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1.
目的 研究紫杉醇+顺铂二线治疗复治小细胞肺癌患者的疗效和毒副反应.方法 纳入一线含铂方案(依托泊苷+卡铂)化疗失败患者38例,采用紫杉醇135 mg/m2,第1天;顺铂70 mg/m2,第1~3天,每3~4周为1个周期,连用2~4个周期.结果 部分缓解12例,稳定14例,进展12例,总有效率31.6%(12/38),疾病控制率68.4%(26/38),总生存期10.5个月,中位生存期6.8个月.化疗敏感者有效率39.3%(11/28);化疗耐药者有效率10.0%(1/10).本组38例均可评价毒副反应,Ⅲ度以上白细胞及中性粒细胞减少分别为47.4%(18/38)、57.9%(22/38).Ⅳ度中性粒细胞减少15.8%(6/38).中性粒细胞减少性发热10.5%(4/38).主要非血液学毒副反应是乏力、恶心呕吐、周围神经毒性,Ⅲ度以上毒性反应是乏力55.3%(21/38)、恶心呕吐31.6%(12/38).结论 紫杉醇+顺铂治疗复治小细胞肺癌有效且毒副反应可耐受.  相似文献   

2.
目的 研究长春瑞滨与铂类联合治疗70岁以上非小细胞肺癌患者的疗效和毒副反应.方法 老年肺癌患者共入选100例.化疗组50例,采用长春瑞滨25 mg/m2第1天和第5天,顺铂60~70mg/m2或卡铂250 mg/m2第2天,每4周为1个周期,连用2~4周期.对照组50例,为同期70岁以上患者,资料完整且未做治疗.结果 治疗组45例可评价疗效,部分缓解16例,有效率35.6%,1年生存率37.8%,中位生存期9.8个月;对照组中位生存期4.0个月.治疗组50例均可评价毒副反应,世界卫生组织(WHO)毒副反应标准Ⅲ度白细胞、中性白细胞、贫血发生率分别为38.0%、52.0%和2.2%,IV度中性粒细胞减少发生率35.5%.WHO毒副反应标准Ⅲ度非血液学毒性乏力、呕吐和便秘发生率分别为22.0%、14.0%和8.0%,因毒性反应终止治疗共5例.结论 长春瑞滨与铂类联合治疗高龄非小细胞肺癌有效且毒副反应可耐受.疗效稳定的患者也可从化疗受益.  相似文献   

3.
健择联合顺铂治疗晚期非小细胞肺癌的临床观察   总被引:1,自引:0,他引:1  
目的观察健择(GEM)加顺铂(DDP)联合治疗晚期非小细胞肺癌,临床疗效及毒副反应。方法健择1000mg/m3静滴30min第1、8天,顺铂40mg静滴,第1、2、3天。每21~28天为1周期,2周期后评价疗效及毒副反应。结果临床疗效50例患者均接受2个周期化疗。其中CR0例,PR24例,NC19例,PD7例,总有效率为48%,其中Ⅲb期有效率为53.8%(15/28),Ⅳ期有效率为40.9%(9/22)。结论健择加顺铂联合治疗晚期非小细胞肺癌疗效确切,副作用较少,是一种值得推荐的化疗方案。  相似文献   

4.
目的观察国产紫杉醇联合顺铂治疗Ⅲ~Ⅳ期非小细胞肺癌(NSCLC)的近期疗效和毒副反应。方法选Ⅲ~Ⅳ期NSCLC病例46例,用紫杉醇150 mg/m~2加入5%葡萄糖注射液500ml中静脉滴注3h,d_1,顺铂60 mg加入生理盐水注射液100 ml中静脉滴注,d_(2、3),3~4周为1周期,2~5周期后评价疗效。结果全组46例有效率为39.13%(18/46),主要毒副反应为血液毒性反应、脱发及消化道反应。结论紫杉醇联合顺铂治疗晚期NSCLC有较好疗效,毒副反应较小,可以耐受。  相似文献   

