GP方案联合益气化痰汤治疗晚期非小细胞肺癌64例

[目的]评价益气化痰汤联合吉西他滨加顺铂方案治疗晚期非小细胞肺癌（NSCLC）的近期疗效及毒副反应。[方法]64例晚期NSCLC患者随机分为单纯化疗组和联合化疗组,两组的化疗方案均采用GP方案,每21d为1个周期：而联合化疗组加服益气化痰汤（主要药物：黄芪、党参、白术、茯苓、陈皮、神曲、厚朴、生意苡、川 贝、石见穿、葶苈子、桑白皮、白花蛇舌草等）。3个周期后评价疗效和毒副反应。[结果]两组均无CR者,联合治疗组有效率46．88％,单纯化疗组有效率40．0％（P〈0．05）．两组毒副反应均可耐受。联合化疗组在改善症状、延长生存期方面较有优势。[结论]益气化痰汤联合GP方案治疗晚期NSCLC可获得较好疗效．减轻毒副反应。     

小牛脾提取物注射液联合化疗治疗晚期食管癌44例

[目的]比较小牛脾提取物注射液联合化疗与单纯化疗对晚期食管癌的疗效、毒副反应及免疫功能的影响。[方法]78例晚期食管癌患者随机分为两组：单纯化疗组（对照组）采用紫杉醇加顺铂方案化疗：治疗组化疗方案同对照组．并同时给予小牛脾提取物注射液静脉滴注。均3周为1个周期,至少治疗2个周期。[结果]治疗组与对照组的中位生存时间及1年生存率无差异。治疗组生活质量KPS评分高于对照组,差异有显著性（P〈0．05）;治疗组血液毒副反应、胃肠道反应、对免疫功能的影响均明显低于对照组（P〈0．05）．[结论]小牛脾提取物注射液联合化疗治疗晚期食管癌能提高疗效．降低化疗对患者免疫功能的影响,减轻毒副反应,改善患者的生活质量．     

爱迪注射液治疗中晚期肺癌的疗效观察

研究爱迪注射液对中晚期肺癌的治疗作用及毒副反应，选用爱迪生注射液联合化疗药物治疗中晚期肺癌30例，以同期单纯化疗药物治疗30例作为对照组，对近期疗效，毒副反应及生活质量改变，按WHO肿瘤客观疗效评定标准进行对比，联合用药组有效率为46．7％，对照组有效率为36．7％，差异不显著（P＞0．05），联合用药组病变进展率为6．7％，对照组33．3％，差异显著（P＜0．05），联合用药组治疗后白细胞下降至13．3％，化疗组36．7％，差异显著（P＜0．05），生活质量评分改善比较两组间差异有显著性（P＜0．05），中药爱迪注射液具有抑制肿瘤生长，提高化疗药效果，减少化疗引起的毒副反应。     

诱导化疗联合三维适形放疗治疗48例局部晚期非小细胞肺癌

[目的]评价诱导化疗加三维适形放射治疗（3DCRT）治疗局部晚期非小细胞肺癌（NSCLC）的疗效及毒副反应。[方法]经病理学或细胞学确诊的78例局部晚期NSCLC患者随机分为单纯3DCRT治疗组（RT组，30例）和诱导化疗与3DCRT联合治疗组（CMT组，48例）。CMT组在3DCRT治疗前给予2～4个周期以铂类药物为主的静脉化疗。[结果]全组中位生存期12．5个月，CMT组中位生存期15个月，RT组中位生存期10个月（P=0．453）。1年生存率CMT组为70．8％，RT组为43．3％（P=0．016）：2年生存率CMT组为37．5％，RT组为26．6％（P=0．323）。两组毒副反应相似，化疗的毒副反应患者能耐受。[结论]诱导化疗加三维适形放疗治疗晚期NSCLC可延长生存期，但并不增加放射副反应。     

区域亚高温热疗联合NP方案治疗晚期非小细胞肺癌23例分析

[目的]评价区域亚高温热疗联合诺维本＋顺铂（NP）方案治疗晚期非小细胞肺癌的近期疗效和毒副反应。[方法]45例晚期非小细胞肺癌患者分两组：热化疗组23例采用区域亚高温热疗联合NP方案化疗，热疗120min-180min／次，每周2次：对照组22例单纯NP方案化疔。两组均以3周为1个周期，完成4个周期后评价疗效。[结果]热化疗组食管内测温治疗温度为40．2～42．0℃，中位数为41．4℃。热化疗组有效率为73．9％，对照组有效率为45．5％：中位生存期（MST）：热化疗组13．9个月，对照组8．2个月；1年生存率：热化疗组66．7％，对照组36．4％（P〈0．05）。常见毒副反应：少量～中等量出汗、加温局部烫伤、骨髓抑制及胃肠道反应。[结论]区域亚高温热疗联合NP化疔方案治疗晚期非小细胞肺癌有助于提高临床疗效。     

