Improved incidence of pT0 downstaged surgical specimens in locally advanced rectal cancer (LARC) treated with induction oxaliplatin plus 5-fluorouracil and preoperative chemoradiation.

PURPOSE: To compare efficacy in terms of pathologic response in LARC patients treated with preoperative chemoradiation, with or without a short-intense course of induction oxaliplatin. PATIENTS AND METHODS: From 05/98 to 10/02, 114 patients were treated with preoperative chemoradiation (4500-5040 cGy + oral Tegafur 1200 mg/day) for cT(3)-(4)N(+/x)M(0) rectal cancer. Starting 05/01, 52 consecutive patients additionally received induction FOLFOX-4, oxaliplatin (85 mg/m(2) iv d1), 5-FU (400 mg/m(2) iv bolus d1) and 600 mg/m(2) iv continuous infusion in 22 h with leucovorin (200 mg iv) d1 and d2, every 15 days (2 cycles), followed by the previously described Tegafur chemoradiation regime. Surgery was performed in 5-6 weeks. Pathological assessment investigated post-treatment T and N status in the rectal wall and peri-rectal tissues. RESULTS: Patients, tumor and treatment characteristics were comparable between groups. Incidence of pT(0) specimens was significantly increased by induction FOLFOX-4 (P = 0.006). Total T and N downstaging were 58% versus 75% and 42% versus 40%, respectively (P = ns). T downstaging of > or =2 categories was significantly superior in FOLFOX-4 group (P = 0.029). CONCLUSIONS: Short-intense induction FOLFOX-4 significantly improves pathologic complete response in LARC patients treated with tegafur-sensitized preoperative chemoradiation. The 44% rate of pT(0)-(1) specimens observed in the oxaliplatin group should impulse innovative surgical approaches to promote ano-rectal sphincter conserving protocols.     

Concurrent chemoradiotherapy with carboplatin and uracil-f tegafur (UFT) for patients with poor performance status with locally advanced squamous cell carcinoma of the head and neck (SCCHN)

Conclusions. Concurrent chemoradiotherapy with carboplatin and uracil-f tegafur (UFT) seems to be a promising and appropriate regimen for patients with poor performance status (PS) with locally advanced squamous cell carcinoma of the head and neck (SCCHN). Objective. We designed a regimen based on divided low-dose administration to reduce toxicity for patients with poor PS with locally advanced SCCHN. Patients and methods. Sixty-two patients with previously untreated stage III–IV SCCHN and PS of 2 or 3 were entered into this study. They received radiotherapy: 70 Gy/35 fractions. The chemotherapy consisted of a combination of carboplatin (Calvert's formula: (GFR+25)×AUC (=5)/4 mg/week; where AUC=area under the curve and GFR=glomerular filtration rate) and UFT (300 mg/day, per os). Results. The overall clinical response rate and the pathological complete response (CR) were 90% (56/62) and 61% (38/62), respectively. Grade ≥3 mucositis occurred in only 6% of patients (4/62) and grade ≥3 leukocytopenia and neutropenia occurred in only 5% (3/62).     

益阳健脾方联合替吉奥、阿帕替尼治疗晚期胃癌临床观察

目的:研究益阳健脾方联合替吉奥、阿帕替尼治疗晚期胃癌证属脾胃虚寒患者的临床疗效.方法:选取符合纳入标准的脾胃虚寒型晚期胃癌患者70例,随机分为两组各35例.对照组予替吉奥、阿帕替尼治疗,治疗组在对照组基础上加用益阳健脾方治疗.均治疗3个疗程后比较两组临床疗效.结果:治疗组临床有效率远优于对照组,且联合组的中医临床证候积...     

HPLC法测定尿嘧啶替加氟片含量

目的采用HPLC法测定尿嘧啶替加氟片的含量。方法 Agilent1200 HPLC仪;Agilent ZOBAX C18色谱柱(150 mm×4.6 mm,5μm);流动相:甲醇-水(10∶90);流速:1.0 ml/min;柱温:30℃;检测波长:271 nm。结果尿嘧啶、替加氟分别在0.16～1.60μg、0.08～0.80μg范围内线性关系良好(r=0.9999、r=0.9995),平均加样回收率分别为99.53%、100.68%,RSD分别为0.74%、1.63%(n=6)。结论本方法简便、准确、重复性好,为完善本产品质量控制提供依据。     

Effect of celecoxib combined with chemotherapy drug on malignant biological behaviors of gastric cancer