5.
目的探讨同步放化疗治疗局部晚期表皮生长因子受体(epidermal growth factor receptor,EGFR)野生型非小细胞肺癌(non-small cell lung cancer,NSCLC)合并慢性阻塞性肺病(chronic obstructive pulmonary disease,COPD)和肺不张患者的近期疗效及毒副反应。方法对42例局部晚期EGFR野生型NSCLC合并COPD和肺不张的患者给予低分割大剂量调强放射治疗,Dt:5Gy/次,隔日一次,3次/周,总剂量达到50~60Gy/10~12次,同步EP方案依托泊苷50 mg/m~2d1~5,顺铂d1~5(总量70 mg/m~2)化疗,每四周为一周期,共化疗两周期后评估患者疗效。结果治疗结束后复查患者胸部CT评估患者肺部原发肿块及纵膈阳性淋巴结退缩情况完全缓解(complete remission,CR)6例(14.3%),部分缓解(partial remission,PR)31例(73.8%),稳定(stable disease,SD)5例(11.9%),进展(progressive disease,PD)0例;毒副反应情况:毒性反应主要表现为放射性肺炎,其中0级16例(38.1%),Ⅰ~Ⅱ级21例(50%),Ⅲ级5例(12%)。结论对于局部晚期EGFR野生型NSCLC合并COPD和肺不张的患者低分割调强放射治疗同步EP方案化疗安全有效,毒副反应可以耐受。  相似文献   

6.
目的观察培美曲塞单药化疗二线治疗老年晚期非小细胞肺癌近期疗效及毒副反应。方法经病理及组织细胞学证实为ⅢB~Ⅳ期非小细胞肺癌(年龄大于70岁)患者21例,既往一线化疗失败,接受培美曲塞500mg/m2化疗,第1天,每21天为1个周期,每例患者至少完成2个周期,观察患者近期疗效及毒副反应。结果 21例患者总有效(完全缓解+部分缓解)率为9.5%(2/21),疾病控制(完全缓解+部分缓解+稳定)率为57.1%(12/21),主要毒副反应为骨髓抑制,其中以中性粒细胞下降为主。结论老年晚期非小细胞肺癌患者可从单药二线培美曲塞化疗中获益;毒副反应轻微。  相似文献   

7.
多西紫杉醇联合卡铂治疗晚期非小细胞肺癌的疗效观察   总被引:6,自引:1,他引:5  
目的观察多西紫杉醇联合卡铂治疗晚期非小细胞肺癌近期疗效及毒副反应。方法47例晚期非小细胞肺癌住院患者给予多西紫杉醇联合卡铂治疗,多西紫杉醇75mg/m2,静滴,d1,卡铂根据AUC5计算用量,静滴,d1,21d为1周期,每个患者均完成2个周期以上,评价疗效和不良反应,并随访生存期。结果47例患者治疗后CR0例、PR24例、NC17例、PD6例,有效率为51.1%。KS评分增加者70.2%(33/47)、稳定21.3%(10/47)、下降8.5%(4/47)。中位生存期9个月(95%CI8~10个月),1年生存率27.1%。最常见的毒副反应为骨髓抑制,全组68.1%(32/47)出现白细胞下降,其中Ⅲ度~Ⅳ度白细胞减少发生率为25.5%,恶心、呕吐29.8%(14/47),脱发87.2%(41/47)。其余毒副反应轻微,均可耐受。结论多西紫杉醇联合卡铂治疗晚期非小细胞肺癌有较好的疗效,毒副反应比较轻微。  相似文献   

8.
目的观察多西他赛联合奥沙利铂治疗晚期非小细胞肺癌的有效性和安全性。方法一线化疗失败的晚期非小细胞肺癌患者62例采用多西他赛联合奥沙利铂化疗,每3周重复,化疗3周期后,按WHO目标病灶缓解标准进行近期疗效和毒副反应评价。结果 62例患者均完成至少3周期化疗,总有效率35.4%,其中CR 3例,PR 19例。主要毒性为骨髓抑制,消化道反应,脱发等。结论多西他赛联合奥沙利铂治疗一线化疗失败的非小细胞肺癌有较好的确切疗效,并且毒性反应可以控制,耐受性好,可作为晚期非小细胞肺癌二线治疗的标准方案。  相似文献   

