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Wang YY, Zhou S, Zhao R, Hai P, Zhe H. The therapeutic response of CDDO-Me in the esophageal squamous cell carcinoma (ESCC) cells is mediated by CaMKIIα. Am J Transl Res 2016; 8:1695-1707. [PMID: 27186293 PMCID: PMC4859898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 04/12/2016] [Indexed: 06/05/2023]
Abstract
CDDO-Me has exhibited a potent anticancer effect in human esophageal squamous cell carcinoma (ESCC) cells in our previous study, but the molecular interactome remains elusive. We applied the approach of stable-isotope labeling by amino acids in cell culture (SILAC) to assess the proteomic responses of CDDO-Me treatment in human ESCC Ec109 cells. The data were subsequently validated using Western blot assay. The results of our study revealed that CDDO-Me increased the expression level of 543 protein molecules, but decreased the expression level of 709 protein molecules in Ec109 cells. Among these modulated protein molecules, calcium/calmodulin-dependent protein kinase type II subunit α (CaMKIIα) was highly expressed in all tested ESCC cell lines, whereas its expression levels were substantially lower in normal control cell line. Its silencing by small interfering RNA inhibited CDDO-Me induced apoptosis and autophagy in ESCC cells. Collectively, these data demonstrate that the therapeutic response of CDDO-Me in the human ESCC cells is mediated by CaMKIIα.
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Affiliation(s)
- Yan-Yang Wang
- Department of Radiation Oncology, General Hospital of Ningxia Medical UniversityYinchuan 750004, Ningxia, China
- Cancer Institute, Ningxia Medical UniversityYinchuan 750004, Ningxia, China
| | - Shun Zhou
- Graduated School, Ningxia Medical UniversityYinchuan 750004, Ningxia, China
| | - Ren Zhao
- Department of Radiation Oncology, General Hospital of Ningxia Medical UniversityYinchuan 750004, Ningxia, China
- Cancer Institute, Ningxia Medical UniversityYinchuan 750004, Ningxia, China
| | - Ping Hai
- Department of Radiation Oncology, General Hospital of Ningxia Medical UniversityYinchuan 750004, Ningxia, China
- Cancer Institute, Ningxia Medical UniversityYinchuan 750004, Ningxia, China
| | - Hong Zhe
- Department of Radiation Oncology, General Hospital of Ningxia Medical UniversityYinchuan 750004, Ningxia, China
- Cancer Institute, Ningxia Medical UniversityYinchuan 750004, Ningxia, China
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Rodríguez-Sanjuán JC, Gómez-Ruiz M, Trugeda-Carrera S, Manuel-Palazuelos C, López-Useros A, Gómez-Fleitas M. Laparoscopic and robot-assisted laparoscopic digestive surgery: Present and future directions. World J Gastroenterol 2016; 22:1975-2004. [PMID: 26877605 PMCID: PMC4726673 DOI: 10.3748/wjg.v22.i6.1975] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 06/20/2015] [Accepted: 11/30/2015] [Indexed: 02/06/2023] Open
Abstract
Laparoscopic surgery is applied today worldwide to most digestive procedures. In some of them, such as cholecystectomy, Nissen's fundoplication or obesity surgery, laparoscopy has become the standard in practice. In others, such as colon or gastric resection, the laparoscopic approach is frequently used and its usefulness is unquestionable. More complex procedures, such as esophageal, liver or pancreatic resections are, however, more infrequently performed, due to the high grade of skill necessary. As a result, there is less clinical evidence to support its implementation. In the recent years, robot-assisted laparoscopic surgery has been increasingly applied, again with little evidence for comparison with the conventional laparoscopic approach. This review will focus on the complex digestive procedures as well as those whose use in standard practice could be more controversial. Also novel robot-assisted procedures will be updated.
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Duan J, Deng T, Ying G, Huang D, Zhang H, Zhou L, Bai M, Li H, Yang H, Qu Y, Wang X, Ba Y. Prognostic nomogram for previously untreated patients with esophageal squamous cell carcinoma after esophagectomy followed by adjuvant chemotherapy. Jpn J Clin Oncol 2016; 46:336-43. [PMID: 26819278 DOI: 10.1093/jjco/hyv206] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 12/16/2015] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE The aim of the study was to establish an effective prognostic nomogram for esophageal squamous cell carcinoma after radical esophagectomy followed by adjuvant chemotherapy in those previously untreated patients. METHODS The clinicopathological data from 328 patients who underwent radical esophagectomy followed by adjuvant chemotherapy or not at the Tianjin Medical University Cancer Institute and Hospital between 2006 and 2010 were retrospectively studied. Nomograms which predicted survival of esophageal squamous cell carcinoma were established based on the Cox proportional hazards regression model. To determine its predictive accuracy and discriminatory capacity, the concordance index and calibration curve were calculated after bootstrapping in the internal validation. An external validation of 76 patients in 2011 was prospectively studied at the same institution. To verify the performance of the nomogram, the comparison between the nomogram and Tumor-Node-Metastasis staging system was conducted. RESULTS The 5-year overall survival was 43.1% in the primary cohort. Based on multivariate analyses, five independent prognostic variables including gender, tumor length, T stage, N stage and chemotherapy cycles were selected to build the nomograms to predict disease-free survival and overall survival. The concordance index of the nomogram to predict overall survival was 0.71 (95% confidence interval, 0.63-0.79), which was superior to the predictive power of Tumor-Node-Metastasis staging system (0.64) in the primary cohort. Meanwhile, the calibration curve showed good accuracy between predictive and actual overall survival. In the validation cohort, the concordance index (0.77) and calibration plot displayed favorable performances. The other nomogram to predict disease-free survival also performed well. CONCLUSIONS The prognostic nomogram provided individualized risk estimate of survival in patients after esophagectomy followed by adjuvant chemotherapy.
