顺铂和替加氟联合放疗治疗中晚期食管癌疗效观察

目的观察顺铂和替加氟联合放疗治疗食管癌的临床疗效及其毒副反应。方法2003年1月至2006年2月对60例食管癌患者采取顺铂20mg·m-2·d,替加氟750mg·m-2·d,连用5天,序贯放疗60~70Gy/6~7周。结果60例患者中,CR24例,PR18例,SD9例,PD9例,RR(CR+PR)为70·0%,主要毒副作用为骨髓抑制、恶心呕吐。肝肾功损害及口腔炎、静脉炎等较轻。结论顺铂和替加氟联合放疗治疗食管癌疗效好,耐受性好值得推广应用。     

影响替加氟脂质体包封率的因素

目的考察各因素对替加氟脂质体包封率(EN)的影响。方法在单因素考察的基础上,采用均匀设计法进行优化实验。结果替加氟脂质体最佳制备工艺为:磷脂质量分数为4.00%、磷脂与胆固醇的质量比为6.00∶1.00、药脂的质量比为1.00∶8.40、pH值为7.40、水化温度为40℃、水化时间为60 min。优化后的包封率为37.5%。结论药脂质量比和磷脂质量分数对替加氟脂质体包封率的影响最大。     

建立人血浆中替加氟高效液相色谱测定法

 目的建立人血浆中替加氟(tegaful)高效液相色谱测定法。方法取0.2mL血浆,以甲硝唑(metronidazole)为内标,采用叔丁基甲醚与正丙醇的混合溶剂(80:20)提取后氮气吹干,复溶,进样分析。流动相:乙腈-水(25:200);流速1.0mL·min^-1;紫外检测波长270nln,室温操作。结果替加氟与内标分离良好,保留时间分别为10.54和9.31min,且达峰处无杂峰干扰。标准曲线范围0.10-25.0μg·mL^-1,线性良好(r=0.9994,n=5),批间误差0.29%-5.65%(n=5),批内误差1.29%-6.37%(n=10),最低检测限为0.02μg·mL^-1。替加氟血样在检测过程保持稳定。结论本方法取样量小,操作快速简便,专一性强,灵敏度高,可满足药动学研究需要。     

Multidisciplinary treatment strategy for locally advanced gastric cancer: A systematic review

BackgroundMultidisciplinary management of patients with locally advanced gastric cancer (LAGC) remains unstandardized worldwide. We performed a systemic review to summarize the advancements, regional differences, and current recommended multidisciplinary treatment strategies for LAGC.MethodsEligible studies were identified through a comprehensive search of PubMed, Web of Science, Cochrane Library databases and Embase. Phase 3 randomized controlled trials which investigated survival of patients with LAGC who underwent gastrectomy with pre-/perioperative, postoperative chemotherapy, or chemoradiotherapy were included.ResultsIn total, we identified 11 studies of pre-/perioperative chemotherapy, 38 of postoperative chemotherapy, and 14 of chemoradiotherapy. In Europe and the USA, the current standard of care is perioperative chemotherapy for patients with LAGC using the regimen of 5-FU, folinic acid, oxaliplatin and docetaxel (FLOT). In Eastern Asia, upfront gastrectomy and postoperative chemotherapy is commonly used. The S-1 monotherapy or a regimen of capecitabine and oxaliplatin (CapOx) are used for patients with stage II disease, and the CapOx regimen or the S-1 plus docetaxel regimen are recommended for those with stage III Gastric cancer (GC). The addition of postoperative radiotherapy to peri- or postoperative chemotherapy is currently not recommended. Additionally, clinical trials testing targeted therapy and immunotherapy are increasingly performed worldwide.ConclusionsRecent clinical trials showed a survival benefit of peri-over postoperative chemotherapy and chemoradiotherapy. As such, this strategy may have a potential as a global standard for patients with LAGC. Outcome of the ongoing clinical trials is expected to establish the global standard of multidisciplinary treatment strategy in patients with LAGC.     

