Background: Hepatic carcinoma (HCC) has rised in China because of hepatitis B virus(HBV) effection, it has been famous for devastating malignancy as well as little treatment effect for HCC Sorafenib, has been successfully applied for solid tumors such as renal cancer, hepatocellular carcinoma. Sorafenib used alone or combination with others can induce growth-inhibition and apoptosis in vitro experiment. Sorafenib now was suggested to advanced hepatic carcinoma patient unqualitied for hepatectomy and transplant. Methods: A team of advanced hepatic carcinoma patients were enrolled for Sorafenib monotherapy or combination with HIAC,TACE, systemtic chemotherapy with arsenic trioxide and octreotide on base of personal disease progress CT and level of AFP were used to assess the tumor effect for decision of next treatment plan, An individualization treatment plan was performed ultimately. Result: Patients of initially HCC were extended survival time by Sorafenib monotherapy or combination with HIAC and TACE. TACE made hepatic lesion stable, added therapy of arsenic trioxide could be able to make TACErefractory and lung metatasis lesion under control. Conclusion: Sorafenib monotherapy or combination with others added therapy on needs of patients personal disease progress can extend survival time. Sorafenib applied individually may be more effective.
The anticancer properties of Vitamin C (ascorbic acid o sodium ascorbate) are known since at least four decades, However, being a cheap and "natural" product, Vitamin C is not patentable and therefore has never been developed as an anticancer molecule. Recent in vitro investigations have confirmed the extraordinary antitumor properties of high doses of Vitamin C (sodium ascorbate), particularly when administered by the intravenous route, and phase I/II randomized, controlled clinical trials have been started to verify its anticancer properties in vivo. Unfortunately, the controlled clinical trials performed so far, do not confirm the extraordinary results obtained with Vitamin C (sodium ascorbate) in vitro. However, this may depend on a number of different factors, such as the pharmaceutical preparation (Sodium ascorbate may be more suitable than buffered ascorbic acid), the schedule of administration (slow infusion better than rapid infusion), tumor tissue oxygenation (Cancer tissue oxygenation is lower that oxygenation of tumor cell lines, in vitro), etc., which deserve further in depth investigation. Even with these limitations, Vitamin C (sodium ascorbate) in high doses, administered by intravenous route, beyond being extremely effective in vitro, against a number of human tumor cell lines, is safe, has minimal contraindications, improves the quality of life of patients, and is highly selective for cancer cells. The Authors discuss these important aspects and suggest possible solutions to improve the in vivo anticancer effects of Vitamin C (sodium ascorbate).
Introduction: Chemotherapy-induced nausea and vomiting are the most common side-effects feared by patients. Although significant advances have been made, chemotherapy-induced nausea and vomiting remain an important adverse effect of treatment.
Purpose: The purpose of our study was to evaluate the prevalence of chemotherapy-induced nausea and vomiting in an oncology day unit in France. We described then the management of this side-effect.
Methods: This retrospective mono-centric observational study assessed 65 patients in our oncology day unit. They all were on chemotherapy for solid tumors and should have had already received one cycle of chemotherapy. Patients were metastatic or treated with a curative intent. During three days, patients were asked if they had experienced nausea and/or vomiting after their last cycle of treatment.
Results: 65 patients were enrolled, 45 women (69%) and 20 men (31%). The median age was 63 years. 20 patients were elderly people. 48 patients were metastatic (74%) and 17(26%) were on neo-adjuvant or adjuvant therapy. 24 people (37%) experienced nausea (20 patients) or vomited (4 patients). Nausea was essentially grade I (60%). All patients received anti-emetic therapies. In the 24 patients who suffered from adverse effects, only 6 had corticosteroids, 15 had NK1 receptor inhibitors, 12 received 5-HT3 receptor inhibitors and 12 anti D2 treatments. 9 patients (14%) experienced refractory nausea and vomiting.
Conclusion: Even if guidelines exist and despite many therapeutics agents have improved patients’ quality of life in terms of nausea and vomiting, in some cases it seems not to be enough.
Background and objective: The aim of this study is to analyze anatomical distribution, timing and outcomes of recurrence after complete cytoreduction and perioperative chemotherapy for peritoneal metastasis from gastric cancer (GCPM). Method: Data of 193 GCPM patients who underwent a complete cytoreductive surgery (CRS) after treatment with neoadjuvant chemotherapy were entered into a prospective database and the recurrence was analyzed. Result: The median time to progression was 16.2 months, median overall survival (OS) was 21.6 months and 5-year survival rate was 18.1%. Five years after CRS, 11 patients were disease free survivors. Recurrence rate was 68.5% (126/184). Mutivariate analysis confirmed small bowel peritoneal cancer index of ≥3 and pathologic nonresponders after NAC as independent risk factors for recurrence. Patients were treated with systemic chemotherapy or second cytoreductive surgery for recurrence. However, survival after diagnosis of recurrence was poor with median survival of 2.9 months. The most common type of recurrence was diffuse peritoneal recurrence (71%, 90/126). Localized intra-abdominal recurrence was experienced in only 7 patients. Conclusion: Pathologic non-responders and small bowel PCI of ≥3 are independent risk factors for recurrence. Exploratory laparoscopy after NAC might be a useful strategy for the selection of patients for CRS.
Background and objectives: Advanced rectal cancers require local and systemic control. Chemo radiotherapy (CRT) is adequate to achieve adequate local control. Systemic control, however, is a dominant obstacle remained in debates. We compared oncology outcome in both arms in patients with advanced rectal cancers in order to identify high-risk group of distant metastasis. Methods: Data for 723 patients for advanced rectal cancer from 2005 to 2013 retrieved retrospectively. Patients were classified to CRT (n=364) or no CRT (n=359) arms. Results: CRT group showed greater local control and achieved pT stage 0, 1, or 2 in 43.7% vs. 28.4% in no CRT (p<0.001) and less CEA marker (11.17 ± 25.2 vs. 6.14 ± 11.3, p<0.001), respectively. Although CRT group had higher rates of advanced tumors, cT3 or T4 (341(93.7%) vs. 294(81.9%), p<0.001) and CRM threat (167 (45.9%) vs. 30(8.4%); p<0.001). Overall local recurrence rate observed in no CRT 3% compared to 2.1% in CRT arm, (p<0.005). Systemic recurrence rate was similar in both groups, (22.5% vs. 23%), respectively. Conclusion: CRT is efficient to downstage locally advanced rectal cancer, not systemic control though. Early recognition of high-risk group is recommended in order to consider CRT modification ahead of planned surgery.