雷丸胶囊联合吉西他滨治疗晚期肺癌的疗效观察

目的探讨雷丸胶囊联合注射用盐酸吉西他滨治疗晚期肺癌的临床疗效。方法选取2013年8月—2015年8月在河北北方学院附属第一医院进行治疗的晚期肺癌患者101例为研究对象,根据用药的差别分成对照组(50例)和治疗组(51例)。对照组于第1、8天静脉滴注注射用盐酸吉西他滨,1 000 mg/m~2加入到生理盐水250 m L中。治疗组在对照组基础上口服雷丸胶囊,1粒/次,3次/d。两组患者均以3周为1个疗程,连续治疗2个疗程。观察两组的临床疗效,比较两组的Karnofsky(KPS)评分、生活质量调查表(SF-36)评分和生存情况。结果治疗后,对照组和治疗组的临床有效率分别为48.00%、70.59%,疾病控制率分别为74.00%、94.12%,两组比较差异有统计学意义(P0.05)。治疗后,两组KPS评分、SF-36评分均显著升高,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标明显高于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组肿瘤进展时间、中位生存期、1年生存率以及2年生存率的改善情况均要优于对照组,两组比较差异有统计学意义(P0.05)。结论雷丸胶囊联合注射用盐酸吉西他滨治疗晚期肺癌具有较好的临床疗效,可改善患者的生存情况与生活质量,安全性较好,具有一定的临床推广应用价值。     

BNIP3在胰腺癌中的表达及其与术后吉西他滨化疗敏感性的关系

目的 探究胰腺癌Bcl-2/腺病毒E1B-19k相关蛋白3（Bcl-2/E1B-19k-interacting protein 3,BNIP3）的蛋白表达水平及其与术后吉西他滨化疗敏感性的关系。方法 回顾性分析2016年7月至2021年8月内蒙古医科大学附属医院58例胰腺癌根治术,并在术后规律应用吉西他滨辅助化疗或以吉西他滨为主的联合化疗患者的临床资料,选取胰腺癌术后组织切片,对其进行BNIP3免疫组织化学检测,通过实验染色强度及范围进行评分,并分析其与胰腺癌患者预后的关系。结果 与BNIP3低表达组比较,BNIP3高表达组的总生存时间（OS） [13（95%CI 11.378~14.622）个月 vs 18（95%CI 16.592~19.408）个月]和无病生存时间（DFS） [7（95%CI 4.082~9.938）个月 vs 14（95%CI 12.936~15.064）个月]均降低（P<0.05）。BNIP3的蛋白表达水平及淋巴转移情况是OS的独立预后因素,而BNIP3的蛋白表达水平及分化程度是DFS的独立预后因素。结论 胰腺癌组织中BNIP3的蛋白表达水平可能与应用吉西他滨化疗敏感性相关,BNIP3低表达患者行术后吉西他滨化疗的OS与DFS较高表达者更长。     

吉西他滨联合替吉奥治疗晚期胰腺癌的疗效观察

目的探究吉西他滨和替吉奥联合在晚期胰腺癌治疗中的临床价值,并在临床工作中进行推广使用。方法选取在我院进行治疗的晚期胰腺癌患者34例,分为观察组和对照组两组,每组17例。观察组患者应用吉西他滨联合替吉奥进行治疗,而对照组患者应用吉西他滨单药进行治疗,观察两组患者治疗的有效率以及不良反应发生率,并进行比较。结果观察组患者的总有效率明显高于对照组患者,差异均具有统计学意义(P<0.05),而不良反应的发生率以及生存时间的差异无统计学意义(P>0.05)。结论采用吉西他滨与替吉奥联合治疗治疗晚期胰腺癌,在不增加不良反应的基础上,可以提高治疗的有效率,具有重要的临床应用价值。     

吉西他滨联合卡铂治疗转移性乳腺癌的临床观察

目的：观察吉西他滨联合卡铂化疗治疗转移性乳腺癌的疗效。方法：针对51例转移性乳腺癌患者,给予吉西他滨联合卡铂治疗,吉西他滨800mg/m2,静脉滴注d1、d8,卡铂AUC 5,静脉滴注d2,21d为1个周期,每例患者治疗2个周期及以上。结果：在51例患者中,经治疗能完全缓解（CR）的12例,能部分缓解（PR）的23例,保持稳定（SD）的9例,发生进展（PD）的7例,有效率达到68.6%,中位疾病进展时间是8.6个月,中位生存时间达到18.3个月。最常见的毒副反应为骨髓抑制,III度以上血小板和白细胞下降发生率分别为23.5%和35.3%,其余毒副反应均轻微,可耐受。结论：采用吉西他滨联合卡铂化疗,能较好地治疗转移性乳腺癌,毒性反应处于可耐受范围。     