诱导化疗联合三维适形放疗治疗48例局部晚期非小细胞肺癌

[目的]评价诱导化疗加三维适形放射治疗（3DCRT）治疗局部晚期非小细胞肺癌（NSCLC）的疗效及毒副反应。[方法]经病理学或细胞学确诊的78例局部晚期NSCLC患者随机分为单纯3DCRT治疗组（RT组，30例）和诱导化疗与3DCRT联合治疗组（CMT组，48例）。CMT组在3DCRT治疗前给予2～4个周期以铂类药物为主的静脉化疗。[结果]全组中位生存期12．5个月，CMT组中位生存期15个月，RT组中位生存期10个月（P=0．453）。1年生存率CMT组为70．8％，RT组为43．3％（P=0．016）：2年生存率CMT组为37．5％，RT组为26．6％（P=0．323）。两组毒副反应相似，化疗的毒副反应患者能耐受。[结论]诱导化疗加三维适形放疗治疗晚期NSCLC可延长生存期，但并不增加放射副反应。     

热疗对晚期非小细胞肺癌化疗增效作用的临床观察

目的评价热疗联合化疗对晚期非小细胞肺癌（NSCLC）的临床疗效。方法晚期NSCLC患者120例随机分成热化疗组和化疗组,热化疗组采用化疗与热疗联合治疗,化疗组仅行化疗,2组病例均在治疗2周期后进行临床疗效及毒副反应评价。结果热化疗组和化疗组有效率分别为66．67％和33．39％,差异有统计学意义（P〈0．05）。热化疗组生活质量改善率76．67％,化疗组为56．67％,差异有统计学意义（P〈0．05）;2组1a生存率分别为55．0％、35．0％,差异有统计学意义（P〈0．05）。结论热疗联合化疗治疗晚期NSCLC疗效优于单纯化疗,且不增加毒副反应,是晚期NSCLC可选择的一种安全有效的治疗方法。     

消癌平注射液联合间断化疗治疗老年晚期非小细胞肺癌

目的 观察消癌平注射液联合间断化疗治疗老年晚期非小细胞肺癌患者的疗效及毒副反应.方法 将老年晚期非小细胞肺癌患者74例随机分为2组,对照组37例应用多西他赛＋奥沙利铂方案连续化疗,观察组37例应用多西他赛＋奥沙利铂方案的同时,给予消癌平注射液.观察2组患者近期疗效、生活质量、中位生存期及毒副反应.结果 有效率观察组和对照组分别为32.4%和24.3%,差异有统计学意义（P〈0.05）;生活质量改善率观察组为75.6%,高于对照组的54.0%（P〈0.05）;中位生存期观察组388 d,长于对照组的243 d（P〈0.05）;毒副反应发生率观察组低于对照组（P〈0.05）.结论 消癌平注射液联合间断化疗治疗晚期非小细胞肺癌,可以提高患者的近期疗效、改善生存质量和延长生存期,安全性好.     

中药益气活血方联合长春瑞滨和顺铂治疗晚期非小细胞肺癌的临床研究

目的探讨中药益气活血方联合长春瑞滨和顺铂（NP方案）化疗治疗晚期非小细胞肺癌（NSCLC）的近期疗效。方法将2008年1月至2012年5月收治的93例的晚期NSCLC患者随机分为中药联合化疗组（45例）和单纯化疗组（48例）,中药联合化疗组采用益气活血方联合NP化疗方案治疗,单纯化疗组采用NP化疗方案。21d为1个治疗周期,治疗3个周期后,对比两组患者临床症状、生活质量改善情况及不良反应。结果（1）中药联合化疗组总体有效率（24．4％）和肿瘤控制率（82．2％）均高于单纯化疗组（18.8％及77．1％）,但差异均无统计学意义（P〉0．05）。（2）中药联合化疗组患者治疗后生活质量改善比例（35．6％）高于单纯化疗组（16．7％）,差异有统计学意义（P〈0．05）,生活质量下降患者比例（15．6％）低于单纯化疗组（31．3％）。（3）中药联合化疗组患者胃肠道反应和白细胞下降者所占比例显著低于单纯化疗组,差异有统计学意义（P〈0．05）。结论益气活血方联合NP化疗方案治疗晚期NSCLC与常规NP方案相比,可明显提高患者生活质量。     

