26, published a paper, said the researchers developed a gene mapping tool that can better diagnose and treatment of common tumors.
According to Agence France-Presse reported, this study focused on mapping the most common and deadly brain tumor molecular characteristics of early, resulting in nuclear magnetic resonance scanning to distinguish it belongs to what type of seeds.
The paper published in the United States, "National Academy of Sciences" magazine published an advance on. Paper the main author, University of California, San Diego, Michael? Guo (sound) said that the same method can also be used to better identify other tumor types.
Guo and his research team used samples to be tested in vivo for different sub-types of cancer genetic structure, mapping, and these results provide in vivo mapping of samples of patients with MRI scan results were compared.
He said: "This is a powerful, scalable technology. It can be with different combination of scanning technology, but also can be applied to different types of tumors, such as liver cancer."
Although this technology for clinical applications still need to undergo further tests before, but it can help doctors confirm the future, what kind of treatment for the tumor sub-types of what to design a better treatment programs.
Guo said: "The medical goal is the right medicine. This technology has the potential are showing signs that might help us achieve this goal the initial prospects."
Sunday, February 7, 2010
Friday, February 5, 2010
Peritoneal mesothelioma drug therapy
Peritoneal mesothelioma (peritoneal mesothelioma) for the primary in the peritoneal epithelium and mesothelial cancer organizations, clinical rare. Can be categorized as pathological adenomatoid mesothelioma (adenomatoid mesothelioma), cystic mesothelioma (cystic mesothelioma) and malignant mesothelioma (peritoneal malignant mesothelioma, PMM).
Peritoneal mesothelioma (peritoneal mesothelioma) for the primary in the peritoneal epithelium and mesothelial cancer organizations, clinical rare. Can be categorized as pathological adenomatoid mesothelioma (adenomatoid mesothelioma), cystic mesothelioma (cystic mesothelioma) and malignant mesothelioma (peritoneal malignant mesothelioma, PMM). The first two are benign. Cystic mesothelioma more common in women, the cause is unknown, occur in the pelvic or accessories around, showing single or multiple cystic masses; patients often palpable abdominal mass due to the treatment. Malignant peritoneal mesothelioma (PMM) account for about 30% of malignant mesothelioma; its occurrence is closely related with exposure to asbestos, about 5% of patients had history of exposure; asbestos fiber intake by mouth, after translocation through the intestinal wall into the peritoneal and pleural metastasis from disease or from. From exposure to asbestos to diagnosis, the disease incubation period of up to 25 to 40 years. But the domestic 1951 ~ 1993 20 reported in the literature 161 cases of PMM in only 1 case had history of exposure to asbestos. ZHOU Ya-kang and other reported 47 cases of mesothelioma there are eight cases of malignant peritoneal mesothelioma, as well as the author collected two cases have history of exposure to asbestos. In the absence of asbestos-exposed populations, its incidence rate is about 1 person / 1 million person-years may be related to certain viral infections and genetic factors. PMM has reported 1 cases of foreign patients come into contact with more than 40 years ago, thorium dioxide colloid (Thorotrast). PMM often occurs in men over the age of 40. Visceral or parietal peritoneum can suffer from; and tumors can be a direct violation of abdominal and pelvic organs; 50% ~ 70% of patients with lymphatic and / or hematogenous metastasis of liver, kidney, adrenal gland, lung, bone and so on.
Treatment
PMM moderately sensitive to chemotherapy drug. Preoperative induction chemotherapy, surgery and postoperative adjuvant chemotherapy could reduce tumor recurrence and improve 3-year survival rate.
PMM effects of chemical treatment of certain drugs doxorubicin, cisplatin, carboplatin, bleomycin and domestic anti-cancer drugs Eiemene so. Vincristine, fluorouracil, cyclophosphamide, mitomycin, also worth a try. Doxorubicin (Adriamycin, ADM) for each adult 30 ~ 60mg/m2, every 3 weeks a time, intravenous or intraperitoneal injection, total dose not exceed 550mg/m2. Adverse reactions to cardiac toxicity, as the, and there is accumulation of sex, and the total dose-related; followed by bone marrow suppression, gastrointestinal reactions and hair loss.
