Combined treatment with photodynamic therapy and chemotherapy for advanced cardiac cancers

In all, 144 patients with advanced cardiac cancers have been treated by photodynamic therapy (PDT), combined chemotherapy and chemotherapy alone from September 1982 to July 1990. A total of 5 mg kg-1 haematoporphyrin derivative (HpD) was intravenously given 48-72 h prior to PDT. The light source was an argon dye laser with an output beam of 630 nm. The irradiation time varied between 12 and 25 min with a fluence of 100-350 mW cm-2. The entire tumour was irradiated with a light dose of 100-250 J cm-2. The combination of UFT and mitomycin C was used as standard chemotherapy. There were 26 responders out of 55 patients (47.3%) in the group treated with PDT alone, 24 out of 41 (58.5%) in the PDT+chemotherapy group, and 24 out of 48 (50.0%) in the chemotherapy alone group. In the PDT+chemotherapy group 19.5% patients had complete remission, which was better than the other two groups (5.5%, 8.3%, p less than 0.05). The following survey of all patients lasted from six months to seven years. The results suggest that a combination of PDT and chemotherapy may prove effective.

A new haplotype of the beta-globin gene complex, Hbbw1, in Chinese wild mouse

A new pattern was observed in the electrophoretic survey of the hemoglobin beta chain (Hbb) in Chinese wild mice, Mus musculus. The electrophoretic mobility of the major component of the new Hbb was identical to that of Hbbs on cellulose acetate plate, although it was almost identical to that of Hbbd or Hbbp on acrylamide gel. This suggests that the major component of Chinese Hbb has a unique primary structure. A minor component of the new Hbb was completely different from that of the other three Hbb haplotypes well known. These results indicate that the Hbb-b1 and Hbb-b2 of the new Hbb haplotype, assigned Hbbw1, are unique genes in their molecular structure. So far, Hbbw1 has been observed in northwestern China.

Acquisition of two endogenous ecotropic murine leukemia viruses in distinct Asian wild mouse populations

Wild mouse DNAs were analyzed for two types of endogenous ecotropic murine leukemia viruses (MuLVs), Akv and Fv-4r-associated MuLV. Endogenous Akv viruses were found only in northern Chinese mice, Korean mice, and Japanese (Mus musculus molossinus) mice. The Fv-4r gene, which is a truncated endogenous MuLV with ecotropic interference properties, was carried by Southeast Asian (M. m. castaneus) mice, Korean mice, and M. m. molossinus. Sequences related to Fv-4r MuLV env were found only in M. m. castaneus. These findings suggest that endogenous Akv viruses were acquired by northern Chinese mice and that the Fv-4r gene or its related endogenous MuLVs were acquired independently by M. m. castaneus. The Fv-4r gene appears to have been generated hundreds of thousands of years ago, before the amplification of the Fv-4r-related endogenous MuLVs in M. m. castaneus. The coexistence of Akv viruses and the Fv-4r gene in M. m. molossinus may be explained by the hybrid origin of M. m. molossinus in crosses between northern Chinese mice and M. m. castaneus, as described in other articles. The absence of the Fv-4r-related endogenous MuLVs in M. m. molossinus may indicate that the ancestral mice of this subspecies either were an ancient type of M. m. castaneus that had acquired the Fv-4r gene but had not yet acquired the Fv-4r-related endogenous MuLVs or were a rare fraction of a mixed population of M. m. castaneus and northern Chinese mice.

Evaluation of photodynamic therapy in advanced gastrointestinal cancer

One hundred forty-two patients with advanced gastrointestinal cancers were treated by PDT from September 1982 to December 1988. Hematoporphyrin derivative (HpD) (5 mg/kg) was given intravenously 48-72 hours before PDT. The light source was an argon dye laser with an output beam of 630 nm. The entire tumor was irradiated with a light dose of 100-250 J/cm 2. Fifteen patients (10.6%) had a complete response, 53 (37.3%) had a partial response, and 32 (22.5%) had a mild response. In all, 100 patients (70.4%) had a response to PDT. The experiments and clinical results show that the estimated energy dose (EED) value 200-250 J/cm 2 is appropriate. All patients were treated by PDT and adjuvant chemotherapy and showed good results with a follow-up of 1-5 years. Thirteen of 15 patients in the CR group are alive (86.7%), and 12 patients survived more than 2 years (8.8%).

Review of photodynamic therapy for gastrointestinal tumours in the past 6 years in China

Patients (142) with advanced gastrointestinal (GI) cancers were treated by photodynamic therapy (PDT) from September 1982 to December 1988. Haematoporphyrin derivative (HpD) (5 mg kg-1) was intravenously given 48-72 h prior to PDT. The light source was an argon dye laser emitting at 630 nm. The entire tumour was irradiated with a light dose of 100-250 J cm-2. Fifteen patients (10.6%) showed complete response (CR), 53 (37.3%) showed partial response (PR) and 32 (22.5%) showed mild response (MR). The clinical results show that the estimated energy dose (EED) of 200-250 J cm-2 is appropriate. All patients were treated by PDT and adjuvant chemotherapy showing good results with a follow-up of 1-5 years; 13 out of 15 patients in the CR group are alive (86.7%); 12 patients survived more than 2 years (8.8%).

