诺维本持续静脉输注联合顺铂治疗转移性乳腺癌临床观察

目的 探索诺维本不同用药方法联合顺铂治疗转移性乳腺癌的疗效和不良反应。方法 对６７例转移性乳腺癌采用随机分组，其中４２例予诺维本持续静脉输注联合顺铂（Ａ组），２５例予诺维本常规静脉冲入联合顺铂（Ｂ组）。结果 Ａ组有效率（ＣＲ＋ＰＲ）４７．６２％。Ｂ组有效率（ＣＲ＋ＰＲ）４０．０％，毒副反应Ａ组明显低于Ｂ组。结论 诺维本持续静脉输注较常规静脉冲入联合顺铂治疗转移性乳腺癌疗效有所提高，毒副反应明显减轻。     

应用ACNU与Me—CCNU联合化疗治疗进展期胃癌的随机研究

作者比较了亚硝酸脲类药物盐酸嘧啶亚硝脲（ＡＣＮＵ）和甲环亚硝脲（Ｍｅ－ＣＣＮＵ）联合化疗对进展期胃癌的疗效。１０３例进展期胃癌分为Ａ组（Ｍｅ－ＣＣＮＵ，５－Ｆｕ和ＡＤＭ）和Ｂ组（ＡＣＮＵ，５－Ｆｕ和ＡＤＭ）进行随机研究，结果，Ａ组无ＣＲ和ＰＲ者，Ｂ组无ＣＲ，但ＰＲ者８／４６（１７．４％），Ｂ组有效率为１７．４％，Ａ组有疗效为０％，中位生存期Ｂ组为１１２天，Ａ组为１０８天，在疗程中，两组均未发生严重     

用PCMF和CAF方案治疗晚期乳腺癌的临床观察

对４５例Ⅳ期乳腺癌采用ＰＣＭＦ或ＣＡＦ方案姑息性化疗的近期疗效、毒副反应等作了比较总结，分析两种方案的利弊及临床适用价值。４５例中，ＰＣＭＦ组２２例，ＣＲ２例（９．１％）、ＰＲ８例，有效率（ＣＲ＋ＰＲ）４５．５％；ＣＡＦ组２３例，ＣＲ２例（８．７％）、ＰＲ８例，有效率４３．５％；两组疗效相当，（Ｐ〉０．０５），其结果与国外文献报道相近。ＰＣＭＦ组的心脏毒性、脱发发生率低于ＣＡＦ组（Ｐ〈０．０５）．     

干扰素甲地孕酮配合EP方案与单纯EP方案治疗晚期非小细胞肺癌的对比研究

目的：较ＩＭ－ＥＰ方案与ＥＰ方案对初始ⅢＢ～Ⅳ期非小细胞肺癌（ｎｏｎ－ｓｍａｌｌ ｃｅｌｌ ｈｕｎｇ ｃａｎｃｅｒ,ＮＳＣＬＣ病人的疗效,毒性及生活质量的改善情况。方法：Ａ组（３３例）接受ＩＭ－ＥＰ方案治疗,Ｂ组（３５例）接受ＥＰ方案治疗。两组均以每４周为一周期,重复３个。客观疗交与毒性反应接ＷＨＯ标准进行评价,生活质量根据临床受益疗效来评价。结果：Ａ、Ｂ两组客观疗效（ＣＲ＋ＰＲ）分别为２７．３％     

PCMF与CAF联合化疗治疗晚期乳腺癌疗效观察

我院从１９９４年到１９９５年１２月，用ＰＣＭＦ和ＣＡＦ联合化职方案治疗晚期乳腺癌４８例，效果满意，ＰＣＭＦ方案的有效率为６６．７％（１６／２４），其中ＣＲ为２９．２％（７／２４），ＰＲ为３７．５％（９／２４），ＣＡＦ方案的有效率为５８．３％（１４／２４），其中ＣＲ为２０．８％（５／２４），ＰＲ主３７．５％（９／２４），两种方案疗效无显著差别（Ｐ〉０．０５）。中位缓解期分别为７和８个月，两种方案相近     

