Long-term outcomes of alternating chemoradiotherapy in patients with advanced nasopharyngeal cancer: a single-centre experience over the last decade

SUMMARY

We assessed the long-term outcomes of alternating chemoradiotherapy (ACRT) using 5-fluorouracil and cisplatin (FP) in 25 patients with stage II or advanced nasopharyngeal cancer treated at our institution between April 1999 and April 2010. Median follow-up duration was 87 months (range 2-189). According to the 2009 TNM classification (UICC), six patients were in stage II, nine in stage III, and 10 in stage IV. Treatment completion, response and five-year survival rates were retrospectively assessed. ACRT was performed with a first course of chemotherapy administered followed by the initial round of radiotherapy (36 Gy). Then, a second course of chemotherapy with additional radiotherapy (20-30 Gy) was administered, followed by a final third course of chemotherapy. For chemotherapy, 5-fluorouracil (5-FU, 800 mg/m2/24 h) was intravenously administered for five days, and cisplatin (CDDP, 50 mg/m2/24 h) was administered on the last two days. Treatment completion rate was 96% (24 of 25 cases), and the response rate was 100% (CR: 24 cases and PR: 1 case). Additionally, the five-year overall survival rate was 89.3%. We have demonstrated that ACRT is an effective regimen to treat nasopharyngeal cancer, revealing higher treatment completion, response, and five-year overall survival rates compared with other combinatorial radiotherapy and chemotherapy treatment regimens.

Influence of cardiac output on the pseudo-steady state remifentanil and propofol concentrations in swine

BACKGROUND

The propofol concentration during constant infusion is affected by a change in cardiac output, but the effect of this change on remifentanil, which is frequently used in combination with propofol, is unclear.

METHODS

Ten swine were anaesthetised through inhalation of isoflurane and maintained with 1.5% isoflurane. After infusion of remifentanil (0.5 μg/kg/min) and propofol (6 mg/kg/h after 2 mg/kg bolus infusion) for 60 min (baseline 1), cardiac output was increased by continuous infusion of dobutamine and termination of isoflurane (high cardiac output state). Dobutamine infusion was then stopped, 1.5% isoflurane was restarted, and cardiac output was allowed to return to baseline (baseline 2). Finally, cardiac output was decreased by administration of 3% isoflurane (low cardiac output state). Blood samples were collected from the femoral artery at 10, 30, and 60 min after the change to each haemodynamic state.

RESULTS

An inverse relationship was found between cardiac output and the plasma remifentanil and propofol concentrations. The plasma drug concentrations were given by the following equations: [remifentanil] (ng/ml) = 17.5/cardiac output (l/min) + 4.52; and [propofol] (μg/ml) = 3.34/cardiac output + 1.17. The influence of changes in cardiac output on remifentanil were similar to those for coadministered propofol and the influence on the concentration of each drug was greater with decreasing cardiac output.

CONCLUSIONS

The plasma remifentanil concentration is influenced by cardiac output in a similar manner to that of propofol during remifentanil and propofol anaesthesia, although the metabolic sites are different.

STUDY OF THE GATE INSULATOR/SILICON INTERFACE UTILIZING SOFT AND HARD X-RAY PHOTOELECTRON SPECTROSCOPY AT SPring-8

The chemical structures of SiO 2/ Si interfaces were studied by photoelectron spectroscopy using high-brilliance soft X-ray with photon energy ranging from 500 to 1500 eV at Super Photon ring 8 GeV(SPring-8) and it is able to probe a depth of about 1.2 to 3 nm with energy resolution of 100 meV. On the other hand, high-brilliance hard X-ray with photon energy ranging from 6 to 10 keV is able to probe a depth of about 8.5 to 12.5 nm with energy resolution of 100 meV. Hard photoelectron spectroscopy are particularly useful for studying the composition and the chemical structure of transition layer at high-k dielectric/silicon interface.

Inhibition by fenoterol of human eosinophil functions including beta2-adrenoceptor-independent actions

Agonists at beta2 adrenoceptors are used widely as bronchodilators in treating bronchial asthma. These agents also may have important anti-inflammatory effects on eosinophils in asthma. We examined whether widely prescribed beta2-adrenoceptor agonists differ in ability to suppress stimulus-induced eosinophil effector functions such as superoxide anion (O2-) generation and degranulation. To examine involvement of cellular adhesion in such responses, we also investigated effects of beta2 agonists on cellular adhesion and on CD11b expression by human eosinophils. O2- was measured using chemiluminescence. Eosinophil degranulation and adhesion were assessed by a radioimmunoassay for eosinophil protein X (EPX). CD11b expression was measured by flow cytometry. Fenoterol inhibited platelet-activating factor (PAF)-induced O2- generation by eosinophils significantly more than salbutamol or procaterol. Fenoterol partially inhibited PAF-induced degranulation by eosinophils similarly to salbutamol or procaterol. Fenoterol inhibited phorbol myristate acetate (PMA)-induced O2- generation and degranulation by eosinophils, while salbutamol or procaterol did not. Fenoterol inhibition of PMA-induced O2- generation was not reversed by ICI-118551, a selective beta2-adrenoceptor antagonist. Fenoterol, but not salbutamol or procaterol, significantly inhibited PAF-induced eosinophil adhesion. Fenoterol inhibited O2- generation and degranulation more effectively than salbutamol or procaterol; these effects may include a component involving cellular adhesion. Inhibition also might include a component not mediated via beta2 adrenoceptors.

