Cis-dichlorodiammine platinum (II) in advanced ovarian carcinoma.

Twenty-seven patients with advanced ovarian cancer were treated with a total of 80 courses of cis-dichlorodiammine platinum (II) (cisplatin). The doses in three courses were less than 50 mg/m2, in 64 courses they were 50 mg/m2, and in eight courses they were 100 mg/m2. In addition, five courses of low-dose daily treatment (20 mg/m2 for five days) were administered. Twelve patients received cisplatin alone, 12 received cisplatin and cyclophosphamide (750 mg/m2), and three patients received cisplatin with other drugs. There were eight responders (33%) in the 24 evaluable patients. Renal toxicity occurred in four patients, ototoxicity in four, and leucopenia (which was life-threatening in one patient) occurred in 16 patients (white cell count less than 3.0 X 10(9)/L). There were two early drug-related deaths. The median survival of patients who responded to cisplatin treatment was longer than 30 weeks compared with nine weeks for non-responders.     

培美曲塞联合顺铂二线治疗晚期卵巢癌临床分析

目的探讨培美曲塞联合顺铂二线治疗治疗晚期卵巢癌的疗效以及不良反应。方法经病理学或细胞学确诊的晚期卵巢癌患者41例,中位年龄48岁,KPS评分≥60。培美曲塞500mg/m2第1d＋顺铂25mg/m2第1-3d,每3周为1个周期。至少2周期以上可评价疗效及不良反应。结果 41例中38例可评价疗效,无CR病例（0%）,PR17例（44.74%）,SD15例（39.47%）,PD6例（15.79%）,总有效率（CR＋PR）为44.74%,临床获益率（CR＋PR＋SD）为84.21%。38例可评价疗效者,中位无进展生存期5.3个月,中位生存期13.2个月,1年生存率34.21%（13/38）。主要不良反应为粒细胞下降、贫血和胃肠道反应。结论培美曲塞联合铂类治疗晚期卵巢癌疗效确切,不良反应发生率低,耐受性较好。     

卵巢癌静脉腹腔联合化疗与静脉化疗的疗效比较

目的 探讨经不同途径给药对卵巢癌化疗疗效的影响。方法 我院1990年1月至1996年1月行卵巢癌化疗124例，均用CAP方案，每隔3－4周，共6－8个疗程。其中A组环磷酰胺、表阿霉素经静脉滴注，顺铂经腹腔灌注。B组 部经静脉滴注。结果 A组全部6个疗程化疗，治疗结束完全缓解率为70．73％，部分缓解率为20．73％，B组完全缓解率为57．14％，部分缓解率为9．52％。两组比较胸显著差异。两组5年存活率分别为30．49％、28．57％，A组高于B组，但相差不显著。结论 顺铂腹腔灌注可减轻药物的副反应，提高完全及部分缓解率，改善患者生存质量，但对提高5年生存率的意义尚不肯定。     

Ovarian cancer. Effective treatment after alkylating-agent failure.

Combination chemotherapy consisting of hexamethylmelamine and cisplatin, alone or with doxorubicin hydrochloride, was given to 27 patients with advanced ovarian cancer who had disease progression with therapy including alkylating agents. Eighteen (67%) had greater than 50% regression of measurable disease or disease that could be evaluated but not measured, for a projected median duration of seven months. The projected median survival for all patients is nine months from the time of entry into the study and 33 months from the time of diagnosis of ovarian cancer. The treatment could be readily administered on an outpatient basis with a regimen of hydration and diuresis that nearly completely prevented platinum-induced renal tubular damage. Myelosuppression was severe in 11 patients (40%), but there was no treatment-related deaths. Agents of such high activity should be considered as components of initial therapy for stage III and IV cancers.     

High dose chemotherapy and autologous bone marrow transplantation in advanced Hodgkin's disease.