艾迪与化疗联合应用治疗晚期大肠癌的临床疗效观察

比较艾迪注射液加联合化疗 (观察组 )与单纯联合化疗 (对照组 )对晚期大肠癌的疗效及对免疫功能的影响。观察组 32例晚期大肠癌患者在HLF方案化疗同期加用艾迪注射液 5 0mL ,溶于生理盐水 40 0mL中 ,每日 1次 ,连用 10d ;对照组 30例晚期大肠癌患者单用HLF方案治疗。结果观察组有效率为 40 6 %高于对照组 30 % ,但差异无显著性 (P>0 0 5 )。观察组治疗前后免疫功能的改变 ,血液毒副反应 ,胃肠反应均明显低于对照组 ,差异有显著性 (P <0 0 5 )。研究结果提示 ,艾迪与化疗联合应用治疗晚期大肠癌 ,疗效显著 ,并降低了化疗对免疫功能、血液学、胃肠道的影响及毒副反应 ,改善了患者的生命质量     

Experience with Impedance Phlebography Compared with Venography

Venography is a particularly reliable method for the diagnosis of deep venous thrombosis but is not suitable as a screening test. Impedance phlebography represents another attempt to discover a simple, non-invasive and reliable method of detecting deep venous thrombosis. It does not, however, meet these criteria.     

Compliance with guidelines and correlation with outcome in patients with advanced germ-cell tumours

PurposeTo evaluate prior compliance with guidelines in patients treated with salvage chemotherapy for advanced germ-cell tumours (GCT).Patients and methodsData concerning the initial management of patients requiring salvage chemotherapy for GCT at Institut Gustave Roussy between 2000 and 2010 were obtained and correlated with recommendations for treatment. Criteria of non-compliance were defined based on guidelines. Compliance with guidelines, predictive factors for non-compliance and the impact on outcome were analysed.ResultsAmong 82 patients treated in the salvage setting, guidelines to initial treatment were followed in only 41 cases (50%). The most common non-compliance criteria were non-adherence to the planned dose (16%), an inappropriate interval between first-line chemotherapy cycles (16%), the lack of post-chemotherapy surgery (16%) and a long interval to post-chemotherapy surgery (48%). Compliance with standard care was better in cancer centres than in other hospitals (private or public) (Odd Ratio (OR): 6.9, P = 0.001). A poor-risk status according to the International Germ Cell Cancer Collaborative Group (IGCCCG) was also predictive of compliance in univariate but not in multivariate analysis. No significant difference in outcome after salvage chemotherapy was observed. Patients relapsing after non-compliant first-line therapy tended to be more easily salvaged, which is consistent with the fact that their initial treatment was inadequate. Some of these relapses were therefore probably not due to true biologically refractory disease.ConclusionGuidelines for first-line treatment are adhered to in only half the patients requiring salvage chemotherapy. As the only predictive factor for non-compliance was the treating centre, centralisation of patients with GCT in well-trained hospitals should be recommended.     

Treatment with methylnaltrexone is associated with increased survival in patients with advanced cancer

BackgroundMethylnaltrexone (MNTX), a peripherally acting μ-opioid receptor (MOR) antagonist, is FDA-approved for treatment of opioid-induced constipation (OIC). Preclinical data suggest that MOR activation can play a role in cancer progression and can be a target for anticancer therapy.Patients and methodsPooled data from advanced end-stage cancer patients with OIC, despite laxatives, treated in two randomized (phase III and IV), placebo-controlled trials with MNTX were analyzed for overall survival (OS) in an unplanned post hoc analysis. MNTX or placebo was given subcutaneously during the double-blinded phase, which was followed by the open-label phase, allowing MNTX treatment irrespective of initial randomization.ResultsIn two randomized, controlled trials, 229 cancer patients were randomized to MNTX (117, 51%) or placebo (112, 49%). Distribution of patients' characteristics and major tumor types did not significantly differ between arms. Treatment with MNTX compared with placebo [76 days, 95% confidence interval (CI) 43–109 versus 56 days, 95% CI 43–69; P = 0.033] and response (laxation) to treatment compared with no response (118 days, 95% CI 59–177 versus 55 days, 95% CI 40–70; P < 0.001) had a longer median OS, despite 56 (50%) of 112 patients ultimately crossing over from placebo to MNTX. Multivariable analysis demonstrated that response to therapy [hazard ratio (HR) 0.47, 95% CI 0.29–0.76; P = 0.002) and albumin ≥3.5 (HR 0.46, 95% CI 0.30–0.69; P < 0.001) were independent prognostic factors for increased OS. Of interest, there was no difference in OS between MNTX and placebo in 134 patients with advanced illness other than cancer treated in these randomized studies (P = 0.88).ConclusionThis unplanned post hoc analysis of two randomized trials demonstrates that treatment with MNTX and, even more so, response to MNTX are associated with increased OS, which supports the preclinical hypothesis that MOR can play a role in cancer progression. Targeting MOR with MNTX warrants further investigation in cancer therapy.Clinical trials numberNCT00401362, NCT00672477.     