Cisplatin (Cisplatin, DDP, cis-platinum) Adult per 80 ~ 120mg/m2, every 3 weeks a time; or 20mg/m2, used in conjunction 5 days every 3 weeks for a course of treatment, intravenous injection. Adverse reactions are nephrotoxicity, ototoxicity, neurotoxicity, gastrointestinal reactions and inhibit bone marrow. Mannitol was added to reduce the accumulation in renal tubules.
Carboplatin (Carboplatin, CBP) for adults for each 300 ~ 400mg/m2, 5% glucose solution or saline, the diluted to the concentration of 0.5mg/ml solution, intravenous drip, repeated every 3 ~ 4 weeks, or 100mg / d by adding 500ml of 5% glucose solution intravenously qd for 5 days; 3 ~ 4 weeks to repeat one time. Can also be used for each intraperitoneal injection of 300 ~ 500mg per week, an times.
Bleomycin (Bleomycin, BLM) for adults 15 ~ 30mg, dissolved in an appropriate saline or 5% glucose solution in the deep intramuscular injection, intravenous injection or intravenous drip, 2 times per week; also be replaced by a second depending on the circumstances / d, or several times a week. Can also be used intraperitoneal injection of 60mg slowly dissolved. Stey intraperitoneal injection with BLM treatment of 1 case PMM patients, the results of ascites disappeared after stopping does not occur again, survive more than 3 years. However, BLM intraperitoneal injection of large doses can cause pneumonia-like symptoms, or pulmonary fibrosis; In addition, fever, gastrointestinal reactions more common, occurring allergic individual patients.
Taxol (Paclitaxel) This product is extracted from the bark of Taxus anticancer drugs, by inducing and promoting tubulin polymerization and stability to prevent depolymerization of microtubules, inhibit cell division and proliferation. Paclitaxel can inhibit mitotic microtubule network required for regeneration, prevent the formation of the mitotic spindle leading to chromosome breaks, inhibition of tumor cell replication. Dose of 135 ~ 175 mg/m2, diluted in normal saline or 5% glucose solution intravenously. Repeated every 3 weeks. 12 hours before treatment should be given dexamethasone 20 mg, 30 ~ 60 minutes ago to be intravenous diphenhydramine 50 mg and cimetidine 300 mg or ranitidine 200 mg, to prevent allergic reactions. Cis-platinum combined with about 66.7% of patients on the force and capability by its toxicity. Adverse reactions are bone marrow suppression, allergic reactions, arthralgia, myalgia, gastrointestinal reactions, peripheral neuropathy, syncope, ataxia, and injection site pain and swelling and so on.
Eiemene (Elemene) Curcuma extract of traditional Chinese medicine to the anti-cancer active substance; chest, intra-abdominal perfusion in the treatment of malignant chest, ascites has good curative effect. In as far as possible after the extraction ascites by intraperitoneal injection of 200 ~ 400mg/m2 usage, 1 ~ 2 times a week. The incidence of adverse reactions was 20% ~ 70%, mainly fever, chills and pain; such as a pre-injection of a small amount of narcotic drugs and hormones, are able to prevent them; other allergic reactions, gastrointestinal reactions.
Cyclophosphamide (CTX) for adults for each 600 ~ 1200mg, week 1 ~ 2 times, intravenous injection. After treatment of bone marrow suppression, gastrointestinal reactions and hemorrhagic adverse events than those in common bladder Yandeng.
Vincristine (VCR) for adults per 2.5 ~ 8mg/m2, week 1, intravenous injection, total volume of 60 ~ 80mg, major adverse reactions of bone marrow suppression.
Methotrexate (MTX) for adults every 15 ~ 50mg, week 1 ~ 2 times, muscle or intravenously. Side effects are bone marrow suppression, gastrointestinal reactions, stomatitis, liver and kidney dysfunction, etc., long-term medication can cause pulmonary fibrosis.