HDCF/5-Fu、DDP联合方案治疗晚期鼻咽癌的近期疗效分析

为了提高５－Ｆｕ＋ＤＤＰ方案治疗复发、转移性鼻咽癌的临床疗效，对２８例晚期ＮＰＣ患者给予２个以上疗程的ＨＤＣＦ／５－Ｆｕ＋ＤＤＰ方案化疗，结果ＣＲ２例、ＰＲ１１例、ＭＲ６例、ＳＤ４例、ＰＤ５例，总有效率为（ＣＲ＋ＰＲ）４６．４％，中位缓解期５．４个月（２～１６个月）。毒性反应主要有ＷＢＣ下降、恶心呕吐、口腔粘膜溃烂等。ＨＤＣＦ／５－Ｆｕ＋ＤＤＰ方案较传统的单用５－Ｆｕ＋ＤＤＰ方案疗效有明显提高，但毒性反应亦较重     

PCMF与CAF联合化疗治疗晚期乳腺癌疗效观察

我院从１９９４年到１９９５年１２月，用ＰＣＭＦ和ＣＡＦ联合化疗方案治疗晚期乳腺癌４８例，效果满意。ＰＣＭＦ方案的有效率为６６．７％（１６／２４），其中ＣＲ为２９．２％（７／２４），ＰＲ为３７．５％（９／２４）。ＣＡＦ方案的有效率为５８．３％（１４／２４），其中ＣＲ为２０．８％（５／２４），ＰＲ为３７．５％（９／２４）。两种方案疗效无显著差别（Ｐ＞０．０５）。中位缓解期分别为７和８个月，两种方案相近。     

乳腺癌c—erbB—2,表皮生长因子受体基因蛋白表达与预后的关系

以免疫组化ＡＢＣ法检测乳腺癌ｃ－ｅｒｂＢ－２、表皮生长因子受体基因蛋白表达，研究其与预后的关系，结果：ｃ－ｅｒｂＢ－２、ＥＧＦＲ阳性表达率各为３８．５％（２５／６５）和４３．１％（２８／６５）。除ＥＧＦＲ表达与ＥＲ、ＰＲ负相关外，ｃ－ｅｒｂＢ－２，ＥＧＦＲ表达与临床预后因素无相关性，二者之间亦无相关性。ｃ－ｅｒｂＢ－２或ＥＧＦＲ阳性组术后生存显著差于阴性组（Ｐ〈０．０１）；多因素分析二者是显著影响     

曲妥珠单抗联合吉西他滨治疗ＨＥＲ２阳性的转移性乳腺癌

目的：探讨曲妥珠单抗（赫赛汀）联合吉西他滨（ＧＥＭ）治疗表皮生长因子受体２（ＨＥＲ２）阳性的转移性乳腺癌（ＭＢＣ）的疗效和不良反应。方法：ＨＥＲ２阳性的ＭＢＣ女性患者９例,给予ＧＥＭ１０００ｍｇ／ｍ^２,静脉滴注,ｄ１、ｄ８、ｄ１５,４周重复;赫赛汀静脉滴注,首次４ｍｇ／ｋｇ,其后每周１次,２ｍｇ／ｋｇ,连续使用。结果：９例患者中,ＣＲ１例（１１.１％）,ＰＲ６例（６６.７％）,ＳＤ和ＰＤ各１例（１１.１％）,有效率（ＲＲ）为７７.８％,疾病控制率（ＤＣＲ）为８８.９％;中位肿瘤进展时间（ＴＴＰ）为１８个月,中位总生存时间（ＯＳ）为２３个月。主要毒性反应是骨髓抑制和消化道反应,且均为Ⅰ ～Ⅱ度。结论：赫赛汀联合吉西他滨对于难治性转移性乳腺癌是有效且安全的治疗方案。     