Celecoxib, a selective cyclooxygenase-2 (COX-2) inhibitor, has been reported to have antitumor effects. In some tumor models, the combination of celecoxib with chemotherapy agents has shown synergistic antitumor effect; however, the effect of celecoxib combination with tegafur/gimeracil/oteracil potassium on the malignant biological behaviors of gastric cancer in nude mice is unclear. In this study, female nude mice were subcutaneously transplanted with SGC-7901 gastric cancer cells. When the tumor model formed, the mice were divided into control group, celecoxib group, tegafur/gimeracil/oteracil potassium group, and the combination of both drug regimens group. Mice were treated for 3 weeks. Following treatment, the proliferating index was calculated, apoptosis related proteins, COX-2, vascular endothelial growth factor-C (VEGF-C) and lymphatic vessel density were quantified in tumor tissues by immunohistochemistry. Apoptosis was evaluated by TUNEL staining. The results revealed that celecoxib and tegafur/gimeracil/oteracil potassium alone significantly inhibited tumor growth. The combination of these two drugs showed a synergistic antitumor effect. Both celecoxib and tegafur/gimeracil/oteracil potassium alone inhibited proliferation and promoted apoptosis. The combination of these two drugs further enhanced this anticancer effect. Both celecoxib and the combination treatment inhibited lymphangiogenesis and the expression of COX-2 and VEGF-C. However, tegafur/gimeracil/oteracil potassium treatment had no obvious effect on lymphangiogenesis. These results suggested that the combination of celecoxib and tegafur/gimeracil/oteracil potassium produced a synergistic antitumor effect, possibly by inhibiting the proliferation of tumor cells and promoting apoptosis. Celecoxib and celecoxib in combination with tegafur/gimeracil/oteracil potassium possibly by reducing the expression of COX-2, in turn down-regulating the expression of VEGF-C, resulted in the inhibition of lymphangiogenesis.     

吉西他滨联合替吉奥治疗晚期胰腺癌的系统评价

目的 系统评价吉西他滨联合替吉奥治疗晚期胰腺癌的有效性和安全性,为临床用药治疗提供科学依据。方法 计算机检索Cochrane图书馆临床对照试验资料库、EMBASE、PubMed、中国生物医学文献数据库（CBM）、中国期刊全文数据库（CNKI）、维普数据库（VIP）、万方科技等数据库中关于吉西他滨联合替吉奥治疗晚期胰腺癌临床随机对照试验（RCT）,检索时间均从各数据库创建至2019年12月。由两名评价员独立评价文献质量、提取资料并交叉核对,并进行方法学质量评价,采用RevMan 5.2的软件进行Meta-分析。结果 共纳入23篇RCTs,共1 817例患者,其中治疗组920例、对照组897例。Meta-分析结果显示：应用吉西他滨联合替吉奥组总有效率[RR=1.76,95% CI（1.51,2.04）,P<0.000 01]和临床获益率[RR=1.40,95% CI（1.30,1.50）,P<0.000 01]与对照组相比有显著性差异;在安全性方面,治疗组不良反应发生危险度高于对照组。结论 基于现有临床证据,吉西他滨联合替吉奥在治疗晚期胰腺癌方面均较对照组疗效更为显著,是一种较为理想的用药方案。     

替加氟片及优福啶片的溶出度考察

目的:考察替加氟片和优福啶片的溶出度 ,评价其内在质量。 方法 :采用反相高效液相色谱法测定含量。色谱柱 :YWG- C1 8(10μm ,4.6mm× 2 5 0 mm ) ;流动相 :甲醇∶水 (2 5∶ 75 ) ;检测波长 2 5 4nm ;流速 0 .8ml/min;进样量 2 0μl。以水为溶出介质 ,采用转篮法 ,对 2个厂家 6个批号的替加氟片及优福啶片进行溶出度比较 ,提取溶出参数。结果 :济南厂替加氟片 2 0 min溶出 85 %以上 ,上海厂替加氟片 10 min溶出 85 %以上 ;优福啶片中的替加氟组份 5 min溶出 80 %以上 ,尿嘧啶组份 7min溶出 80 %以上。结论:2个厂家 6个批号的产品均符合中国药典 1995年版溶出质量标准规定     

