人乳腺癌裸鼠移植瘤MTD间歇期给予CTX节律化疗的实验观察

目的:研究最大耐受剂量(MTD)化疗间歇期给予节律低剂量CTX对人乳腺癌裸鼠移植瘤的作用.方法:建立人乳腺癌裸鼠移植瘤模型,随机分为小剂量节律(LDM)组、最大耐受剂量(MTD)组、最大耐受剂量联合节律(MTD+LDM)组和生理盐水对照组,治疗21 d为1个周期.测量瘤体积、裸鼠体质量及外周血白细胞计数.处死裸鼠后测量瘤质量,应用免疫组化方法检测瘤组织中血管内皮生长因子(VEGF)、微血管密度(MVD)及增殖细胞核抗原(PCNA)的表达.结果:各治疗组均抑制了肿瘤生长;联合组瘤质量及21d时肿瘤体积与其他各组相比均显著降低,P＜0.05.联合组抑瘤率为69.15％,与对照组及MTD组相比,联合组和LDM组肿瘤组织的VEGF水平及MVD值显著降低,P＜0.05;与LDM组和对照组相比,联合组和MTD组肿瘤组织PCNA表达水平均显著降低,P＜0.05.各治疗组裸鼠体质量及白细胞计数差异无统计学意义,P＞0.05.结论:最大耐受剂量间歇期给予节律低剂量CTX通过同时抑制肿瘤细胞增殖活性和肿瘤血管生成,在未增加毒副反应的前提下抑瘤效果更好,为可行有效的方案.     

榄香烯对裸鼠胃癌原位移植瘤血管生成的抑制作用

 目的 观察榄香烯对裸鼠胃癌原位移植瘤生长和血管生成的抑制作用。 方法 采用裸小鼠胃癌原位移植模型,随机分为0.9%氯化钠溶液(NS)组、5-Fu组、榄香烯组和联合组 ,腹腔注射给药。比较各组移植瘤瘤重的差异;免疫组织化学法检测肿瘤微血管密度 (Microvessel Density,MVD) 和VEGF、p53蛋白表达,RT-PCR法检测VEGF mRNA表达。 结果 联合组裸鼠胃癌移植瘤的瘤重显著低于NS组(P＜0.05);榄香烯组、联合组瘤组织MVD、VEGF蛋 白、p53蛋白及VEGF mRNA表达亦明显低于NS组(P＜0.05);各组移植瘤的瘤重与瘤组织MVD呈正 相关(r=0.669,P＜0.01)。 结论 榄香烯能抑制裸鼠胃癌原位移植瘤生长和血管生成,其机制可能与抑制裸鼠胃癌组织VEGF和突 变型p53的表达有关。     

低剂量环磷酰胺对肺癌肿瘤血管生成的影响

目的研究低剂量环磷酰胺(CTX)对肺癌肿瘤血管生成的影响,观察其抑瘤效果及对生存期影响.方法以荷Lewis肺癌的C57/BL6小鼠为模型,分别给予低剂量CTX、最大耐受剂量(MTD)CTX灌胃,免疫组化染色测定肿瘤微血管密度(MVD)、血管内皮生长因子(VEGF)和核增殖抗原表达基因(Ki-67),观察小鼠生存期.结果低剂量CTX治疗组小鼠肿瘤MVD值较对照组和MTDCTX治疗组均降低,同时低剂量CTX组VEGF及Ki-67表达也降低(P＜0.05);低剂量CTX治疗组小鼠生存期较MTD CTX治疗组延长(P＜0.05).结论持续低剂量CTX给药方式可抑制肺癌肿瘤微血管生成,具有良好抑瘤效果,动物生存期延长.     

