●AIM:To evaluate the efficacy and safety of combined intraarterial chemotherapy(IAC)and intravitreal melphalan(IVM)for the treatment of advanced unilateral retinoblastoma.●METHODS:This retrospective study involved 3...●AIM:To evaluate the efficacy and safety of combined intraarterial chemotherapy(IAC)and intravitreal melphalan(IVM)for the treatment of advanced unilateral retinoblastoma.●METHODS:This retrospective study involved 30 consecutive eyes from 30 Chinese patients with advanced unilateral retinoblastoma.All patients were initially treated with IAC combined with IVM.The clinical status and complications were recorded at each visit.●RESULTS:The International Intraocular Retinoblastoma Classification groups were D in 23 eyes and E in 7 eyes.All eyes showed severe cloud vitreous seeds at the first visit.The mean number of IAC cycles and intravitreal injections was 3.2(range,3-4)and 6(range,1-14),respectively.The median follow-up time was 29 mo(range,7-36 mo).Treatment success with regression of the retinal tumor and vitreous seeds was achieved in 29 of 30 eyes(96.7%).Globe salvage was attained in 93.3%(28/30)eyes,and enucleation(n=2)was per formed due to neovascular glaucoma and persistent vitreous hemorrhage.Complications included retinal pigment epithelium(RPE)atrophy(n=13;43%),mild lens opacity(n=7;23%),vitreous hemorrhage(n=5;17%)and rhegmatogenous retinal detachment(n=1;3%).No extraocular tumor extension or metastasis occurred.●CONCLUSION:Combined IAC and IVM is effective and safe for the treatment of advanced unilateral retinoblastoma.展开更多
Bone tumor is a refractory neoplastic growth of tissue in bone. According to the unique environment and phys-chemical characteristics of bone tissues, the chemotherapeutic agents are unlikely to prolong the survival o...Bone tumor is a refractory neoplastic growth of tissue in bone. According to the unique environment and phys-chemical characteristics of bone tissues, the chemotherapeutic agents are unlikely to prolong the survival of patients and often associated with systemic side effects. The bone targeting drug delivery via systemic administration may provide both better treatment efficacy and less frequent administration. In this study, we describe the synthesis, in vitro and in vivo evaluation of novel melphalan-bisphosphonate hybrids, with a tumor microenvironment sensitive linkage, which could be enzymatic activation under tumor microenvironment conditions. We have also evaluated the in vitro targeting efficiency of these prodrugs via the affinity of hydroxyapatite （HA） and cellular proliferation. The in vivo distribution suggested the bisphosphonate conjugated prodrugs with high bone selectivity.展开更多
AIM： To evaluate the safety and efficacy of posterior sub-Tenon＇s carboplatin injection compared to intravitreal melphalan injection in the management of retinoblastoma （RB） with secondary vitreous seeds. The outc...AIM： To evaluate the safety and efficacy of posterior sub-Tenon＇s carboplatin injection compared to intravitreal melphalan injection in the management of retinoblastoma （RB） with secondary vitreous seeds. The outcome measures were vitreous seeds regression, need for other treatment modalities to achieve ocular salvage and treatment side effects. METHODS： A prospective interventional comparative nonrandomized study included RB eyes developed secondary vitreous seeds during the period of follow up. They subdivided into two groups： study group Ⅰ where posterior sub-Tenon＇s carboplatin （20 mg/2 mL） was injected and study group Ⅱ where intravitreal melphalan （20 μg/0.1 mL） was injected. The injections repeated every 2-4wk. RESULTS： Thirty-three eyes were included in the study. Seventeen eyes （16 patients） in study group Ⅰ and 16 eyes （16 patients） in study group Ⅱ. Ten eyes （30.3%） were completely salvaged following local chemotherapies, Ocular salvage was 23.5% following posterior sub-Tenon＇s carboplatin injection versus 