,总生存率为100％,2例(2.7％)患者出现复发(1例于冷刀锥切术后5年半出现全身多发淋巴结转移行化疗,另1例为术后4年盆腔局部复发给予放化疗).74例患者中,发病年龄≤45岁有64例(86.5％),其中6例患者术后自然妊娠,但仅3例完成生育(1例足月顺产,1例足月剖宫产,1例早产),另2例行人工流产术,1例因胚胎停育行清宫术.结论 宫颈冷刀锥切术可安全有效地治疗要求保留生育功能(或保留子宫)的ⅠA1期宫颈癌患者,病灶浸润深度与术后复发、转移可能有关,而病灶状态(多灶性浸润与单灶性浸润)、淋巴脉管间隙是否受侵与患者术后的复发、转移无关,术后应长期严密随诊.

Despite recent advances in chemotherapy and surgical resection, the 5-year survival rate of esophageal cancer still remains at the low level. Therefore, it is very important to discover a new agent to improve the life expectancy of patients with esophageal cancer. Dihydroartemisinin (DHA), a semisynthetic derivative of artemisinin, has recently exhibited promising anticancer activity against various cancer cells. But so far, the specific mechanism remains unclear. We have previously demonstrated that DHA reduced viability of esophageal cancer cells in a dose-dependent manner in vitro and induced cell cycle arrest and apoptosis. Here, we extended our study to further observe the efficacy of DHA on esophageal cancer cells in vivo. In the present study, for the first time, we found that DHA significantly inhibits cell proliferation in xenografted tumor compared with the control. The mechanism was that DHA induced cell apoptosis in both human esophageal cancer cell lines Eca109 and Ec9706 in vivo in a dose-dependent manner. The results suggested that DHA was a promising agent against esophageal cancer in the clinical treatment.

OBJECTIVE:This study aimed to investigate the role of neoadjuvant bleomycin, etoposide, and cisplatin (BEP) regimen in patients with extensively advanced yolk sac tumors (YSTs). METHODS:Between July 1982 and December 2015, a total of 58 patients with YST were initially treated at our institution, among which 18 were evaluated to be inoperable and received neoadjuvant BEP regimen. They were either too debilitated by the disease [Eastern Cooperative Oncology Group Performance Status Scale (ECOG ps) ≥2] to undergo a major surgery or were with too extensively disseminated lesions to be optimally debulked. This cohort of patients was retrospectively reviewed. RESULTS:One or 2 cycles of BEP regimen were prescribed to the majority of patients preoperatively. At the completion of neoadjuvant chemotherapy, 17 of them had ECOG ps of 1 or less. Seventeen (94.4%) exhibited clinical partial tumor regression, and 1 (5.6%) had clinical stable disease. Pathological complete tumor regression was observed in 2 (11.1%) patients, whereas the remaining 16 (88.9%) had nearly complete pathological regression. Seventeen patients were cytoreduced to no macroscopic residual disease; the remaining 1 was cytoreduced to macroscopic residual disease of 2 cm or less. No major surgical complications occurred. After a median follow-up of 83.5 months, 17 patients were free of recurrence. Five-year disease-free survival and overall survival were both 94.4%. Fertility-sparing surgery was carried out in all the 17 patients with the desire to preserve their fertility, and 5 infants were delivered in 6 patients who attempted conception. CONCLUSIONS:One or 2 cycles of neoadjuvant BEP regimen followed by cytoreductive surgery offer a chance for cure in extensively advanced patients with YSTs and help pave the way for fertility-sparing surgery.

Background/Aims: Although photodynamic therapy (PDT) can relieve esophageal obstruction and prolong survival time of patients with esophageal cancer, it can induce nuclear factor-kappa B (NF-κB) activation in many cancers, which plays a negative role in PDT. Dihydroartemisinin (DHA), the most potent artemisinin derivative, can enhance the effect of PDT on esophageal cancer cells. However, the mechanism is still unclear. Methods: We generated stable cell lines expressing the super-repressor form of the NF-κB inhibitor IκBα and cell lines with lentivirus vector-mediated silencing of the HIF-1α gene. Esophageal xenograft tumors were created by subcutaneous injection of Eca109 cells into BALB/c nude mice. Four treatment groups were analyzed: a control group, photosensitizer alone group, light alone group, and PDT group. NF-κB expression was detected by an electrophoretic mobility shift assay, hypoxia-inducible factor α (HIF-1α) and vascular endothelial growth factor (VEGF) by real-time PCR, NF-κB, HIF-1α, and VEGF protein by western blot, and Ki-67, HIF-1α, VEGF, and NF-κB protein by immunohistochemistry. Results: PDT increased NF-κB activity and the gene expression of HIF-1α and VEGF in vitro and in vivo. In contrast, the DHA groups, particularly the combined DHA and PDT treatment group, abolished the effect. The combined treatment significantly inhibited tumor growth in vitro and in vivo. NF-κB activity and HIF-1α expression were also reduced in the stable IκBα expression group, whereas the former showed no change in HIF-1α-silenced cells. Conclusion: DHA might increase the sensitivity of esophageal cancer cells to PDT by inhibiting the NF-κB/HIF-1α/VEGF pathway.