温郁金对VEGF和MVD在人胃癌裸小鼠移植瘤中表达的研究

目的研究温郁金对人胃癌裸鼠移植瘤生长的抑制作用和对血管内皮生长因子(VEGF)的表达和微血管密度(MVD)的影响.方法采用人胃癌SGC7901细胞株种植裸小鼠皮下建立胃癌移植瘤模型.自肿瘤种植后,待肿瘤生长到2 mm时开始给药,每日2次,连续7周,每周测量瘤体的大小.第7周处死动物,测定肿瘤重量,免疫组化ElivisionTM plus法测定VEGF及肿瘤内MVD.结果温郁金治疗组瘤重和体积明显低于对照组,VEGF表达的程度和MVD计数明显低于对照组.结论温郁金对人胃癌裸鼠移植瘤的生长具有明显的抑制作用,可下调瘤灶中VEGF的表达,减少肿瘤灶内的MVD.     

常规化疗联合节拍化疗对乳腺癌裸鼠移植瘤的实验研究

背景与目的:乳腺癌治疗应从全局出发,将针对肿瘤细胞本身和肿瘤微环境相结合,而研究发现节拍化疗在抗血管生成等改善肿瘤微环境方面有明显优势.本文旨在观察环磷酰胺(cyclophosphamide,CTX)常规化疗联合节拍化疗对乳腺癌裸鼠移植瘤的抑瘤效应,探讨其对血管新生和细胞增殖、凋亡的影响.方法:建立乳腺癌裸鼠原位移植瘤模型,随机分成4组:节拍化疗(LDM)组、常规化疗(MTD)组、联合(LDM+MTD)组和0.9％NaCl溶液对照组,治疗期间观察裸鼠一般状况、隔日称重并测量皮下移植瘤体积,每周尾静脉采血白细胞计数(white blood cell counts,WBC).实验结束后处死小鼠取瘤称重,计算各组抑瘤率.免疫组织化学法检测移植瘤组织中微血管密度(microvessel density,MVD),以及血管内皮细胞生长因子(vascularendothelial growth factor,VEGF)、凝血酶敏感蛋白1(thrombospondin-1,TSP-1)、增殖细胞核抗原(proliferating cell nuclear antigen,PCNA)表达,TUNEL检测肿瘤细胞凋亡.结果:CTX 3种化疗方案均可不同程度抑制移植瘤生长,其中LDM组和MTD组移植瘤生长曲线类似,LDM+MTD组移植瘤生长明显缓于其他各组;LDM组、MTD组和LDM+MTD组的抑瘤率分别为32.95％、41.57％和69.15％; LDM组和LDM+MTD组MVD、VEGF相对低表达、TSP-1相对高表达,而组间比较差异无统计学意义(P＞0.05),但与其余两组比较差异有统计学意义(P＜0.05).MTD组和LDM+MTD组PCNA相对低表达,与其余两组比较差异有统计学意义(P＜0.05),LDM+MTD组凋亡指数(apoptosis index,AI)明显高于其他各组,差异有统计学意义(P＜0.05).结论:CTX常规化疗联合节拍化疗兼有抗血管生成、抑制细胞增殖、促进肿瘤细胞凋亡作用,抑瘤作用较单一传统化疗和节拍化疗更为明显,不良反应不明显.     

重组人血管内皮抑素联合紫杉醇对裸鼠MKN-45胃癌抗肿瘤效应的实验研究

目的探讨重组人血管内皮抑素联合紫杉醇对裸鼠原位移植人胃癌抗肿瘤效应及作用机制,为进一步的临床研究提供理论依据。方法采用人胃癌细胞株MKN-45完整组织块作裸鼠原位移植,建立裸鼠胃癌模型,种植后从体表可以触及肿瘤,将32只人胃癌原位种植的裸鼠随机分为重组人血管内皮抑素组(重组人血管内皮抑素15 mg/kg),单一化疗组(选用紫杉醇20 mg/kg),联合用药组(重组人血管内皮抑素15 mg/kg+紫杉醇20 mg/kg)及对照组(等体积生理盐水)4组。给药后取肿瘤组织,测量原位肿瘤重量,计算抑瘤率、肿瘤细胞凋亡、肿瘤微血管密度(MVD)以及血清血管内皮细胞生长因子(VEGF)和碱性成纤维细胞生长因子(bFGF)的表达,观察肿瘤细胞腹膜、肝、其他脏器转移及腹水情况。结果联合用药组瘤重、血清VEGF和bFGF、MVD等较单一化疗组及对照组明显降低(P0.01或P0.05),凋亡指数较单一化疗组明显增高(P0.01或P0.05)。结论重组人血管内皮抑素联合紫杉醇能明显抑制裸鼠原位移植人胃癌的生长和转移,显示出较好的协同抗肿瘤作用。     

