吉西他滨联合大剂量顺铂治疗晚期非小细胞肺癌

目的观察吉西他滨(Gemcitabine GEM)联合大剂量顺铂(HD—DDP)方案治疗晚期非小细胞肺癌(ANSCLC)的近期疗效及其不良反应。方法经病理组织学或细胞学证实的26例晚期非小细胞肺癌用吉西他滨1000mg／m^2。静脉滴注，第1，8，15天，顺铂80～100mg/m^2静脉滴注，第1天，4周为1周期。所有病人至少接受2周期治疗。结果可评价疗效26例，总有效率46．2％，初治病例14例，有效率57．1％。复治病例12例，有效率33．3％。主要毒副作用是骨髓抑制，恶心呕吐，其他毒性反应均轻微可耐受。结论吉西他滨联合大剂量顺铂治疗晚期非小细胞肺癌具有较好疗效，毒性可耐受，是治疗晚期非小细胞肺癌较理想方案之     

生脉注射液联合健择加顺铂治疗晚期非小细胞肺癌的临床观察

目的观察生脉注射液联合健择加顺铂方案治疗晚期非小细胞肺癌的临床效果及其减毒增效作用。方法将52例晚期非小细胞肺癌患者随机分为中药加化疗组和单纯化疗组各26例。化疗组予健择1000mg／m^2第1、8天30min静滴，顺铂75mg／m^2第1天静滴，21d为1个周期；中药加化疗组于化疗前3d生脉注射液60ml加入5％GS500ml静滴。每天1次连用3周，两个周期后按照WHO实体瘤近期客观疗效评定标准进行评价。结果中药加化疗组和单纯化疗组近期有效率为46．15％和42．31％，中药加化疗组的Karnorfsky评分增加9例，单纯化疗组增加3例，中药加化疗组体重明显增加，外周血白细胞及血小板下降和贫血发生率明显较单纯化疗组低。结论生脉注射液能提高健择加顺铂方案化疗患者的生存质量，改善临床症状，减轻化疗后骨髓抑制。     

吉西他滨联合顺铂治疗复发性晚期头颈部癌的临床研究

 目的 评价吉西他滨联合顺铂治疗复发性晚期头颈部肿瘤的疗效及毒副作用。方法 对复治的晚期头颈部肿瘤患者，给予GEM 1000mg／m²静滴，第1、8d，每周期CDDP 60mg／m²，静滴（分5次第1-5d），21d为1周期，2周期后评定疗效，平均3．52个周期。结果 27例可评价疗效，完全缓解1例，部分缓解7例，总有效率29．63％，中位缓解期4．4个月，中位生存期9个月。毒副作用主要为剂量限制性毒性，表现为骨髓抑制。结论 吉西他滨加顺铂可作为复发性晚期头颈部肿瘤的挽救性化疗方案。     

HIF1α-siRNA and gemcitabine combination-based GE-11 peptide antibody-targeted nanomedicine for enhanced therapeutic efficacy in pancreatic cancers

Abstract

Pancreatic cancer is one of the deadliest cancers across the world with an average 5-year survival rate of less than <6%. In this study, gemcitabine (GEM) and HIF1α-siRNA loaded GE-11 peptide conjugated liposome was successfully prepared and evaluated for its antitumor efficacy in pancreatic cancer cells. The GE11 increased the targeting specificity of liposome carrier and increased the intracellular concentrations in the cancer cells. Furthermore, synergistic combination of GEM and HIF1a-siRNA exhibited remarkable improvement in the declining of cancer cell proliferations. siRNA could effectively decrease the expression of HIF1a gene in the cancer cells. Importantly, GE-11 peptide-conjugated GEM/siRNA-loaded liposomes (GE-GML/siRNA) increased the total amount of apoptosis cells with higher proportion of cells in late apoptosis phase. GE-GML induced remarkable apoptosis of cancer cells and induced chromatin condensation and nuclear fragmentation which are considered to be typical features of apoptosis and cell death. GE-GML/siRNA showed a significant reduction in the tumour burden suggesting the superior anticancer efficacy of this formulation. GE-GML/siRNA showed four-fold reduction in tumour compared to control and two-fold reduction compared to GE-GML, respectively. Overall, present work lays foundation for the combination of GEM and HIF1a-siRNA loaded in a targeted nanocarrier system as a unique therapeutic option in pancreatic cancer treatment.     