OBJECTIVE: To present the use of high dose chemotherapy with autologous bone marrow transplantation as salvage therapy for advanced Hodgkin's disease in Australia. DESIGN: A prospective open study for patients whose disease was resistant to conventional treatment. SETTING: The bone marrow transplantation units of four Australian tertiary hospitals. PATIENTS: Seventeen patients (median age 30 years) entered and completed the study. The stage of the disease at initial diagnosis was I or II (seven patients), III (seven patients) and IV (three patients). Histological types were lymphocyte predominant (one), nodular sclerosis (12), mixed cellularity (three) and unknown (one). Therapy before consideration for transplantation included radiotherapy (13), mustine, vincristine, procarbazine and prednisone (MOPP--17 patients) or doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD--13 patients) and other chemotherapy regimens (five). The median interval from diagnosis to transplantation was 29 months (range, 9-178 months). The patient's disease was classified as sensitive (nine) or resistant (eight) to treatment, depending on the response to the most recent course of chemotherapy. INTERVENTIONS: Morphologically normal autologous bone marrow was harvested and cryopreserved. The conditioning regimen given was cyclophosphamide, carmustine and etoposide (14) or busulphan and cyclophosphamide (three). The marrow was then infused. MAIN OUTCOME MEASURES: Remission (complete or partial), disease-free survival and overall survival. RESULTS: Over all, 10 of 17 patients (59%) entered or remained in complete remission and four of 17 (24%) achieved partial remission. The overall actuarial survival at 30 months was 70%. Eight of the nine patients with treatment-sensitive disease (89%) remain disease-free at a median of 22 months (range, 18-29 months) after transplantation. Two of the eight patients with resistant disease (25%) are disease-free at 20 and 28 months. There was one procedure-related death from haemorrhage and four disease-related deaths at six, seven, eight and 13 months after transplantation. CONCLUSION: Autologous bone marrow transplantation may provide an effective salvage therapy in advanced Hodgkin's disease, particularly for patients with treatment-sensitive disease and a low tumour burden.     

小剂量拓扑替康联合顺铂治疗晚期肺鳞癌的临床研究

目的：观察小剂量拓扑替康联合顺铂治疗晚期肺鳞癌的疗效和毒副反应。方法：经病理组织学或细胞学证实的38例肺鳞癌患者给予拓扑替康0．8mg/m^2静滴，第1－5天，顺铂50－70mg/m^2静滴，第6天，21天为1周期，结果：全组无完全缓解，部分缓解17例，稳定15例，进展6例，27例初治者和11例复治者近期有效率分别为48．1％，36．4％，总有效率44．7％，中位生存期10个月（4－14个月），1年生存率为34．2％，毒副反应主要有骨髓抑制，胃肠道反应及轻度脱发，结论：小剂量拓扑替康联合顺铂治疗肺鳞癌具有较好的疗效，不良反应可耐受。     

Combination chemotherapy with cisplatin, vindesine and mitomycin-C for advanced, inoperable non-small-cell lung cancer.

OBJECTIVES: To assess the activity of chemotherapy with cisplatin, vindesine and mitomycin-C (PVM) in advanced non-small-cell lung cancer (NSCLC) and to test the feasibility of preemptive therapy with PVM. DESIGN AND SETTING: A phase II clinical trial of PVM in patients with NSCLC treated at the Royal Prince Alfred Hospital between June 1987 and July 1990. PATIENTS: Forty-one patients with advanced, inoperable or recurrent NSCLC--22 women, 19 men, with a median age of 51 years. Thirteen patients had been treated previously with radiotherapy and/or surgery; 18 had extrathoracic metastases. Four patients previously deemed inoperable were treated preemptively with PVM before proceeding to radical surgery. INTERVENTIONS: Cisplatin 100 mg/m2, vindesine 5 mg and mitomycin-C 8 mg/m2, all given intravenously on Day 1, with vigorous hydration and antiemetic therapy. Cycles were repeated every four weeks. MAIN OUTCOME MEASURES: Objective tumour response to treatment, patient survival time, time to treatment failure, and treatment toxicity. RESULTS: There was one complete tumour response to PVM and 15 partial responses; 14 patients had stable disease and nine had progressive disease--yielding an objective response rate (complete plus partial responses) of 39% (16/41; 95% confidence interval [CI], 24%-56%). Responses were documented in all histological subgroups, in both locally advanced and disseminated disease, and in recurrent disease. Median survival of the group was six months (95% CI, 5-10 months; range, 0.5-19+ months), and is unchanged by exclusion of the four patients treated before surgery. Seven of the 41 patients (17%) survived 12 months or longer. Median time to treatment failure in patients who had an objective response was six months (95% CI, 5-10 months). Grade 3 or 4 nausea and vomiting occurred in 21 patients (51%). Haematological, renal and neurological toxicity were not major problems; there were no deaths from treatment toxicity. CONCLUSION: PVM is an active regimen in advanced NSCLC and can produce durable remissions. The potential palliative effects of PVM in incurable disease must be weighed against the risk of subjective toxicity.     