环磷酰胺LDM联合MTD化疗对乳腺癌抗血管作用的实验研究

目的观察环磷酰胺最大耐受量联合低剂量节律化疗对裸鼠人乳腺癌皮下移植瘤的抗血管生成及促肿瘤细胞凋亡的作用。方法荷瘤裸鼠随机分成4组：LDM组、联合用药组（MTD联合LDM组）、MTD组和对照组。给药21天后,观察各组小鼠瘤质量、瘤体积、白细胞数量,采用免疫组织化学法检测移植瘤MVD、TSP-1表达情况,TUNEL法检测肿瘤细胞凋亡情况。结果联合用药组裸鼠肿瘤的生长速度较其他组明显减慢（P〈0.05）。联合用药组裸鼠的肿瘤重量为（0.35±0.03）g,明显轻于其他组（P〈0.05）。联合用药组MVD表达水平明显低于MTD组（P〈0.05）。联合用药组TSP-1表达水平明显高于MTD组（P〈0.05）。联合用药组肿瘤细胞凋亡率明显高于其他组（P〈0.05）。结论环磷酰胺MTD联合LDM节律化疗可以抑制乳腺肿瘤的生长速度、血管生成,并促进肿瘤细胞凋亡。     

槲皮素对人乳腺癌裸鼠移植瘤的抑制作用及其对血管生成的影响

目的:观察槲皮素(Quercetin)对人乳腺癌裸鼠移植瘤的抑制作用,并探讨其对血管生成的影响。方法:复制人乳腺癌MCF-7裸鼠移植瘤模型;24只荷瘤鼠随机分为4组:A组(对照组)、B组(Quercetin)、C组(5-FU)、D组(Quercetin+5-FU),用药15日。用药中观察药效及不良反应,15日后收集肿瘤标本行光、电镜观察、免疫组化分析微血管密度(MVD)、VEGF及MMP-9。结果:1)B组、C组、D组瘤重明显低于A组,抑瘤率分别为36.46%、38.01%、48.52%(P<0.05)。2)光镜、电镜观察,使用槲皮素组肿瘤细胞出现坏死,同时肿瘤间质中血管数减少、内皮细胞有形态学改变。3)免疫组化结果:微血管密度值(MVD),B、D组高于A、C组(P<0.05)。VEGF检测显示:B、C、D组VEGF表达明显低于A组(P<0.01)。MMP-9检测显示:各组间差异无统计学意义(P>0.05)。4)单用槲皮素对裸鼠未出现不良反应,联合用药可减轻5-FU的不良反应,C组鼠体重低于A、B、D组(P<0.05)。结论:槲皮素可显著抑制MCF-7乳腺癌细胞在裸鼠体内的生长,对机体无明显不良反应。槲皮素体内抑瘤作用的机制,与其特异性抑制VEGF的表达及抑制肿瘤血管生成有关。     