新辅助化疗对局部晚期非小细胞肺癌患者临床疗效和手术切除率的影响

目的 探讨局部晚期非小细胞肺癌(NSCLC)患者手术前进行新辅助化疗的临床效果以及对患者的手术和生存情况的影响.方法 66例Ⅲ期NSCLC患者,其中36例患者在手术前进行2个周期全身化疗,为观察组;其余30例患者确诊后直接进行手术,为对照组.对2组患者的手术切除情况、手术相关指标、生存率以及T淋巴细胞亚群等指标进行收集整理.结果 新辅助化疗的有效率为58.3％,其中有13例患者病情下调,病情下调率为36.1％.观察组患者的手术切除率显著高于对照组(P＜0.05);在手术时,2组患者的术中出血量和手术时间均存在统计学差异,其中观察组均显著低于对照组(P＜0.05).术后随访3年,观察组和对照组患者的1年生存率、2年生存率和3年生存率分别是83.3％和60.0％、75.0％和50.0％、63.9％和40.0％,2组患者差异具有统计学意义(P＜0.05).手术前观察组患者的CD4+和CD4 +/CD8+显著高于对照组(P＜0.05).结论 在手术前进行新辅助化疗对NSCLC患者手术切除率以及生存率等情况都有提高的效果,可能与提高患者免疫水平和降低术中出血量有关.     

Tumor treating fields in combination with gemcitabine or gemcitabine plus nab-paclitaxel in pancreatic cancer: Results of the PANOVA phase 2 study

Background

Tumor Treating Fields (TTFields), low intensity alternating electric fields with antimitotic activity, have demonstrated survival benefit in patients with glioblastoma. This phase 2 PANOVA study was conducted to examine the combination of TTFields plus chemotherapy in patients with pancreatic ductal adenocarcinoma (PDAC).

Gemcitabine, vinorelbine and prednisone for refractory or relapsed aggressive lymphoma,results of a phase II single center study

The optimum therapy for patients with relapsed or refractory aggressive non-Hodgkin’s lymphomas (NHL) not qualifying for platinum-based and/or high-dose chemotherapy is not known. We conducted a prospective phase II study evaluating a regimen consisting of gemcitabine (1 g/m², days 1 and 8), vinorelbine (30 mg/m², days 1 and 8) and prednisone (100 mg/day, days 1–8) (GVP) given every 21 days. Fifteen patients with a median age of 68 years and a median of three previous therapies were enrolled. Diagnoses included B lymphoblastic (n=1), diffuse large B cell (n=10), anaplastic large T cell (n=2) and peripheral T-cell NHL (n=2). The median international prognostic index score was 3 (six patients with a score of 4 or 5). Five patients achieved a complete remission and three patients a partial remission. The median overall survival was 13.8 months, and the median time to next treatment was 4.4 months. Haematological toxicities of World Health Organisation grades 3/4 were leucopenia in 58%, thrombocytopenia in 33% and anaemia in 17% of all courses. Three patients had grade 3 infections. There was no treatment-related mortality. GVP shows substantial activity in poor prognosis relapsed or refractory aggressive lymphomas and is generally well tolerated, but haematological toxicity is dose limiting.     

替吉奥与顺铂分别联合吉西他滨治疗进展期胰腺癌疗效比较

目的：评价吉西他滨联合替吉奥与吉西他滨联合顺铂治疗局部晚期或转移性胰腺癌临床疗效。方法回顾性分析2010年2月至2012年12月收治的42例不可切除的胰腺癌,分为吉西他滨+顺铂（GP组）18例与吉西他滨+替吉奥（GS组）24例。GP组：吉西他滨1000mg/m2,第1,8d,顺铂30mg/d,第4-6d,每3周重复;GS组：吉西他滨1000mg/m2,第1,8d,替吉奥根据体表面积,予80-120mg/d,口服,第1-14d,每3周重复。结果 GS组和GP组总有效率(CR+PR)分别为37.3%和33.3%(P>0.05)。 GS组和GP组6个月生存率分别为79.2%和83.3%(P>0.05),1年生存率分别为29.2%和22.2%(P>0.05)。中位无疾病进展时间分别为5.5个月和4.5个月(P<0.05),中位总生存时间分别为8.8个月和8.15个月(P>0.05)。两种方案毒副反应：GP组恶心、呕吐发生率明显高于GS组(83.3%vs 45.8%,P=0.024),差异有统计学意义。结论吉西他滨联合替吉奥或联合顺铂治疗晚期胰腺癌安全有效,在延长生存期方面也显示出一定的优势,但差异无统计学意义。     

吉西他滨联合顺铂内科保守方法治疗老年晚期胃癌患者的效果

目的 :探讨吉西他滨联合顺铂内科保守方法治疗老年晚期胃癌患者的效果。方法 :选取2011年1月-2013年6月间收治的110例胃癌术后行化疗的住院患者,随机分为观察组以及对照组,对照组予以吉西他滨治疗,观察组联合用顺铂治疗,比较两组患者的近期疗效、不良反应情况。结果 :两组患者均进行了2-4个疗程的化疗,平均为3个疗程。观察者的治疗有效率为40%,明显高于对照组的20%,组间比较差异有统计学意义,两组化疗的主要毒性为骨髓抑制以及恶性呕吐反应,而外周神经毒性为顺铂所特有,其余并发症如Hb下降、PLT下降、肝毒性、肾毒性等比较无明显差异,且均为轻度,不影响下周期的化疗。结论 :吉西他滨联合顺铂应用于晚期老年胃癌化疗疗效优于单独应用于吉西他滨,建议使用其应用于多程化疗失败的晚期胃癌患者。