吉西他滨联合奥沙利铂治疗化疗无效的淋巴瘤的临床观察

目的:观察吉西他滨联合奥沙利铂治疗化疗无效的淋巴瘤的临床疗效和安全性。方法:60例化疗无效的淋巴瘤患者按随机数字表法均分为对照组和观察组。对照组患者给予吉西他滨1 000 mg/m2,d1、d8静脉滴注30 min;观察组患者在对照组治疗的基础上给予奥沙利铂130 mg/m2,d1静脉滴注2⁶ h。两组患者在治疗同时均给予还原型谷胱甘肽1.2 g静脉滴注,昂丹司琼8mg肌肉注射。21 d为1个疗程,治疗2个疗程后评价疗效、毒性反应及生存率。结果:观察组患者总有效率、6个月生存率显著高于对照组,两组比较差异有统计学意义(P<0.05)。两组患者毒性反应、3个月生存率比较,差异无统计学意义(P>0.05)。结论:吉西他滨联合奥沙利铂治疗化疗无效的淋巴瘤患者较单用吉西他滨疗效更好,安全性亦较好,可提高患者生存率。     

小剂量吉西他滨联合顺铂时序用药对晚期肺腺癌的临床研究

目的 探讨临床中晚期肺腺癌患者应用小剂量吉西他滨与顺铂时序用药治疗效果.方法 选取我院2009年1月至2009年12月80例晚期肺腺癌患者为研究对象,将其按照随机数字法分为研究组和对照组,研究组给予小剂量吉西他滨与顺铂时序用药治疗,对照组给予小剂量吉西他滨与顺铂常规用药治疗,观察两组的治疗效果.结果 研究组治疗有效率为65.0％,对照组治疗有效率为42.5％,研究组治疗有效率明显的高于对照组,差异有统计学意义（P＜0.05）.研究组骨髓抑制、血小板减少和粒细胞减少以及周围神经损害与恶心、呕吐发生率均明显的低于对照组,差异有统计学有意义（P＜0.05）.研究组和对照组1年后的生存率分别为72.5％、70.0％,两组的数据比较差异无统计学意义（P＞0.05）;研究组和对照组3年后生存率分别为52.5％、27.5％,两组的数据比较差异有统计学意义（P＜0.05）.结论 临床中对于晚期肺腺癌患者应用小剂量吉西他滨与顺铂联合治疗采取时序用药治疗效果显著,毒副反应少,值得临床中应用与推广.     

吉西他滨联合顺铂治疗晚期三阴乳腺癌的临床观察

目的：观察吉西他滨联合顺铂（GP方案）治疗蒽环类和紫杉类失败的晚期三阴乳腺癌近期疗效和毒副反应。方法30例晚期三阴乳腺癌患者给予吉西他滨1.0 g/m2静脉滴注第1、8天（30min内滴注完毕）,顺铂75 mg/m2,分2 d静脉滴注（第1、2天）,21 d为1周期,2周期后评价客观疗效。30例患者近期疗效 CR：0例, PR：11例（36.7%）, SD ：12例（40%）, PD ：7例（23.3%）;总有效率36.7%。该方案的主要毒副反应为胃肠道反应和骨髓抑制。结果疗效30例患者均完成2周期化疗,均可评价疗效,其中CR 0例, PR 11例（36.7%）, SD例12（40%）, PD7例（23.3%）,有效率为36.7%。不良反应主要表现为消化道反应、骨髓抑制,无治疗相关性死亡。结论GP方案治疗晚期三阴乳腺癌具有良好的近期疗效,耐受性较好。     

Efficacy and tolerance of gemcitabine and nab-paclitaxel in elderly patients with advanced pancreatic ductal adenocarcinoma