雷帕霉素抑制人宫颈癌裸鼠移植瘤生长的作用及其机制北大核心CSCD

目的探讨雷帕霉素(rapamycin,RAPA)对人宫颈癌HeLa裸鼠皮下移植瘤生长的抑制作用及其可能的机制。方法裸鼠皮下接种HeLa细胞,建立人宫颈癌裸鼠皮下移植瘤模型,随机分为对照组、RAPA低剂量组(1.5 mg/kg)、RAPA高剂量组(4.5 mg/kg)。RAPA治疗过程中,检测肿瘤的体积、质量,免疫组织化学法及RT-PCR法检测低氧诱导因子-1α(hypoxia-inducible factor-1alpha,HIF-1α)mRNA、血管内皮生长因子(vascular endothelial growth factor,VEGF)mRNA的表达及肿瘤微血管密度(microvessel density,MVD)。结果 RAPA低剂量组、高剂量组肿瘤生长曲线均减缓;RAPA低剂量组及高剂量组裸鼠皮下移植瘤平均体积、重量与对照组比较显著减小(P<0.01);低剂量组与高剂量组间比较差异无统计学意义(P>0.05)。RAPA低剂量组及高剂量组VEGF蛋白、VEGF及HIF-1α含量、MVD与对照组比较显著减少(P均<0.01),低剂量与高剂量组间比较,差异无统计学意义(P>0.05)。结论 RAPA对裸鼠皮下移植瘤生长(体积、重量)具有明显的抑制作用,其可能机制是通过抑制HIF-1α的表达抑制VEGF的合成,进而抑制肿瘤组织的血管形成。     

低剂量化疗抑制肺癌血管生成的研究

背景与目的近期一些国外研究表明降低化疗药物的剂量可特异地杀伤新生肿瘤血管内皮细胞,利用化疗药物的这一新靶点,可能帮助解决常规化疗剂量引起的毒副作用和耐药性的难题。为此本研究观察持续低剂量环磷酰胺(CTX)对肺癌血管生成的影响,并观察其抑瘤效果和毒副作用。方法建立荷Lewis肺癌C57/BL6小鼠模型,分别给予持续低剂量(LDM)CTX、最大耐受剂量(MTD)CTX治疗,观察肿瘤体积、小鼠体重和外周血白细胞计数及小鼠生存期。实验终末时行免疫组化染色,测定肿瘤微血管密度(MVD)和血管内皮生长因子(VEGF)表达情况。结果与对照组和MTDCTX治疗组比较,LDMCTX治疗组小鼠肿瘤MVD值和VEGF表达均显著降低(P<0.05)。与MTDCTX治疗组比较,LDMCTX治疗组肿瘤生长比较缓慢,并且没有明显的体重减轻或白细胞数下降等毒性迹象,小鼠生存期显著延长(P<0.05)。结论CTX的持续低剂量给药方式靶向于肺癌血管生成,不易产生耐药,增加了抑瘤效果,毒副作用小,动物生存期明显延长。     

Low-dose docetaxel combined with (-)-epigallocatechin-3-gallate inhibits angiogenesis and tumor growth in nude mice with gastric cancer xenografts

Low-dose metronomic (LDM) chemotherapy represents a new strategy to treat solid tumors by stronger antiangiogenic activity and less side-effects, especially in combination with other antiangiogenic agents. The aim of the study is to investigate the antiangiogenic effect of docetaxel alone and combined with (-)-epigallocatechin-3-gallate (EGCG) in preclinical settings of gastric cancer. BGC-823 human gastric cancer xenograft model was used, and tumor growth, side-effects of mice were closely monitored. Expression of vascular endothelial growth factor and CD31 were observed by immunohistochemistry, and microvessel density of the tumor tissues was assessed by CD31 immunohistochemical analysis. Our results indicated that LDM docetaxel inhibited angiogenesis and growth of gastric cancer with less toxicity, and the effects were further enhanced by the concurrent administration of EGCG. Our study, for the first time, rationally demonstrated that LDM docetaxel treatment used alone or combined with EGCG is effective and safe in preclinical settings of gastric cancer. Our data suggest that LDM docetaxel used alone or combined with EGCG may be an innovative and promising therapeutic strategy in the experimental treatment of human gastric cancer.     