腹腔灌注联合静脉化疗治疗晚期卵巢癌疗效观察

目的:探讨顺铂腹腔灌注联合多西他赛静脉化疗治疗晚期卵巢癌患者的疗效和不良反应。方法:选取晚期卵巢癌患者(Ⅲ-Ⅳ期)70例为研究对象,将患者随机分为顺铂联合多西他赛静脉化疗36例(对照组),以及顺铂腹腔灌注联合多西他赛静脉化疗34例(观察组)。对比分析两组化疗效果以及化疗不良反应。结果:观察组患者总有效率为76.47%,对照组总有效率为50.00%,两组比较差异有统计学意义(P<0.05)。观察组不良反应率为47.06%,毒副反应级别主要为Ⅰ-Ⅱ级。观察组与对照组相比,差异有统计学意义(P<0.05)。各组患者5年生存率无统计学意义(P>0.05);而观察组患者3年生存率为55.88%,显著高于对照组,差异有统计学意义(P<0.05)。观察组平均中位生存时间显著优于对照组,差异有统计学意义(P<0.05)。结论:顺铂腹腔灌注联合多西他赛静脉化疗治疗晚期卵巢癌,较顺铂联合多西他赛静脉化疗疗效好,化疗毒副反应小。     

培美曲塞在晚期非小细胞肺癌二线治疗中的应用

目的探讨培美曲塞单药或联合顺铂作为二线治疗方案治疗晚期复发或进展的非小细胞肺癌患者的疗效及毒副反应。方法回顾性总结接受培美曲塞二线治疗的50例晚期非小细胞肺癌患者,按照用药情况分为单药治疗组22例及联合铂类治疗组28例。评价2组近期疗效及不良反应。结果 50例患者均可评价疗效。2组均无CR病例。单药治疗组PR2例,SD10例,PD10例,有效率（CR＋PR）9.1%,疾病控制率（CR＋PR＋SD）54.5%,中位无进展生存期3.8个月;联合治疗组PR3例,SD13例,PD8例,有效率7.1%,疾病控制率71.4%,中位无进展生存期4.8个月。2组比较,有效率及中位无进展生存期差异无统计学意义（P均〉0.05）,联合铂类治疗组疾病控制率较高（P〈0.05）。与药物相关的不良反应主要为I/II度骨髓抑制、胃肠道反应、皮疹,与联合铂类治疗组比较,单药治疗组的副作用（红细胞减少、消化道反应）较低（P〈0.05）。结论晚期非小细胞肺癌的二线治疗方案可选择培美曲塞单药或联合顺铂,安全性相对较好,但是两药联合治疗方案毒副反应略有增加。     

Long-term outcomes of gemcitabine and cisplatin in patients with recurrent or metastatic esophageal squamous cell carcinoma: a phase II trial

Background  Esophageal cancer is the sixth most common cause of cancer-related death worldwide. Prior studies had demonstrated potential synergistic antitumor activity of gemcitabine in combination with cisplatin. Therefore, we studied the efficacy and tolerability of such combination for esophageal cancer.