Combination of two types of transmissible drug-resistance factors in a host bacterium

Mitsuhashi, Susumu (Gunma University, Maebashi, Japan), Kenji Harada, Hajime Hashimoto, Mitsuo Kameda, and Mitsue Suzuki. Combination of two types of transmissible drug-resistance factors in a host bacterium. J. Bacteriol. 84:9-16. 1962.-When two types of R factor, R(TC) and R (CM.SM.SA), or R(TC) and R (CM), were brought together in a host bacterium by superinfection with both factors, loss of either one or both factors was found. In the imperfectly stable existence of both factors in a host bacterium, both factors were transmitted separately by conjugation. As the result of interaction between the two types of R factor present in a host bacterium, recombinant factors were formed, R(25) (TC.CM.SM.SA) and R(31) (CM.TC). The recombinant factors were able to transfer their resistance by conjugation. They were also transduced as one unit into Escherichia coli K12 by Plke phage in the same fashion as the original R(11) (TC.CM.SM.SA) and R(14) (CM.TC) factors independently isolated from dysenteric patients.

DRUG RESISTANCE OF ENTERIC BACTERIA. II. TRANSDUCTION OF TRANSMISSIBLE DRUG-RESISTANCE (R) FACTORS WITH PHAGE EPSILON

Harada, Kenji (Gunma University, Maebashi, Japan), Mitsuo Kameda, Mitsue Suzuki, and Susumu Mitsuhashi. Drug resistance of enteric bacteria. II. Transduction of transmissible drug-resistance (R) factors with phage epsilon. J. Bacteriol. 86:1332-1338. 1963.-Transmissible drug-resistance (R) factors, which transfer resistance to tetracycline (TC), chloramphenicol, streptomycin, and sulfonamide by cell-to-cell contact, were found to be transduced in the system of Salmonella E group with phage epsilon (epsilon(15) and epsilon(34)). The R(+) transductants of S. newington (S-84) and S. chittagong (S-224) were all found to be unable to transfer their R factors by conjugation, and their R factors were not eliminated by treatment with acridine dyes so far as tested. The R factors containing TC resistance were consistently segregated when transduced. At low multiplicities of infection, the R(+) transductants with epsilon(15) were all nonlysogenic and unable to produce normal epsilon(15) phage particles; among the R(+) transductants with epsilon(34), 34% were lysogenic and 66% were sensitive to epsilon(34).

DRUG RESISTANCE OF ENTERIC BACTERIA. 3. ACQUISITION OF TRANSFERABILITY OF NONTRANSMISSIBLE R(TC) FACTOR IN COOPERATION WITH F FACTOR AND FORMATION OF FR(TC)

Harada, Kenji (Gunma University, Maebashi, Japan), Mitsuo Kameda, Mitsue Suzuki, and Susumu Mitsuhashi. Drug resistance of enteric bacteria. III. Acquisition of transferability of nontransmissible R(TC) factor in cooperation with F factor and formation of FR(TC). J. Bacteriol. 88:1257-1265. 1964.-Transmissible drug-resistance factor R, which confers resistance to tetracycline, chloramphenicol, streptomycin, and sulfonamide, was previously found to be transduced in the system of the Salmonella E group with phage epsilon. The R factor of R(+) transductants was nontransmissible by cell-to-cell contact, and it was not eliminated by treatment with acridine dye. When R(+) transductants were infected with F factor, the nontransmissible R factor acquired transferability by conjugation. The R(+) conjugants, to which only the R factor was separately transmitted by conjugation from the (F(+)R(+)) donor, were still unable to transfer their R factor by conjugation. However, the (FR)(+) conjugants, to which both F and R factor were transmitted simultaneously by conjugation, were also capable of transferring their F and R factors by conjugation. From the present study, it was concluded that the recombinant (FR) factor was formed as a result of an interaction between F and R factors present in a host bacterium, and that one of the mechanisms of acquisition of transferability is accounted for by the formation of recombinant (FR) factor. The recombinant (FR) factor was transferable by conjugation, and it conferred both the drug-resistance and F(+) characters to the recipient cells. The (FR) factor was eliminated by treatment with acridine dye and also transduced as one unit into Escherichia coli K-12 by P1kc phage.