Uptake of Adriamycin in tumour and surrounding brain tissue in patients with malignant gliomas

Summary Eight patients with malignant gliomas verified on CT scan, received an intravenous injection of 50 mg of Adriamycin R, 24 hours prior to surgical removal of the tumour. Peroperatively, both tumour and surrounding tissue specimens were obtained for determination of the tissue concentrations of Adriamycin and its reduced metabolite Adriamycinol. It was found that Adriamycin could be detected in tumour tissue from all patients. The concentration varied between 0,9 and 4,6 nmol/g tissue. In contrast, Adriamycin could only be detected in surrounding brain tissue from one patient.In anin vitro study a human malignant glioma cell line (U-251 MG) was exposed to various concentrations of Adriamycin for 24 hours. It was found that an intracellular drug concentration above 30 nmol/g cells caused a concentration dependent inhibition of cell growth. Thus, it is likely that the poor effect of Adriamycin on patients with malignant gliomas is due to an ineffective drug accumulation in the tumour tissue.     

长春瑞滨加异环磷酰胺加顺铂治疗晚期非小细胞肺癌98例临床疗效观察

目的观察长春瑞滨(NVB)、异环磷酰胺(IFO)、顺铂(PDD)三药联合(NIP)治疗晚期非小细胞肺癌的疗效和毒性.方法共收治ⅢB～Ⅳ期非小细胞肺癌98例,其中鳞癌51例,腺癌42例,大细胞癌5例.ⅢB期59例,Ⅳ期39例.初治71例,复治27例.方案:NVB 25 mg/m2静滴,第1,8天;IFO 1.5 g/m2,静滴,第1～3天;PDD 30 mg/m2,静滴,第1～3天.4周为一周期.结果 CR 1例,PR 44例,NC 45例,PD 8例,总有效率(CR PR)为45.9%.中位缓解期8个月,中位生存期11个月,1年生存率为48.0%.骨髓抑制为剂量限制性毒性,其中Ⅲ～Ⅳ度占40.8%.结论 NIP方案是治疗晚期非小细胞肺癌有效且安全的方案.     

善存片联合健脾理气中药预防肿瘤患者化疗所致口腔溃疡的临床观察

目的观察在全身化疗前应用善存片联合健脾理气中药对肿瘤患者口腔溃疡的预防作用。方法将66例肿瘤患者随机分配为治疗组和对照组，每组33例。在全身静脉化疗前3天开始，治疗组每天口服善存片1片及健脾理气中药1剂，对照组服用维生素B：治疗，两组服药化疗后10天为1个疗程。每周期化疗结束后统计口腔溃疡的发生率，共4周期。结果治疗组口腔溃疡的发生率显著降低（P〈0．01）。结论善存片联合健脾理气中药可有效预防及治疗肿瘤患者化疗所致的口腔溃疡。     

卵巢未成熟畸胎瘤43例综合治疗疗效分析

为探讨不同手术方式及化疗方法对卵巢未成熟畸胎瘤的疗效及相关影响因素，对43例卵巢未成熟畸胎瘤患者进行回顾性分析。手术方式分为：保守性手术（患侧附件、大网膜切除术＋盆、腹腔腹膜结节切除术＋盆腔淋巴结清扫术）及根治性手术（全子宫、双附件及大网膜切除术＿肿瘤细胞减灭术＋盆腔淋巴结清扫术）。术后采用VAC（长春新碱，阿霉素，环磷酰胺）方案、BEP（博莱霉素或平阳霉素，足叶乙叉甙，顺铂或卡铂）方案或VBP（长春新碱，博莱霉素或平阳霉素，顺铂或卡铂）方案进行联合化疗。患者5年生存率根治性手术为44．4％，保守性手术为64．0％，差异无显著性。VAC方案与BEP（或VBP）方案的5年生存率分别为33．3％和77．3％（P＜0．01）。疗程数≥4患者的5年生存率为73．9％，明显高于疗程数＜4患者的38．9％（P＜0．05）。认为对于有生育要求的卵巢未成熟畸胎瘤患者，可仅行保守性手术，术后辅以联合化疗。BEP（或VBP）方案对患者长期生存率的改善明显优于VAC方案。术后化疗的疗程数与疗效有关，对长期生存率的影响较明显。     

表阿霉素联合化疗方案治疗29例恶性肿瘤疗效观察

目的观察以表阿霉素为主的不同化疗方案对常见恶性肿瘤的疗效及其毒副作用。方法以表阿霉素为主的CEP、CEOP、TE、IEO方案治疗肺癌、非霍奇金淋巴瘤、晚期乳腺癌和横纹肌肉瘤，其中表阿霉素60mg/m^2分2天静脉注射，其他药物都为常规剂量。21～28天为1个治疗周期，治疗2～3个周期后评价疗效。结果全组29例中CR7例，PR13例，SD5例，PD4例，总有效率68．97％。主要不良反应为骨髓抑制，其次是脱发和消化道反应。对肝肾功能和心脏影响轻微。结论以表阿霉素为主的联合化疗方案对常见恶性肿瘤疗效佳，安全性好，患者能较好地耐受。     