Methods  Between October 2003 and October 2006, thirty-eight patients with metastatic or recurrent advanced squamous cell carcinoma of the esophagus were enrolled. The median number of treatment cycles per patient was 4 (range 1–7). Gemcitabine was given at 1000 mg/m² over 30 minutes on days 1, 8 and cisplatin 40 mg/m² was given on days 1, 2 in an every 21-day cycle. 

Results  The median follow-up for all 38 patients was 76 months (range 11–88 months). The overall response rate was 42.1% (95%CI, 25.5%–56.5%). Median progression-free survival and median survival for all patients were 4.1 months (95%CI, 3.0–5.7 months) and 10 months (95%CI, 7–12 months), respectively. Patients with a response had significantly longer median survival compared with the patients without a response (11 months vs. 7.5 months, P=0.0069). Overall survival at 1 year was 36.8%, at 2 years was 10.5%, and at 5 years was 5.3%. The most common grade 3–4 toxicity for all patients was leucopenia (44.7%). 

Conclusions  This cisplatin-gemcitabine regimen was manageable and had significant efficacy in patients with esophageal squamous cell carcinoma. Patients with a response had improved survival time. Furthermore, a small number of the patients with metastatic esophageal cancer were still alive in 5 years with this regimen.

     

NP和CAF方案治疗晚期乳腺癌疗效及副反应分析

目的比较NP和CAP方案对晚期乳腺癌的疗效和毒副反应.方法 78例晚期乳腺癌患者分别接受NP、CAF方案的治疗,病例数分别为37和41,观察疗效和毒副反应.结果 NP组总有效率为64.9%(其中初治组73.7%,复治组55.6%),CAF组有效率为41.5%(其中初治组52.4%,复治组30.0%).两组初治、复治病例有效率差异无统计学意义(P＞0.05),总有效率差异有统计学意义(P＜0.05);其中位缓解期分别为7.6和8.1个月,中位生存期分别为17.5和18.6个月,两组差异无统计学意义.NP组静脉炎发生率多于CAF组,而CAF组心脏毒性及脱发多于NP组,其余不良反应发生率相近.结论NP方案是治疗晚期乳腺癌的有效方案,其不良反应均能耐受.     

Chemotherapy for bronchogenic carcinoma. Methotrexate, doxorubicin, cyclophosphamide, and lomustine

A combination chemotherapy (MACC) consisting of methotrexate, doxorubicin hydrochloride (Adriamycin), cyclophosphamide, and lomustine (CCNU) was given to 41 patients with stage III bronchogenic carcinoma, 34 of whom had disseminated disease. The objective response rate was 46% for all patients with a median actuarial survival of nine months. Response was seen in all cell types, including four of ten patients with squamous cell carcinoma, six of 17 with adenocarcinoma, and six of seven with small-cell anaplastic carcinoma. Prolongation of survival was apparent for patients of all cell types. Toxic reactions were moderate and allowed for easy outpatient use.     

125I放射性粒子肺内插植联合吉西他滨+顺铂支气管动脉灌注化疗治疗中晚期非小细胞肺癌临床疗效观察

目的探讨125I放射性粒子肺内插植联合吉西他滨+顺铂支气管动脉灌注化疗治疗中晚期非小细胞肺癌临床疗效、不良反应及注意事项。方法将我院呼吸科自2011年3月～2012年8月期间收诊的206例中晚期非小细胞肺癌患者随机分为治疗组和对照组,治疗组103例给予125I放射性粒子肺内插植联合吉西他滨+顺铂支气管动脉灌注化疗治疗,对照组103例给予吉西他滨联合顺铂支气管动脉灌注化疗治疗,以两组患者的临床治疗有效率、中位生存期和不良反应发生率为观察指标对比治疗效果。结果治疗组的临床治疗有效率(42.11%)明显高于对照组(25.00%),治疗组的中位生存期(15.06±1.03)个月明显高于对照组(10.12±1.78)个月,差异均有统计学意义(P<0.05)。治疗组的不良反应发生率(36.02%)与对照组(35.08%)比较,差异无统计学意义。结论125I放射性粒子肺内插植联合吉西他滨+顺铂支气管动脉灌注化疗治疗中晚期非小细胞肺癌临床疗效确切,不良反应少,可以明显延长患者的中位生存期,建议在临床上大力推广使用。     