5570 Background: Due to the highly aggressive biological behavior and early intra-abdominal spread potential of ovarian yolk sac tumor (YST), a considerable proportion of patients were inoperalbe at initial diagnosis. The aim of this study was to investigate the role of neoadjuvant chemotherapy (NACT) in this cohort of patients. Methods: Between July 1982 and December 2015, 58 patients diagnosed as YSTs were initially treated at Cancer Hospital of China Academy of Medical Science (CAMS), among which 18 were evaluated to be inoperable and received NACT. They were either too debilitated by the disease (ECOG ps≥2) to undergo a major surgery, or were with too extensively disseminated lesions to be optimally debulked. Massive ascites, pleural effusion, dyspnea, neoplastic fever, hypoproteinemia, or electrolyte disturbance were also common in these 18 patients. This cohort of patients was retrospectively reviewed. Results: One or 2 cycles of BEP regimens were prescribed to the majority of patients preoperatively. At the completion of NACT, all the 18 patients had ECOG ps≤1 . Seventeen of them (94.4%) exhibited clinical partial tumor regression and 1(5.6%) had clinical stable disease. Pathological complete tumor regression was observed in 2 (11.1%) patients, whereas the remaining 16(88.9%) had nearly complete pathological response. All these 18 patients were rendered operable at the completion of NACT, yielding a resection rate of 100%. Seventeen patients (94.4%) were cytoreduced to no macroscopic residual disease, 1 (5.6%) patient was cyto-reduced to macroscopic residual disease ≤2 cm. No major surgical complications occurred in our series. After a median follow-up of 83.5 months, 17 patients were free of recurrence. Five-year DFS and OS were both 94.4%. Fertility-sparing surgery was carried out in all the 17 patients with fertility desire, and 5 infants were delivered in 6 patients who attempted conception. Conclusions: One or 2 cycles of NACT followed by early cyto-reductive surgery offers a chance for cure in patients with extensively advanced YSTs. It allows for a more through and safe cyto-reductive surgery, improves survival outcomes, and helps pave the way for fertility-sparing surgery.

Controversy remains over whether random cervical biopsies and endocervical curettage (ECC) should be used in women with positive screening but negative colposcopy. Our paper aims to determine the indications for random biopsies and ECC among these screened positive women.Three thousand two hundred thirteen women with any positive screening test result but negative colposcopy, who received random 4-quadrant biopsies, were pooled from 17 population-based cervical cancer screening studies done in China from 1999 to 2008. The detection rates of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) and CIN grade 3 or worse (CIN3+) stratified by cytology and high-risk human papillomavirus (HR-HPV) status were assessed, as well as the false negative rates for CIN2+ and CIN3+ by random biopsies without ECC.Compared with women with negative cytology and positive HR-HPV, those with atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesion (ASC-US/LSIL) and negative HR-HPV had the equivalent lower risks of CIN2+ and CIN3+, but ascending risks were observed in the groups of ASC-US/LSIL and positive HR-HPV, and atypical glandular cells/atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion/high-grade squamous intraepithelial lesion or worse (AGC/ASC-H/HSIL+). If random biopsies were only taken without ECC, 9.3% of CIN2+ and 18.5% of CIN3+ would have been missed.For women with any positive screening but negative colposcopy, in areas with good cytological infrastructure, it was necessary to perform random biopsies plus ECC on those with cytological ASC-US/LSIL and positive HR-HPV, AGC, ASC-H, or HSIL+. In contrast, those with other results should be followed up.

卵巢癌的死亡率居妇科恶性肿瘤首位，5年生存率为30％左右［1］。目前，铂类药物联合紫杉醇已成为卵巢癌术后的一线标准化疗方案。已知临床上卵巢癌患者对铂类药物疗效存在明显个体差异，铂类耐药是化疗失败的主要原因［2］。研究表明，单核苷酸多态性是基因多态性的主要形式，是决定药物敏感性差异的主要因素，可作为临床预测指标［3－5］。

Objective To investigate the expression of the has-miR-141 in the serum of patients with endometrial can-cer and the clinical significance. Method 55 blood samples from patients with endometrial cancer, and in the same peri-od 12 serum samples from patients with hysteromyoma were collected within 24 h before surgery, while another 5 blood samples were collected from healthy volunteers as control, then real-time quantitative PCR was used to detect the expres-sion of has-miR-141 in those specimens, and the correlation between clinical pathological risk factors and the expression of has-miR-141 in 55 cases of endometrial cancer was analyzed. Result The expression of has-miR-141 in endometrial cancer patients (2.6295±2.038) was significant higher than that in control group (1.561±0.695) (P<0.05). The expression of has-miR-141 was closely related with pathological types, lymph node metastasis and clinical staging (P<0.05). The ex-pressions in patients with non-endometrioid adenocarcinoma, lymph node metastasis and at stage III-IV were higher than those with endometrioid adenocarcinoma, without lymph node metastasis and at stage I-II. The expressions were of no sta-tistically significant difference (P>0.05) in patients with different histopathological stages, age and CA125 levels. Conclu-sion The has-miR-141 is highly expressed in the serum of patients with endometrial cancer, and is closely related with lymph node metastasis, pathological types and clinical staging, making it a promising alternative predictor in diagnosis of endometrial cancer, furthermore it may play a role in determining the progression of advanced endometrial cancer, provid-ing evidence for the early diagnosis and treatment of endometrial cancer.