9.
目的观察紫杉醇(PTX)加顺铂(CDDP)联合化疗治疗晚期非小细胞肺癌的近期疗效及毒副反应。方法PTX135~175mg/m2静脉滴注,第1天;CDDP75mg/m2,分三次用完。每21天为1个周期,连用2或3周期。结果可评价疗效者37例,其中PR16例,总有效率为43.2%。毒副反应主要是骨髓抑制和恶心呕吐。结论PTX DDP治疗晚期非小细胞肺癌可获得较高疗效,毒副反应轻,是一个较好的联合化疗方案。  相似文献   

10.
目的探究依托泊苷联合顺铂对完全切除性肺低分化神经内分泌癌术后的近期疗效、远期生存及毒副反应。方法前瞻性分析收集肺低分化神经内分泌癌SCLC和LCNEC受试者共44例,给予依托泊苷(VP-16)100 mg/m~2,第1-3天;顺铂25 mg/m~2,第1-3天,21天为一个周期。至少完成3个周期的化疗以后评估疗效和毒副反应。结果有效率RR 61%,疾病控制率DCR为89%,其中LCNEC达92%,SCLC有83%(P0.05)。3年生存率达到82%,3年内无进展生存期(RFS)75%。主要的毒副反应为骨髓抑制,其中LCNEC血小板减少率,恶心呕吐及肝肾功能损害的发生率略高于SCLC。结论依托泊苷联合顺铂的化疗辅助方案对完全切除性肺低分化神经内分泌癌的治疗在可接受的毒性范围内,且具有可行性。  相似文献   

11.
The efficacy and toxicity of treatment with carboplatin (AUC= 5)+ docetaxel (70mg/m2) were analyzed retrospectively in 27 elderly patients with advanced non-small-cell lung cancer (NSCLC) aged 70 years or more. The median age of the patients was 74 years (range, 70-83 years). The performance status (ECOG), clinical stage, and tumor histology in the patients were as follows: PS: PS 0, 12 patients; PS 1, 11 patients; PS 2, 4 patients; disease stage: stage IIIA, 5 patients; stage IIIB, 11 patients; stage IV, 11 patients; tumor histology: adenocarcinoma, 18 patients; squamous cell carcinoma, 9 patients. The median number of treatment cycles administered was 4. The median survival time was 11.1 months and the 1-year survival rate was 40.7%. The response rate was 33.3%. The major toxicities were leukopenia and neutropenia; grade 3/4 neutropenia occurred in 22 patients (81.5%). Nonhematologic toxicities were generally mild, including grade 3 anorexia in 13 patients (48.1%) and grade 3 febrile neutropenia in 9 patients (33.3%). No treatment-related deaths were observed. Thus, it was concluded that the combination of carboplatin + docetaxel is a feasible, well-tolerated, and effective regimen for fit elderly patients with NSCLC. Prospective studies comparing carboplatin + docetaxel with third-generation single-agent chemotherapy or non-platinum-based combination chemotherapy are needed to confirm the efficacy and safety of this drug combination.  相似文献   

12.
The purpose of this study was to determine the maximum tolerated dose of carboplatin administered with 500 mg/m2 thiotepa and 100 mg/m2 melphalan followed by autologous peripheral blood stem cell (PBSC) infusion in patients with refractory malignancies. Twenty-eight patients with refractory malignancies received high-dose thiotepa (500 mg/m2, melphalan (100 mg/m2) and escalating doses of carboplatin 900-1500 mg/m2) followed by infusion of cryopreserved autologous PBSCs. The maximum tolerated doses were determined to be 500 mg/m2 thiotepa, 100 mg/m2 melphalan and 1350 mg/m2 carboplatin. Two consecutive patients receiving 1500 mg/m2 carboplatin experienced grade 3 mucositis and colitis. Ten patients were enrolled at the maximum tolerated dose and none had grade 3-4 regimen-related toxicity and mortality. All patients at this level experienced grade 1-2 mucositis, 90% grade 1-2 gastrointestinal toxicity, 30% grade 1-2 cardiac and renal toxicity, and 10% experienced grade 1 hepatic toxicity. The median time to achieve a granulocyte count of 0.5x10(9)/l was 9 days (range 7-12 days) and platelet count of 20x10(9)/l was 10 days (range 7-15 days). Of eight patients with stage IV refractory breast cancer, even were evaluable for response, one patient on day 75 will be evaluated soon. Five of seven (71.5%) evaluable patients achieved a complete remission (CR) and two had no response. Of seven patients with non-Hodgkin's lymphoma (n = 4) or Hodgkin's disease (n = 3), five achieved a CR (71.5%). Thiotepa, melphalan and carboplatin can be administered in high doses with tolerable mucositis as the major side-effect. This combination has significant activity in patients with breast cancer, and phase II studies in patients with breast cancer and other chemotherapy-sensitive malignancies are warranted.  相似文献   

