Search

Yuan Cheng,1 Shu Kui Qin,1 Yan Ping Chen,2 Li Hua Dong,3 Xiang Dong Sun,4 Shi Ying Yu,5 Shi Kai Wu6 1Department of Oncology, Bayi Hospital Affiliated to Nanjing University of Chinese Medicine, Nanjing 210002, China; 2Department of Stomatology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China; 3Department of Radiotherapy, First Hospital of Jilin University, Changchun 130021, China; 4Department of Radiotherapy, Bayi Hospital Affiliated to Nanjing University of Chinese Medicine, Nanjing 210002, China; 5Department of Oncology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430012, China; 6Department of Radiation Oncology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 10071, China Objective: CAM2028 (Episil®; Camurus AB, Lund, Sweden) is a liquid for use in the oral cavity to treat various pains associated with mouth injuries. Upon contact with the swollen oral mucosa, the oral liquid forms a thin protective film that acts as a mechanical barrier to relieve pain. This study was the first in China to evaluate the local analgesic effect of oral liquid in cancer patients who developed oral mucositis following chemotherapy and/or radiotherapy.Methods: A total of 60 patients were randomized in a 1:1 ratio to the CAM2028 group (the pump device was firmly pressed three times and the fluid was distributed to the painful area of the oral cavity) or KS (a mucoadhesive oral wound rinse, Kangsu™; Luye Pharmaceutical Co. Ltd, Nanjing, China) group (5mL of the oral rinse was poured into and kept in the oral cavity for at least 1 minute). The primary endpoint was the area under the oral mucosal pain score–time curve (AUC) within 6 hours of treatment in the trial and control groups. Medical device adverse events were assessed according to the National Cancer Institute’s Common Terminology Criteria for Adverse Events, version 4.0. Statistical analyses were performed using the chi-squared test (Fisher’s exact test), independent-samples t-test, and analysis of covariance.Results: Sixty patients were included in the per-protocol set population analysis. The average (mean±SD) 6-hour AUC of the CAM2028 group and the KS group was 14.20±10.29 and 24.46±14.15, respectively. The difference between the groups was statistically significant (P=0.0022). The incidence of adverse events in the trial group and the control group was 16.67% and 30.0%, respectively, and there was no statistical difference.Conclusions: CAM2028 displayed an efficacious local analgesic effect in cancer patients who developed oral mucositis following chemotherapy and/or radiotherapy. The results demonstrated its potential value in clinical applications. Keywords: oral mucositis, radiotherapy, chemotherapy, analgesic effect, episil

Chao Liu,1,* Wei Wang,2,* Xiangying Meng,1 Bing Sun,1 Yang Cong,1 Jiannan Liu,1 Qian Wang,1 Guangxian Liu,2 Shikai Wu1 1Department of Radiation Oncology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, People’s Republic of China; 2Cancer Therapy Center, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, People’s Republic of China *These authors contributed equally to this work Background: Previous studies have demonstrated the prognostic value of globulin (GLB), albumin (ALB), the ALB/GLB ratio (AGR), body mass index (BMI), hemoglobin (Hb), and prognostic nutritional index (PNI) in breast cancer. The underlying mechanism has been investigated by examining the impact of nutritional parameters on T cells, natural killer cells, and dendritic cells, but little is known about their effect on checkpoint molecules. Methods: Here, we investigated the correlation of mRNA expression of programmed cell death protein 1 (PD-1), cluster of differentiation 28 (CD28), cytotoxic T-lymphocyte antigen-4 (CTLA-4), and cluster of differentiation 25 (CD25) with AGR, ALB, GLB, total protein, pre-ALB, Hb, BMI, and PNI in the peripheral blood of breast cancer patients. One hundred and three patients and 21 age- and sex-matched healthy controls were enrolled. Quantitative real-time PCR was used to test relative mRNA expression. Results: The results indicated that the mRNA levels of PD-1 and CD25 were 5.2- and 3.3-fold higher in patients with low AGR than in those with high AGR (P < 0.05). The mRNA levels of PD-1 were 3.5-fold higher in patients with high GLB than in those with low GLB (P < 0.05). In addition, breast cancer patients had higher expression levels of PD-1, CD28, CTLA-4, and CD25 mRNA in their peripheral blood compared with healthy volunteers (P < 0.05). Conclusion: These results suggest that AGR is negatively correlated with PD-1 and CD25 mRNA levels, while GLB is positively associated with PD-1 mRNA levels. Nutritional status in breast cancer patients may influence the PD-1 pathway and have implications for the optimization of cancer therapy. Keywords: nutrition, AGR, globulin, immune checkpoint, PD-1, CTLA-4, breast cancer

Chao Liu,1,2 Zhou Huang,1 Qiusheng Wang,1 Bing Sun,1 Lijuan Ding,1 Xiangying Meng,1 Shikai Wu1,2 1Department of Radiation Oncology, Affiliated Hospital of Academy of Military Medical Sciences, 2Department of Radiation Oncology, 307 Hospital of PLA, 307 Clinical College, Anhui Medical University, Beijing, People’s Republic of China Purpose: We aimed to investigate the relationship between pretreatment neutrophil-to-lymphocyte ratio (NLR)/platelet-to-lymphocyte ratio (PLR) and the estimation of hormone-receptor-negative (HR-) breast cancer patients’ survival in a Chinese cohort.Patients and methods: Of 434 consecutive HR- nonmetastatic breast cancer patients treated between 2004 and 2010 in the Affiliated Hospital of Academy of Military Medical Sciences, 318 eligible cases with complete data were included in the present study. Kaplan–Meier analysis was performed to determine the overall survival (OS) and disease-free survival (DFS). Univariate and multivariate Cox proportional hazards models were used to test the usefulness of NLR and PLR.Results: Univariate analysis indicated that both elevated NLR and PLR (both P