曲妥珠单抗联合紫杉醇+替吉奥二线治疗HER-2阳性转移性晚期胃癌的疗效

目的:评价曲妥珠单抗联合紫杉醇+替吉奥方案二线化疗治疗人表皮生长因子受体2 (human epidermal growthfactor recetor-2,HER-2)阳性的晚期胃癌的临床效果及安全性.方法:收集新疆医科大学附属肿瘤医院消化内科2012年1月至2014年3月收治的17例既往一线治疗进展的HER-2阳性转移性晚期胃癌患者的临床资料,患者既往接受奥沙利铂联合氟尿嘧啶方案化疗进展后,观察二线应用曲妥珠单抗联合紫杉醇+替吉奥方案化疗的疗效和不良反应.结果:17例患者均可评价疗效,部分缓解4例,疾病稳定7例,疾病进展6例,客观有效率4/17,疾病控制率为11/17;中位无进展生存时间和中位总生存时间分别为6.5个月(95％CI为4.9～11.1个月)和11.9个月(95％CI为8.7～13.8个月).全组患者最常见的不良反应为食欲下降、粒细胞减少、乏力、脱发,且多为1～2级.在曲妥珠单抗可能相关的不良反应方面,未观察到左心室射血分数值明显降低,亦无心脏不良事件发生.结论:曲妥珠单抗联合紫杉醇+替吉奥方案化疗二线治疗HER-2阳性的晚期胃癌安全有效,有必要深入研究.     

替吉奥治疗晚期非小细胞肺癌的有效性及安全性

目的探讨替吉奥联合顺铂治疗晚期非小细胞肺癌的有效性及安全性。方法将90例晚期非小细胞肺癌患者按治疗方法的不同分为观察组(n=39)和对照组(n=51),对照组采用吉西他滨联合顺铂疗法,观察组采用替吉奥联合顺铂疗法,比较两组患者近期疾病控制率、治疗前后卡氏功能状态(KPS)评分、治疗前后血清肿瘤标志物[癌胚抗原(CEA)、细胞角质蛋白19片段抗原21-1(CYFRA21-1)及鳞状上皮细胞癌抗原(SCCA)]水平变化及不良反应发生情况。结果观察组患者的近期疾病控制率为76.92%,明显高于对照组的52.94%,差异有统计学意义(P﹤0.01)。治疗前,两组患者KPS评分比较,差异无统计学意义(P﹥0.05);治疗后,两组患者KPS评分均升高(P﹤0.05),且观察组患者KPS评分明显高于对照组(P﹤0.01)。治疗前,两组患者CEA、CYFRA21-1及SCCA水平比较,差异均无统计学意义(P﹥0.05);治疗后,两组患者CEA、CYFRA21-1及SCCA水平均降低(P﹤0.05),且观察组各指标水平均明显低于对照组(P﹤0.01)。观察组患者白细胞减少、血小板减少、胃肠道反应发生率均明显低于对照组,差异均有统计学意义(P﹤0.01)。结论替吉奥治疗晚期非小细胞肺癌疾病控制率高,能显著改善患者生活质量,且不良反应发生率低于临床常规用药。     

奥沙利铂联合替吉奥治疗晚期大肠癌疗效观察

目的观察奥沙利铂联合替吉奥治疗晚期大肠癌的近期疗效和安全性。方法 46例晚期大肠癌患者随机分为治疗组和对照组各23例,治疗组给予奥沙利铂＋替吉奥方案化疗,每21d为1个周期;对照组给予FOLFOX6（奥沙利铂＋亚叶酸钙＋氟尿嘧啶）方案化疗,每14d为1个周期。化疗2个周期后评价疗效和不良反应,并随访观察生存时间。结果 46例均可评价疗效,治疗组共完成72个周期化疗,对照组共完成71个周期;治疗2个周期后评定疗效,治疗组有效率（52.2%）高于对照组（39.1%）（P〈0.05）;2组白细胞减少、血小板减少、贫血、恶心呕吐、腹泻发生率比较差异无统计学意义（P〉0.05）,治疗组手足综合征（0）及肾功能异常（0）发生率低于对照组（13.0%和4.3%）（P〈0.05）;治疗组中位生存期为6.02个月,对照组为5.13个月,治疗组6、9、12、18个月生存率（73.9%、65.2%、21.7%、13.0%）与对照组（60.9%、30.4%、13.0%、4.3%）比较差异有统计学意义（P〈0.05）。结论奥沙利铂联合替吉奥方案治疗晚期大肠癌近期疗效优于FOLFOX6方案,可延长患者生存期,不良反应较轻。