13.
目的研究培关曲塞联合顺铂或卡铂治疗老年恶性胸膜间皮瘤的疗效和安全性。方法回顾性研究5年来我院收治的16例〉65岁,经病理及免疫组化确诊的Ⅱ一Ⅳ期老年恶性胸膜间皮瘤病例,体力状况评分(PS)2~3分者采用联合化疗,Ps4分者采用单药化疗,11例培美曲塞联合顺铂,4例培美曲塞联合卡铂,1例培美曲塞单药治疗,评价其客观有效率、无进展生存时间(PFS)以及不良反应。结果16例患者无完全缓解(CR)者,部分缓解(PR)率为37.50%,稳定(SD)为37.50%,进展(PD)为25.00%,中位PFS为3.5月。不良反应主要有:骨髓抑制Ⅲ~Ⅳ度3例,乏力12例,轻度肝功能损害3例,重度黏膜反应1例,色素沉着11例,无Ⅳ度消化道反应。结论培美曲塞联合顺铂或卡铂治疗老年恶性胸膜间皮瘤疗效较好,且不良反应可以耐受。  相似文献   

14.
Incidence of non-small cell lung cancer is increasing especially among elderly with about 40% arising in patients over 70 years old. Most of these elderly patients are under treated. Seventy-one patients with lung cancer over 70 years old were treated in Institut Paoli-Calmettes from January 2000 until December 2003 (male/female: 57/14). Median age was 75.5 years (70-92). OMS 0-1-2-3=4.2-60.6-25.4-4.2%, respectively. Comorbidities were represented by arterial hypertension, coronaropathy, cardiac failure, thrombo-embolism, respiratory failure, diabetes, vascular cerebral dysfunction, and renal failure. 29.6% of patients were without comorbidity, and 14.1% had at least three comorbidities. The averages of the Charlson comorbidity score and the Age-Charlson comorbidity score were 3.4 and 6.6, respectively. Histological characteristics: epidermo?d/adenocarcinoma/undifferentiated/small cells: 39.4%/26.8%/15.5%/9.9%. Most of them were advanced lung cancer: St IIIB=14 (19.7%) and St IV=37 (52.1%). Forty-six patients received chemotherapy (64.8%) with 40 patients (86.9%) with platin (carboplatin or cisplatin). The median number of treatment cycles was 4.1 (range 1-7). Two patients achieved complete response and 15 had partial response. The response rate was 39.6%. The 1-year survival rate was 48.5% and the estimated median survival time was 11 months (95%; 7-18 months) for all patients. The 1-year survival rate was 75% and 21.6% and the estimated median survival time was 25.9 months (95%; 12.6, ND) and 5.7 months (95%; 4.2-9.6) for stage IIIB and IV, respectively. Toxicities were judged acceptable with 19 hospitalizations after chemotherapy, for 16 patients who represent 34.8% of patients who received chemotherapy. CONCLUSIONS: Chemotherapy is feasible in elderly patients with lung cancer. Patients should be evaluated for chemotherapy based on their performance status and comorbidities especially with geriatric assessment rather than age alone. The chemotherapy with platinum seems to be tolerable and effective.  相似文献   