紫杉醇联合顺铂腹腔给药治疗52例晚期卵巢癌效果分析

【摘要】目的探讨紫杉醇联合顺铂腹腔给药途径治疗晚期卵巢癌的临床效果。方法选择2005年2月-2007年2月间我院收治的晚期卵巢癌患者52例为观察组,以同时期52例晚期卵巢癌患者为对照组。观察组行腹腔给药途径,对照组通过静脉给药。比较两组患者的治疗效果及不良反应发生情况。结果观察组和对照组的有效率分别为94．2％、88．4％（X2=4．57,P=0．133）;中位无进展生存期分别为28-3个月、26．4个月（P=0．342）;1年生存率分别为79．3％及78．2％（P=0．572）,3年生存率分别为42．5％及43．1％（P=0．837）,5年生存率分别为30．7％及28．4％（P=0．593）,中位生存期分别为36_4个月、34．2个月（P=0．371）。观察组不良反应的发生率略高于对照组,但差异并无统计学意义（P〉0．05）。结论紫杉醇联合顺铂腹腔给药治疗晚期卵巢癌疗效确切,患者远、近期疗效均有一定改善,值得进一步的临床研究。     

环磷酰胺和5-氟尿嘧啶对卵巢透明细胞腺癌的协同作用

目的 研究环磷酰胺和5-氟尿嘧啶对卵巢透明细胞腺癌的协同作用。方法 采用四唑基础半自动化的比色（MTT）检验法，评价在6个卵巢癌细胞系包括4个透明细胞腺癌和两个浆液性乳头状腺癌中，应用7种单独的药物和7种药物联合体系化疗药物的细胞毒性作用。结果 顺铂产生的50%生长抑制药物浓度（IC50）在5个细胞系中是在临床可达到的药物浓度范围之内，环磷酰胺的IC50曲线下的面积（AUC）在两个浆液性乳头细胞系中是在临床中可达到的AUC之下，Paclitxel在透明细胞癌中比浆液乳头细胞癌中更加有效。当不考虑这些原发肿瘤的组织病理学特征，在Paclitaxel和顺铂，环磷酰胺和顺铂或5-Fu联合用药中发现细胞毒性加强，结论 卵巢癌细胞系对于化疗药物反应的不同依赖于组织病理学特性，个性化的治疗方案可能改善卵巢癌患者的预后。     

新辅助化疗在晚期卵巢癌治疗中的意义

目的探讨新辅助化疗在治疗晚期卵巢癌中的临床意义。方法选择采用肿瘤细胞减灭术＋化疗综合治疗的Ⅲ、Ⅳ期卵巢癌患者45例,其中新辅助化疗组20例,先期手术组25例做对照研究。结果新辅助化疗组化疗有效率55.0%,腹水消失率56.3%。新辅助化疗组和先期手术组手术最佳减灭率分别为65.0%和32.0%（P〈0.05）。中位生存时间分别为34个月和28个月,两组间生存率比较,差异无统计学意义（P〉0.05）。结论对先期手术预计不能达到满意肿瘤减灭术或不能进行手术的晚期卵巢癌患者,新辅助化疗能提高最佳减灭率,但并未延长患者的生存时间。     

