红参发酵产物联合长春瑞滨及顺铂化疗方案治疗晚期非小细胞肺癌患者的疗效

目的探讨红参发酵产物联合长春瑞滨及顺铂化疗方案治疗晚期非小细胞肺癌患者的疗效。方法将104例晚期非小细胞肺癌患者随机分为治疗组及对照组,每组52例。对照组患者给予单纯长春瑞滨^+顺铂化疗方案,治疗组患者在对照组基础上联合应用红参发酵产物。分别在治疗前后采用疲劳症状量表(FSI)、肺癌治疗功能评价量表(FACT-L)评价两组患者疲劳症状及生活质量,并比较治疗前后两组患者血清肿瘤标志物水平、免疫功能指标水平、药物不良反应及生存情况。结果治疗前,两组患者FSI各维度评分及总分,FACT-L各维度评分及总分,细胞角质蛋白19片段抗原21-1(CYFRA21-1)、神经元特异性烯醇化酶(NSE)、癌胚抗原(CEA)、自然杀伤(NK)细胞、CD3^+、CD4^+、CD8^+、CD4^+/CD8^+水平比较,差异均无统计学意义(P﹥0.05)。治疗后,对照组患者FSI各维度评分及总分均高于治疗前及治疗组;治疗组患者生理状态、情绪状态、对疾病关注度评分及总分均高于治疗前,且生理状态、社会家庭状态、情绪状态、功能状态、对疾病关注度评分及总分均高于对照组;两组患者CEA、CYFRA21-1及NSE水平均较治疗前下降,且治疗组患者均低于对照组患者;治疗组患者NK细胞、CD3^+、CD4^+及CD4^+/CD8^+水平均较治疗前上升,且均高于对照组患者,差异均有统计学意义(P﹤0.05)。治疗组患者血液学不良反应发生例数少于对照组,差异有统计学意义(P﹤0.05)。结论红参发酵产物联合长春瑞滨及顺铂化疗方案能够有效提高晚期非小细胞肺癌患者的免疫功能及生活质量,降低血清肿瘤标志物水平,并减轻血液学不良反应。     

口服与注射长春瑞滨联合卡培他滨治疗蒽环类，紫杉类耐药性晚期乳腺癌的比较研究

目的 探讨口服长春瑞滨联合卡培他滨治疗葸环类、紫杉类耐药的转移性乳腺癌的疗效及不良反应。方法 80例确诊葸环类、紫杉类耐药的转移性乳腺癌患者随机分为两组。口服长春瑞滨联合希罗达组（试验组）：40例患者口服江苏豪森酒石酸长春瑞滨软胶囊45．50mg／（m^2-d），第1、8、15天服用，口服卡培他滨1650mg／（m^2·d），连服1—14d，每3周为1个周期，连用4个周期。注射长春瑞滨联合希罗达组（对照组）：40例患者，长春瑞滨（江苏豪森）25mg／（m^2·d）第1、8天静脉滴注，口服卡培他滨1650mg／（m^2·d），连服1-14d，每3周为1个周期，连用4个周期。治疗结束2周后评价疗效。结果 入组患者80例均可评价疗效，试验组有效率为42．5％，1年生存率为45．0％，中位进展时间4．7月，中位生存时间11．0月；对照组有效率为37．5％，1年生存率为42．5％，中位进展时间4．6月，中位生存时间10．6月；两组比较差异无统计学意义（P〉0．05）。在毒副反应方面，Ⅲ／IV便秘、局部静脉炎、HB下降、WBC下降、ANC下降、总Ⅲ／IV反应率两组比较。差异均有统计学意义（P〈0．05）。结论 口服长春瑞滨联合卡培他滨治疗葸环类、紫杉类耐药的转移性乳腺癌与静脉剂型疗效一致，并且在毒副反应上，口服长春瑞滨明显较静脉剂型轻，并且应用方便。     

长春瑞滨诱导人肺癌Calu-3细胞凋亡及机制

目的　观察长春瑞滨 (VRB)诱导人肺癌Calu 3细胞凋亡时Bcl 2和半胱天冬酶 3的表达有无变化。方法　以不同浓度的VRB( 2 0 ,40和 60 μmol·L-1)作用于体外培养的人肺癌Calu 3细胞 2 4h后 ,TUNEL法和吖啶橙染色法观察肺癌细胞凋亡形态学特征 ;流式细胞仪检测肺癌细胞凋亡率和肺癌细胞Bcl 2蛋白表达水平 ;以半胱天冬酶 3荧光分析检测试剂盒测定肺癌细胞半胱天冬酶 3活性。结果　VRB( 2 0 ,40和60 μmol·L-1)处理细胞 2 4h ,TUNEL法及吖啶橙染色均观察到典型的凋亡细胞形态学特征。流式细胞仪检测VRB处理的肺癌细胞凋亡率分别为 ( 3 .1±0 .6) % ,( 7.8± 1 .2 ) %和( 1 9.6± 4.3 ) % ,较对照组 (凋亡率为 0 )显著增高且呈剂量依赖性 (P <0 .0 1 ) ;Bcl 2蛋白阳性表达细胞率分别为 ( 3 7.6±6.9) % ,( 2 5 .4±6.2 ) %和( 8.4±2 .5 ) % ,较对照组 ( 4 8.3±7.1 ) %显著降低且呈剂量依赖性 (P <0 .0 5 ) ;肺癌细胞半胱天冬酶 3活性分别为 ( 3 3 2± 1 6) ,( 4 1 7± 1 1 )和 ( 63 1± 2 7)μmol·L-1·h-1,较对照组 ( 1 95±1 2 ) μmol·L-1·h-1显著增高且呈剂量依赖性(P <0 .0 1 )。结论　VRB可以诱导肺癌细胞凋亡 ,抑制Bcl 2表达及增强半胱天冬酶 3活性     

