Objective To study the effect of immunogene therapy on the improvement of the outcome of malignant tumor. Methods Literatures about immunogene therapy of malignant tumor were collected and reviewed. Results The major methods of immunogene therapy of malignant tumor were as follows： ①Transference of cytokin genes into lymphocytes. ②Genetically engineered autologous tumor cells used as vaccine. ③Combined gene therapy.Conclusion The therapeutic effect of malignant tumor can be improved by immunogene therapy.
ObjectiveTo explore the relationship between nuclear factor κB (NFκB) and the occurrence, metastasis, and treatment of colon cancer. MethodsThe literature on the structure and the property of molecular biology of NFκB, the relationship between NFκB and apopotosis, malignant tumor and colon cancer were reviewed.ResultsNFκB had action of antiapopotosis. The occurrence of malignant tumor had close relation with the oncogene by NFκB, the metastasis of malignant tumor was that cell of cancer escaped the killing and supervising of immunity by NFκB. NFκB affected the occurrence and metastasis of colon cancer by regulating cmyc, Cox2, ICAM1.Conclusion NFκB has important action in the occurrence and metastasis of colon cancer. It will become a new target of treatment.
Objective To improve the vigilance and awareness of malignancy presenting as dermatosis and reduce misdiagnosis. Methods Two cases of gastric cancer presenting as dermatomyositis and erythroderma respectively in the last two years were retrospectively analyzed and the relevant literatures were reviewed. Results The two patients were admitted to hospital due to skin diseases， diagnosis of gastric cancer through endoscopy， and proved to be gastric cancer associated with dermatosis by pathological examination after surgical resection. Conclusions Paraneoplastic dermatoses can be seen as an early manifestation of the internal malignancy. The patients with paraneoplastic dermatoses should be excluded visceral tumors by the means of biomarkers， endoscopy， PET/CT， and so on.
After freatment of prosthesis replacement for 12 malignant tumer of the proximal humoral werereported. The operation were performed after the indications and methods of treatment had beendefined. All of the 12 cases were followed-up, in the average of 8 yeare. On functional evaluation , 8cases had satisfactory result , but per in 1 cases and 3 cases died from recurrence or metastasis withinfive years. The indieation of the procthetic replantation, the complications, and revision weredisecused.
Objective To evaluate the efficacy of transposition of the medial gastracnemius muscle flap in the limbsalvage operation of the proximal tibial tumors. Methods From January 2001 to September 2005, 13 patients (8 males,5 females; aged 14-57 years, averaged 29.7 years) suffering from the proximal tibial tumors were treated with a limbsalvage operation. Among them, there were 4 patients with osteosarcoma, 6 with malignant fibrous histocytoma, 1 with malignant giant cell tumor, 1 with synovial sarcoma, and 1 with Ewing’s sarcoma. According to the Enneking staging system, 1 case was in Stage ⅠB, 9 in Stage ⅡA, and 3 in Stage ⅡB. One or two cycles of neo-adjuvant chemotherapy were used to each of the patients before operation. All of the patients underwent the medial head of the gastrocnemius muscle flap transposition to reconstruct the soft tissues after resection of the tumors and reconstruction of the bone defect by prothesis or bone-graft or the two methods combined. Results The follow-up for 7-47 months (average, 19.2 months) in all the patients revealed that. there was no flap necrosis, no skin necrosis at the incision margins, and no infection or fracture of the implanted bone. The patient with malignant fibrous histocytoma died of systemic metastasis 20 monthsafter operation. The patient with Ewing’s sarcoma had a local tumor recurrence 18 months after operation; though treated with the focal cleaning and the bone cement filling, the patient still developed lung metastasis of the tumor 26 months after operation. The patient with osteosarcoma underwent amputation 12 months after operation because of the tumor recurrence. According to the function assessment by the Mankin system, there were 6 patients who had an excellent result, 4 had a good result, and 3 had a poor result, with a satisfaction rate of 77%. Conclusion The flap transposition of the medial head of the gastrocnemius muscle can reconstruct the soft tissue defect, decrease the local complication rate and improve the clinical outcome of the limb salvage for the proximal tibia malignant tumor.
Malignant tumors are the major diseases which threat human beings. Anti-cancer medicines play important roles in the treatment of malignant tumors, especially for the new targeted therapies. They bring the life hope for cancer patients who were sentenced to death, and improve quality of life, and some patients may achieve normal lifetime. However, the new anti-cancer medicines are usually too expensive to afford, and most of them have not yet been included in Chinese public health security system, the accessibility of the new anti-cancer medicines is seriously limited. This paper introduces the accessibility of high-cost anti-cancer medicines in China, analyzes the influence factors, and proposes policy recommendations to improve the accessibility of high-cost anti-cancer medicines in China.