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Affiliation(s)
- Jingjing Duan
- Department of Gastrointestinal Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Ting Deng
- Department of Gastrointestinal Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Guoguang Ying
- Department of Gastrointestinal Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Dingzhi Huang
- Department of Gastrointestinal Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Haiyang Zhang
- Department of Gastrointestinal Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Likun Zhou
- Department of Gastrointestinal Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Ming Bai
- Department of Gastrointestinal Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Hongli Li
- Department of Gastrointestinal Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Huimin Yang
- Department of Gastrointestinal Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Yanjun Qu
- Department of Gastrointestinal Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Xia Wang
- Department of Gastrointestinal Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Yi Ba
- Department of Gastrointestinal Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
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Thirunavukarasu P, Gabriel E, Attwood K, Kukar M, Hochwald SN, Nurkin SJ. Nationwide analysis of short-term surgical outcomes of minimally invasive esophagectomy for malignancy. Int J Surg 2015; 25:69-75. [PMID: 26602969 DOI: 10.1016/j.ijsu.2015.11.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Revised: 11/11/2015] [Accepted: 11/17/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Minimally invasive esophagectomy (MIE) is being increasingly utilized for esophageal cancer. It is unclear if MIE if being safely performed with satisfactory outcomes across the USA. We aimed to analyze the short-term surgical outcomes of MIE as compared to open esophagectomy (OE). METHODS The National Cancer Database (NCDB) was queried for patients who underwent MIE or OE for esophageal malignancy between 2010 and 2011. Margin positivity, lymph node retrieval, 30-day mortality, 30-day unplanned readmission rate and hospital length of stay. RESULTS A total of 4047 patients were identified; 3050 (75.4%) underwent OE, and 997 (24.6%) underwent MIE. The proportion of MIE increased from 21.9% in 2010 to 27.4% in 2011 (p < 0.001). The conversion rate was 13.7%. There were no differences in-patient or tumor characteristics between the two cohorts. OE and MIE were comparable in terms of margin positive resection rate (7.4% vs. 8.1%, p = 0.48), 30-day unplanned readmission rate (7.6% vs. 7.2%, p = 0.64) and 30-day mortality rate (4.3% vs. 3.3%, p = 0.71). Compared to OE, MIE was associated with higher node retrieval (median 12 vs 14, p < 0.001), and shorter hospital stay (median 11.0 vs 10.0 days, p < 0.001). Logistic regression analysis showed that surgical approach (OE vs MIE) was not associated with 30-day mortality rate. In an ANCOVA analysis, MIE was independently associated with a shorter hospital stay compared to OE (estimated mean difference 1.57 ± 0.53 days, p = 0.003). MIE patients who underwent conversion had a longer hospital stay compared to those who did not (11.0 vs 10.0 days, p = 0.02). CONCLUSION MIE is being offered more frequently to patients with esophageal cancer, and maybe accompanied with better short-term outcomes including shorter hospital stay when compared to open esophagectomy.
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Affiliation(s)
| | - Emmanuel Gabriel
- Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Kristopher Attwood
- Department of Biostatistics and Bioinformatics, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Moshim Kukar
- Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Steven N Hochwald
- Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Steven J Nurkin
- Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA.