长春瑞滨联合奥沙利铂治疗晚期非小细胞肺癌

目的 :观察长春瑞滨 (NVB)加奥沙利铂 (乐沙定 ,LOHP)治疗晚期非小细胞肺癌 (NSCLC)的疗效及毒副反应。方法 :经病理组织学或细胞学证实的 5 0例晚期非小细胞肺癌患者 ,随机分为治疗组 2 6例及对照组 2 4例 ,分别给予NVB LOHP及NVB CDDP治疗 ,2 1天为一个周期 ,均治疗 2周期以上。结果 :治疗组总有效率为 38.5 % ,对照组总有效率为 4 1.6 % (P >0 .0 5 )。毒副反应以白细胞降低、胃肠道反应和周围神经炎为主 ,而Ⅲ～Ⅳ度消化道反应、肾脏损害及心功能下降主要发生在对照组 ,周围神经炎主要发生在治疗组 (P <0 .0 5 ) ,但均可耐受。结论 :长春瑞滨 (NVB)加奥沙利铂与长春瑞滨 (NVB)加顺铂治疗晚期非小细胞肺癌相似 ,均有较好的近期疗效 ,而长春瑞滨(NVB)加奥沙利铂组的毒副反应较轻 ,临床应用更安全 ,更适合于老年患者。     

诺维本联合放射对人肺腺癌细胞的杀伤作用

[目的]研究诺维本联合放射对人肺腺癌细胞(PAA)的杀伤作用.[方法]应用四唑盐比色试验(MTT)检测诺维本对PAA细胞生长的抑制率和时间效应;流式细胞术检测细胞周期及凋亡情况.[结果]不同浓度(20、40、60、80、100μmol/L)的诺维本作用24h后对细胞生长的抑制率分别为6.12%、18.80%、53.91%、77.10%和90.20%,ID50为59.10μmol/L;诺维本对细胞生长的抑制作用在高浓度时具有明显的时间依赖性;从流式细胞术的细胞周期分析结果发现,经诺维本作用后G2/M期细胞的比例明显增加;单纯药物组的凋亡在24h出现,单纯放射组在放射后12h出现明显的凋亡小峰,药物放射联合组出现凋亡的时间更早,凋亡峰亦更明显,各组细胞在不同时间内的平均凋亡百分数分别为:对照组5.362±4.123,单纯放射组6.523±6.214,单纯药物组9.985±9.023,药物联合放射组18.100±8.965,药物联合放射组与其它3组相比,P均＜0.05.[结论]诺维本联合放射对人肺腺癌细胞有协同杀伤作用.     

Capecitabine and vinorelbine in elderly patients (> or =65 years) with metastatic breast cancer: a phase I trial (SAKK 25/99).

BACKGROUND: Few chemotherapy regimens are suitable for the treatment of elderly patients with advanced breast cancer. With the aim of finding a regimen with a low burden of subjective non-overlapping toxic effects, vinorelbine and capecitabine were chosen to be investigated in a phase I dose-finding study. PATIENTS AND METHODS: Thirty-six patients with advanced breast cancer were stratified for the presence of bone and non-bone involvement and treated at four dose levels from capecitabine 800 mg/m2 orally days 1-14 and vinorelbine 20 mg/m2 intravenously days 1 and 8, to capecitabine 1250 mg/m2 orally days 1-14 and vinorelbine 25 mg/m2 intravenously days 1 and 8, for a maximum of six cycles. None of the patients had received prior chemotherapy for metastatic/advanced disease. Fifty-three per cent of patients with bone metastases and 67% of patients without bone metastases had visceral disease. The median age was 70 years for the 15 with bone involvement patients and 73 years for the 21 without bone involvement patients. RESULTS: Twenty-eight patients were fully evaluable for hematological dose-limiting toxicity (DLT), and all patients for other DLTs and for antitumor activity. One DLT with grade 3 venous thrombosis at dose level 2 and two dose-limiting neutropenia events at level 3 occurred in patients without bone involvement. Two dose-limiting neutropenia events were observed at dose level 2 for patients with bone involvement. Thus, the recommended dose was defined at level 1 (capecitabine 1000 mg/m2 days 1-14 and vinorelbine 20 mg/m2 days 1 and 8) for patients with bone involvement. For patients without bone involvement, the recommended dose was at level 2 (capecitabine 1250 mg/m2 days 1-14 and vinorelbine 20 mg/m2 days 1 and 8). For patients without bone involvement the overall response rate was 48% and the time to progression (TTP) was 4.5 months [95% confidence interval (CI) 3.3-6.9]. For patients with bone involvement the overall response rate was 53% and TTP was 5.3 months (95% CI 2.7-7.8). CONCLUSIONS: This regimen of capecitabine and vinorelbine is well tolerated and effective in elderly patients with metastatic breast cancer. Toxicity was mainly hematological and was observed at a lower dose in patients with bone involvement. A phase II study with the two different dose levels for elderly patients with and without bone involvement is currently being conducted.     

