参芪扶正注射液联合化疗治疗非小细胞肺癌的临床观察

目的：比较参芪扶正注射液联合化疗与单纯化疗治疗非小细胞肺癌的临床疗效及不良反应。方法：60例非小细胞肺癌患者随机分为参芪扶正注射液配合化疗组（治疗组）和单纯化疗组（对照组）,其中配合化疗组30例,采用紫杉醇135mg／m。＋生理盐水500ml静滴3小时以上,第1天,后予顺铂25mg／m2静滴,第1—3天方案化疗,化疗时常规行预处理,化疗前3天开始静滴参芪扶正注射液250ml,1次／日,连用10天,每2l天为1周期。对照组30例化疗方案同治疗组,至少2个周期后评价疗效及生存质量改善情况。结果：参芪扶正注射液配合化疗组总有效率（40．0％）较单纯化疗组（33．3％）高,但差异无统计学意义（P〉0．05）,但在改善患者生活质量、减轻化疗毒性方面明显优于单纯化疗组,差异有显著性（P〈0．05）。结论：参芪扶正注射液联合化疗在治疗非小细胞肺癌中可提高化疗疗效,减轻化疗毒性,提高患者生活质量。     

参芪扶正注射液配合紫杉醇加顺铂治疗中晚期非小细胞肺癌的临床观察

目的：评价参芪扶正注射液配合紫杉醇加顺铂在中晚期非小细胞肺癌化疗中的作用。方法：60例中晚期非小细胞肺癌患者随机分为参芪扶正注射液配合化疗组（治疗组）和单纯化疗组（对照组），其中配合化疗组30例，采用紫杉醇135mg／m^2＋生理盐水500ml静滴3小时以上，第1天，后予顺铂30mg／m^2静滴，第1—3天方案化疗，化疗时常规行抗过敏预处理及止吐处理，化疗当天静滴参芪扶正注射液250ml，1次／日，连用10天-14天，每21天为1周期。对照组30例化疗方案同配合化疗组，至少2个周期后评价疗效及生存质量改善情况。结果：参芪扶正注射液配合化疗组总有效率（53．3％）较单纯化疗组（46．6％）高，但差异无统计学意义（P〉0．05），在改善患者生活质量、减轻化疗毒性方面明显优于单纯化疗组，差异有显著性（P〈0．05）。结论：参芪扶正注射液配合紫杉醇加顺铂在治疗非小细胞肺癌中可提高化疗疗效，减轻化疗毒性，提高患者生活质量。     

参芪扶正注射液配合吉西他滨治疗老年晚期非小细胞肺癌的临床观察

目的 观察参芪扶正注射液配合吉西他滨化疗在老年晚期非小细胞肺癌治疗中的作用.方法 将93例老年晚期非小细胞肺癌随机分为治疗组和对照组,其中治疗组47例,对照组46例.治疗组应用参芪扶正注射液静脉滴注配合吉西他滨每周方案化疗,化疗前3 d用参芪扶正注射液250 mL,静脉滴注,1次/d,7 d为1个周期;吉西他滨1.0 g/m2,d1,8,静脉注射,21 d为1个周期.对照组仅给予吉西他滨化疗,方案同治疗组.治疗后评价疗效和毒副反应.结果 两组疗效相近(P＞0.05),治疗组临床受益反应(CBR)高于对照组(P＜0.05).治疗组主要毒副反应发生率低于对照组(P＜0.05).结论 参芪扶正注射液配合吉西他滨化疗治疗老年晚期非小细胞肺癌能减轻化疗的毒副反应,提高CBR评价,改善患者生活质量.     

艾迪注射液联合化疗中晚期非小细胞肺癌的临床疗效

目的:探讨艾迪注射液联合化疗中晚期非小细胞肺癌的临床疗效.方法:将65例中晚期非小细胞肺癌患者随机分为治疗组(艾迪加化疗组)33例和对照组(单纯化疗组)32例.治疗组:采用艾迪注射液联合化疗,化疗方案为盖诺25mg/m2静滴第1、8天,顺铂(DDP)30mg/m2静滴第1～3天;同时配合艾迪注射液50ml加5%葡萄糖水500ml静脉滴注,每天一次;连用10天为一周期,每间隔21天重复治疗,共3～4周期.对照组:单用化疗,方案同治疗组,每间隔21天重复化疗,共3～4周期.结果:治疗组近期有效率(CR+PR)为66.67%,对照组近期有效率(CR+PR)为40.63%;生活质量改善率(等级提高)治疗组为78.80%,对照组为46.88%,两组比较有统计学意义(P＜0.05);两组毒性反应主要为骨髓抑制和胃肠道反应,骨髓抑制发生率治疗组为36.36%、对照组为75.0%,两组比较有统计学意义(P＜0.05);胃肠道反应发生率治疗组为42.42%、对照组为37.50%,两组比较无统计学意义(P＞0.05).结论:艾迪注射液联合化疗治疗中晚期非小细胞肺癌能提高化疗疗效,同时又能减轻化疗的毒性反应,提高患者生活质量,并有保护骨髓的作用,故艾迪注射液可作为一种有效的化疗增效减毒剂,配合化疗治疗中晚期非小细胞肺癌.     