37.5% following intravitreal melphalan raised to 47.1% and 75% with addition of external beam radiotherapy （EBR） with no statistically significant difference between the study groups （P=0.16）. A statistically significant correlation was found between ocular salvage rate and type of vitreous seeds either dust, spheres and clouds （r=0.42, P=-0.015） and eyes harbor new solid tumor growth （r=0.35, P=0.045）. The mean and median follow up periods following local chemotherapy injections were 2.0y in the study group Ⅰand 2.37y in the study group Ⅱ. Few complications were reported： periorbital edema in all eyes and ocular motility disturbances in 13 eyes （76.5%） following posterior sub-Tenon＇s carboplatin injection. Vitreous hemorrhage developed in 2 eyes （12.5%） and localized retinopathy in 5 eyes （31.25%） following intravitreal melphalan. ~ CONCLUSION： Local chemotherapy for treatment of RB with secondary vitreous seeds is safe and can salvage 30.3% of eyes without EBR. There is a superiority of intravitreal melphalan in ocular salvage however, no statistically significant difference between both groups.展开更多
Multiple myeloma(MM)is the second most common hematological tumor characterized by the proliferation of monoclonal plasma cells.Melphalan(MEL)is commonly used in the treatment of MM and is especially essential for pat...Multiple myeloma(MM)is the second most common hematological tumor characterized by the proliferation of monoclonal plasma cells.Melphalan(MEL)is commonly used in the treatment of MM and is especially essential for patients undergoing autologous stem cell transplantation(ASCT).Although many drugs for MM have been developed in recent years,chemotherapy followed by ASCT remains the optimal option.Melphalan,the backbone of the conditioning regimen,brings severe toxicities at a high dose.Nanodrug delivery systems enable drugs to be highly effective and have low toxicity.In this study,methoxy poly(ethylene glycol)-poly(D,L-lactide)copolymer(MPEG-PDLLA)was chosen to encapsulate melphalan,and the characteristics,effectiveness,and safety of MEL/MPEG-PDLLA in vitro and in vivo were investigated.MEL/MPEG-PDLLA showed slow release and was easily engulfed by MM cells despite a result of the antitumor assay comparable to that of free melphalan in vitro.The in vivo results showed that MEL/MPEG-PDLLA could significantly alleviate tumor burden and prolong survival time without increasing the toxicity to vital organs.In addition,MEL/MPEG-PDLLA could significantly reduce the damage to the intestinal mucosa caused by melphalan.In conclusion,MEL/MPEG-PDLLA shows improved antitumor activity and has the potential to alleviate pains of MM patients undergoing ASCT.展开更多
Introduction:Multiple myeloma (MM) is a geriatric disease with onset at an average age of approximately 61 years.With the aging of the population,the incidence rate of MM is climbing.In the United States,the annual in...Introduction:Multiple myeloma (MM) is a geriatric disease with onset at an average age of approximately 61 years.With the aging of the population,the incidence rate of MM is climbing.In the United States,the annual incidence rate of MM is 2-5/100,000.Multiple myeloma accounts for approximately 1% of all tumor eases and slightly 】10% of cases with hematologic malignancy.Although an展开更多
ccordmg to Reese-Ellsworth Classification tot .retmoblastoma, retinoblastoma with vitreousseeding initially is grade 5B with poor prognosis and was proposed tbr enucleation. Chemotherapy combined with local treatment...ccordmg to Reese-Ellsworth Classification tot .retmoblastoma, retinoblastoma with vitreousseeding initially is grade 5B with poor prognosis and was proposed tbr enucleation. Chemotherapy combined with local treatment for retinoblasloma has been proposed as conservative treatment.1 Because of the lack of blood supply to vitreous seeding, the chemotherapy drugs could not reach the vitreous body through blood-retinal barrier. This has been one of the important limiting factors in the treatment of children with retmoblastoma with vitreous seeding.展开更多
