大剂量卡铂化疗的药物毒性观察

6例肺癌患者接受了大剂量卡铂并自体骨髓移植治疗 ,卡铂剂量从 5 60～ 1375 mg/ m2 ,5例加用 VP～ 1630 0 mg,1例并用 MMC6mg和 VCR2 mg;主要毒性反应为白细胞、中性粒细胞、血小板减少和脱发 ( WHO毒性反应 ～ 级 )其次是贫血、皮肤粘膜出血、呕吐和可逆性肝功能损害 ,口腔粘膜溃疡及轻度发烧各 2例 ,一过性蛋白尿、室上性心动过速和便秘各 1例 ,尿素氮和肌酐未见升高 ;全部患者骨髓均获解救 ,从自体骨髓回输到骨髓造血功能重建成功平均 2 6.67( 17～ 32 )天     

Report of a Case of Pericardial Mesothelioma with Liver Metastases Responding Well to Pemetrexed and Platinum-Based Chemotherapy

Pericardial mesothelioma remains a disease with a bleak prognosis. We report the case of a patient with metastases to liver and good response to pemetrexed and carboplatin-based combination chemotherapy and consequent prolonged progression-free survival.     

卡铂对离体培养成年灰鼠前庭毛细胞的损害

目的 观察并建立不同浓度卡铂损害成年灰鼠前庭终器的离体实验模型。方法 应用前庭终器分离取材技术、前庭器官离体培养技术和组织学检查技术，观察不同浓度卡铂对成年灰鼠前庭各终器的损害。结果 卡铂主要损害灰鼠前庭I型毛细胞，这种损害随着卡铂剂量的增加而加重。结论 卡铂选择性破坏离体培养的灰鼠前庭I型毛细胞。     

长春瑞滨联合卡铂治疗老年晚期非小细胞肺癌

目的：观察长春瑞滨(诺维本，NVB)联合卡铂化疗方案治疗老年晚期非小细胞肺癌患的临床疗效及不良反应。方法：对住院治疗的25例老年晚期非小细胞肺癌患采用NVB联合卡铂化疗方案，NVB25mg／m^2第1、8天，卡铂350mg／m^2第1天。每4周重复，至少治疗两周期，按标准评价疗效和毒副反应。结果：可评价患25例，有效率为48％，中位生存期7个月，1年生存率为32％。主要毒性反应为骨髓抑制、消化道反应及静脉炎，多数为Ⅰ～Ⅲ度反应。结论：NVB联合卡铂方案治疗老年晚期非小细胞肺癌临床疗效较好，毒性反应可以耐受。     

卡铂联合化疗治疗老年非小细胞肺癌剂量探讨

 目的探讨老年非小细胞肺癌患者联合化疗时卡铂按AUC=5mg/ml·min(AUC,areaundertheconcentrationtimecurve)的剂量是否适宜。方法33例老年晚期非小细胞肺癌患者采用Taxol+CBP、Gemzar+CBP、NVB+CBP方案化疗,卡铂用药剂量按AUC=5的水平给药。全部患者共完成73周期化疗。每周期化疗前后对患者的化疗毒副反应及生活质量变化进行评估。结果骨髓毒副反应常见且较重,中性粒细胞出现Ⅲ/Ⅳ级副反应为47.9%(35/73)、血小板出现Ⅲ/Ⅳ级副反应为28.8%(21/73)。其余毒副反应不重。生存质量评分(依据国内肿瘤患者生存质量评分标准)平均下降6.5分。结论老年非小细胞肺癌患者联合化疗时,卡铂按AUC=5的剂量水平用药毒副反应较重,且对生存质量有不利影响,可能与剂量偏大有关。     

吉西他滨联合卡铂治疗晚期非小细胞肺癌

目的　观察吉西他滨联合卡铂治疗晚期非小细胞肺癌的疗效及毒副反应。方法　 41例晚期非小细胞肺癌患者给予吉西他滨与卡铂联合治疗 ,吉西他滨 10 0 0mg/m2 ,静脉滴注第 1、8、15天 ,卡铂AUC 5 ,静脉滴注第 1天 ,2 8天为一周期 ,每例患者治疗 2周期以上。结果　全组完全缓解 2例 ,部分缓解 18例 ,稳定15例 ,进展 6例 ,总有效率为 48.8%。初治组有效率为 5 5 .6% ,复治组为 43 .5 % (P >0 .0 5 )。全组中位生存期 11.8月 ,1年生存率为 49%。KPS评分增加者占 70 .7% ( 2 9/4 1)。最常见的毒副反应为骨髓抑制 ,Ⅲ～Ⅳ度白细胞和血小板下降发生率分别为 3 4.1%和 2 9.3 % ,其余毒副反应均轻微 ,可耐受。结论　吉西他滨联合卡铂一线治疗或二线治疗晚期非小细胞肺癌均有较好的疗效 ,毒性可以耐受。     

