Hepatic veno-occlusive disease after neoadjuvant treatment of colorectal liver metastases with oxaliplatin: A lesson of the month

A patient is presented who was treated with neoadjuvant oxaliplatin-based chemotherapy followed by hepatic resection complicated by fatal liver failure. Histopathological examination revealed hepatic veno-occlusive disease, which is an infrequent reported side effect of oxaliplatin.     

Fatal pneumonitis induced by oxaliplatin

Oxaliplatin has been approved for adjuvant treatment of colorectal cancer. Toxicity induced by oxaliplatin is moderate and manageable, but some isolated cases of severe pulmonary toxicity associated to oxaliplatin have been reported. Two fatal cases of interstitial pneumonitis rapidly evolving to pulmonary fibrosis are reported here.     

First-line treatment of advanced gastric cancer and hepatic dysfunction with oxaliplatin, 5-fluorouracil and cetuximab

There is no standard chemotherapy regimen in advanced gastric cancer with poor performance status and hepatic dysfunction. New chemotherapeutical agents and targeted therapy have demonstrated promising results in terms of efficacy and safety in phase II clinical trials. We report the case of a 68-year-old man with stage IV gastric cancer and severe hepatic dysfunction due to liver metastases treated with a combination of oxaliplatin, 5-fluorouracil and cetuximab.     

A multicenter randomized phase Ⅱ trail of Oxaliplatin in the patients with colorectal cancer

Objective： To evaluate the efficacy and safety of Oxaliplatin in the patients with colorectal cancer. Methods： In a multicenter randomized control study, a total of 144 patients were divided into four groups： Oxaliplatin （Haitong） ＋ 5-FU, CF （group A） 41 cases; 5-FU ＋ CF （group B） 41 cases; Oxaliplatin （Haitong） ＋ 5-FU, CF （group C） 31 cases; Oxaliplatin （positive drug） ＋ 5-FU ＋ CF （group D） 31 cases. Oxaliplatin combination regimen： L-OHP 130 mg/m2 i.v. infusion 2 h dl; CF 200 mg/m2 i.v. 2 h d1-d5; 5-FU 300 mg/m2 i.v. infusion 4 h d1-d5 （after CF）. 5-FU ＋ CF combination regimen： CF 200 mg/m^2 i.v. infusion 2 h d1-d5, 5-FU 300 mg/m^2 i.v. infusion 4h d1-d5 （after CF）, the schedule was repeated every 3 weeks. The total cycles were 3. Results： After three circles treatment, overall response rate of 4 groups was 24.4% （group A）, 2.4% （group B）, 25.8% （group C） and 19.4% （group D）, respectively. The response rate was significantly different between group A and group B （P 〈 0.01）, but no significant difference was observed between group C and group D （P 〉 0.05）. Conclusion： The Oxaliplatin （Haitong） for injection combination regimen is effective in the treatment of celorectal cancer.     

周剂量多西紫杉醇、奥沙利铂联合低剂量氟尿嘧啶方案治疗晚期胃癌的临床观察

目的：研究周剂量多西紫杉醇、奥沙利铂联合低剂量氟尿嘧啶（5-FU）持续滴注治疗晚期胃癌的近期疗效和毒副作用。方法：晚期胃癌31例，应用多西紫杉醇40mg／m^2，静滴1小时，每周1次，连用2周；奥沙利铂70mg／m^2，静滴2小时，每周1次，连用2周；5-FU200mg／m^2，连用14天。以上化疗方案每4周重复，2周期后评定疗效。结果：31例晚期胃癌总有效率67．7％，其中CR2例，PR19例。主要毒性反应为骨髓抑制、消化道反应、脱发等。结论：多西紫杉醇、奥沙利铂作为新的抗胃癌药物，联合低剂量5-FU持续滴注对晚期胃癌近期效果显著，毒副反应较小，可以作为晚期胃癌的一种选择方案。     