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Chen X, Zhang H, Zhu H, Yang X, Yang Y, Yang Y, Min H, Chen G, Liu J, Lu J, Cheng H, Sun X. Endostatin combined with radiotherapy suppresses vasculogenic mimicry formation through inhibition of epithelial-mesenchymal transition in esophageal cancer. Tumour Biol 2015; 37:4679-88. [PMID: 26511968 DOI: 10.1007/s13277-015-4284-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 10/19/2015] [Indexed: 02/08/2023] Open
Abstract
The growth of solid tumors requires angiogenesis to provide oxygen and nutrients and to support cell proliferation. The switch from an avascular to a vascular phenotype is typically related to acceleration of tumor growth. Anti-angiogenic therapy is becoming a very promising way for malignant tumors. Meanwhile, malignant tumor cells themselves were able to develop the formation of cell-lined vessels that contribute to tumor neovascularization and supply the nutrients and oxygen, which is called vasculogenic mimicry (VM). However, the molecular mechanism of VM remains unclear. The purpose of this study was to investigate the efficacy of the novel recombinant human endostatin (rh-Endo) protein combined with radiotherapy on human esophageal squamous cell carcinoma (ESCC) cell lines Eca-109 and TE13. Our results showed that rh-Endo combined with radiotherapy significantly inhibited the proliferation, migration, invasion, and VM of human esophageal cancer cells in a dose-dependent manner; however, it has no direct effect on apoptosis of carcinoma cells, which indicated that rh-Endo combined with radiotherapy significantly changed the microenvironment of esophageal carcinoma, and played an important role in preventing distant metastasis. Our findings suggested that rh-Endo inhibited the metastasis of esophageal cancer and the activation of AKT pathway, and the down-regulation of epithelial-mesenchymal transition (EMT) may be associated with such effect of rh-Endo. These results also supported the bright prospect of rh-Endo combined with radiotherapy for clinical applications in the future.
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Affiliation(s)
- Xiaochen Chen
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Hao Zhang
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Hongcheng Zhu
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xi Yang
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Yuehua Yang
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Yan Yang
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Hua Min
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Guangzong Chen
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Jia Liu
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Jing Lu
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Hongyan Cheng
- Department of General Internal Medicine, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xinchen Sun
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
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Zhu H, Yang X, Ding Y, Liu J, Lu J, Zhan L, Qin Q, Zhang H, Chen X, Yang Y, Yang Y, Liu Z, Yang M, Zhou X, Cheng H, Sun X. Recombinant human endostatin enhances the radioresponse in esophageal squamous cell carcinoma by normalizing tumor vasculature and reducing hypoxia. Sci Rep 2015; 5:14503. [PMID: 26412785 PMCID: PMC4585975 DOI: 10.1038/srep14503] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 08/26/2015] [Indexed: 02/06/2023] Open
Abstract
The aim of this study was to investigate the effect of recombinant human endostatin (rh-Endo) in combination with radiation therapy (RT) on esophageal squamous cell carcinoma (ESCC) and explore the potential mechanisms. ECA109-bearing nude mice were administered RT and/or rh-Endo treatment. Tumor volume, survival, hypoxia and vascular parameters were recorded during the treatment schedule and follow-up as measures of treatment response. ESCC cell lines (ECA109 and TE13) and human umbilical vein endothelial cells (HUVECs) were developed to investigate the outcomes and toxicities of rh-Endo and RT in vitro. Hypoxia inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) were also evaluated. In vivo studies of ECA109-bearing xenografts showed that rh-Endo improved the radioresponse, with normalization of tumor vasculature and a reduction in hypoxia. In vitro studies showed that rh-Endo did not radiosensitize ESCC cell lines but did affect endothelial cells with a time- and dose-dependent manner. Studies of the molecular mechanism indicated that the improved radioresponse might be due to crosstalk between cancer cells and endothelial cells involving HIF and VEGF expression. Our data suggest that rh-Endo may be a potential anti-angiogenic agent in ESCC especially when combined with RT. The improved radioresponse arises from normalization of tumor vasculature and a reduction in hypoxia.
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Affiliation(s)
- Hongcheng Zhu
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xi Yang
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yuqiong Ding
- Department of Radiation Oncology, Changzhou Cancer Hospital of Soochow University, Changzhou 213001, China
| | - Jia Liu
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Jing Lu
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Liangliang Zhan
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Qin Qin
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Hao Zhang
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xiaochen Chen
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yuehua Yang
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yan Yang
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Zheming Liu
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Meiling Yang
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xifa Zhou
- Department of Radiation Oncology, Changzhou Cancer Hospital of Soochow University, Changzhou 213001, China
| | - Hongyan Cheng
- Department of General Internal Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xinchen Sun
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
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Wang QY, Li JP, Zhang L, Jiang NQ, Wang ZL, Zhang XY. Mediastinoscopic esophagectomy for patients with early esophageal cancer. J Thorac Dis 2015; 7:1235-40. [PMID: 26380740 DOI: 10.3978/j.issn.2072-1439.2015.07.20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 07/13/2015] [Indexed: 11/14/2022]
Abstract
OBJECTIVE The purpose of this study was to detect the feasibility, safety, and effectiveness of mediastinoscopic esophagectomy for early esophageal cancer. METHODS The clinical data of 194 patients who underwent mediastinoscopic esophagectomy for early esophageal cancer in our center from December 2005 to October 2014 were retrospectively analyzed. RESULTS All the surgery was performed successfully. The average duration of thoracic surgery was 48.2±7.8 min and the average intra-operative blood loss was 128.1±34.5 mL. An average of 3.1±1.6 lymph node stations were dissected, with an average number of dissected lymph nodes being 9.38±6.2, among which 4.2±5.4 were mediastinal lymph nodes. No peri-operative mortality was noted, and the rate of peri-operative morbidity was 13.4%. The median duration of follow-up was 39 [3-108] months, and the overall survival was 72.73%. The overall survival rates significantly differed among different T stages; more specifically, the 5-year survival was 95.23% in patients with stage T1a esophageal cancer, 70.15% for T1b, and 55.56% for T2 (P<0.001). The overall survival was significantly better in patients with negative lymph nodes than those with lymph nodes metastasis (P=0.003); more specifically, the 5-year survival rate was 84.9% for N0, 62.5% for N1, and 50.0% for N2 + N3. CONCLUSIONS The mediastinoscopic esophagectomy can achieve a similar effectiveness as the conventional thoracoscopic surgery for patients with early stage esophageal cancer.