参芪扶正注射液配合化疗治疗恶性肿瘤的疗效观察

目的:观察参芪扶正注射液配合化疗治疗恶性肿瘤的疗效增效作用。方法:配合化疗组42例及单纯化疗组42例。按不同病种及病理类型制定相应化疗方案。配合化疗组,化疗开始前1天开始配合应用参芪扶正注射液250ml,1日1次,21天为1周期。结果:参芪扶正注射液配合化疗组在改善患者临床症状,提高生活质量、提高免疫功能、保护骨髓造血功能等方面明显优于单纯化疗组,对化疗有明显的增效减毒作用。结论:参芪扶正注射液有扶正固本、增强免疫功能、减轻化疗的毒副反应、提高生存质量等作用。     

参芪扶正注射液联合化疗对中晚期非小细胞肺癌患者生存质量的影响

目的:观察参芪扶正注射液联合化疗对中晚期非小细胞肺癌患者生存质量(QOL)的影响.方法:将60例中晚期非小细胞肺癌患者随机分为两组.均采用相同的PT化疗方案,即紫杉醇135mg/m2,d1,顺铂25mg/m2,d2-4,3周为一疗程.联合组加用参芪扶正注射液250ml静滴,每日1次,化疗前3天开始,连用10天.共观察两个疗程.采用欧洲癌症研究和治疗组织的肺癌病人功能量表(EORTC QLQ-C43)、肺癌治疗状态评价量表(FACT-L)两种国际生存质量量表及上海胸科医院设计的中医生存质量量表作为测定工具,并以传统疗效评价指标KPS(体能状态卡氏评分)、ECOG(东部协作组体能状态计分)作为参照,观察治疗期间患者的生存质量影响.结果:通过三种量表的评价,治疗后联合组较对照组QOL有一定程度改善,两组间比较差异有显著性(P<0.05),而体能状态ECOG、KPS评分结果相似(P>0.05).结论:参芪扶正注射液联合化疗能够显著提高中晚期非小细胞肺癌患者的生存质量.     

参芪扶正注射液联合GP方案治疗晚期非小细胞肺癌的临床观察

观察参芪扶正注射液联合GP方案治疗晚期非小细胞肺癌的疗效和毒副作用。方法治疗组35例,对照组35例,均采用相同的GP化疗方案,即吉西他滨1g／m^3,d1、8,DDP 25mg／m^2 d1～3。治疗组加用参芪扶正注射液250ml静滴,每天1次,连用10天。结果两组疗效无显著性差异（P〉0．05）;治疗组血液毒副作用和消化道发生率明显低于对照组,有显著性差异（P〈0．05）。结论参芪扶正注射液联合GP方案治疗晚期非小细胞肺癌可降低化疗对患者的毒副作用,改善患者的生存质量。     

参芪扶正注射液辅助NP方案治疗老年晚期非小细胞肺癌近期疗效

目的：观察参芪扶正注射液辅助NP方案治疗老年晚期非小细胞肺癌（NSCLC）近期疗效和毒性反应。方法：治疗组35例，对照组34例，长春瑞滨（NVB）25mg／m^２静脉推注，第1、8天，顺铂（PDD）30mg，静脉滴注，第1—4天；治疗组化疗期间常规静滴参芪扶正注射液250ml每日1次，连用10日。结果：两组近期疗效差异无显著性（P＞0．05）；治疗组血液毒性反应和恶心、呕吐发生率明显低于对照组，差异有显著性（P＜0．05）。所有不良反应均能耐受。结论：参芪扶正注射液辅助NP方案治疗老年晚期NSCLC安全有效，参芪扶正注射液对老年晚期NSCLC化疗有一定减毒作用。     

参芪扶正注射液配合化疗治疗肺癌的临床观察

目的探讨参芪扶正注射液配合化疗治疗肺癌的增效减毒,改善肺癌化疗副反应的作用。方法将100例肺癌患者随机分为治疗组和对照组。治疗组化疗前3天用参芪扶正注射液250ml静脉滴入,每天1次,10天为一个周期。对照组为单纯化疗。结果治疗组总有效率为52%,对照组总有效率为32%,血液毒性白细胞降低Ⅱ度以上发生率治疗组为40%,对照组为62%,血小板分别为22%及44%,两组间有显著性差异(P<0.05)。同时体重及生活质量治疗组均较对照组提高,差异有显著性(P<0.05)。胃肠道反应治疗组较对照组明显减轻。结论参芪扶正注射液联合化疗有明显协同作用,能减轻化疗的副反应,保护造血系统,改善恶心、呕吐反应,使体重增加,提高患者的生活质量。     

