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Biomedical subjects

Shun Tang

Publications and source records attributed to Shun Tang.

7 recordsLinked to original sources

[Preliminary report of combination chemotherapy including Arsenic trioxide for stage III osteosarcoma and Ewing sarcoma].

OBJECTIVE: To determine the efficacy of Arsenic trioxide combined with other chemo agents in patients with metastatic osteosarcoma and Ewing sarcoma. METHODS: From December 2002 to June 2005, 32 patients with metastatic osteosarcoma and Ewing sarcoma were treated with chemotherapy comprised Arsenic trioxide, including 19 male and 13 female, aging from 7 to 32 years. Diagnoses included 27 cases with osteosarcomas and 5 with Ewing sarcomas. Twenty-five and 7 patients had multiple lung and skeletal metastasis respectively. All patients had received 4 to 6 cycles standard chemotherapy and surgical treatments before the metastatic lesions were found. The chemotherapy protocol consisted of Arsenic trioxide, VP-16 and paclitaxel. Twenty-eight patients accepted 2 cycles, and 4 patients accepted 3 cycles chemotherapy. RESULTS: Five patients (15.6%), whose lung focus disappeared and no new metastases proved, got complete response (CR); Six patients (18.8%) got partial response (PR); In thirteen stable disease (SD) patients (40.6%), the metastatic lesions did not reduce in evidence but completely calcified in 2 patients and partly calcified in 11 patients; Eight patients (25%) whose tumor size was even bigger after the chemotherapy were defined as progress disease (PD). The average follow-up period was 20 months (ranging from 6 months to 3 years). Three patients were eventually died; The disease was progressed in 5 patients, and the tumor growth was controlled in 24 patients. CONCLUSIONS: Arsenic trioxide is a low-toxic and effective remedy for treatment of stage III osteosarcoma and Ewing sarcoma.

Adolescent↗

[Resection and reconstruction for tumors of iliac bone].

OBJECTIVE: To discuss the resection of tumors, reconstruction of defects. METHODS: Sixty-one patients with tumors in ileum were treated surgically in People's Hospital from July 1998 to July 2004. The series comprised 38 males and 23 females with an average age of 43 years old (range from 12 to 78 years old). According to Enneking staging system, 36 cases had lesions in region I, 17 cases in region I and II, and 8 cases in region I and IV. After tumor resected, posterior fixation system of spine was applied to reconstruct the integrality of pelvic ring in series of region I cases. The four pedicle screws were implanted in the lumbar and sacrum superiorly, pubis and ischium inferiorly. For children patients, bone graft or bone cement and Steinmann's pins internal fixation was applied to reconstruct the pelvis. RESULTS: Among all the 61 cases, 48 cases followed up from 16 months to 6 years. Thirty-three cases were survived and had no local recurrence or metastasis. Fifteen cases were dead. Oncology result: local recurrence were found in 19.4% patients with region I resection (7/36), the resection level was close to acetabulum (in order to reserve the acetabulum), and it might be the reason of recurrence. 35.3% of patients (6/17) with region I and II resection had local recurrence, the recurrence maybe related to residual tumor after curettage. 50.0% of the patients (4/8) with region I and IV resection had local recurrence, the tumor residual in sacrum might be the reason of recurrence. Functional result: all of the 36 cases received region I resection regained normal walking function. The hip joint function was normal in 17 cases received tumor curettage, bone cement or hip joint replacement. CONCLUSIONS: The posterior fixation system of spine can be used to reconstruct the integrality of pelvic ring after resection of iliac tumors. Simple reconstruction is more favorable for child patients. Allograft or self-ileum can be implanted in the space of sacral wing and residual ileum, and the bone graft is fixed with compressional screw.

Acetabulum↗

[In vitro antitumor immune response induced by fusion of dendritic cells and Ewing's sarcoma cells].