BackgroundThe efficacy and safety of gemcitabine and nab-paclitaxel (GnP) among elderly patients with advanced pancreatic ductal adenocarcinoma (PDAC) remains poorly understood. We aimed to evaluate the safety and efficacy of GnP in this setting.Patients and methodsWe retrospectively included all consecutive patients aged ≥65 years with histologically proven PDAC who received at least one cycle of GnP (January 2014 to May 2018) in four academic centers. The primary endpoints were toxicity and overall survival (OS). Secondary endpoints were progression-free survival (PFS) and objective response rate. We compared patients aged ≥ or <75 years.ResultsThe study included 127 patients; among them 42 (33.1%) were aged ≥ 75 years. Fifty-seven and seventy patients received GnP as the first-line and the second-line treatment or beyond, respectively. Sixty-seven patients had at least one grade 3/4 adverse event, the most frequent being neutropenia and peripheral neuropathy. No deaths were related to toxicity. OS (median, 8.0 months; 95% confidence interval (CI), 5.8–10.2) and PFS (median, 5.5 months; 95% CI, 4.8–6.2) were similar for patients aged <75 or ≥75 years in the whole cohort and among patients receiving GnP as the first-line treatment. Cephalic PDAC, liver metastases, hypoalbuminemia, and GnP received beyond the first-line were associated with a significantly shorter OS on the multivariate analysis.ConclusionGnP is well tolerated and effective in elderly patients with advanced PDAC, even patients aged ≥75 years. The data from daily clinical practice are consistent with the results reported with first-line treatment and highlight the relevance of GnP administration in elderly patients.     

Efficacy and safety of gemcitabine-oxaliplatin combined with huachansu in patients with advanced gallbladder carcinomaTian-Jie Qin,Xin-Han Zhao,Jun Yun,Ling-Xiao Zhang,Zhi-Ping Ruan,Bo-Rong Pan

AIM:To evaluate the efficacy and safety of gemcitabine-oxaliplatin(GEMOX)cornbined with huachansu(cinobufagin)injection treatment in patients with locally advanced or metastatic gallbladder carcinoma(GBC),and to assess the quality of life(QOL)of such patients.METHODS:Twenty-five patients with locally advanced or metastatic GBC were treated with intravenous gemcitabine(1000 mg/m2)over 30 min on days 1 and 8,2 h infusion of oxaliplatin(120 mg/m2)on day 1,and 2-3 h infusion of huachansu(20 mL/m2)on days-3-11,every 3-4 wk.Treatment was continued until occurrence of unacceptable toxicity or disease progression.QOL of patients was assessed by the EORTC QLQ-C30 at baseline,at the end of the first,third and sixth chemotherapy cycles,and 1 mo after the treatment.RESULTS:Among the 25 patients with a median age of 64 years(range 42-78 years),23 were evaluable in the study.A total of 137 cycles of therapy were performed and the median cycle was 5(range 1-8)per patient.Out of the 23 patients whose response could be evaluated,8 partial responses(PR)were observed(34.8%),while 7 patients(30.4%)demonstrated a stable disease(SD).The disease control rate was 65.2%.Progression of cancer was observed in 8(34.8%)patients.The median progression-free and overall survival time was 5.8 mo(95% CI:4.5-7.1 mo)and 10.5 mo,respectively.The therapy was well tolerated,with moderate myelosuppression as the main toxicity.Anemia grade 2 was seen in 16.0%,neutropenia grade 3 in 8.0% and thrombocytopenia grade 3 in 24.0% of patients,respectively.Non-hematologic toxicity ranged from mild to moderate.No death occurred due to toxicity.The QOL of patients was improved after chemotherapy,and the scores of QOL were increased by 10 t0 20 points.CONCLUSION:GEMOX combined with huachansu(cinobufagin)injection is well tolerated,effective,thus ireproving the QOL of patients with advanced GBC.(C)2008 The WJG Press.All rights reserved.     

Pancreatic carcinoma with brain metastases: case report and literature review

The case of a patient developing multiple brain metastases from carcinoma of the exocrine pancreas has been described. A 56-year-old man with stage IV pancreatic cancer attained a clinical and radiographic response while receiving the G-FLIP chemotherapy regimen (biweekly gemcitabine, irinotecan, 5-fluorouracil, leucovorin and cisplatin). After 4 months of therapy, he developed gait imbalance and weakness in the right hand. An MRI of the brain showed multiple 1-2 mm enhancing nodules in the cerebral hemispheres and pons. A subsequent biopsy confirmed that these were pancreatic carcinoma metastases. The patient experienced a rapid deterioration in his neurological status and died 3 days after brain biopsy. Previously reported cases of brain metastases from pancreatic cancer are reviewed.