山药提取物联合替加氟对结肠癌HT-29细胞株体内外杀伤作用的研究

目的 观察山药提取物联合替加氟对结肠癌 HT-29 细胞的体内外杀伤作用。方法 采用 2×2 析因设计的方法,用含二甲基亚砜的生理盐水（空白对照）、替加氟（36 mg/L）、山药提取物（125 mg/L）、山药提取物（125 mg/L）联合替加氟（36 mg/L）作用于结肠癌 HT-29 细胞后,观察细胞形态的变化,用 MTT 法检测对结肠癌 HT-29 细胞增殖抑制的情况,用流式细胞仪检测肿瘤干细胞（CD133+细胞）表达的情况。建立荷结肠癌 HT-29 细胞裸鼠模型,按上述方法给予治疗,计算抑瘤率。用免疫组化法检测瘤体组织的血管内皮生长因子（VEGF）阳性率。结果 联合治疗组（山药提取物联合替加氟治疗组）对结肠癌 HT-29 增殖的抑制明显高于单独使用山药提取物组及替加氟组,3 个给药组均 高于空白对照组;联合治疗组作用于 HT-29 细胞后,细胞中 CD133+细胞的比例明显低于山药提取物组及替加氟组,3 个给药组均低于空白对照组。3 个给药组治疗结束后,荷瘤鼠的瘤质量及 VEGF 阳性率明显低于空白对照组,联合治疗组低于山药提取物组及替加氟组。结论 山药提取物联合替加氟对结肠癌体内外均有杀伤作用。     

替加氟口服乳剂的二阶导数分光光度测定

采用二阶导数分光光度法测定口服乳剂中替加氟的含量。在波长２９０￣２９３ｎｍ范围内辅料对测定均无干扰,在２６￣８２μｇ／ｍｌ浓度范围内振幅Ｄ与浓度具有良好的线性关系。平均回收率９９．８６％,ＲＳＤ为０．２４％,方法简便,结果准确。     

替吉奥胶囊联合奈达铂及紫杉醇治疗远处转移鼻咽癌疗效观察

 目的评价替吉奥胶囊(compound tegafur capsule, S-1)联合奈达铂(NDP)及紫杉醇(PTX)方案治疗晚期鼻咽 癌的临床疗效及不良反应。方法治疗晚期远处转移鼻咽癌患者21例,给予S-1 80 mg/m2,分2次,餐后口服,d1~14; NDP 80 mg/m2及PTX 135 mg/m2静脉滴注,第1天;每4周为1周期,所有患者均治疗2~4周期,按RECIST 1. 1标准评 价客观疗效和不良反应。结果CR 3例(14.3%), PR 12例(57.1%), SD 5例(23.8%), PD 1例(4.8%),RR 71.4%。该方 案最主要的不良反应为骨髓抑制,Ⅲ~Ⅳ度粒细胞减少占71.5%;Ⅱ~Ⅲ度血小板下降占52.3%,其余不良反应则可以耐 受。结论替吉奥联合奈达铂、紫杉醇治疗晚期远处转移鼻咽癌的近期临床疗效较好,不良反应可以耐受,值得临床进 一步研究验证。     

Severe chronic active hepatitis induced by UFTR containing tegafur and uracil

Summary A 77-year-old female patient developed severe hepatic injury after the administration of UFT^R, which contains tegafur and uracil, for postoperative chemotherapy of colon cancer. Liver damage was recognized 10 months after its administration. Serum markers for viral hepatitis and various autoantibodies were negative. The wedged biopsied liver specimen revealed advanced chronic active hepatitis with periportal confluent necrosis, marked intralobular spotty necrosis, and significant proliferation of pseudo-bile ductules. Although the cessation of the drug and conservative therapies improved hepatic function, an accidental readministration of UFT^R caused her severe hepatic damage again. These findings suggest that liver injury in the present case was caused by UFT^R. Histological findings were unique. Although tegafur is known to worsen hepatic function when given to patients with liver cirrhosis, UFT^R may also cause severe hepatic injury in those without preexisting liver disease.     

2种化学治疗方案治疗晚期胃癌疗效比较

目的对比观察2种化学治疗方案治疗晚期胃癌的近期疗效、患者生活质量及不良反应。方法 89例晚期胃癌患者分为观察组和对照组,对照组44例给予多西紫杉醇、顺铂和氟尿嘧啶治疗,观察组45例给予奥沙利铂和替吉奥胶囊治疗,2组患者均治疗2个周期后评定疗效。结果观察组患者治疗有效率为48.9%,控制率为73.3%;对照组治疗有效率为31.8%,控制率为52.3%;2组患者有效率比较差异无统计学意义(P>0.05);观察组患者治疗控制率显著高于对照组,差异有统计学意义(P<0.05)。观察组患者生活质量改善显著优于对照组,差异有统计学意义(P<0.05)。观察组患者胃肠道反应、血小板下降及白细胞下降发生率显著低于对照组,差异有统计学意义(P<0.05);但2组患者手足综合征发生率比较差异无统计学意义(P>0.05)。结论奥沙利铂联合替吉奥化学治疗方案治疗晚期胃癌疗效显著,且不良反应少。