Introduction:Multiple myeloma(MM)is a geriatric dis-ease with onset at an average age of approximately 61years.With the aging of the population,the incidence rate ofMM is climbing.In the United States,the annual incid...Introduction:Multiple myeloma(MM)is a geriatric dis-ease with onset at an average age of approximately 61years.With the aging of the population,the incidence rate ofMM is climbing.In the United States,the annual incidence展开更多
Percutaneous hepatic perfusion(PHP)is an investigative technique for treating patients with diffuse unresectable metastatic liver disease.The technique has been clinically evaluated and shows great treatment potential...Percutaneous hepatic perfusion(PHP)is an investigative technique for treating patients with diffuse unresectable metastatic liver disease.The technique has been clinically evaluated and shows great treatment potential for regional therapy to the liver.The advantage of PHP lies in its minimally invasive approach and ability to be repeated when compared to isolated hepatic perfusion.In a literature search,135 publications were screened and 16 of these publications,including clinical trials and reviews,contributed to this review of PHP with melphalan.Melphalan is an alkylating agent that,when used as the chemotherapeutic agent in PHP,has shown potential for significant control of tumor burden in the liver,especially in metastatic ocular melanoma.In the current landscape of liver directed therapy,PHP is a viable option for those with unresectable metastatic disease to the liver.This article will focus on the technical aspects of PHP and describe the current data available from clinical trials,including outcomes of patients treated with this minimally invasive approach.展开更多
目的:探讨大剂量美法仑联合自体造血干细胞移植治疗多发性骨髓瘤的安全性、疗效和预后。方法:回顾2020年3月至2022年10月在皖南医学院弋矶山医院血液科进行自体移植一线巩固治疗的17例初诊多发性骨髓瘤患者的临床资料,分析治疗的安全性...目的:探讨大剂量美法仑联合自体造血干细胞移植治疗多发性骨髓瘤的安全性、疗效和预后。方法:回顾2020年3月至2022年10月在皖南医学院弋矶山医院血液科进行自体移植一线巩固治疗的17例初诊多发性骨髓瘤患者的临床资料,分析治疗的安全性、疗效和预后。结果:17例患者中,男性10例,女性7例,中位年龄56(45-64)岁。干细胞植入率100%,中性粒细胞中位植入时间为+10(9-12)d,血小板中位植入时间为+12(10-21)d。口腔黏膜炎及肠道感染发生率100%,肺部感染2例,泌尿系感染1例,皮肤感染1例;11例患者发生血清淀粉酶一过性升高。移植后评估13例获得CR以上疗效,CR率较移植前有提高趋势(13/17 vs 8/17;P=0.078)。中位随访18(6-36)个月,15例无进展存活,1例出现疾病进展,1例因临床复发放弃治疗而死亡,2年OS率约90.0%,2年PFS率约83.9%。结论:大剂量美法仑联合自体造血干细胞移植一线巩固治疗多发性骨髓瘤能加深患者缓解深度,进一步提高疗效,而且移植相关并发症可控,值得在临床中推广。展开更多
基金Supported by Shanghai Science and Technology Committee(No.17411952900)Shanghai Shen Kang Hospital Development Center(No.16CR4017A).
文摘●AIM:To evaluate the efficacy and safety of combined intraarterial chemotherapy(IAC)and intravitreal melphalan(IVM)for the treatment of advanced unilateral retinoblastoma.●METHODS:This retrospective study involved 30 consecutive eyes from 30 Chinese patients with advanced unilateral retinoblastoma.All patients were initially treated with IAC combined with IVM.The clinical status and complications were recorded at each visit.●RESULTS:The International Intraocular Retinoblastoma Classification groups were D in 23 eyes and E in 7 eyes.All eyes showed severe cloud vitreous seeds at the first visit.The mean number of IAC cycles and intravitreal injections was 3.2(range,3-4)and 6(range,1-14),respectively.The median follow-up time was 29 mo(range,7-36 mo).Treatment success with regression of the retinal tumor and vitreous seeds was achieved in 29 of 30 eyes(96.7%).Globe salvage was attained in 93.3%(28/30)eyes,and enucleation(n=2)was per formed due to neovascular glaucoma and persistent vitreous hemorrhage.Complications included retinal pigment epithelium(RPE)atrophy(n=13;43%),mild lens opacity(n=7;23%),vitreous hemorrhage(n=5;17%)and rhegmatogenous retinal detachment(n=1;3%).No extraocular tumor extension or metastasis occurred.●CONCLUSION:Combined IAC and IVM is effective and safe for the treatment of advanced unilateral retinoblastoma.