Primary tubal choriocarcinoma

Choriocarcinoma is one of the most serious forms of gestational trophoblastic tumor. It is a malignant tumor from the epithelium of the chorionic villi. The most frequent location site is the uterus. Associated with ectopic pregnancy, it is extremely rare and in general, very aggressive. In 75% of the cases, it items from distant metastasis; therefore, a histological examination of the tubes must be performed in all ectopic pregnancies. Our patient was a 33-year-old woman who was admitted to emergency room (ER) with an intense pain in the right, iliac cavity, and limited genital bleeding. During the exploration, there was abdominal pain, with doubtful signs of peritoneal irritation. The vaginal ultrasound offered an image that was compatible with an extra uterine pregnancy in the left appendages. At emergency, right salpingectomy was performed via laparotomy. The patient was treated with polychemotherapy and contraceptives for a year, with no recurrence of the disease. Control follow-up was performed using beta-human chorionic gonadotropin (HCG) testing on a weekly basis during the first month and then bi-monthly during the first year of follow-up.     

Prognostic importance of the time interval from surgery to chemotherapy in treatment of ovarian carcinoma

In a large study on 1,220 patients with ovarian carcinoma in FIGO stages I-IV, the prognostic importance of the time factor for start of postoperative chemotherapy was studied together with other important factors for long-term survival. The patient series was a total geographic material of ovarian carcinoma patients treated during the years 1975-1993. All patients were followed up for 10 years or until death. The 5-year cancer-specific survival rate of the complete series was 50%. Significant and independent prognostic factors with regard to long-term cancer-specific survival were FIGO stage, histology, tumor grade, and completeness of the primary surgery. Special attention was paid to the prognostic importance of the time interval between primary surgery and the first course of chemotherapy. Patient groups with intervals shorter or longer than the median value were compared. In early-stage disease, no significant difference was noted. In advanced and bulky disease, an interval longer than the median value seemed to be beneficial compared with a shorter interval. However, after correction for other prognostic factors, the interval was not a significant factor (P = 0.647) with regard to the cancer-specific survival rate. Therefore, the time factor should not be an important argument for how to best organize the gynecologic oncology service.     

综合治疗晚期原发性肝癌72例疗效观察

目的 探讨腹腔化疗或联合其他方法综合治疗晚期原发性肝癌的治疗效果.方法 72例不能手术切除的、合并门静脉癌栓、腹腔内转移或淋巴结转移的晚期肝癌,采取腹腔化疗或者联合TACE等其他方法治疗.5-氟尿嘧啶(5-FU)0.5～0.75 g,腹腔内注入1/日,连用10～15天,总量5.0～12.5 g,最后一天腹腔内注入丝裂霉素(MMC)10 mg或卡铂100 mg.7例胆管细胞癌联合使用健择800～1000 mg.结果 全组平均生存时间13.97±6.27月.累积1年、2年生存率分别为59.7%和30.6%.肝功能Child A级平均生存时间15.91±5.49月,B级8.55±5.09月,有显著性差别.结论 腹腔化疗或联合其他综合治疗方法是肝癌并腹腔内转移的有效治疗方法,可延长部分晚期肝癌患者的生存时间,改善生活质量.     

Preoperative Chemotherapy for Colorectal Liver Metastases: Impact on Hepatic Histology and Postoperative Outcome

Some investigators have suggested that preoperative chemotherapy for hepatic colorectal metastases may cause hepatic injury and increase perioperative morbidity and mortality. The objective of the current study was to examine whether treatment with preoperative chemotherapy was associated with hepatic injury of the nontumorous liver and whether such injury, if present, was associated with increased morbidity or mortality after hepatic resection. Two-hundred and twelve eligible patients who underwent hepatic resection for colorectal liver metastases between January 1999 and December 2005 were identified. Data on demographics, clinicopathologic characteristics, and preoperative chemotherapy details were collected and analyzed. The majority of patients received preoperative chemotherapy (n = 153; 72.2%). Chemotherapy consisted of fluoropyrimidine-based regimens: 5-FU monotherapy, 31.6%; irinotecan, 25.9%; and oxaliplatin, 14.6%. Among those patients who received chemotherapy, the type of chemotherapy regimen predicted distinct patterns of liver injury. Oxaliplatin was associated with increased likelihood of grade 3 sinusoidal dilatation (p = 0.017). Steatosis >30% was associated with irinotecan (27.3%) compared with no chemotherapy, 5-FU monotherapy, and oxaliplatin (all p < 0.05). Irinotecan also was associated with steatohepatitis, as two of the three patients with steatohepatitis had received irinotecan preoperatively. Overall, the perioperative complication rate was similar between the no-chemotherapy group (30.5%) and the chemotherapy group (35.3%) (p = 0.79). Preoperative chemotherapy was also not associated with 60-day mortality. In patients with hepatic colorectal metastases, preoperative chemotherapy is associated with hepatic injury in about 20 to 30% of patients. Furthermore, the type of hepatic injury after preoperative chemotherapy was regimen-specific. Presented at the American Hepato-Pancreato-Biliary Association 2006 Annual Meeting, March 11, Miami, Florida.