紫杉醇联合奥沙利铂及低剂量替吉奥治疗老年晚期贲门癌的近期疗效及安全性分析

目的 分析观察紫杉醇联合奥沙利铂及低剂量替吉奥治疗老年晚期贲门癌的临床疗效和安全性.方法 选取78例经病理学确诊的老年晚期贲门癌患者,按治疗方法不同分为A、B、C 3组,每组各26例,A组为紫杉醇联合奥沙利铂及低剂量替吉奥治疗,B组为低剂量替吉奥联合奥沙利铂治疗,C组为高剂量替吉奥联合奥沙利铂治疗,每组均21 d为1个周期,药物治疗2个周期后观察每组的临床疗效及不良反应发生情况.结果 A、B、C 3组的近期化疗有效率分别为19.2%、19.2%、11.5%,疾病控制率分别为92.3%、84.6%、84.6%,差异均无统计学意义(P﹥0.05);A组的整体疗效高于B、C两组(P﹤0.05).A、B、C 3组的化疗不良反应主要表现为血液系统和消化道系统不良反应,如贫血、血小板减少、便秘、腹泻等,其中A组的贫血、血小板减少、中性粒细胞缺乏、恶心呕吐、便秘、腹泻的发生率低于B、C组,差异有统计学意义(P﹤0.05).结论 紫杉醇联合奥沙利铂及低剂量替吉奥治疗老年晚期贲门癌的总体临床有效率高,不良反应小,在老年晚期贲门癌患者中应予以推广.     

A case of gastric cancer with abdominal wall invasion treated by weekly low-dose paclitaxel therapy

Here we report a case of gastric cancer with diffuse abdominal wall invasion treated with weekly low-dose paclitaxel therapy. A 62-year-old male visited our hospital because of abdominal distention, prepubic tumor,and testicular hydrocele. Computed tomography revealed diffuse swelling of the abdominal wall and hydronephrosis of the right kidney. Upper gastrointestinal endoscopy demonstrated type 3' advanced gastric cancer. Pathological diagnosis of both gastric tumor and abdominal wall biopsy specimens was poorly-differentiated adenocarcinoma containing signet ring cell carcinoma. Low-dose paclitaxel (90 mg/body) was given once a week for 3 weeks. Abdominal wall swelling like cuirass disappeared after 2 courses of low-dose paclitaxel therapy. Nine repeated courses of this regimen have been given until now; the relapse of the abdominal wall invasion has not become apparent, and primary gastric lesion has been a stable disease. Diffuse abdominal wall invasion of gastric cancer like cuirass without ascites is a rare condition, and low-dose paclitaxel was very effective for this condition.     

低剂量紫杉醇联合沙利度胺抑制小鼠S-180肉瘤血管生成的研究

目的:探讨低剂量紫杉醇联合沙利度胺对小鼠S-180肉瘤血管生成的作用。方法:建立S-180移植瘤小鼠模型,将40只荷瘤小鼠随机分为4组。A组:生理盐水组(对照组);B组:紫杉醇组,腹腔内注射20 mg/kg,每周3次,连续2周;C组:沙利度胺组,200 mg/kg灌胃,每周3次,连续2周;D组:紫杉醇+沙利度胺组,腹腔内注射紫杉醇(20 mg/kg)和沙利度胺(200 mg/kg)灌胃,每周3次,连续2周。观察瘤重、抑瘤率、血管内皮生长因子(vascular endothelial growth factor,VEGF)的表达和微血管密度(microvessel density,MVD)计数。结果:与对照组比较,B、C、D组均能降低瘤重、减少VEGF的表达、降低MVD计数(P<0.05);D组分别与B、C组比较,VEGF的表达及MVD计数均低于B、C组,且差异具有统计学意义(P<0.05)。结论:小剂量紫杉醇联合沙利度胺能一定程度上抑制S180肉瘤血管的生长,两者具有协同作用。     

Synergistic inhibitory effect of wogonin and low-dose paclitaxel on gastric cancer cells and tumor xenografts