Costs associated with complications are lower with capecitabine than with 5‐fluorouracil in patients with colorectal cancer

BACKGROUND:

Capecitabine, an oral alternative to 5‐fluorouracil (5‐FU) in patients with colorectal cancer (CRC), has equal clinical efficacy and a favorable safety profile; however, its use may be limited because of unit cost concerns. In this study, the authors measured the cost of chemotherapy‐related complications during treatment with capecitabine‐ and 5‐FU–based regimens.

METHODS:

Patients with CRC who received at least 1 administration of capecitabine or 5‐FU during 2004 and 2005 were identified from the Thomson MarketScan research databases. Monthly frequency and cost for 23 complications were recorded. Logistic regression was used to predict complication probability. General linear models were used to predict monthly complication cost and total monthly expenditure.

RESULTS:

In total, 4973 patients with CRC met the inclusion criteria for this analysis. Although the most frequently observed complications were the same between capecitabine and 5‐FU (nausea and vomiting, infection, anemia, neutropenia, diarrhea), each was observed with greater frequency in 5‐FU–based regimens. The mean predicted monthly complication cost was significantly higher (by 136%) with 5‐FU monotherapy than with capecitabine monotherapy (difference, $601; 95% confidence interval [95% CI], $469‐$737). In addition, the mean predicted monthly complication cost for 5‐FU+oxaliplatin was higher than the cost with capecitabine plus oxaliplatin (difference, $1165; 95% CI, $892‐$1595). When acquisition, administration, and complication costs were taken into consideration, there were no significant differences in the total cost between capecitabine regimens and 5‐FU regimens.

CONCLUSIONS:

Capecitabine compared well with 5‐FU–based therapy in patients with CRC and was associated with lower complication rates and associated costs. Cancer 2009. © 2009 American Cancer Society.     

Living with secondary breast cancer: coping with an uncertain future with unmet needs

JOHNSTON S.R.D. (2010) European Journal of Cancer Care 19 , 561–563 Living with secondary breast cancer: coping with an uncertain future with unmet needs     

奥沙利铂联合羟基喜树碱治疗晚期胃癌临床分析

背景与目的体外及体内的临床研究显示,奥沙利铂(L-OHP)对多种肿瘤有显著抑制作用并与绝大多数抗癌药物具有相加或协同细胞毒作用.本文旨在观察L-OHP联合羟基喜树碱(HCPT)治疗晚期胃癌的近期疗效和患者耐受性,并与传统的化疗方案进行对比.方法采用非随机的分组方法将43例晚期胃癌患者分为L-OHP+HCPT方案组(治疗组)与Vp-16+CF+5-FU(ELF)方案组(对照组),其中男性28例,女性15例,中位年龄59岁,KPS评分≥60,观察两组的近期疗效和患者耐受性.结果治疗组24例有效率58.3%(14/24),对照组19例有效率42.1%(8/19).治疗组有效率高于对照组,两组差异有显著性(P<0.05).两组不良反应主要是骨髓抑制、恶心、呕吐、口腔炎、周围神经炎、静脉炎、脱发等,均在Ⅰ、Ⅱ度范围内.结论L-OHP联合HCPT方案治疗晚期胃癌疗效较好,不良反应可以耐受.     

Varicella-Zoster Virus Prophylaxis with Low-Dose Acyclovir in Patients with Multiple Myeloma Treated with Bortezomib

BackgroundVaricella-zoster virus (VZV) reactivation is a common complication in patients with multiple myeloma (MM) treated with bortezomib, with an incidence rate of 10%-60%. The aim of our study was to analyze the effect of acyclovir prophylaxis in this patient population.Patients and MethodsWe studied 98 consecutive patients with relapsed MM treated with bortezomib. Bortezomib 1.3 mg/m² was given on days 1, 4, 8, and 11 of a 21-day cycle. At first, patients did not receive any VZV prophylaxis, but because of the high incidence of VZV reactivation, VZV prophylaxis with acyclovir was implemented subsequently.ResultsA total of 11 patients treated with bortezomib did not have any VZV prophylaxis, and 4 of these 11 patients (36%) developed VZV reactivation in the form of herpes zoster. No VZV reactivations were observed in the 32 patients who received acyclovir 400 mg 3 times daily or the 55 patients who received acyclovir in a dose reduced to 400 mg once daily during bortezomib treatment.ConclusionVaricellazoster virus reactivation is a common and serious adverse effect of bortezomib treatment. Acyclovir 400 mg once daily is sufficient to protect from VZV reactivation in patients with MM treated with bortezomib.