Peritoneal mesothelioma (peritoneal mesothelioma) for the primary in the peritoneal epithelium and mesothelial cancer organizations, clinical rare. Can be categorized as pathological adenomatoid mesothelioma (adenomatoid mesothelioma), cystic mesothelioma (cystic mesothelioma) and malignant mesothelioma (peritoneal malignant mesothelioma, PMM). The first two are benign. Cystic mesothelioma more common in women, the cause is unknown, occur in the pelvic or accessories around, showing single or multiple cystic masses; patients often palpable abdominal mass due to the treatment. Malignant peritoneal mesothelioma (PMM) account for about 30% of malignant mesothelioma; its occurrence is closely related with exposure to asbestos, about 5% of patients had history of exposure; asbestos fiber intake by mouth, after translocation through the intestinal wall into the peritoneal and pleural metastasis from disease or from. From exposure to asbestos to diagnosis, the disease incubation period of up to 25 to 40 years. But the domestic 1951 ~ 1993 20 reported in the literature 161 cases of PMM in only 1 case had history of exposure to asbestos. ZHOU Ya-kang and other reported 47 cases of mesothelioma there are eight cases of malignant peritoneal mesothelioma, as well as the author collected two cases have history of exposure to asbestos. In the absence of asbestos-exposed populations, its incidence rate is about 1 person / 1 million person-years may be related to certain viral infections and genetic factors. PMM has reported 1 cases of foreign patients come into contact with more than 40 years ago, thorium dioxide colloid (Thorotrast). PMM often occurs in men over the age of 40. Visceral or parietal peritoneum can suffer from; and tumors can be a direct violation of abdominal and pelvic organs; 50% ~ 70% of patients with lymphatic and / or hematogenous metastasis of liver, kidney, adrenal gland, lung, bone and so on.
Treatment
PMM moderately sensitive to chemotherapy drug. Preoperative induction chemotherapy, surgery and postoperative adjuvant chemotherapy could reduce tumor recurrence and improve 3-year survival rate.
PMM effects of chemical treatment of certain drugs doxorubicin, cisplatin, carboplatin, bleomycin and domestic anti-cancer drugs Eiemene so. Vincristine, fluorouracil, cyclophosphamide, mitomycin, also worth a try. Doxorubicin (Adriamycin, ADM) for each adult 30 ~ 60mg/m2, every 3 weeks a time, intravenous or intraperitoneal injection, total dose not exceed 550mg/m2. Adverse reactions to cardiac toxicity, as the, and there is accumulation of sex, and the total dose-related; followed by bone marrow suppression, gastrointestinal reactions and hair loss.
Cisplatin (Cisplatin, DDP, cis-platinum) Adult per 80 ~ 120mg/m2, every 3 weeks a time; or 20mg/m2, used in conjunction 5 days every 3 weeks for a course of treatment, intravenous injection. Adverse reactions are nephrotoxicity, ototoxicity, neurotoxicity, gastrointestinal reactions and inhibit bone marrow. Mannitol was added to reduce the accumulation in renal tubules.
Carboplatin (Carboplatin, CBP) for adults for each 300 ~ 400mg/m2, 5% glucose solution or saline, the diluted to the concentration of 0.5mg/ml solution, intravenous drip, repeated every 3 ~ 4 weeks, or 100mg / d by adding 500ml of 5% glucose solution intravenously qd for 5 days; 3 ~ 4 weeks to repeat one time. Can also be used for each intraperitoneal injection of 300 ~ 500mg per week, an times.
Bleomycin (Bleomycin, BLM) for adults 15 ~ 30mg, dissolved in an appropriate saline or 5% glucose solution in the deep intramuscular injection, intravenous injection or intravenous drip, 2 times per week; also be replaced by a second depending on the circumstances / d, or several times a week. Can also be used intraperitoneal injection of 60mg slowly dissolved. Stey intraperitoneal injection with BLM treatment of 1 case PMM patients, the results of ascites disappeared after stopping does not occur again, survive more than 3 years. However, BLM intraperitoneal injection of large doses can cause pneumonia-like symptoms, or pulmonary fibrosis; In addition, fever, gastrointestinal reactions more common, occurring allergic individual patients.
