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| 1 | Gastrointestinal perforation in metastatic colorectal cancer patients with peritoneal metastases receiving bevacizumab显示文摘AIM:To investigate the safety and efficacy of adding bevacizumab to first-line chemotherapy in metastatic colorectal cancer patients with peritoneal disease.METHODS:We compared rates of gastrointestinal perforation in patients with metastatic colorectal cancer and peritoneal disease receiving first-line chemotherapy with and without bevacizumab in three distinct cohorts:(1) the AGITG MAX trial(Phase Ⅲ randomised clinical trial comparing capecitabine vs capecitabine and bevacizumab vs capecitabine,bevacizumab and mitomycin C);(2) the prospective Treatment of Recurrent and Advanced Colorectal Cancer(TRACC) registry(any first-line regimen ± bevacizumab);and(3) two cancer centres in New South Wales,Australia [Macarthur Cancer Therapy Centre and Liverpool Cancer Therapy Centre(NSWCC) from January 2005 to Decenber 2012,(any first-line regimen ± bevacizumab).For the AGITG MAX trial capecitabine was compared to the other two arms(capecitabine/bevacizumab and capecitabine/bevacizumab/mitomycin C).In the AGITG MAX trial and the TRACC registry rates of gastrointestinal perforation were also collected in patients who did not have peritoneal metastases.Secondary endpoints included progression-free survival,chemotherapy duration,and overall survival.Time-toevent outcomes were estimated using the Kaplan-Meier method and compared using the log-rank test.RESULTS:Eighty-four MAX,179 TRACC and 69 NSWCC patients had peritoneal disease.There were no gastrointestinal perforations recorded in either the MAX subgroup or the NSWCC cohorts.Of the patients without peritoneal disease in the MAX trial,4/300(1.3%) in the bevacizumab arms had gastrointestinal perforations compared to 1/123(0.8%) in the capecitabine alone arm.In the TRACC registry 3/126(2.4%) patients who had received bevacizumab had a gastrointestinal perforation compared to 1/53(1.9%) in the chemotherapy alone arm.In a further analysis of patients without peritoneal metastases in the TRACC registry,the rate of gastrointestinal perforations was 9/369(2.4%) in the chemotherapy/bevacizumab group and 5/177(2.8%) in the chemotherapy alone group.The addition of bevacizumab to chemotherapy was associated with improved progression-free survival in all three cohorts:MAX 6.9 m vs 4.9 m,HR = 0.64(95%CI:0.42-1.02);P = 0.063;TRACC 9.1 m vs 5.5 m,HR = 0.61(95%CI:0.37-0.86);P = 0.009;NSWCC 8.7 m vs 6.8 m,HR = 0.75(95%CI:0.43-1.32);P = 0.32.Chemotherapy duration was similar across the groups.CONCLUSION:Patients with peritoneal disease do not appear to have an increased risk of gastrointestinal perforations when receiving first-line therapy with bevacizumab compared to systemic therapy alone. | Aflah Roohullah Hui-Li Wong Katrin M Sjoquist Peter Gibbs Kathryn Field Ben Tran Jeremy Shapiro Joe Mckendrick Desmond Yip Louise Nott Val Gebski Weng Ng Wei Chua Timothy Price Niall Tebbutt Lorraine Chantrill | 2015 | World Journal of Gastroenterology2015，21，17： | 3 |
| 2 | Management of asymptomatic primary tumours in stage Ⅳ colorectal cancer: Review of outcomes显示文摘AIM: To compare outcomes for patients presenting withstage IV colorectal cancer and an asymptomatic primary tumour, undergoing primary tumour resection(PTR) plus palliative chemotherapy vs primary chemotherapy up-front.METHODS: A literature search was conducted using MEDLINE and EMBASE. The primary outcome was overall survival. Secondary outcomes included perioperative mortality, morbidity and delayed surgical intervention rates in patients undergoing PTR and subsequent complication rates in patients with an un-resected primary tumour. Tertiary outcomes included impact on systemic treatment and identification of prognostic factors relevant for survival in this cohort. RESULTS: Twenty non-randomised studies met the inclusion criteria. Eleven studies included comparative overall survival data. Three studies showed an overall survival advantage for PTR, 7 studies showed no statistically significant advantage, and 1 study showed a significant worsening in survival in the surgical group. The perioperative mortality rate ranged from 0% to 8.5%, and post-operative morbidity rate from 10% to 35%, mainly minor complications that did not preclude subsequent chemotherapy. The rate of delayed primarytumour related symptoms, most commonly obstruction, in patients with an un-resected primary tumour ranged from 3% to 46%. The strongest independent poor prognostic factor was extensive hepatic metastases, in addition to poor performance status, M1 b stage and non-use of modern chemotherapy agents.CONCLUSION: Based on the current literature, both PTR and up front chemotherapy appear appropriate initial management strategies, with a trend towards an overall survival advantage with PTR. The procedure has a low post-operative mortality, and most complications are transient and minor. The results of recruiting randomised trials are eagerly anticipated. | Kate Jessica Wilkinson Wei Chua Weng Ng Aflah Roohullah | 2015 | World Journal of Gastrointestinal Oncology2015，7，12： | 1 |
| 3 | In-vitro and in-vivo pharmacological screening of Iris albicans显示文摘OBJECTIVE:To evaluate the anti-oxidant,enzyme inhibition,anti-pyretic,anti-inflammatory and anti-diabetic activities of Iris albicans.METHODS:Anti-oxidant assay was evaluated using DPPH(2,2-diphenyl-1-picrylhydrazyl)radical scavenging and ABTS(2,2'-azino-bis-3-ethylbenzothiazoline-6-sulfonic acid)inhibitory protocol while enzyme inhibitory assay was evaluated by lipoxygenase and cyclooxygenase-2 inhibitory protocol respectively.Antipyretic,anti-inflammatory and anti-diabetic potential was evaluated using brewer's yeast induced pyrexia,carrageenan induced paw edema and streptozocin induced diabetes protocols respectively.Serum biochemical parameters were monitored for the period of study.RESULTS:The anti-oxidant activity of chloroform fraction of Iris albicans showed the highest scavenging potential against DPPH and ABTS while the maximum inhibitory action recorded against lipo-oxygenase and cyclooxygenase-2 enzymes was shown by n-hexane and chloroform fractions respectively.The anti-pyretic potential of the crude methanolic extract showed dose dependent activity in reducing pyrexia,thereby when the dose was increased the anti-pyretic effect was also enhanced.The anti-inflammatory action of the crude methanolic extract administered at the dose of 300 mg/kg was significant at 1 h after its administration,which was found maintained up to 5 h.Similarly the anti-diabetic effect of the crude methanolic extract administered at the dose of 200 and 300 mg/kg was noted highly significant at day 6 and was found well maintained throughout the study time period up to 10 days.Significant(P<0.001)improvement appeared in hemoglobin,protein,cholesterol,triglycerides,urea,creatinine,HDL and LDL of extract treated diabetic mice.CONCLUSION:From this data it could be concluded that Iris albicans have significant anti-oxidant,enzyme inhibition,ant-pyretic,anti-inflammatory and anti-diabetic potential. | Dawood Kamal Roohullah Fazle Rabbi Attiqa Naz Muhammad Bilal | 2022 | Journal of Traditional Chinese Medicine2022，42，1： | 0 |
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