OBJECTIVE: Human Ewing sarcoma A673 cells and human peripheral blood-derived DCs were fused to induce an antitumor activity against human EW. METHODS: EW A673 cells and human peripheral blood-derived DCs were fused with polyethylene glycol (PEG). RESULTS: Mature DCs with highly expressed surface markers (CD80, CD86, CD83 and HLA-DR) were generated in vitro and flow cytometry. It showed that the highest fusion efficiency was 23.01%. T cell proliferation assay indicated that the novel dendritomas in fused DCs/A673 cells were the most potent in activation of autologous T cell proliferation. The IFN-gamma assay showed that The IFN-gamma secretion by CTLs activated by the novel dendritomas increased more than by other stimulators. CTL assay demonstrated that the novel dendritomas induced A673 cell-specific cytotoxic responses to lyse the A673 cells in the context of MHC class I. CONCLUSION: The data indicates that fusion of tumor cells with DCs is an attractive strategy to induce tumor rejection.

Cancer Vaccines↗

[Surgical treatment of metastatic spinal tumors by anterial approach].

OBJECTIVE: To investigate the efficacy of surgical treatment of the patients with metastatic spinal tumors by anterial decompression and stabilization. METHODS: From December 1997 to December 2003, 93 patients (40 women and 53 men) with metastatic spinal tumors were treated in our department. The locations of the tumor included, thoracic vertebra (53 cases), lumbar vertebra (33 cases), and cervical region (7 cases). The original tumors included lung cancer (21 cases), renal cancer (13 cases), prostate cancer (8 cases), hepatic cancer (5 cases), breast cancer (13 cases), thyroid cancer (5 cases), gastrointestinal tumor (3 cases), and multiple myeloma (8 cases). However, no primary tumor was found in the rest of 17 cases. Among 54 of 93 patients who presented with neurological dysfunction, 16 patients completely paralyzed and others incompletely paralyzed. The follow-up time ranged from 10 to 72 months. RESULTS: Pain was relieved in 87 of 93 patients (93.5%) and neurological function was improved in 47 of the 54 patients. Among 16 completely paralyzed patients, 7 patients experienced a neurological function improvement (from Frankel grade A or B to C or D after decompression). The average amount of blood transfused was 3000 ml. No severe complications were seen in our series. The one-year survival rate was 85% (79 cases). CONCLUSIONS: The integrity of the spinal column structure and neurological function should be considered firstly in the treatment of spinal metastasis. Thorough resection of metastatic tumor and stable internal fixation by anterior approach should be performed when single or two vertebra are involved. In order to alleviate paralysis, promote spinal stability, and improve the quality of life, urgent decompression should be performed on patient with spinal metastasis.

Breast Neoplasms↗

[Resection and reconstruction for primary pelvic tumors around acetabular].

OBJECTIVE: To discuss the resection of tumors, reconstruction of defects and the postoperative complications. METHODS: Thirty-one patients with tumors around acetabular were treated surgically in People's Hospital between July 1997 and July 2003. The series comprised 19 males and 12 females. Twelve patients were diagnosed with chondrosarcoma, 1 with Ewing sarcoma, 3 with osteosarcoma, 1 with lymphoma, 1 with carcinosarcoma, 1 with malignant fibrohistiocytoma (MFH), 2 with myeloma, 9 with giant cell tumor (GCT), 1 with aneurysmal bone cyst. Among 31 patients with peri-acetabular tumors, 8 were reconstructed with hemi-pelvic prosthesis, 7 with saddle prosthesis, 6 with cauterized tumor bone and total hip arthroplasty, 10 with total hip replacement after curettage of lesion and cemented. RESULTS: Among 21 patients who underwent tumor resection and reconstruction in region II, 6 had local relapse. Two of 3 patients with osteosarcoma were dead. Five of 12 patients with chondrosarcoma were free of disease. Twenty-one patients with acetabular reconstruction after resection of lesions in region II could sit and stand normally and walked with a cane, several of which even had normal gait. CONCLUSION: Allograft or pelvic prosthesis can be used to reconstruct the acetabulum after resection of tumors. We must pay more attention on the following points in the surgical treatment of periacetabular tumors: (1) Extensively resect tumors as far as possible; (2) Be acquainted with advantages and disadvantages of different reconstructive methods of acetabulum to prevent the complications; (3) The reconstructed acetabulum is unstable, so the patients must stand with a cane to protect the reconstructed hip joint; (4) Prevent wound necrosis and infection; (5) Surgical treatment of pelvic tumors would easily result in poor wound healing especially in the patients receiving chemotherapy or radiotherapy because of extensive soft tissue stripping. The destroyed soft tissue caused by chemotherapy or radiotherapy may increase the great tissue tension after implantation of allograft. And the factors of poor blood supply and hematoma in the wound theoretically increase the chance of infection.