泰素加卡铂与泰素加顺铂治疗晚期肺腺癌的比较

目的 观察比较泰素加卡铂与泰素加顺铂治疗晚期肺腺癌的近期疗效及不良反应。方法 35例晚期肺腺癌患者随机分为Taxol+CRP组(A组)及Taxol+DDP组(B组),治疗2个周期后进行疗效及不良反应的评估。结果 A组18例,有效率为44.4％;B组17例,有效率为41.2％。两组的主要不良反应均为骨髓抑制、恶心呕吐、肝功能损害、脱发等。结论 Taxol+CBP及Taxol+DDP在治疗晚期肺腺癌方面均有较好疗效,不良反应可耐受。两组的疗效和不良反应无明显差别。     

Phase II trial of edatrexate plus carboplatin in metastatic non-small-cell lung cancer: a Southwest Oncology Group study

Background: Edatrexate and carboplatin are each active single agents in the treatment of non-small-cell lung cancer (NSCLC). Preclinical studies in NSCLC lines have demonstrated schedule-dependent synergy of edatrexate followed by carboplatin. In a phase I trial, we demonstrated the tolerability of this combination, the ability of ice-chip cryotherapy to ameliorate dose-limiting mucositis, and promising activity in NSCLC. This phase II trial (SWOG 9207) was undertaken to investigate the efficacy of this regimen in stage IV NSCLC. Methods: A total of 24 patients with stage IV disease were accrued to this Southwest Oncology Group (SWOG) multicenter study. Treatment consisted of edatrexate 80 mg/m² (50% dose on day 8) intravenously weekly for 5 weeks, then every other week, and carboplatin 350 mg/m² every 28 days. Results: Of the 24 patients, 23 were assessable for toxicity and response; one was ineligible for study entry. Myelosuppression was the most significant toxicity; grade 3–4 neutropenia was seen in 8/23 patients. Two patients died of neutropenic sepsis during the first cycle of therapy, in both instances associated with the presence of pleural effusions. Although mild mucositis was common, it was dose-limiting (grade 3) in only three patients. Objective response was observed in 3/23 patients (13%). The median survival time was 7 months, and 30% of patients remained alive at one year. Conclusions: This study suggests that ice-chip cryotherapy is effective in reducing the severity of mucositis typically associated with this edatrexate schedule of administration. However, unexpectedly severe myelosuppression resulted in death from neutropenic sepsis in two patients with third space fluid collections, leading to a protocol amendment to exclude such patients from study entry. Furthermore, response and median survival with this dose schedule of edatrexate and carboplatin do not appear to be improved compared to other chemotherapeutic regimens tested by SWOG in this patient population. Received: 12 August 1996 / Accepted: 8 May 1997     

灰鼠疆孔内听神经纤维的定量观察

目的为了观察正常灰鼠和卡铂（Ｃａｒｂｏｐｌａｔｉｎ）耳中毒灰鼠耳蜗单个疆孔（ｈａｂｅｎｕｌａｐｅｒｆｏｒａｔａ）内的神经纤维数量。方法１２只灰鼠中６只按１００ｍｇ／ｋｇ腹腔注射卡铂２次，６只作正常对照，３个月后处死，沿蜗轴平面作半薄切片，甲苯胺蓝－美蓝染色后光镜观察，组间统计学比较采用ｔ检验。结果正常灰鼠的神经纤维数量在耳蜗不同部位有所不同，其中在底回起始段每个疆孔中通过９３．７±１２．２（ｘ±ｓ，下同）根神经纤维，底回末段为１８１．５±３０．４，第二回中段为１２９．７±２７．８，顶回中段为７５．８±１３．２。应用加倍大剂量卡铂将内毛细胞和Ｉ型螺旋神经元全部破坏后，疆孔内残存的神经纤维数仅占正常值的七分之一。结论疆孔内七分之六的神经是支配内毛细胞的Ｉ型神经元。