艾迪注射液联合化疗中晚期非小细胞肺癌的临床疗效

目的探讨艾迪注射液联合化疗中晚期非小细胞肺癌的临床疗效。方法将65例中晚期非小细胞肺癌患者随机分为治疗组(艾迪加化疗组)33例和对照组(单纯化疗组)32例。治疗组采用艾迪注射液联合化疗,化疗方案为盖诺25mg/m2静滴第1、8天,顺铂(DDP)30mg/m2静滴第1～3天;同时配合艾迪注射液50ml加5%葡萄糖水500ml静脉滴注,每天一次;连用10天为一周期,每间隔21天重复治疗,共3～4周期。对照组单用化疗,方案同治疗组,每间隔21天重复化疗,共3～4周期。结果治疗组近期有效率(CR+PR)为66.67%,对照组近期有效率(CR+PR)为40.63%;生活质量改善率(等级提高)治疗组为78.80%,对照组为46.88%,两组比较有统计学意义(P<0.05);两组毒性反应主要为骨髓抑制和胃肠道反应,骨髓抑制发生率治疗组为36.36%、对照组为75.0%,两组比较有统计学意义(P<0.05);胃肠道反应发生率治疗组为42.42%、对照组为37.50%,两组比较无统计学意义(P>0.05)。结论艾迪注射液联合化疗治疗中晚期非小细胞肺癌能提高化疗疗效,同时又能减轻化疗的毒性反应,提高患者生活质量,并有保护骨髓的作用,故艾迪注射液可作为一种有效的化疗增效减毒剂,配合化疗治疗中晚期非小细胞肺癌。     

Experience with Impedance Phlebography Compared with Venography

Venography is a particularly reliable method for the diagnosis of deep venous thrombosis but is not suitable as a screening test. Impedance phlebography represents another attempt to discover a simple, non-invasive and reliable method of detecting deep venous thrombosis. It does not, however, meet these criteria.     

Treatment with methylnaltrexone is associated with increased survival in patients with advanced cancer

BackgroundMethylnaltrexone (MNTX), a peripherally acting μ-opioid receptor (MOR) antagonist, is FDA-approved for treatment of opioid-induced constipation (OIC). Preclinical data suggest that MOR activation can play a role in cancer progression and can be a target for anticancer therapy.Patients and methodsPooled data from advanced end-stage cancer patients with OIC, despite laxatives, treated in two randomized (phase III and IV), placebo-controlled trials with MNTX were analyzed for overall survival (OS) in an unplanned post hoc analysis. MNTX or placebo was given subcutaneously during the double-blinded phase, which was followed by the open-label phase, allowing MNTX treatment irrespective of initial randomization.ResultsIn two randomized, controlled trials, 229 cancer patients were randomized to MNTX (117, 51%) or placebo (112, 49%). Distribution of patients' characteristics and major tumor types did not significantly differ between arms. Treatment with MNTX compared with placebo [76 days, 95% confidence interval (CI) 43–109 versus 56 days, 95% CI 43–69; P = 0.033] and response (laxation) to treatment compared with no response (118 days, 95% CI 59–177 versus 55 days, 95% CI 40–70; P < 0.001) had a longer median OS, despite 56 (50%) of 112 patients ultimately crossing over from placebo to MNTX. Multivariable analysis demonstrated that response to therapy [hazard ratio (HR) 0.47, 95% CI 0.29–0.76; P = 0.002) and albumin ≥3.5 (HR 0.46, 95% CI 0.30–0.69; P < 0.001) were independent prognostic factors for increased OS. Of interest, there was no difference in OS between MNTX and placebo in 134 patients with advanced illness other than cancer treated in these randomized studies (P = 0.88).ConclusionThis unplanned post hoc analysis of two randomized trials demonstrates that treatment with MNTX and, even more so, response to MNTX are associated with increased OS, which supports the preclinical hypothesis that MOR can play a role in cancer progression. Targeting MOR with MNTX warrants further investigation in cancer therapy.Clinical trials numberNCT00401362, NCT00672477.     