Objective To assess the methodological quality of clinical studies using Shen-Mai injection as an adjunct therapy to tumor chemotherapy and to evaluate its efficacy and safety. Methods A comprehensive search strategy was designed to identify all randomized controlled trials (RCT) comparing Shen-Mai injection plus routine chemotherapy versus routine chemotherapy alone by searching for the CBMdisc (issue 3) and TCMLRS database (1981-2001). The methodological quality of the trials was assessed by two reviewers independently for which a meta analysis was perfermed. Results Thirteen RCTs met the inclusion criteria. methodological quality was poor (all the trials included were level C). Compared with the control group, the combined outcome of Shen-Mai injection increased the effect of chemotherapy (OR 1.73 95%CI 1.27 to 2.34, P＝0.000 4), reduced the side effect of bone marrow inhibition (OR 0.29, 95%CI 0.16 to 0.52, P＝0.000 04) in WBC counting and (OR 0.11, 95%CI 0.02 to 0.49, P＝0.004 in PLT count. And Shen-Mai injection relieved the symptoms of nausea and vomiting (OR 0.26, 95%CI 0.16 to 0.43, Plt;0.000 01). Conclusions The methodological quality of the trails using Shen-Mai injection should be improved. Based on the results of the review and the meta-analysis, Shen-Mai injection may have positive effects on chemotherapy in patients with malignant tumor, although the evidence is weak. No serious adverse events are reported. Further well-designed clinical trials should be performed.
ObjectiveTo systematically review the efficacy and safety of autologous natural killer cells (NK) cells for the treatment of malignant tumors. MethodsThe PubMed, Web of Science, and Embase databases were electronically searched to collect clinical studies on autologous NK cells for the treatment of malignant tumors from inception to July 1, 2023. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Descriptive analysis of the results were conducted. ResultsA total of 15 studies were included. The most common tumor type was non-small cell lung cancer. The dose of NK cell injections usually ranged from 7.0×107 to 7.0×109 cells, with a treatment interval of 14-21 days and a frequency of 3-6 injections. The overall response rate for NK cell therapy ranged from 0% to 77.78%. The main adverse effects were fever (3.98%), fatigue (1.99%), rash (0.4%), and dizziness (1.20%). ConclusionCurrent evidence shows that autologous NK cell therapy is safe for treating malignant tumors, and some studies have shown that NK cell therapy has a relieving effect. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusion.
OBJECTIVE: To investigate the clinical effects of repairing skin defect after resection of cutaneous malignant tumors. METHODS: From 1984 to 2001, cutaneous malignant tumors of 38 patients were resected and diagnosed pathologically. There were 12 cutaneous squamous cancer, 14 carinal cutaneous fibrosarcomas, 2 in situ cancers, 1 wart like cancer, 4 eczematoid cancers, and 5 deteriorative chronic ulcers. The biggest skin defect was 14 cm x 20 cm in size. Skin defects were repaired with flaps, myocutaneous flaps, free skin grafts and suturations. There were 4 gastronomies flaps, 6 latissimus flaps, 2 tensor fascia lata myocutaneous flaps, 1 transverse recuts abdominis myocutaneous flap, 5 plantaris medialis flaps, 3 random flaps, 12 free skin grafts and 5 suturings. RESULTS: All the operations succeed. Among 21 cases followed up for 3 to 12 years, 19 healed and 2 relapsed, but the 2 patients healed after second operation. CONCLUSION: Thorough resection of tumor is the key to eradicate malignant tumor. The method to repair skin defect after resection should be chosen according to the patients individually.
OBJECTIVE To analyze the indications for revision surgery after limb salvage procedure of malignant bone tumor and summarize the experiences in revision surgery. METHODS From January 1994 to December 1997, 8 cases were re-operated after primary limb salvage procedure. The average survival period with no-tumor occurrence was 8 years. The common causes for the revision were traumatic osteoarthritis, fracture, and bone resorption. The main difficulties in revision were soft tissue contracture and limb discrepancy from limb shortening. RESULTS In this study, there was total hip replacement in 1 case, large segmental allograft for reconstruction of distal femur in 3 cases, total knee replacement upon composite of previously transplanted allograft in 3 cases, removing of intramedullary nail and re-internally fixed with intramedullary nail in 1 cases. The isotopic bone scan before the revision showed active bone metabolism in all 4 transplanted segmental allograft. The pathologic study of the transplanted allograft after revision confirmed new bone formation in allograft. The revision procedure reduced the pain, and improved the limb function. CONCLUSION The main causes of revision surgery after limb salvage procedure of malignant bone tumor are fracture of transplanted allograft segment or devitalized tumor segment, and poor function of the affected joint. Constrained knee prostheses with rotating hinges or semi-constrained ball-axis resurfacing knee prostheses improve the function of knee joint postoperatively.