长春瑞滨联合顺铂和依托泊甙治疗31例晚期非小细胞肺癌

[目的]观察长春瑞滨联合顺铂和依托泊甙治疗晚期非小细胞肺癌的临床疗效和毒副作用。[方法]可评价的晚期非小细胞肺癌31例,均以NVB25mg/m2静注,第1,8天;DDP20mg/m2静注,第1～5天;Vp鄄16胶囊50mgBid×10天。[结果]初治17例有效率52.9%,复治14例有效率35.7%,总有效率45.2%,主要毒副反应为骨髓抑制。[结论]长春瑞滨、顺铂和依托泊甙联合化疗治疗晚期非小细胞肺癌疗效较高,副反应可耐受,值得临床进一步观察。     

以顺铂为基础的两种联合化疗方案治疗晚期非小细胞肺癌的临床研究

目的　比较顺铂为基础的两种联合化疗方案 :顺铂 (cisplatin ,DDP)联合长春瑞宾 (vinorelbine ,NVB)与顺铂联合紫杉醇 (pacli taxel,Taxel)治疗晚期NSCLC病人的临床疗效及不良反应。方法　住院治疗的中晚期NSCLC患者 48例 ,分别接受顺铂 +长春瑞宾(PN)治疗 2 5例 ,顺铂 +紫杉醇 (PT)治疗 2 3例。按WHO疗效及不良反应评价标准评价 ,完成治疗 2个周期以上的患者进行临床疗效及不良反应评估。结果　可评价患者 45例 ,其中PN组 2 3例 ,有效率 (RR) 2 6 1% (6/2 3 ) ,中位缓解期为 6个月 ,1年生存率3 5 1% (9/2 3 ) ;PT组 2 2例 ,RR 2 7 3 % (6/2 2 ) ,中位缓解期为 7 8个月 ,1年生存率 45 5 % (10 /2 2 )。两组有效率、中位缓解期、1年生存率统计学处理均无差异 (p >0 0 5 )。主要不良反应为骨髓抑制、胃肠道反应、末梢神经炎、肌肉与关节酸痛。结论　PN方案与PT方案具有相近的临床疗效 ,但PN方案较为经济 ,可作为治疗中晚期NSCLC病人的首选方案。     

Vinorelbine, bleomycin and methotrexate as a salvage therapy for patients with head and neck squamous carcinoma in relapse after cisplatin/fluorouracil

Background: Cisplatin (CDDP) and 5-fluorouracil (5-FU) represent the standard chemotherapy for advanced/recurrent head and neck squamous carcinoma (HNSC); however, the duration of response is often short, with a median survival of only five to six months.Patients and methods: Patients with HNSC were treated with vinorelbine 20 mg/m² and methotrexate 50 mg/m² every week and bleomycin 15 mg/m² every two weeks. All patients were previously treated with a CDDP/5-FU regimen.Results: Forty-eight patients were evaluable for response and toxicity. After a median follow-up of 15 months, 16 patients are still alive and 32 have died. We had one complete response (2%), 12 partial responses (25%) (overall response rate 27%; 95% CI: 14%–39%), 11 stabilizations (23%) and 24 progressions (50%) of disease. Neutropenia grade 3–4 was seen in 12 patients; peripheral neurotoxicity in two patients. There were no toxic deaths.Conclusions: This regimen, administered in an outpatient setting, revealed some activity as a second-line treatment in patients with HNSC, with acceptable toxicity.     

AT方案与NP方案治疗晚期乳腺癌临床疗效观察

目的比较AT方案与NP方案治疗晚期乳腺癌的临床疗效、毒副反应及临床受益反应(clinicalbenefitresponse,CBR)。方法Ⅲ～Ⅳ期乳腺癌患者64例,分为AT组(ADM+TAX)38例,NP组(NVB+DDP)26例。结果AT组有效率68.4%(26/38),CBR率55.3%(21/38);NP组有效率65.4%(17/26),CBR率53.8%(14/26)。组间疗效及CBR无显著性差异(P>0.05)。主要毒副作用为骨髓抑制、消化道反应和静脉炎,均为可逆性。结论AT方案和NP方案对于复发或有远处转移的晚期乳腺癌疗效确切,毒副作用可以耐受,均可作为一线治疗方案应用。