Compliance with guidelines and correlation with outcome in patients with advanced germ-cell tumours

PurposeTo evaluate prior compliance with guidelines in patients treated with salvage chemotherapy for advanced germ-cell tumours (GCT).Patients and methodsData concerning the initial management of patients requiring salvage chemotherapy for GCT at Institut Gustave Roussy between 2000 and 2010 were obtained and correlated with recommendations for treatment. Criteria of non-compliance were defined based on guidelines. Compliance with guidelines, predictive factors for non-compliance and the impact on outcome were analysed.ResultsAmong 82 patients treated in the salvage setting, guidelines to initial treatment were followed in only 41 cases (50%). The most common non-compliance criteria were non-adherence to the planned dose (16%), an inappropriate interval between first-line chemotherapy cycles (16%), the lack of post-chemotherapy surgery (16%) and a long interval to post-chemotherapy surgery (48%). Compliance with standard care was better in cancer centres than in other hospitals (private or public) (Odd Ratio (OR): 6.9, P = 0.001). A poor-risk status according to the International Germ Cell Cancer Collaborative Group (IGCCCG) was also predictive of compliance in univariate but not in multivariate analysis. No significant difference in outcome after salvage chemotherapy was observed. Patients relapsing after non-compliant first-line therapy tended to be more easily salvaged, which is consistent with the fact that their initial treatment was inadequate. Some of these relapses were therefore probably not due to true biologically refractory disease.ConclusionGuidelines for first-line treatment are adhered to in only half the patients requiring salvage chemotherapy. As the only predictive factor for non-compliance was the treating centre, centralisation of patients with GCT in well-trained hospitals should be recommended.     

奥沙利铂联合羟基喜树碱治疗晚期胃癌临床分析

背景与目的体外及体内的临床研究显示,奥沙利铂(L-OHP)对多种肿瘤有显著抑制作用并与绝大多数抗癌药物具有相加或协同细胞毒作用.本文旨在观察L-OHP联合羟基喜树碱(HCPT)治疗晚期胃癌的近期疗效和患者耐受性,并与传统的化疗方案进行对比.方法采用非随机的分组方法将43例晚期胃癌患者分为L-OHP+HCPT方案组(治疗组)与Vp-16+CF+5-FU(ELF)方案组(对照组),其中男性28例,女性15例,中位年龄59岁,KPS评分≥60,观察两组的近期疗效和患者耐受性.结果治疗组24例有效率58.3%(14/24),对照组19例有效率42.1%(8/19).治疗组有效率高于对照组,两组差异有显著性(P<0.05).两组不良反应主要是骨髓抑制、恶心、呕吐、口腔炎、周围神经炎、静脉炎、脱发等,均在Ⅰ、Ⅱ度范围内.结论L-OHP联合HCPT方案治疗晚期胃癌疗效较好,不良反应可以耐受.     

Living with secondary breast cancer: coping with an uncertain future with unmet needs

JOHNSTON S.R.D. (2010) European Journal of Cancer Care 19 , 561–563 Living with secondary breast cancer: coping with an uncertain future with unmet needs     

Varicella-Zoster Virus Prophylaxis with Low-Dose Acyclovir in Patients with Multiple Myeloma Treated with Bortezomib

BackgroundVaricella-zoster virus (VZV) reactivation is a common complication in patients with multiple myeloma (MM) treated with bortezomib, with an incidence rate of 10%-60%. The aim of our study was to analyze the effect of acyclovir prophylaxis in this patient population.Patients and MethodsWe studied 98 consecutive patients with relapsed MM treated with bortezomib. Bortezomib 1.3 mg/m² was given on days 1, 4, 8, and 11 of a 21-day cycle. At first, patients did not receive any VZV prophylaxis, but because of the high incidence of VZV reactivation, VZV prophylaxis with acyclovir was implemented subsequently.ResultsA total of 11 patients treated with bortezomib did not have any VZV prophylaxis, and 4 of these 11 patients (36%) developed VZV reactivation in the form of herpes zoster. No VZV reactivations were observed in the 32 patients who received acyclovir 400 mg 3 times daily or the 55 patients who received acyclovir in a dose reduced to 400 mg once daily during bortezomib treatment.ConclusionVaricellazoster virus reactivation is a common and serious adverse effect of bortezomib treatment. Acyclovir 400 mg once daily is sufficient to protect from VZV reactivation in patients with MM treated with bortezomib.     

Pseudomembranous colitis associated with chemotherapy with 5-fluorouracil

Pseudomembranous colitis is frequently associated with antibiotics and more rarely with chemotherapeutic agents such as 5-fluorouracil. The objective of this study is to show that it is possible to confuse this infection with chemotherapy associated toxicity. We present a 54 year old woman who underwent surgery for colorectal cancer and in the first cycle of chemotherapy with 5-fluorouracil developed pseudomembranous colitis. We detected the toxin B of Clostridium difficile in stools and we began early antibiotic treatment. Thus, in patients with post chemotherapy neutropenia and diarrhoea that develop negatively, we have to rule out this infection.