Taxol (Paclitaxel) This product is extracted from the bark of Taxus anticancer drugs, by inducing and promoting tubulin polymerization and stability to prevent depolymerization of microtubules, inhibit cell division and proliferation. Paclitaxel can inhibit mitotic microtubule network required for regeneration, prevent the formation of the mitotic spindle leading to chromosome breaks, inhibition of tumor cell replication. Dose of 135 ~ 175 mg/m2, diluted in normal saline or 5% glucose solution intravenously. Repeated every 3 weeks. 12 hours before treatment should be given dexamethasone 20 mg, 30 ~ 60 minutes ago to be intravenous diphenhydramine 50 mg and cimetidine 300 mg or ranitidine 200 mg, to prevent allergic reactions. Cis-platinum combined with about 66.7% of patients on the force and capability by its toxicity. Adverse reactions are bone marrow suppression, allergic reactions, arthralgia, myalgia, gastrointestinal reactions, peripheral neuropathy, syncope, ataxia, and injection site pain and swelling and so on.
Eiemene (Elemene) Curcuma extract of traditional Chinese medicine to the anti-cancer active substance; chest, intra-abdominal perfusion in the treatment of malignant chest, ascites has good curative effect. In as far as possible after the extraction ascites by intraperitoneal injection of 200 ~ 400mg/m2 usage, 1 ~ 2 times a week. The incidence of adverse reactions was 20% ~ 70%, mainly fever, chills and pain; such as a pre-injection of a small amount of narcotic drugs and hormones, are able to prevent them; other allergic reactions, gastrointestinal reactions.
Cyclophosphamide (CTX) for adults for each 600 ~ 1200mg, week 1 ~ 2 times, intravenous injection. After treatment of bone marrow suppression, gastrointestinal reactions and hemorrhagic adverse events than those in common bladder Yandeng.
Vincristine (VCR) for adults per 2.5 ~ 8mg/m2, week 1, intravenous injection, total volume of 60 ~ 80mg, major adverse reactions of bone marrow suppression.
Methotrexate (MTX) for adults every 15 ~ 50mg, week 1 ~ 2 times, muscle or intravenously. Side effects are bone marrow suppression, gastrointestinal reactions, stomatitis, liver and kidney dysfunction, etc., long-term medication can cause pulmonary fibrosis.
Monday, February 1, 2010
Peritoneal mesothelioma chemotherapy
Peritoneal mesothelioma (peritoneal mesothelioma) for the primary in the peritoneal epithelium and mesothelial cancer organizations, clinical rare. Can be categorized as pathological adenomatoid mesothelioma (adenomatoid mesothelioma), cystic mesothelioma (cystic mesothelioma) and malignant mesothelioma (peritoneal malignant mesothelioma, PMM).
Peritoneal mesothelioma (peritoneal mesothelioma) for the primary in the peritoneal epithelium and mesothelial cancer organizations, clinical rare. Can be categorized as pathological adenomatoid mesothelioma (adenomatoid mesothelioma), cystic mesothelioma (cystic mesothelioma) and malignant mesothelioma (peritoneal malignant mesothelioma, PMM). The first two are benign. Cystic mesothelioma more common in women, the cause is unknown, occur in the pelvic or accessories around, showing single or multiple cystic masses; patients often palpable abdominal mass due to the treatment. Malignant peritoneal mesothelioma (PMM) account for about 30% of malignant mesothelioma; its occurrence is closely related with exposure to asbestos, about 5% of patients had history of exposure; asbestos fiber intake by mouth, after translocation through the intestinal wall into the peritoneal and pleural metastasis from disease or from. From exposure to asbestos to diagnosis, the disease incubation period of up to 25 to 40 years. But the domestic 1951 ~ 1993 20 reported in the literature 161 cases of PMM in only 1 case had history of exposure to asbestos. ZHOU Ya-kang and other reported 47 cases of mesothelioma there are eight cases of malignant peritoneal mesothelioma, as well as the author collected two cases have history of exposure to asbestos. In the absence of asbestos-exposed populations, its incidence rate is about 1 person / 1 million person-years may be related to certain viral infections and genetic factors. PMM has reported 1 cases of foreign patients come into contact with more than 40 years ago, thorium dioxide colloid (Thorotrast). PMM often occurs in men over the age of 40. Visceral or parietal peritoneum can suffer from; and tumors can be a direct violation of abdominal and pelvic organs; 50% ~ 70% of patients with lymphatic and / or hematogenous metastasis of liver, kidney, adrenal gland, lung, bone and so on.