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Affiliation(s)
- Qian-Yun Wang
- 1 Department of Cardiothoracic Surgery, the Third Affiliated Hospital to Soochow University, Changzhou 213003, China ; 2 Department of Thoracic Surgery, Guangzhou Medical University First Affiliated Hospital, Guangzhou 213003, China
| | - Jing-Pei Li
- 1 Department of Cardiothoracic Surgery, the Third Affiliated Hospital to Soochow University, Changzhou 213003, China ; 2 Department of Thoracic Surgery, Guangzhou Medical University First Affiliated Hospital, Guangzhou 213003, China
| | - Lei Zhang
- 1 Department of Cardiothoracic Surgery, the Third Affiliated Hospital to Soochow University, Changzhou 213003, China ; 2 Department of Thoracic Surgery, Guangzhou Medical University First Affiliated Hospital, Guangzhou 213003, China
| | - Nan-Qing Jiang
- 1 Department of Cardiothoracic Surgery, the Third Affiliated Hospital to Soochow University, Changzhou 213003, China ; 2 Department of Thoracic Surgery, Guangzhou Medical University First Affiliated Hospital, Guangzhou 213003, China
| | - Zhong-Lin Wang
- 1 Department of Cardiothoracic Surgery, the Third Affiliated Hospital to Soochow University, Changzhou 213003, China ; 2 Department of Thoracic Surgery, Guangzhou Medical University First Affiliated Hospital, Guangzhou 213003, China
| | - Xiao-Ying Zhang
- 1 Department of Cardiothoracic Surgery, the Third Affiliated Hospital to Soochow University, Changzhou 213003, China ; 2 Department of Thoracic Surgery, Guangzhou Medical University First Affiliated Hospital, Guangzhou 213003, China
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Wang W, Zhou Y, Feng J, Mei Y. Oncological and surgical outcomes of minimally invasive versus open esophagectomy for esophageal squamous cell carcinoma: a matched-pair comparative study. Int J Clin Exp Med 2015; 8:15983-15990. [PMID: 26629102 PMCID: PMC4658991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Accepted: 06/23/2015] [Indexed: 06/05/2023]
Abstract
Only a few series have demonstrated the safety and efficacy of minimally invasive esophagectomy (MIE) for esophageal squamous cell carcinoma and the benefits of this approach. This report describes the results of a pair-matched comparative study between minimally invasive and open esophagectomy (OE) for esophageal squamous cell carcinoma. Patients were retrospectively matched in pairs for the following criteria: age, sex, American Society of Anesthesiology (ASA) score, clinical TNM stage, tumor location, and type of resection. A total of 97 patients undergoing MIE were compared with patients undergoing OE during the same period. Operative, postoperative, and oncologic outcomes were compared. Significantly less bleeding was observed in the MIE group (P = 0.001). Transfusion was required for three patients in the MIE group and ten patients in the OE group (P = 0.044). Overall morbidity was similar in the two groups. The hospital stay was significantly shorter for the patients undergoing MIE (P = 0.027). The surgical margin and tumor stage were not affected by MIE. The overall survival rates in the MIE group were 54% at 5 years and 46% in the OE group (P = 0.631). The disease-free survival rates in the MIE group were 45% at 5 years, 41% in the OE group (P = 0.704). In summary, MIE for esophageal squamous cell carcinoma for selected patients gave a better postoperative outcome without oncologic consequences.