基金financially supported by the National Natural Science Foundation of China (Nos. 31600811, 81573154, 81773432)the Application Fundamental Research Foundation of Sichuan Province Science and Technology Department, China (Nos. 2016JY0157, 2017JY0123)Scientific Research Foundation of the Health and Family Planning Commission of Sichuan Province, China (Nos. 17PJ556, 17PJ563)
文摘Bone tumor is a refractory neoplastic growth of tissue in bone. According to the unique environment and phys-chemical characteristics of bone tissues, the chemotherapeutic agents are unlikely to prolong the survival of patients and often associated with systemic side effects. The bone targeting drug delivery via systemic administration may provide both better treatment efficacy and less frequent administration. In this study, we describe the synthesis, in vitro and in vivo evaluation of novel melphalan-bisphosphonate hybrids, with a tumor microenvironment sensitive linkage, which could be enzymatic activation under tumor microenvironment conditions. We have also evaluated the in vitro targeting efficiency of these prodrugs via the affinity of hydroxyapatite （HA） and cellular proliferation. The in vivo distribution suggested the bisphosphonate conjugated prodrugs with high bone selectivity.
文摘AIM： To evaluate the safety and efficacy of posterior sub-Tenon＇s carboplatin injection compared to intravitreal melphalan injection in the management of retinoblastoma （RB） with secondary vitreous seeds. The outcome measures were vitreous seeds regression, need for other treatment modalities to achieve ocular salvage and treatment side effects. METHODS： A prospective interventional comparative nonrandomized study included RB eyes developed secondary vitreous seeds during the period of follow up. They subdivided into two groups： study group Ⅰ where posterior sub-Tenon＇s carboplatin （20 mg/2 mL） was injected and study group Ⅱ where intravitreal melphalan （20 μg/0.1 mL） was injected. The injections repeated every 2-4wk. RESULTS： Thirty-three eyes were included in the study. Seventeen eyes （16 patients） in study group Ⅰ and 16 eyes （16 patients） in study group Ⅱ. Ten eyes （30.3%） were completely salvaged following local chemotherapies, Ocular salvage was 23.5% following posterior sub-Tenon＇s carboplatin injection versus 37.5% following intravitreal melphalan raised to 47.1% and 75% with addition of external beam radiotherapy （EBR） with no statistically significant difference between the study groups （P=0.16）. A statistically significant correlation was found between ocular salvage rate and type of vitreous seeds either dust, spheres and clouds （r=0.42, P=-0.015） and eyes harbor new solid tumor growth （r=0.35, P=0.045）. The mean and median follow up periods following local chemotherapy injections were 2.0y in the study group Ⅰand 2.37y in the study group Ⅱ. Few complications were reported： periorbital edema in all eyes and ocular motility disturbances in 13 eyes （76.5%） following posterior sub-Tenon＇s carboplatin injection. Vitreous hemorrhage developed in 2 eyes （12.5%） and localized retinopathy in 5 eyes （31.25%） following intravitreal melphalan. ~ CONCLUSION： Local chemotherapy for treatment of RB with secondary vitreous seeds is safe and can salvage 30.3% of eyes without EBR. There is a superiority of intravitreal melphalan in ocular salvage however, no statistically significant difference between both groups.
基金supported by the National Natural Science Foundation of China(Nos.U21A20417,31930067,32271450,31700868)PostDoc Research Project,West China Hospital,Sichuan University(No.2020HXBH165)1·3·5 Project for Disciplines of Excellence,West China Hospital,Sichuan University(No.ZYGD18002)。
文摘Multiple myeloma(MM)is the second most common hematological tumor characterized by the proliferation of monoclonal plasma cells.Melphalan(MEL)is commonly used in the treatment of MM and is especially essential for patients undergoing autologous stem cell transplantation(ASCT).Although many drugs for MM have been developed in recent years,chemotherapy followed by ASCT remains the optimal option.Melphalan,the backbone of the conditioning regimen,brings severe toxicities at a high dose.Nanodrug delivery systems enable drugs to be highly effective and have low toxicity.In this study,methoxy poly(ethylene glycol)-poly(D,L-lactide)copolymer(MPEG-PDLLA)was chosen to encapsulate melphalan,and the characteristics,effectiveness,and safety of MEL/MPEG-PDLLA in vitro and in vivo were investigated.MEL/MPEG-PDLLA showed slow release and was easily engulfed by MM cells despite a result of the antitumor assay comparable to that of free melphalan in vitro.The in vivo results showed that MEL/MPEG-PDLLA could significantly alleviate tumor burden and prolong survival time without increasing the toxicity to vital organs.In addition,MEL/MPEG-PDLLA could significantly reduce the damage to the intestinal mucosa caused by melphalan.In conclusion,MEL/MPEG-PDLLA shows improved antitumor activity and has the potential to alleviate pains of MM patients undergoing ASCT.