培美曲塞与吉西他滨联合顺铂一线治疗晚期非小细胞肺癌的对比研究

目的:探讨培美曲塞与吉西他滨联合顺铂一线治疗晚期非小细胞肺癌（NSCLC）的临床疗效及不良反应。方法:分析晚期NSCLC一线化疗病人46例,采用培美曲塞联合顺铂化疗组22例（培美曲塞组）,吉西他滨联合顺铂化疗组24例（吉西他滨组）。比较2组病人的近期疗效、中位无疾病进展生存时间（PFS）和不良反应发生情况。结果:培美曲塞组和吉西他滨组的客观缓解率分别为36.4%和29.2%,疾病控制率分别为62.5%和45.8%,中位PFS分别为6.5个月和6.0个月,差异均无统计学意义（P>0.05）。2组病人不良反应均可耐受。培美曲塞组和吉西他滨组粒细胞减少分别为36.4%（8/22）和66.7%（16/24）,差异有统计学意义（P<0.05）。结论:培美曲塞或吉西他滨联合顺铂治疗晚期NSCLC的临床疗效相似,但前者不良反应发生率减低,病人耐受性较好,值得临床推广。     

吉西他滨与多西他赛联合顺铂治疗晚期NSCLC的临床研究

目的 研究比较吉西他滨与多西他赛联合顺铂治疗晚期非小细胞肺癌（NSCLC）的临床疗效。方法 将 72 例晚期非小细胞肺癌患者随机分成两组,分别接受吉西他滨与多西他赛联合顺铂化疗,每例患者至少接受 2 个周期以上的同一方案治疗,比较两组方案治疗的近期疗效、不良反应及 1 年生存期。结果 吉西他滨联合顺铂化疗组有效率为 47.2％,多西他赛联合顺铂化疗组有效率为 44.5％,吉西他滨联合顺铂化疗组患者中位生存期 11.4 m,1年生存率为 44.5％,多西他赛联合顺铂化疗组患者中位生存期 11.1 m,1 年生存率 41.7％,两组的各项结果比较均无统计学差异（P＞0.05）。结论 吉西他滨与多西他赛联合顺铂方案治疗晚期 NSCLC 疗效相似,可以作为临床一线治疗方案。     

GP与NP方案治疗晚期非小细胞肺癌的临床对比观察

目的评价吉西他滨联合顺铂(GP)方案与诺维本联合顺铂(NP)方案治疗晚期非小细胞肺癌的疗效及毒副反应。方法经病理组织学或细胞学证实的62例非小细胞肺癌患者,随机分为两组,吉西他滨联合顺铂组(A组)31例,以吉西他滨1 200 mg/m2静滴,第1、8天,顺铂80 mg/m2静滴,第1天;诺维本联合顺铂组(B组)31例,以诺维本25mg/m2静滴,第1、8天,顺铂80 mg/m2静滴,第1天。两方案均每3周重复,3周期以上评价疗效。结果A、B两组的有效率分别为48.3%(15/31)、51.1%(16/31),组间无显著性差异(P>0.05);中位疾病进展时间分别为4.8个月和3.8个月,组间有显著性差异(P<0.05);一年生存率A组为45.2%、B组为41.9%,组间无显著性差异(P>0.05)。A组Ⅲ~Ⅳ度血小板减少高于B组,但Ⅲ~Ⅳ度白细胞减少及脱发明显低于B组。结论A、B两组在有效率、中位生存期及一年生存率方面均较接近,但中位疾病进展时间吉西他滨组略占优势。     

Medical adrenalectomy with aminoglutethimide in the management of advanced breast cancer

Sixty-five patients with actively progressing advanced breast cancer were treated with aminoglutethimide, a drug which inhibits adrenal steroid synthesis and decreases peripheral conversion of androgens to oestrogens. Of the 38 patients who have so far been classified, 13 (34%) have experienced objective regression of their disease, while in a further six patients (16%) the disease has become static. The median duration of the objective remission was in excess of 14 months, while in the group with static disease, the median duration of the static condition was longer than eight months. Side effects were either nonexistent or mild in the majority of cases, and the drug was well tolerated. Aminoglutethimide is an important new modality in the treatment of advanced breast cancer.