15.
The efficacy of the docetaxel–carboplatin combination chemotherapy was studied in various phase II studies. Based on these data we aimed to test the regimen in previously untreated patients with advanced advanced non-smoking lung cancer (NSCLC) with docetaxel 80 mg/m2 a standard dose of carboplatin at AUC = 5, in an attempt to define the efficacy and tolerability of the combination in an open-label phase II study. Patients with histologically confirmed advanced NSCLC stage IIIB and IV were candidates for the present study. Docetaxel was administered at 80 mg/m2 over 1 h by intravenous (IV) infusion followed by carboplatin AUC = 5 in 30 min IV infusion, both on day 1, and recycled every 21 days. Sixty patients received 263 courses of therapy in total; 231/263 (88%) were administered according to the planned doses, and 48/60 (80%) patients received chemotherapy without decrement of the dose; 32/263 (12%) of the courses were administered with a 10%–30% dose reduction. Complete responses (CR) were seen in 5 patients (8.3%) and partial responses (PR) in 16 patients (26.7%) for an overall response rate of 35%. Median duration of response was 7.5 months [95% confidence interval (CI)-7.1–7.9], time to progression (TIP) 11.5 months (95% CI-8.2–14.8), median overall survival (OS) 15.0 months (95% CI-10.8–19.2). One-year survival was 61.7%. Toxicity was acceptable; it was calculated according to the administered cycles and was mainly neutropenia: grade 3, 9% and grade 4, 2%; anemia: grade 3, 8%; nausea and vomiting: grade 3, 8%. The outpatient regimen of docetaxel–carboplatin is effective with acceptable toxicity in patients with advanced NSCLC.  相似文献   

16.
Thymoma is a chemotherapy-sensitive tumor with a 30-50% 5-year survival in previously untreated patients. Unfortunately, durable CRs with salvage chemotherapy are rarely observed. We initiated a phase II trial of high-dose carboplatin and etoposide in patients with relapsed thymoma or thymic carcinoma. All patients had progressive disease (PD) after initial or salvage chemotherapy, but were not cisplatin-refractory. PBSCs were mobilized using 10 microg/kg/day G-CSF. Patients received carboplatin 700 mg/m(2) and etoposide 750 mg/m(2) i.v. on days -5, -4, -3. Five patients were enrolled and evaluated after tandem transplants 4 weeks apart. All patients had pleural-based and lung parenchymal metastasis, one or two prior surgeries and two or more courses of prior cisplatin-based chemotherapy regimens. Chemotherapy was well tolerated, although grade IV hematological toxicity occurred in all patients. Progression-free survival following HDC ranged from 3.5 to 16.5 months. One patient maintained a CR for 12.8 months, then died from an unrelated cause. With a minimum of 2 years follow-up for all patients, three of five patients remain alive at 26+, 36+, and 49+ months. High-dose carboplatin and etoposide in relapsed thymoma is feasible with acceptable toxicity; however, these limited data do not appear superior to standard-dose salvage therapy.  相似文献   

17.
目的研究紫杉醇联合卡铂治疗老年和中青年晚期非小细胞肺癌患者的疗效、预后和毒副反应。方法对2002年1月~2005年12月我院收治的50例≥70岁的肺癌患者(老年组)和同一时间随机选择的50例〈70岁肺癌患者(中青年组)分别给予紫杉醇联合卡铂方案化疗。结果老年组有效率37.5%,中青年组有效率38.8%,差异无显著性(P〉0.05)。老年组中位生存时间为11.8个月,1年、2年生存率分别为31.3%、6.3%,中青年组中位生存期11.3个月,1年、2年生存率28.6%、4.1%,无显著性差异(P〉0.05)。主要毒副反应是骨髓抑制,Ⅲ及Ⅳ中性粒细胞减少老年组34.0%,中青年组30.0%,差异无显著性(P〉0.05)。结论年龄不是影响肺癌患者疗效、预后和毒副反应的主要因素。  相似文献   