文摘Introduction:Multiple myeloma (MM) is a geriatric disease with onset at an average age of approximately 61 years.With the aging of the population,the incidence rate of MM is climbing.In the United States,the annual incidence rate of MM is 2-5/100,000.Multiple myeloma accounts for approximately 1% of all tumor eases and slightly 】10% of cases with hematologic malignancy.Although an
文摘ccordmg to Reese-Ellsworth Classification tot .retmoblastoma, retinoblastoma with vitreousseeding initially is grade 5B with poor prognosis and was proposed tbr enucleation. Chemotherapy combined with local treatment for retinoblasloma has been proposed as conservative treatment.1 Because of the lack of blood supply to vitreous seeding, the chemotherapy drugs could not reach the vitreous body through blood-retinal barrier. This has been one of the important limiting factors in the treatment of children with retmoblastoma with vitreous seeding.
文摘Introduction:Multiple myeloma(MM)is a geriatric dis-ease with onset at an average age of approximately 61years.With the aging of the population,the incidence rate ofMM is climbing.In the United States,the annual incidence
基金supported by the NIH grant:NCI 04-C-0273(http://grantome.com/grant/NIH/ZIA-BC011012-06).
文摘Percutaneous hepatic perfusion(PHP)is an investigative technique for treating patients with diffuse unresectable metastatic liver disease.The technique has been clinically evaluated and shows great treatment potential for regional therapy to the liver.The advantage of PHP lies in its minimally invasive approach and ability to be repeated when compared to isolated hepatic perfusion.In a literature search,135 publications were screened and 16 of these publications,including clinical trials and reviews,contributed to this review of PHP with melphalan.Melphalan is an alkylating agent that,when used as the chemotherapeutic agent in PHP,has shown potential for significant control of tumor burden in the liver,especially in metastatic ocular melanoma.In the current landscape of liver directed therapy,PHP is a viable option for those with unresectable metastatic disease to the liver.This article will focus on the technical aspects of PHP and describe the current data available from clinical trials,including outcomes of patients treated with this minimally invasive approach.
文摘目的:探讨大剂量美法仑联合自体造血干细胞移植治疗多发性骨髓瘤的安全性、疗效和预后。方法:回顾2020年3月至2022年10月在皖南医学院弋矶山医院血液科进行自体移植一线巩固治疗的17例初诊多发性骨髓瘤患者的临床资料,分析治疗的安全性、疗效和预后。结果:17例患者中,男性10例,女性7例,中位年龄56(45-64)岁。干细胞植入率100%,中性粒细胞中位植入时间为+10(9-12)d,血小板中位植入时间为+12(10-21)d。口腔黏膜炎及肠道感染发生率100%,肺部感染2例,泌尿系感染1例,皮肤感染1例;11例患者发生血清淀粉酶一过性升高。移植后评估13例获得CR以上疗效,CR率较移植前有提高趋势(13/17 vs 8/17;P=0.078)。中位随访18(6-36)个月,15例无进展存活,1例出现疾病进展,1例因临床复发放弃治疗而死亡,2年OS率约90.0%,2年PFS率约83.9%。结论:大剂量美法仑联合自体造血干细胞移植一线巩固治疗多发性骨髓瘤能加深患者缓解深度,进一步提高疗效,而且移植相关并发症可控,值得在临床中推广。