Acetabulum↗

[Neoadjuvant chemotherapy for osteosarcoma].

OBJECTIVE: To summarize the experience in neoadjuvant chemotherapy for osteosarcoma. METHODS: Between July 1996 and December 2002 113 patients, 65 males and 48 females, aged 7 approximately 31, with osteosarcoma located in pelvis (n = 2), sacrum (n = 1), proximal femur (n = 6), shaft of femur (n = 4), distal femur (n = 49), proximal tibia (n = 37), shaft of tibia (n = 2), distal tibia (n = 1), fibula (n = 3), scapula (n = 1), clavicle (n = 1), or proximal humerus, (n = 7) without metastasis, 7 of which being at the Ennecking stage of IIA and 106 of which being at the stage of IIB, underwent 2 cycles of chemotherapy with high dose methotrexate (MTX) preoperatively and then operation. If poor response was observed after the first cycle of chemotherapy MTX was abandoned and operation was performed immediately. Twenty-two patients underwent reimplantation of devitalized tumor bone and 80 patients underwent prosthetic replacement. The protocol of cisplatin, ifosfamide, and paclitaxel was adopted after operation. At least 3 cycles of chemotherapy were given postoperatively for all patients. The patients were followed up for 20 approximately 66 months. RESULTS: Sixty patients showed excellent response to the preoperative chemotherapy, 35 showed good response, and 18 showed poor response. Relapse of tumor was found in 12 out of the 22 patients (55%) receiving reimplantation of devitalized tumor bone and in 5 out of the 60 patients (8.3%) receiving prosthetic replacement. The 5-year survival rate of the whole group was 71.93%. The lung metastasis rates were 18.3%, 37%, and 78% in the preoperative excellent response group, good response group, and poor response group respectively. CONCLUSION: The neoadjuvant chemotherapy protocol with the second-line drugs such as ifosfamide and paclitaxel used to the patients responding poorly to MTX is more effective than the older protocol. Local arterial chemotherapy is feasible.

Adolescent↗

[Clinical study of solitary bone plasmacytoma].

OBJECTIVE: To study the clinical characteristics and the prognosis of solitary bone plasmacytoma (SBP). METHODS: From June 1997 to June 2002, ten SBP patients were treated in our department. Two lesions were in sacrum, two in pelvis, the other six lesions were in proximal femur, femoral diaphyseal, scapula, thoracic vertebra, proximal humus, and rib respectively. The preoperative laboratory tests were normal. Operation was performed on all patients. The pathologic diagnose was plasmacytoma and then they underwent further laboratory examination, urine Bence-Jone protein is positive in 3 patients, serous IgG value was higher than normal in 2 patients, abnormal M protein was found in electrophoresis in 2 patients. All patients received radiotherapy postoperatively. RESULTS: Four patients were excluded, whose follow-up were lessen than ten months, the other six patients's average follow-up is 28.2 months (from 18 to 48 months), one patient who developed multiple myeloma (MM) six months postoperatively received chemotherapy using M2 protocol and died 21 months after operation. The other five patients had disease-free survive and remain solitary bone lesion after the treatment of surgery and radiology. CONCLUSION: Compared with MM, SBP patients are younger, the therapeutic results and prognosis are better. The main prognostic factors include age, the size of lesion, the axial bone lesion, persistence of myeloma protein after radiotherapy, early diagnosis and treatment, and so on.

Bone Neoplasms↗