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Affiliation(s)
- Wenli Wang
- Department of Thoracic Cardiovascular Surgery, Tongji Hospital of Tongji University No. 389 Xincun Road, Shanghai 200065, People's Republic of China
| | - Yongxin Zhou
- Department of Thoracic Cardiovascular Surgery, Tongji Hospital of Tongji University No. 389 Xincun Road, Shanghai 200065, People's Republic of China
| | - Jing Feng
- Department of Thoracic Cardiovascular Surgery, Tongji Hospital of Tongji University No. 389 Xincun Road, Shanghai 200065, People's Republic of China
| | - Yunqing Mei
- Department of Thoracic Cardiovascular Surgery, Tongji Hospital of Tongji University No. 389 Xincun Road, Shanghai 200065, People's Republic of China
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Chen X, Yang J, Peng J, Jiang H. Case-matched analysis of combined thoracoscopic-laparoscopic versus open esophagectomy for esophageal squamous cell carcinoma. Int J Clin Exp Med 2015; 8:13516-13523. [PMID: 26550289 PMCID: PMC4612974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 06/21/2015] [Indexed: 06/05/2023]
Abstract
The aim of this study is to evaluate surgical results and long-term survival of combined thoracoscopic-laparoscopic esophagectomy (TLE) performed for esophageal squamous cell carcinoma. Data of 59 patients with esophageal squamous cell carcinoma, undergoing TLE from January 2007 to January 2015, were compared to a control group of 59 patients who underwent open esophagectomy (OE) during the same period. The two groups were matched in terms of age, sex, American Society of Anesthesiology (ASA) score and clinical TNM stage. Laparoscopic approach resulted in longer operating time (P=0.003) and lower blood loss (P=0.000). There was no difference in perioperative morbidity and mortality rate; TLE approach was associated with a shorter hospital stay (P=0.000). After a mean follow up of 38 months, 5-year disease free survival and 5-year overall survival were 38% and 50% for TLE group, and 36% and 45% for OE group (P>0.05). TLE for esophageal squamous cell carcinoma is feasible and safe in selected patients and can result in good surgical results, with similar outcomes in terms of long-term outcomes.
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Affiliation(s)
- Xianglai Chen
- Department of Cardiothoracic Surgery, The Second Affiliated Hospital of Nanchang University 1 Minde Road, Nanchang 330006, Jiangxi, People's Republic of China
| | - Juesheng Yang
- Department of Cardiothoracic Surgery, The Second Affiliated Hospital of Nanchang University 1 Minde Road, Nanchang 330006, Jiangxi, People's Republic of China
| | - Jinhua Peng
- Department of Cardiothoracic Surgery, The Second Affiliated Hospital of Nanchang University 1 Minde Road, Nanchang 330006, Jiangxi, People's Republic of China
| | - Han Jiang
- Department of Cardiothoracic Surgery, The Second Affiliated Hospital of Nanchang University 1 Minde Road, Nanchang 330006, Jiangxi, People's Republic of China
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Understanding Complete Pathologic Response in Oesophageal Cancer: Implications for Management and Survival. Gastroenterol Res Pract 2015; 2015:518281. [PMID: 26246803 PMCID: PMC4515501 DOI: 10.1155/2015/518281] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 05/28/2015] [Accepted: 06/25/2015] [Indexed: 12/18/2022] Open
Abstract
Despite significant improvement over recent decades, oesophageal cancer survival rates remain poor. Neoadjuvant chemoradiotherapy followed by oesophageal resection is mainstay of therapy for resectable oesophageal tumours. Operative morbidity and mortality associated with oesophagectomy remain high and complications arise in up to 60% of patients. Management strategies have moved towards definitive chemoradiotherapy for a number of tumour sites (head and neck, cervical, and rectal) particularly for squamous pathology. We undertook to perform a review of the current status of morbidity and mortality associated with oesophagectomy, grading systems determining pathologic response, and data from clinical trials managing patients with definitive chemoradiotherapy to inform a discussion on the topic.
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Yan S, Tian S, Kang Q, Xia Y, Li C, Chen Q, Zhang S, Li Z. Rhizoma Paridis Saponins Suppresses Tumor Growth in a Rat Model of N-Nitrosomethylbenzylamine-Induced Esophageal Cancer by Inhibiting Cyclooxygenases-2 Pathway. PLoS One 2015; 10:e0131560. [PMID: 26147856 PMCID: PMC4493120 DOI: 10.1371/journal.pone.0131560] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 05/27/2015] [Indexed: 11/19/2022] Open
Abstract
Rhizoma Paridis Saponins (RPS), a natural compound purified from Rhizoma Paridis, has been found to inhibit cancer growth in vitro and in animal models of cancer. However, its effects on esophageal cancer remain unexplored. The purpose of this study was to investigate the effects of RPS on tumor growth in a rat model of esophageal cancer and the molecular mechanism underlying the effects. A rat model of esophageal cancer was established by subcutaneous injection of N-nitrosomethylbenzylamine (NMBA, 1mg/kg) for 10 weeks. RPS (350 mg/kg or 100mg/kg) was administered by oral gavage once daily for 24 weeks starting at the first NMBA injection. RPS significantly reduced the size and number of tumors in the esophagus of rats exposed to NMBA and inhibited the viability, migration, and invasion of esophageal cancer cells EC9706 and KYSE150 in a dose dependent manner (all P < 0.01). Flow cytometry revealed that RPS induced apoptosis and cell cycle G2/M arrest in the esophageal cancer cells. The expression of cyclooxygenases-2 (COX-2) and Cyclin D1 in rat esophageal tissues and the esophageal cancer cells were also significantly reduced by RPS (all P < 0.01). Consistently, RPS also significantly decreased the release of prostaglandin E2, a downstream molecule of COX-2, in a dose-dependent manner (P < 0.01). Our study suggests that RPS inhibit esophageal cancer development by promoting apoptosis and cell cycle arrest and inhibiting the COX-2 pathway. RPS might be a promising therapeutic agent for esophageal cancer.