奥沙利铂联合5-Fu／CF治疗晚期大肠癌临床观察

目的：观察应用奥沙利铂联合治疗晚期大肠癌的近期疗效及毒副反应。方法：72例晚期大肠癌随机分为两组，一组为治疗组，奥沙利铂联合5-Fu／CF；另一组为对照组5-Fu／CF。结果：治疗组有效率52．8％，对照组有效率30．6％．有显著性差异（P〈0．05）。毒副反应主要是恶心、呕吐、贫血和感觉神经毒性，对白细胞和血小板影响较小。结论：奥沙利铂联合5-Fu／CF，治疗晚期大肠癌有效而安全。     

奥沙利铂联合亚叶酸钙和氟尿嘧啶治疗晚期大肠癌的临床观察

目的评价奥沙利铂联合亚叶酸钙和大剂量氟尿嘧啶（5-FU）持续48 h静脉滴注治疗晚期大肠癌的疗效和安全性。方法32例大肠癌患者采用静脉滴注奥沙利铂100 mg/m^2,亚叶酸钙200 mg/m^2,亚叶酸钙滴注之后用5-FU 0．5 g静注,接着用5-FU 3．0 g/m^2持续静脉滴注48h,每2周1次,2次为1个周期。结果32例病例中,平均疗程数为4个周期,其中完全缓解（CR）1例,部分缓解（PR）15例,稳定（SD）12例,进展（PD）4例,总有效率（CR＋PR）为50%。不良反应为恶心、呕吐和骨髓抑制,但多为Ⅰ～Ⅱ度,一过性感觉异常。结论奥沙利铂联合亚叶酸钙和氟尿嘧啶治疗晚期大肠癌疗效较高,不良反应轻而且安全,患者容易耐受,值得推广使用。     

Validation of a LC method for the analysis of oxaliplatin in a pharmaceutical formulation using an experimental design

A rapid and sensitive RP-HPLC method with UV detection for routine control of oxaliplatin in a pharmaceutical formulation (Eloxatin®) was developed. Quantitation was accomplished with the internal standard method. The procedure was validated by linearity (correlation COEFFICIENT=0.999948), accuracy, robustness and intermediate precision. Experimental design was used during validation to calculate method robustness and intermediate precision. For robustness test three factors were considered: percentage v/v of acetonitrile, flow rate and temperature; an increase in the flow rate results in a decrease of the drug found concentration, while the percentage of organic modifier and temperature have no important effect on the response. For intermediate precision measure the considered variables were: analyst, equipment and days. The RSD value (2.27%, n=24) indicated a good precision of the analytical method.     

卡培他滨联合草酸铂和紫杉醇一线治疗晚期或转移性胃癌

目的 评估卡培他滨联合草酸铂和紫杉醇一线治疗晚期或转移性胃癌的疗效和毒副反应.方法 全组36例患者,采用卡培他滨1250mg/(m2·d),连用14d;紫杉醇90mg/(m2·d)静滴,第1、8d;草酸铂100mg/(m2·d)静滴,第1、8d;21d为1周期,用药2～6个周期后进行评估.结果 全组34例可评价,获得CR 1例,PR 21例,SD 8例,PD 3例,有效率(CR PR)为69.5%,中位TTP为9个月(2～17个月),中位生存时间16个月(2～38个月).主要毒副反应为胃肠反应和骨髓抑制,多为Ⅰ～Ⅱ度毒性反应,Ⅲ～Ⅳ度毒性反应主要为口腔炎、恶心呕吐、白细胞和血小板降低.所有患者均无化疗相关性死亡.结论 卡培他滨联合草酸铂和紫杉醇一线治疗晚期胃癌患者近期疗效较好,不良反应可以耐受,值得临床推广.     

奥沙利铂神经毒性处理及预防研究进展

神经毒性是OXA最常发生的剂量限制性毒性,近期研究发现OXA急性毒性的产生可能与一过性的钙依赖的钠通道功能失调有关,这一作用可被Na+通道阻滞剂所阻断,临床发现支持这一观点,这些临床发现指出药学性阻断Na+通道可预防和(或)抑制OXA的神经毒性。本文综述了OXA神经毒性的细胞机制、病理生理及处理预防措施进展。