Chemotherapy:
To give a systemic anti-cancer chemotherapy drug, the peritoneal cavity less drug distribution. Foreign reports, whether single-agent or combination therapy, systemic chemotherapy, efficiency is only 11% ~ 14%. Combination chemotherapy programs include: DDP + ADM, DDP + CTX + VCR, CTX + VCR + BLM and so on. But many scholars stressed that the chemotherapy does not improve the curative effect. Poulain, etc. In vitro studies of the DDP, CBP and amphotericin B (AmB) in malignant mesothelioma cell lines in cytotoxicity. Cell line exposure to these drugs two hours, six days later --- inhibit the growth curve shows that the concentration of 5 ~ 10mg / L of AmB on sensitive or resistant cell lines to DDP, and CBP can be 50% of growth - inhibitory concentration (IC50) reduced by 5 ~ 10 times. The role of AmB may be associated with a significant increase in the tumor cells to platinum intake, increased intracellular concentration of platinum, platinum enhanced cytotoxic effects. Phosphodiesterase inhibition methylxanthine (phosphodiesterase inhibiting methylxanthines) and AmB had synergistic effect, its own toxicity is weak, and can alleviate the toxicity of AmB kidney. But so far no clinical report of the joint application of these drugs.
2 intraperitoneal chemotherapy in recent years that the intraperitoneal injection drug use can increase local drug concentrations, reducing systemic adverse reactions; not only the eradication of residual tumor tissue after surgery to reduce the recurrence; also allows partial loss surgery patients the opportunity to reduce the mass, ascites reduced, disease has been effectively controlled.
Intra-abdominal and intravenous dose once a dosage similar to or slightly higher than the latter; 1 week later to repeat. According to the disease can be a continuous injection for several weeks. Ito and so can not give one cases of surgical resection of patients with PMM intraperitoneal injection DDP, and the combination of uracil and tegafur, made an unexpected effect: In the 223 days after abdominal mass and ascites disappeared completely. But in the first 8 months after the recurrence of pelvic masses; re-awarded to DDP and camptothecin, the effect is poor. Ma, etc. are heated by continuous hyperthermic peritoneal perfusion (continuous hyperthermic peritoneal perfusion, CHPP) combined local injection of DDP treatment of PPM. The average amount of the initial DDP infusion 120mg/ml (81 ~ 166mg/ml), perfusion flow rate 1.5L/min, the average infusion volume of 5.1L (4 ~ 7L), reperfusion after 90 minutes, measuring intra-abdominal temperature were three 41.5 ℃, 40.5 ℃ and 41.1 ℃. DDP infusion fluid total area under the curve (AUC) for plasma DDP AUC 21-fold, plasma concentrations and systemic DDP when medication is similar. Course of treatment, no significant local adverse reactions, patients are able to tolerate CHPP. Follow-up of 10 months, no one cases of death due to CHPP treatment. Park, also has similar coverage. It seems now, CHPP as good for the treatment of PMM is an effective way.