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Affiliation(s)
- Shu Yan
- Departments of Pharmacology, Nankai Hospital, Tianjin, P. R. China
| | - Shuxia Tian
- Departments of Pharmacology, Nankai Hospital, Tianjin, P. R. China
| | - Qingwei Kang
- Departments of Pharmacology, Nankai Hospital, Tianjin, P. R. China
| | - Yafei Xia
- Departments of Pharmacology, Nankai Hospital, Tianjin, P. R. China
| | - Caixia Li
- Institute of Integrative Medicine Therapy for Acute Abdominal Diseases of Tianjin, Nankai Hospital, Tianjin, P. R. China
| | - Qing Chen
- Department of Pharmacology, Taizhou Hospital, Taizhou City, Zhejiang Province, P.R. China
| | - Shukun Zhang
- Institute of Integrative Medicine Therapy for Acute Abdominal Diseases of Tianjin, Nankai Hospital, Tianjin, P. R. China
| | - Zhigang Li
- Department of Thoracic Surgery, Nankai Hospital, Nankai District, Tianjin, P. R. China
- * E-mail:
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62
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Long Noncoding RNAs in Digestive System Malignancies: A Novel Class of Cancer Biomarkers and Therapeutic Targets? Gastroenterol Res Pract 2015; 2015:319861. [PMID: 26064090 PMCID: PMC4429197 DOI: 10.1155/2015/319861] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Accepted: 04/20/2015] [Indexed: 01/17/2023] Open
Abstract
High throughput methodologies have revealed the existence of an unexpectedly large number of long noncoding RNAs (lncRNAs). The unconventional role of lncRNAs in gene expression regulation and their broad implication in oncogenic and tumor suppressive pathways have introduced lncRNAs as novel biological tumor markers. The most prominent example of lncRNAs application in routine clinical practice is PCA3, a FDA-approved biomarker for prostate cancer. Regarding digestive system malignancies, the oncogenic HOTAIR is one of the most widely studied lncRNAs in the preclinical level and has already been identified as a potent prognostic marker for major malignancies of the gastrointestinal tract. Here, we provide an overview of recent findings regarding the emerging role of lncRNAs not only as key regulators of cancer initiation and progression in colon, stomach, pancreatic, liver, and esophageal cancers, but also as reliable tumor markers and therapeutic tools. lncRNAs can be easily, rapidly, and cost-effectively determined in tissues, serum, and gastric juice, making them highly versatile analytes. Taking also into consideration the largely unmet clinical need for early diagnosis and more accurate prognostic/predictive markers for gastrointestinal cancer patients, we comment upon the perspectives of lncRNAs as efficient molecular tools that could aid in the clinical management.
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Schmidt T, Sisic L, Sterzing F, Haag GM, Kunzmann R, Grenacher L, Weichert W, Jäger D, Büchler MW, Ott K. [Salvage surgery in esophageal cancer : Feasibility in patients after definitive radiochemotherapy (> 50 Gy)]. Chirurg 2015; 86:955-62. [PMID: 25715974 DOI: 10.1007/s00104-014-2971-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Salvage surgery as an additional therapy option is currently discussed for an increasing number of patients with esophageal cancer after definitive radio(chemo)therapy after tumor progression, recurrence or on explicit request of the patient. OBJECTIVES The objective of this study was an analysis of the surgical option of salvage esophagectomy after definitive radiation in patients with esophageal cancer. Additionally the current literature on this topic was evaluated. MATERIAL AND METHODS A total of 92 patients with esophageal cancer from a prospective database were included in this study who underwent esophagectomy either after neoadjuvant radio(chemo)therapy (< 50 Gy) or definitive radio(chemo)therapy (> 50 Gy) between 2002 and 2012. The analysis was performed retrospectively. RESULTS The median survival of the two groups of patients was not significantly different after initial diagnosis with 24.2 months (95 % CI 0.0-51.93) for patients undergoing definitive radio(chemo)therapy and 30.7 months (95 % CI 9.3-52.2) for patients after neoadjuvant therapy (p = 0.96). Both patient groups showed no differences in pretherapeutic characteristics and response to radio(chemo)therapy. Postoperative complications and perioperative mortality were not different. DISCUSSION Salvage esophagectomy is now an additional treatment option after definitive radio(chemo)therapy in patients with esophageal cancer. In preselected patients with tumor recurrence, progression or with a strong wish for surgical therapy, salvage surgery should be discussed in interdisciplinary tumor boards after exclusion of distant metastases.