Photodynamic therapy in the treatment of malignant tumours: an analysis of 540 cases

Malignant tumours (540 cases), including tumours of the lung, oesophagus, cardia, stomach, rectum, bladder, other urinary genital organs, face and mouth, eyes, ear, nose and throat (ENT), head and neck, breast and skin, were treated using photodynamic therapy (PDT) between 1982 and 1985 in Beijing. All of the cases were identified pathologically and the patients received haematoporphyrin derivative (HPD) (5 mg kg-1) intravenously 48-72 h prior to PDT. An argon-pumped dye laser emitting at 630 nm was used for the treatment. The results were as follows: complete response (CR) was obtained in 227 cases (42.1%), partial response (PR) was obtained in 114 cases (21.1%), mild response (MR) was obtained in 120 cases (22.2%) and 79 cases (14.6%) showed no response (NR). The effectiveness of PDT in the different organs was compared. HPD fluorescence was examined in 409 cases of malignant tumours: 344 lesions (84.1%) revealed red fluorescence (positive reaction), 32 gave an equivocal response and 33 gave a negative reaction. Positive fluorescence was seen in all types of malignant tumour in our study. Indications and limitations of PDT for the different organs are discussed and compared.

[Combined UFTM for 140 patients with advanced gastric cancer]

140 patients with advanced gastric cancer confirmed by pathology were treated by UFT (Uracil, FT-207) and mitomycin C (MMC) from Sept. 1985 to June 1987. All the patients received UFT #3 T. i. d. to a total dose of 30 g. Mitomycin C, 8-20 mg i. v. Q. wk was given to a total dose of 48-60 mg. Of the 140 patients, 65 had cancer of cardia, 36 cancer of gastric body, and 39 cancer of gastric antrum. There were 125 males and 15 females. The ages ranged from 30 to 80 years. In this series, CR was 10.0% and PR 44.3% with total remission rate of 54.3% (76/140). Thirty-four patients receiving UFT alone as control had a response rate of 26.5%. The response rate was higher in patients treated with UFTM than those with UFT alone. The median remission was 4 months. That main side effects were leukopenia and thrombocytopenia. The results showed that combination chemotherapy (UFTM) was valid in treating advanced gastric cancer.

[Pathologic study on the treatment-effect of hematoporphyrin derivative in carcinoma of the gastric cardia]

42 patients with carcinoma of gastric cardia treated by HPD are reported. The endoscopic biopsy specimens of these patients were classified histologically before treatment. There were 2 papillary adenocarcinoma (PAC), 14 well differentiated adenocarcinoma (WDAC), 11 moderate differentiated adenocarcinoma (MDAC), 5 poor differentiated adenocarcinoma (PDAC), 6 mucinous adenocarcinoma (MAC), 1 undifferentiated carcinoma (UDC) and 3 squamous cell carcinoma (SCC). After four weeks' treatment, reexaminations by endoscopy and biopsy were done in 39 patients and operation were performed on three. Histologic changes following the treatment were degeneration, necrosis of tumor cells, and infiltration of lymphocytes and plasmacytes in the stroma to different degrees. The histologic changes were graded into H0, H1, H2 and H3 by the authors. Grades H0, H1 are considered as noneffective and grades H2, H3 as effective. Of 42 patients, 10 were H0, 21 H1, 8 H2 and 3 H3. The overall effective rate was 26.2% (11/42) which was correlated with the histologic type of carcinoma. Thus, 21.4% (3/14) of WDAC, 18% (2/11) of MDAC, 40% (2/5) of PDAC, 50% (3/6) of MAC and 100% (1/1) of UDC responded well to the treatment, but all SCC and PAC were refractory. It should also be noted that the HPD treatment was effective in patients with tumor infiltrations relatively limited and superficial in the gastric wall, but was unsatisfactory in patients with wider and deeper infiltrations.

[Photo-chemistry therapy of gastrointestinal tumor--analysis of hematoporphyrin derivative (HpD) plus laser photodynamic therapy of 50 cases]

This paper reports 50 cases of gastrointestinal tumors treated by photodynamic therapy. The dose of HpD was 5 mg/kg. Fourty-eight to 72 hours after HpD injection, laser (wavelength 630 nm, power density 100-250 J/cm2), transmitted through a quartz fiber, was given. The criteria of therapeutic effectiveness were: complete remission (CR), significant remission (SR), minor remission (MR) and no remission (NR). All patients received endoscopic examination 4 weeks after treatment. No severe complication was observed. Thirty-eight of 50 cases gave CR, SR or MR (76%). The factors effecting treatment are discussed.

Hematoporphyrin derivative and laser photodynamical reaction in the diagnosis and treatment of malignant tumors

This paper reports the use of hematoporphyrin derivative (HpD) with laser activation in China for the diagnosis and treatment of various kinds of malignant neoplasms. Fluorescence observation for diagnosis was performed for 170 tumors. One hundred and fifty-one (88.8%) fluoresced visably upon excitation with either argon or He-Cd laser light. One hundred and thirty-nine malignant tumors in 136 patients were treated by this method. The percentage of all tumors responding to treatment was 80.6%. Partial to complete response were obtained in 51.1% of the tumors treated. The advantages and disadvantages of this method are discussed. It was found effective in treating various kinds of neoplasms located at different anatomical sites. The penetrating depth of the laser is shallow. This limits its effect and application. A search for new photosensitizing drugs and an increase in the penetrating depth of laser irradiation are urgent goals for further development of this technique.