吉西他滨联合顺铂治疗耐药三阴性晚期乳腺癌的临床观察

目的　观察吉西他滨联合顺铂方案治疗ＥＲ、ＰＲ、ＨＥＲ-２均阴性对蒽环类耐药的晚期转移性乳腺癌的疗效和安全性。方法　３４例对蒽环或紫杉类耐药晚期转移性乳腺癌患者,经免疫组化证实ＥＲ、ＰＲ、ＨＥＲ-２均阴性,给予吉西他滨联合顺铂方案治疗,具体用药为：吉西他滨１０００ｍｇ／ｍ^２静脉滴注,第１,８天;顺铂２５ｍｇ／ｍ^２静脉滴注,第１～３天。２１天为１周期,至少２个周期,２周期后评价疗效和毒副反应。结果　３４例患者均可评价疗效,获完全缓解（ＣＲ）２例（５.９％）,部分缓解（ＰＲ）１２例（３５.３％）,稳定（ＳＤ）１４例（４１.２％）,进展（ＰＤ）６例（１７.６％）,总有效率（ＣＲ＋ＰＲ）为４１.２％;中位疾病进展时间为５.２个月。主要不良反应包括骨髓抑制和胃肠道反应,无化疗相关死亡。结论　吉西他滨联合顺铂方案对蒽环类或紫杉类耐药的转移性三阴性乳腺癌有较好的近期疗效,不良反应可耐受,是有效的解救方案之一。     

Combination chemotherapy--present status and problems

Principles for the development of effective clinical combination chemotherapy has been recognized for many years, and many trials have been continue to be used in the design of more effective combinations. Drugs to be used in the combination chemotherapy regimen are as follows: 1) Only those drugs proven effective should be combined, 2) Each drugs have a different mechanism of action, 3) Each drug have a different spectrum of toxicities, 4) Each drugs should be administered at their adequate dose intensity and schedule. Optimally, all agents would be administered simultaneously, but they can be administered in alternating sequence. However, the available results have not provided definitive evidence for the development of adequate, effective combination chemotherapy. Prospective randomized comparisons will eventually elucidate the better regimens. Further studies are warranted.     

肿瘤热疗与免疫治疗

热疗通过提高免疫效应细胞活性、诱导免疫效应细胞再分布、影响细胞因子表达、诱导热休克蛋白表达上调等作用调节机体的免疫功能，抑制肿瘤生长和转移。热疗与细胞因子、树突状细胞、肿瘤疫苗、基因治疗等免疫疗法的联合应用，在体外和小鼠肿瘤模型中显示了一定的有效性，但目前还处于实验室研究阶段，有待于进一步完善。     

Combination of Ofloxacin and Other Antimicrobial Agents

Summary

We evaluated the combination of ofloxacin with piperacillin, gentamicin, vancomycin, rifampin, clindamycin, and metronidazole by the checkerboard agar dilution method against 165 isolates which included Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Serratia marcescens, Pseudomonas aeruginosa, Providencia stuartii, Acinetobacter, Staphylococcus aureus, Bacteroides fragilis, and Citrobacter perfringens. Synergy of piperacillin-ofloxacin was demonstrated for 50% and 40% respectively of E. cloacae and P. aeruginosa. Some ofloxacin and piperacillin-resistant isolates were susceptible with the combination. Ofloxacin-gentamicin was indifferent for aerobic gram-negative species. Ofloxacin and vancomycin or gentamicin was indifferent for S. aureus and E. faecalis, but rifampin-ofloxacin showed addition. Combination of ofloxacin and metronidazole or clindamycin or erythromycin was indifferent for aerobic and anaerobic species.

Ofloxacin could be combined with piperacillin with benefit against P. aeruginosa, but combination with aminoglycosides is not of benefit.     

Combination of levofolinate calcium and 5-fluorouracil

It has been determined that in the combination of Leucovorin (LV) and 5-fluorouracil (5-FU), LV potentiates the cytotoxic effect of 5-FU based on biochemical modulation. Many data suggest that LV/5-FU is a very effective combination, and most clinicians worldwide now regard it as the standard therapy for colorectal cancer. In Japan, clinical examinations of this combination using Levofolinate calcium (I-LV) have shown its effectiveness, and I-LV/5-FU for gastric and colorectal cancer was authorized by the Ministry of Public Welfare in Oct. 1999.