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Affiliation(s)
- T Schmidt
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Deutschland
| | - L Sisic
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Deutschland
| | - F Sterzing
- Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Deutschland
| | - G-M Haag
- Department of Medical Oncology, National Center of Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Deutschland
| | - R Kunzmann
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Deutschland
| | - L Grenacher
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Deutschland
| | - W Weichert
- Department of Pathology, University of Heidelberg, Heidelberg, Deutschland
| | - D Jäger
- Department of Medical Oncology, National Center of Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Deutschland
| | - M W Büchler
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Deutschland
| | - K Ott
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Deutschland.
- Department of General, Vascular and Thoracic Surgery, Klinik für Allgemein-, Gefäß- und Thoraxchirurgie, RoMed Klinikum Rosenheim, Pettenkoferstr. 10, 83022, Rosenheim, Deutschland.
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Tabatabaei SA, Hashemi SM, Kelidari B. Transhiatal Esophagectomy without Mediastinal Manipulation for Lower Third Esophageal and Cardial Cancers: The First Experience of a New Technique. IRANIAN JOURNAL OF CANCER PREVENTION 2015; 8:89-93. [PMID: 25960847 PMCID: PMC4411469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 02/07/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Considering the poor survival rate of patients with esophageal cancers, mainly due to the disease effects and surgical co morbidities, we have aimed to introduce a new method of Transhiatal Esophagectomy (THE) without mediastinal manipulation for lower third esophageal and cardial cancers. It has suggested that using this technique would decrease mentioned complications. METHODS In this prospective study, patients with esophageal cancer who referred for surgical treatment have enrolled and undergone to new method of THE, without mediastinal manipulation. Pre and post-operative morbidities as well as the duration of procedure, duration of hospital and ICU stay have recorded. All patients have followed up or 4-40 months. RESULTS In this study 53 patients with mean age of 55.2+/-10.3 years have undergone esophagectomy, and then in 50 of them the new method has performed. Median operative time and volume of blood loss was 120 minutes and 130 ml, respectively. Median duration of hospital and ICU stay was 7 and 1 day, respectively. There were no Pre-operative mortalities, arrhythmia, hemodynamic instability and mediastinal vessels injury. The most common co morbidities have related to our new method were mediastinal pleura injury, anastomotic leaks and anastomotic narrowing with 20%, 16% and 10% reported rate, respectively. CONCLUSION The findings of current study have indicated that transhiatal esophagectomy without mediastinal manipulation, has represented a safe and effective method for treatment of lower third esophageal and cardial cancers due to its potential advantages of decreased blood loss, being a less traumatic procedure, minimal cardiopulmonary complications and low rate of hospital mortality.
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Affiliation(s)
- Seyed Abbas Tabatabaei
- Department of surgery, Isfahan University of Medical Science (IUMS), Isfahan, Iran,Corresponding Author:
Seyed Abbas Tabatabaei, MD.
| | | | - Behrooz Kelidari
- Department of surgery, Isfahan University of Medical Science (IUMS), Isfahan, Iran
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Pei C, Zeng G. Use of endoscopic ultrasound-based techniques in tumor of the guts and beyond. Chin J Cancer Res 2014; 26:644-6. [PMID: 25561760 PMCID: PMC4279201 DOI: 10.3978/j.issn.1000-9604.2014.12.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 11/21/2014] [Indexed: 01/19/2023] Open
Affiliation(s)
- Chu Pei
- State Key Laboratory of Respiratory Disease, National Clinical Center for Respiratory Diseases, Guangzhou Institute of Respiratory Diseases, First Affiliated Hospital, Guangzhou Medical University, Guangzhou 510120, China
| | - Guangqiao Zeng
- State Key Laboratory of Respiratory Disease, National Clinical Center for Respiratory Diseases, Guangzhou Institute of Respiratory Diseases, First Affiliated Hospital, Guangzhou Medical University, Guangzhou 510120, China
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Combined downregulation of microRNA-133a and microRNA-133b predicts chemosensitivity of patients with esophageal squamous cell carcinoma undergoing paclitaxel-based chemotherapy. Med Oncol 2014; 31:263. [PMID: 25280517 DOI: 10.1007/s12032-014-0263-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 09/19/2014] [Indexed: 12/15/2022]
Abstract
microRNA-133a (miR-133a) and miR-133b, located on chromosome 18 in the same bicistronic unit, have been commonly identified as being downregulated in esophageal squamous cell carcinoma (ESCC). The aim of this study was to investigate the correlation of miR-133a/b expression with efficacy of paclitaxel-based chemotherapy and clinical outcome of ESCC patients. miR-133a expression and miR-133b expression were examined in 100 newly diagnosed ESCC patients prior to treatment by quantitative real-time PCR. Then, the patients received four cycles of paclitaxel-based chemotherapy, the short-term treatment efficacy was evaluated, and a 3-year follow-up was performed. Expression levels of miR-133a and miR-133b were both significantly lower in ESCC tissues compared to adjacent noncancerous tissues (both P < 0.001). In addition, combined miR-133a/b downregulation was found to be closely correlated with advanced tumor stage (P = 0.02) and poor differentiation (P = 0.01). Moreover, the response rate of ESCC patients to paclitaxel-based chemotherapy was significantly higher in combined miR-133a/b downregulation group compared with other groups (P = 0.02). Furthermore, univariate and multivariate Cox analyses revealed that tumor stage and combined expression of miR-133a/b were independent prognosis factors in ESCC patients. Our data offer the convincing evidence that combined expression of miR-133a and miR-133b may predict chemosensitivity of patients with ESCC undergoing paclitaxel-based chemotherapy, implying its importance in applying 'personalized cancer medicine' in the clinical treatment of ESCC. We also identified combined expression of miR-133a and miR-133b as an effective prognostic marker of this malignancy.