18.
The purpose of this study was to determine the efficacy of salvage chemotherapy with, P-IMVP-16/CBDCA, consisting of carboplatin (CBDCA), etoposide (VP-16), ifosfamide (IFM), and methotrexate (MTX), for patients with aggressive non-Hodgkin's lymphoma (NHL) who had previously received CHOP [a regimen of cyclophosphamide, hydroxydaunomycin, Oncovin (vincristine), and prednisolone], as first-line chemotherapy. The 45 consecutively enrolled patients received methylprednisolone (mPSL) 1000 mg per body for 3 d (from day 1 to day 3), IFM 1000 mg/m(2) for 5 d (from day 1 to day 5), MTX 30 mg/m(2) on day 3 and day 10, VP-16 80 mg/m(2) for 3 d (from day 1 to day 3), and CBDCA 300 mg/m(2) on day 1, with granulocyte colony-stimulating factor every 21 d. Patients 70 yr of age or older were given 75% of the standard dose. The response rate [complete response (CR) plus partial response (PR)] was 55.6% (25/45), including 12 (26.7%) CR and 13 (28.9%) PR. The overall survival rate for the 45 patients was 31.1% at 1 yr and 17.3% at 2 yr. The failure-free survival rate for the 45 patients was 6.7% at 1 yr and 4.4% at 2 yr. The survival rate for the 25 responders was 48.0% at 1 yr and 24.0% at 2 yr, and the survival rate for the 20 non-responders was 10.0% at 1 yr (P<0.001). Multivariate analysis demonstrated that prior chemotherapy (reduced-dose CHOP for age 70 yr or older) and the number of cases of extranodal involvement (>1) were significant unfavorable factors for overall survival. Although the major toxicity was neutropenia, no patient died of infection related to neutropenia. Non-hematological adverse effects were predominantly mild and tolerable. Unfortunately, the clinical outcome with P-IMVP-16/CBDCA was unfavorable, possibly because the study comprised consecutive patients who had received identified intensive chemotherapy, such as biweekly CHOP. Salvage chemotherapy with P-IMVP-16/CBDCA is not sufficient to cure relapsed or refractory aggressive NHL. Aggressive NHL should be cured by first-line chemotherapy with or without hematopoietic stem cell transplantation.  相似文献   

19.
BACKGROUND: Carboplatin/paclitaxel every 3 weeks is the standard for patients with ovarian cancer, but elderly patients frequently receive modified schedules or single agent chemotherapy to avoid toxicity. A phase II study was conducted to describe tolerability of a weekly schedule of both drugs in elderly patients. METHODS: Patients aged>or=70 years with stage IC-IV ovarian cancer, performance status相似文献   

20.
吉西他滨联合铂类治疗晚期非小细胞肺癌的临床分析   总被引:5,自引:0,他引:5  
目的评价吉西他滨联合不同铂类化疗药物治疗ⅢB~Ⅳ期非小细胞肺癌(NSCL)的临床疗效和毒副反应。方法45例经细胞学或病理学证实ⅢB~Ⅳ期NSCLC患者(初治35例,复治10例),患者的预计生存时间均超过2个月。按三种方案联合化疗:(1)吉西他滨+顺铂(GEM/DDP),每3周重复1次;(2)吉西他滨+卡铂(GEM/CBP),每3周重复1次;(3)吉西他滨+顺铂(GEM/DDP),每4周重复1次。按美国癌症研究所(NCI)实体瘤疗效评价标准(Recist标准)对目标病灶评价,毒性反应按2007中国肺癌临床指南(NCI—CTCV2.0)标准进行评价。随访患者中位生存时间并计算1年生存率。结果共完成158个周期全身化疗,平均每个病人接受3.5个周期化疗。吉西他滨联合顺铂3周及4周方案、吉西他滨联合卡铂三种方案的有效率分别为45.8%(11/24)、45.5%(5/11)和50%(5/10),总有效率为46.7%(21/45),35例初治患者中有效18例,有效率51.4%,10例复治患者中有效3例,有效率30%。毒副反应主要为白细胞减少、血小板减少、消化道反应、皮疹和搔痒。中位生存时间(MST)为8.9个月,1年生存率为38.7%。结论吉西他滨联合铂类化疗药物治疗晚期NSCL疗效较好,且毒性反应少,耐受性好。  相似文献   

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