Objective：To investigate the synergistic inhibitory effects of wogonin （WOG） and chemotherapeutic drugs on growth of gastric cancer cells and tumor xenografts.Methods：The IC50 values of WOG,cisplatin （CDDP） and paclitaxel （PTX） in four gastric cancer cell lines were determined by MTS assay.Hoechst staining and the median effect method of Chou-Talalay were used to assess the apoptosis of cells and the interaction of two drugs,respectively.BGC-823-derived xenografts in nude mice were established to investigate the effects of WOG combined with chemotherapeutic drugs in vivo.Results：WOG,CDDP and PTX inhibited the growth of BGC-823,MGC-803,MKN-45 and HGC-27 gastric cancer cells in a dose-dependent manner.WOG combined with CDDP or PTX synergistically inhibited the growth of all gastric cancer cell lines in vitro.In BGC-823,MGC-803,HGC-27 and MKN-45 cell lines,synergisms between WOG and PTX were shown when the fraction affected （Fa） values were ＜0.45,＜0.90,＜0.85 and ＜0.60.While WOG and CDDP had a synergistic inhibitory.effect when the Fa values were ＞0,＞0,＞0.65 and ＞0.10.From the results of in vivo experiments using tumor xenografts,WOG and low-dose PTX showed better efficacy than either drug alone.The inhibitory percentages of tumor weight were 61.58％,20.29％,and 22.28％ for the combination,WOG-alone,and low-dose PTX-alone groups,respectively.Notably,WOG combined with CDDP displayed very high toxicity.Conclusions：A synergistic inhibitory effect on growth was observed when WOG was combined with low-dose PTX in gastric cancer cells and tumor xenografts.These findings provide evidence for the design of a clinical trial to test the combination of WOG with low-dose PTX in human gastric cancer.     

Combined trastuzumab and paclitaxel treatment better inhibits ErbB-2-mediated angiogenesis in breast carcinoma through a more effective inhibition of Akt than either treatment alone

BACKGROUND: Trastuzumab (Herceptin; Genentech, South San Francisco, CA) is a humanized anti-ErbB-2 monoclonal antibody that has demonstrated antitumor function, especially in combination with other chemotherapies such as paclitaxel (Taxol; Bristol Myers-Squibb, Princeton, NJ), in patients with tumors that overexpress ErbB-2. Because the repeated administration of low-dose chemotherapy, such as paclitaxel, endorsed an antiangiogenic effect in vitro, and because trastuzumab was shown to inhibit angiogenesis in tumor xenografts, the authors investigated whether ErbB-2-mediated angiogenic responses would be inhibited more effectively by the combined treatment of paclitaxel plus trastuzumab. METHODS: Tumor xenografts were established in 37 severe combined immunodeficiency mice by injecting the mammary fat pad with ErbB-2-overexpressing human breast carcinoma cells. Mice then were treated with an immunoglobulin (IgG) control, trastuzumab, paclitaxel, or a combination treatment of trastuzumab plus paclitaxel. Tumorigenicity, lung metastasis, and tumor microvessel density (MVD) were evaluated. Vascular endothelial growth factor (VEGF) secretion, endothelial cell migration after treatment, and the status of phosphorylated Akt were evaluated in vitro to determine mechanisms underlying the inhibition of ErbB-2-induced angiogenesis. RESULTS: Mice treated with the trastuzumab plus paclitaxel combination exhibited significantly reduced mean tumor volumes compared with mice treated with the IgG control (419.5 mm(3) vs. 786.6 mm(3), P < 0.0001). Mice treated with trastuzumab had a mean tumor volume of 543.9 mm(3), and mice treated with paclitaxel had a mean tumor volume of 574.9 mm(3). Tumors from the trastuzumab-plus-paclitaxel group also had significantly decreased mean MVD compared with the control (30 +/- 8 MVD vs. 44 +/- 12 MVD, P < 0.05). The trastuzumab group had tumors with a MVD of 35 +/- 7, similar to the paclitaxel-treated group (35 +/- 9). Forty-four percent of the mice in the trastuzumab-plus-paclitaxel group had metastases to the lungs compared with 50%, 63%, and 75% of the mice in the paclitaxel, trastuzumab, and control groups, respectively. In vitro, the ErbB-2-overexpressing cells treated with combined trastuzumab plus paclitaxel secreted less VEGF than the cells treated with trastuzumab, paclitaxel, or control (185.9 pg/mL vs. 233.2 pg/mL, 261.3 pg/mL, and 286.4 pg/mL, respectively). In addition, the conditioned media from the combination group stimulated less mean endothelial cell migration (31.0 cells vs. 47.0 cells, 39.2 cells, and 67.5 cells, respectively). Furthermore, Akt phosphorylation contributed to VEGF up-regulation and Akt phosphorylation was reduced more effectively by combined trastuzumab plus paclitaxel treatment compared with the other treatments. CONCLUSIONS: Combined trastuzumab plus paclitaxel treatment more effectively inhibited ErbB-2-mediated angiogenesis than either treatment alone, which resulted in more pronounced tumoricidal effects. This effect may be mediated via the reduction of phosphorylated Akt.     