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He J, Zeng ZC, Shi SM, Yang P. Clinical features, outcomes and treatment-related pneumonitis in elderly patients with esophageal carcinoma. World J Gastroenterol 2014; 20:13185-13190. [PMID: 25278715 PMCID: PMC4177500 DOI: 10.3748/wjg.v20.i36.13185] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 07/03/2014] [Accepted: 07/25/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the clinical features and prognoses of elderly patients with esophageal carcinoma and to compare the effects of radiotherapy and rates of treatment-related pneumonitis (TRP) between elderly and non-elderly patients.
METHODS: A total of 236 patients with esophageal carcinoma who received radiotherapy between 2002 and 2012 were enrolled. The patients were divided into two groups: an elderly group (age ≥ 65 years) and a non-elderly group (age < 65 years). The tumor position and stage, lymph node and distant metastases, and incidence and severity of TRP were compared. Multivariate analysis was applied to identify independent prognostic factors.
RESULTS: The median overall survival times after radiotherapy in the elderly and non-elderly groups were 18.5 and 20.5 mo, respectively. Cox regression analysis showed that TRP grade and tumor-node-metastasis (TNM) stage were independent prognostic factors in the elderly group. High-dose radiotherapy (> 60 Gy) was associated with a high incidence of TRP. Tumor TNM staging was significantly different between the two groups in which TRP occurred. Multivariate analysis showed that TNM stage was an independent prognostic factor. Esophageal carcinoma in elderly patients was relatively less malignant compared with that in non-elderly patients.
CONCLUSION: An appropriate dose should be used to decrease the incidence of TRP in radiotherapy, and intensity modulated radiation therapy should be selected if possible.
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Xing SZ, Zhang Y. Efficacy and safety of transdermal fentanyl for the treatment of oral mucositis pain caused by chemoradiotherapy in patients with esophageal squamous cell carcinoma. Support Care Cancer 2014; 23:753-9. [PMID: 25179692 DOI: 10.1007/s00520-014-2419-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Accepted: 08/25/2014] [Indexed: 12/22/2022]
Abstract
PURPOSE Oral mucositis is one of the most painful side effects found in esophageal squamous cell carcinoma (ESCC) patients treated with chemoradiotherapy. The transdermal route of administration is worthy of investigation for patients who suffer from dysphagia due to severe oral mucositis. In this phase 2 study, we investigated the efficacy and safety of transdermal fentanyl (TDF) for mucositis pain caused by chemoradiotherapy in ESCC patients. METHODS Forty-six ESCC patients who experienced moderate to severe oral mucosal pain during chemoradiotherapy received TDF for pain relief. The assessment of pain was made according to the Numeric Rating Scale (NRS). Efficacy and safety of TDF was collected and conducted in an open-label fashion. The analgesic effect, quality of life, and side effects were evaluated after the administration of transdermal fentanyl using the paired sample Wilcoxon signed rank test. RESULTS The mucositis-induced pain disappeared in 31 (67.4 %) patients during the treatment with transdermal fentanyl with the median time of onset at day 6.6 (range 3-14). The median Numeric Rating Scale (NRS) score was reduced from 6 (range 3-9) before treatment to 4.5 (range 2-9), 3 (range 2-8), 2.5 (range 1-8), 2 (range 0-6), and 0 (range 0-4) on days 3, 6, 9, 11, and 15, respectively, after treatment (P < 0.001). The patients' quality of life also improved significantly (P < 0.01). The side effects of treatment were mild and disappeared within several days. CONCLUSION Transdermal fentanyl is an effective, convenient, and well-tolerated treatment for mucositis pain caused by chemoradiotherapy, which can improve ESCC patients' quality of life.
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Affiliation(s)
- Shao-Zhi Xing
- Department of Oncology, School of Clinical Medicine, Binzhou Medical College, No.661, Yellow-River Second Street, 256603, Binzhou, China,
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