A sex cord tumor with annular tubules (SCTAT) is a rare but distinctive subtype of sex cord stromal tumor of the ovary. Its clinical features depend on an association with Peutz-Jeghers syndrome (PJS). SCTAT associated with PJS typically manifests as bilateral, multifocal, and small lesions and is clinically benign. In contrast, SCTAT not associated with PJS often manifests as a unilateral large mass and 20% of such tumors have malignant potential. Most patients with SCTAT are diagnosed at stage I, and metastasis is rare. Here we present a case of malignant SCTAT of stage III A1(ii) (retroperitoneal lymph node metastasis, largest dimension of metastasis >10 mm) in a 14-year-old girl without PJS.

肿瘤患者的个体化治疗与疗效和预后的关系日益受到重视，而完善的分子诊断技术是实现个体化治疗的基础和前提。在恶性肿瘤的风险评估、早期诊断、分子分型、肿瘤生物学行为预测、预后评估、药物筛选、疗效监测等研究和临床应用方面，分子诊断技术已体现出巨大的优势。但目前分子诊断技术在寻找卵巢癌新的治疗靶点、指导卵巢癌的靶向治疗、预测卵巢癌患者的预后及指导复发性卵巢癌的个体化治疗方面的应用研究较少，还需要进一步积累数据。

Objective To evaluate the short-term effect of topotecan (Hycamtin) in the treatment of advanced recurrent gynecologic cancer and its hematological toxicity.Methods Twenty patients with advanced recurrent gynecologic cancer from November 2011 to February 2014 were recruited and randomly divided into weekly therapy group (11 cases) receiving topotecan every week [3.5 mg/(m2 · d) at the 1st,8th and 15th,repeated every 28 days] and monthly therapy group (9 cases) receiving topotecan (single or combined use) every month [1.25 mg/(m2 · d),from the 1st-5th,repeated every 21 days].The median course of treatment was three.The administration method,recurrence type,clinical response,course number and extent of myelosuppression were observed.Results No complete response was recorded among the 20 patients,there were 2 of partial response,10 of stable disease and 8 of disease progression.Five patients in weekly therapy group and 7 in monthly therapy group (including 3 of drug combination) had clinical improvement.There were 5 patients of platinum-sensitive,among them 4 cases had improvement,there were 15 cases with platinum-resistant,among them 8 cases had improvement.Grades 3 or 4 myelosuppression occurred in 4 patients including 3 of monthly therapy group and 1 of weekly therapy group,suggesting less hematological toxicity of monthly therapy project.Conclusions Topotecan shows good effect in the treatment of advanced recurrence gynecologic cancer patients with platinum-sensitive or not type and weekly administration can be well tolerated with less hematological toxicity.

The aim of this study was to investigate the clinical effect of bevacizumab (BEV) combined with chemotherapy in advanced or recurrent uterine sarcoma. The clinical data of 4 patients with advanced or recurrenct uterine sarcoma, who received treatment with BEV combined with chemotherapy in our hospital between May, 2006 and May, 2014, were retrospectively analyzed. We estimated the chemotherapy response rate [complete response (CR) + partial response (PR)], clinical benefit rate [CR + PR+ stable disease (SD)], progression-free survival (PFS) and overall survival (OS), and evaluated treatment safety and toxicity reactions. Of the 4 patients, 1 achieved CR, with a disease-free survival time of 96 months; 1 achieved PR, with a PFS of 13 months and an OS of 25 months; 1 achieved SD, with a PFS of 9 months and an OS of 24 months; and 1 developed progressive disease, with a PFS of 3 months and an OS of 9 months. The response rate (CR+PR) was 50%, and the clinical benefit rate (CR+PR+SD) was 75%. Treatment-related adverse reactions occurred in all 4 patients, including bone marrow suppression and gastrointestinal reactions. Of the 4 patients, 1 developed grade 4 bone marrow suppression (thrombocytopenia), whereas the remaining 3 patients developed grade 2 bone marrow suppression (leukopenia). Of the 4 cases, 2 developed grade 2 gastrointestinal reactions, and the remaining 2 patients grade 1 gastrointestinal reactions. Therefore, BEV combined with chemotherapy was able to effectively control advanced or recurrent uterine sarcoma, was well-tolerated, and is considered to be a safe and effective candidate treatment for this type of tumor.