Peritoneal mesothelioma (peritoneal mesothelioma) for the primary in the peritoneal epithelium and mesothelial cancer organizations, clinical rare. Can be categorized as pathological adenomatoid mesothelioma (adenomatoid mesothelioma), cystic mesothelioma (cystic mesothelioma) and malignant mesothelioma (peritoneal malignant mesothelioma, PMM). The first two are benign. Cystic mesothelioma more common in women, the cause is unknown, occur in the pelvic or accessories around, showing single or multiple cystic masses; patients often palpable abdominal mass due to the treatment. Malignant peritoneal mesothelioma (PMM) account for about 30% of malignant mesothelioma; its occurrence is closely related with exposure to asbestos, about 5% of patients had history of exposure; asbestos fiber intake by mouth, after translocation through the intestinal wall into the peritoneal and pleural metastasis from disease or from. From exposure to asbestos to diagnosis, the disease incubation period of up to 25 to 40 years. But the domestic 1951 ~ 1993 20 reported in the literature 161 cases of PMM in only 1 case had history of exposure to asbestos. ZHOU Ya-kang and other reported 47 cases of mesothelioma there are eight cases of malignant peritoneal mesothelioma, as well as the author collected two cases have history of exposure to asbestos. In the absence of asbestos-exposed populations, its incidence rate is about 1 person / 1 million person-years may be related to certain viral infections and genetic factors. PMM has reported 1 cases of foreign patients come into contact with more than 40 years ago, thorium dioxide colloid (Thorotrast). PMM often occurs in men over the age of 40. Visceral or parietal peritoneum can suffer from; and tumors can be a direct violation of abdominal and pelvic organs; 50% ~ 70% of patients with lymphatic and / or hematogenous metastasis of liver, kidney, adrenal gland, lung, bone and so on.
Chemotherapy:
To give a systemic anti-cancer chemotherapy drug, the peritoneal cavity less drug distribution. Foreign reports, whether single-agent or combination therapy, systemic chemotherapy, efficiency is only 11% ~ 14%. Combination chemotherapy programs include: DDP + ADM, DDP + CTX + VCR, CTX + VCR + BLM and so on. But many scholars stressed that the chemotherapy does not improve the curative effect. Poulain, etc. In vitro studies of the DDP, CBP and amphotericin B (AmB) in malignant mesothelioma cell lines in cytotoxicity. Cell line exposure to these drugs two hours, six days later --- inhibit the growth curve shows that the concentration of 5 ~ 10mg / L of AmB on sensitive or resistant cell lines to DDP, and CBP can be 50% of growth - inhibitory concentration (IC50) reduced by 5 ~ 10 times. The role of AmB may be associated with a significant increase in the tumor cells to platinum intake, increased intracellular concentration of platinum, platinum enhanced cytotoxic effects. Phosphodiesterase inhibition methylxanthine (phosphodiesterase inhibiting methylxanthines) and AmB had synergistic effect, its own toxicity is weak, and can alleviate the toxicity of AmB kidney. But so far no clinical report of the joint application of these drugs.
2 intraperitoneal chemotherapy in recent years that the intraperitoneal injection drug use can increase local drug concentrations, reducing systemic adverse reactions; not only the eradication of residual tumor tissue after surgery to reduce the recurrence; also allows partial loss surgery patients the opportunity to reduce the mass, ascites reduced, disease has been effectively controlled.
Intra-abdominal and intravenous dose once a dosage similar to or slightly higher than the latter; 1 week later to repeat. According to the disease can be a continuous injection for several weeks. Ito and so can not give one cases of surgical resection of patients with PMM intraperitoneal injection DDP, and the combination of uracil and tegafur, made an unexpected effect: In the 223 days after abdominal mass and ascites disappeared completely. But in the first 8 months after the recurrence of pelvic masses; re-awarded to DDP and camptothecin, the effect is poor. Ma, etc. are heated by continuous hyperthermic peritoneal perfusion (continuous hyperthermic peritoneal perfusion, CHPP) combined local injection of DDP treatment of PPM. The average amount of the initial DDP infusion 120mg/ml (81 ~ 166mg/ml), perfusion flow rate 1.5L/min, the average infusion volume of 5.1L (4 ~ 7L), reperfusion after 90 minutes, measuring intra-abdominal temperature were three 41.5 ℃, 40.5 ℃ and 41.1 ℃. DDP infusion fluid total area under the curve (AUC) for plasma DDP AUC 21-fold, plasma concentrations and systemic DDP when medication is similar. Course of treatment, no significant local adverse reactions, patients are able to tolerate CHPP. Follow-up of 10 months, no one cases of death due to CHPP treatment. Park, also has similar coverage. It seems now, CHPP as good for the treatment of PMM is an effective way.
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