EGCG对胃癌血管新生中VEGF信号通路的多靶点作用

目的:探讨EGCG对胃癌血管生成抑制作用及其信号通路。方法:建立裸鼠异位胃癌模型,经腹腔注射EGCG,检测肿瘤生长及肿瘤组织微血管密度;不同浓度EGCG处理胃癌细胞24 h,检测胃癌VEGF蛋白和mRNA表达及VEGF分泌;同时不同浓度EGCG处理脐静脉内皮细胞,检测内皮细胞生长、迁移和体外小管形成。结果:EGCG显著抑制胃癌生长和肿瘤血管生成,平均肿瘤抑制率60.4%;EGCG显著抑制胃癌VEGF蛋白、mRNA表达和VEGF分泌;EGCG时间和剂量依赖性地抑制VEGF诱导的内皮细胞增殖,同时也剂量依赖性地抑制VEGF诱导的内皮细胞的迁移和小管生成。结论:EGCG多靶点作用于VEGF信号通路,抑制胃癌生长和血管生成。     

单周方案紫杉醇单药治疗在晚期胃癌应用的进展

晚期胃癌给予化疗加支持治疗，患者的生存率和生活质量都较单独给予支持治疗高。目前，在晚期胃癌治疗中，紫杉醇类的药物是最有前途的细胞毒药物之一。紫杉醇的单药使用，特别是低剂量每周的单药治疗，显示出了令人振奋的作用，且毒副反应较低，起效快，迅速缓解症状，对于一些老年、生存状况差、不适于进行联合化疗，甚至失去常规化疗指征的晚期胃癌患者，不失为一种可供选择的治疗方法。本文着重介绍小剂量每周紫杉醇单药治疗晚期胃癌的一些临床报道。     

A case of recurrent gastric cancer with skin and lung metastasis treated by low-dose paclitaxel therapy

A case of recurrent gastric cancer with metastases to the skin and lung was treated successfully with low-dose paclitaxel after oral TS-1 administration. The patient was a 73-year-old man who underwent total gastrectomy for gastric cancer on April 3, 2000. Two years and four months after the operation, an increasing CA19-9 concentration and metastases to the skin and both lungs were observed. Oral TS-1 was given, but had to be stopped because of diarrhea. The metastatic lesions of the skin were resected, and low-dose paclitaxel (100 mg) was given once a week for 6 weeks. Five months later, the metastatic lesions of the right and left lung had decreased in size by 62% and 100%, respectively. CA19-9 fell to below the cut-off value 2 months after starting therapy. A decrease in the hemoglobin level of grade 1 was observed. Low-dose paclitaxel for recurrent gastric cancer after TS-1 therapy causes few side effects and may well be effective.     

紫杉醇联合奥沙利铂治疗30例晚期胃癌临床观察

[目的]观察紫杉醇(PTX)联合奥沙利铂(L-OHP)治疗晚期胃癌的疗效和毒性.[方法] 30例晚期胃癌患者采用紫杉醇联合奥沙利铂方案化疗:PTX 130mg/m2,静脉滴注,第1天;L-OHP 130mg/m2,静脉滴注,第1天.28天为1周期,至少2周期后评定疗效.[结果]26例可评价疗效,其中完全缓解4例,部分缓解14例,总有效率为69.2%;中位无进展期7.2个月;中位生存期12.5个月.毒副作用主要为骨髓抑制、周围神经炎和脱发.[结论]紫杉醇联合奥沙利铂方案治疗晚期胃癌患者,缓解率高,耐受性良好.