Salivary biomarkers have been increasingly popular in stress research as saliva is easily produced and collection is non-invasive and not limited by geographical distance or lack of infrastructure. Several salivary biomarkers have been utilized in stress research, for instance, salivary cortisol, salivary amylase and salivary immunoglobulin A. Despite being sensitive to changes in fatigue, they have limitations such as inter-individual variability, and interactions with other constituents that may confound the results. Recently, Hyperion Biotechnology has developed the Fatigue Biomarker Index (FBI), which is a measurement of the changes in concentration of salivary peptides with fatigue. The FBI has been shown to be an accurate and objective biomarker of fatigue, and has huge potential for use in various fields and industries.This article will review some of the previous and current salivary biomarkers of stress, as well as critically appraise the new salivary peptide test in terms of its accuracy, application and access.
Abstract. Currently, adjunctive therapy for gastric cancer is not standardized worldwide and the most effective combination of different modalities has not been clearly determined. The aim of the present study was to retrospectively analyze the efficacy and toxicity of the combination of perioperative epirubicin, capecitabine and oxaliplatin (EOX) chemotherapy and postoperative concurrent chemoradiotherapy in the treatment of locally advanced gastric cancer. A total of 41 patients with locally advanced gastric cancer who had undergone perioperative EOX chemotherapy and surgical resection followed by chemoradiotherapy, were assessed. The perioperative EOX regimen consisted of 50 mg/m 2 epirubicin and 130 mg/m 2 oxaliplatin on day 1, with 625 mg/m 2 capecitabine administered twice daily on days 1-21. The perioperative regimen was repeated 2-3 times every 3 weeks. After complete resection following the perioperative EOX regimen, concurrent chemoradiotherapy with capecitabine (4,500 cGy in daily fractions of 180 cGy administered 5 days per week for 5 weeks, with 625 mg/m 2 capecitabine twice daily during radiotherapy) and 2 cycles of the EOX regimen 4 weeks after radiotherapy, were performed. In total, 30/41 patients (73.2%) completed all the planned treatments, including perioperative chemotherapy, surgical resection and chemoradiotherapy. The effective rate of preoperative chemotherapy (partial and complete response) was 56.1%; 30/41 patients received R0 resection, and the overall 3-year survival rate was 57.7%. Grade 3/4 gastrointestinal toxicity (nausea/vomiting) occurred in 22% of the patients, while 18 patients (43.9%) developed grade 3/4 hematological toxicity (granulocytopenia). The results of the present study indicated that the combination of perioperative EOX chemotherapy and postoperative concurrent chemoradiotherapy is feasible and effective for locally advanced gastric cancer.
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