艾迪注射液合并放射治疗鼻咽癌的临床观察

比较艾迪注射液加放疗与单纯放疗对鼻咽癌的疗效、毒副反应的影响。将 62例鼻咽癌患者随机分为两组。治疗组放疗同时加用艾迪注射液 5 0mL静脉滴入 ,1次 /d ,用至放疗结束。对照组单用放疗。治疗组有效率为83 87% ,对照组为 79 2 3 % ,差异无统计学意义 ,P >0 0 5。治疗组贫血、口腔溃疡方面均明显低于对照组 ,差异均有统计学意义 ,P <0 0 5。治疗组生活质量KPS评分高于对照组 ,差异有统计学意义 ,P <0 0 5。初步研究结果提示 ,艾迪注射液配合放疗治疗鼻咽癌 ,可降低放疗的毒副反应 ,改善患者的生活质量     

艾迪注射液配合放化疗治疗中晚期鼻咽癌疗效观察

比较艾迪注射液加放化疗 (治疗组 )与单纯放化疗 (对照组 )对中晚期鼻咽癌的疗效 毒副反应及免疫功能的影响。治疗组 :放化疗同时加用艾迪注射液 5 0mL溶于 5 %葡萄糖注射液 2 5 0mL中 ,静脉滴入 ,1次 /d ,连用 3 0d ;对照组 :单用放化疗。结果治疗组总有效率 10 0 % ( 80 /80 ) ,其中显效 87 5 % ( 70 /80 ) ;对照组总有效率 10 0 % ( 76/76) ,其中显效 85 5 % ( 65 /76) ,两组比较差异无统计学意义 ,P >0 0 5。治疗组毒副反应 治疗前后免疫功能改变均明显低于对照组 ,差异有统计学意义 ,P <0 0 5。生活质量评分治疗组高于对照组 ,两组间差异有统计学意义 ,P <0 0 5。初步研究结果提示 ,艾迪注射液与放化疗联合治疗中晚期鼻咽癌 ,可降低放化疗对患者免疫功能的影响及毒副反应 ,改善患者的生活质量     

艾迪注射液联合化疗治疗晚期非小细胞肺癌80例疗效分析

目的 观察艾迪注射液联合化疗治疗晚期非小细胞肺癌患者的疗效、生活质量及毒副反应.方法 80例晚期非小细胞肺癌患者随机分为两组,A组应用多西他赛(TAX) 顺铂(DDP)化疗的同时加用艾迪注射液80-100 ml,每天1次,连用14 d,均3周为一周期,治疗两周期.B组单纯使用TAX DDP化疗.结果 A组有效率为57.5%,B组为40.0%,差异有显著性(P＜0.05).A组生活质量Xarnofsky评分高于B组,差异有显著性(P＜0.05).A组血液毒副反应、胃肠道反应明显低于B组,差异均有显著性(P＜0.05).结论 艾迪注射液配合TP方案治疗晚期非小细胞肺癌,可提高疗效,改善患者的生活质量,降低化疗对患者的毒副反应.     

艾迪注射液合并放射治疗鼻咽癌的临床观察

比较艾迪注射液加放疗与单纯放疗对鼻咽癌的疗效、毒副反应的影响。将62例鼻咽癌患者随机分为两组。治疗组放疗同时加用艾迪注射液50mL静脉滴入，1次/d．用至放疗结束。对照组单用放疗。治疗组有效率为83.87％，对照组为79．23％，差异无统计学意义．P>0．05。治疗组贫血、口腔溃疡方面均明显低于对照组．差异均有统计学意义，P<0．05。治疗组生活质量KPS评分高于对照组，差异有统计学意义，P<0．05。初步研究结果提示．艾迪注射液配合放疗治疗鼻咽癌，可降低放疗的毒副反应，改善患者的生活质量。     

艾迪提高癌症患者生活质量的临床观察

目的　观察艾迪注射液提高肿瘤化疗病人免疫功能,减轻化疗的毒副反应,改善生存质量的疗效及不良反应。方法　共收集 76例患者。使用艾迪注射液 50ml加入 250ml~500ml的生理盐水或 5%葡萄糖中静脉滴注,每日一次,连用 15 ~20天为一疗程, 2个疗程以后评价疗效。结果　艾迪注射液可以提高患者的karnofsky评分,治疗前后有显著差异(P<0. 05),并且可以增加食欲,改善睡眠,精神及日常生活,使生存质量进一步提高。治疗后CD3及NK细胞活性升高,有显著性差异 (P<0. 05),而CD4,CD8及CD4 /CD8无显著性差异。无明显的毒副作用。结论　艾迪注射液可以提高肿瘤病人的免疫功能,减轻化疗的毒副反应,明显改善生存质量。     

艾迪注射液联合髂内动脉化疗治疗浸润性膀胱癌的临床分析

目的分析艾迪注射液联合髂内动脉化疗（观察组）与单纯髂内动脉化疗（对照组）对浸润性膀胱癌的疗效、毒副反应及对免疫功能的影响。方法观察组36例浸润性膀胱癌患者在采用髂内动脉化疗同期加用艾迪注射液,对照组30例浸润性膀胱癌患者单用髂内动脉化疗。结果观察组有效率为38．9％高于对照组26．9％,差异有统计学意义（P〈0．05）。观察组治疗前后免疫功能的改变、毒副反应、胃肠反应均明显低于对照组,差异有统计学意义（P〈0．05）。结论艾迪联合髂内动脉化疗治疗浸润性膀胱癌,疗效显著,并降低了髂内动脉化疗方案对免疫功能、胃肠道的影响及毒副反应,此种方法可以作为不能手术切除的浸润性膀胱癌的治疗。     

康莱特注射液配合化疗治疗晚期非小细胞肺癌的临床观察

目的比较康莱特注射液加化疗与单独化疗治疗晚期非小细胞肺癌患者的疗效和毒副反应。方法将288例经病理组织学确诊的晚期非小细胞肺癌患者分成2组,每组144例。治疗组：NP方案（诺维本＋顺铂）＋康莱特注射液200 mL,每天1次,连用20天;对照组：单用NP方案。完成2周期后作疗效评价。结果治疗组有效率44.4%,对照组33.3%,两组差异无统计学意义（P〉0.05）。治疗组血液毒副反应和消化道反应低于对照组,两组差异有统计学意义（P〈0.05）。生活质量评分治疗组高于对照组,两组间差异有统计学意义（P〈0.01）。治疗组化疗后较化疗前比较,CD 3比例略有上升,CD 4和CD 4/CD 8明显上升,CD 8明显下降（均P〈0.05）。结论康莱特注射液与化疗联合治疗晚期非小细胞肺癌可降低化疗对患者的毒副反应,提高细胞免疫功能,改善患者的生活质量。     

艾迪注射液结合化疗治疗进展期胃癌56例

[目的]观察中药艾迪注射液加化疗对进展期胃癌的近期疗效、毒副反应。[方法]56例晚期胃癌患者随机分成2组。治疗组26例:化疗同时加用艾迪注射液50ml/d,静脉滴注,21d为1个疗程,连用4个疗程。对照组30例单用化疗。[结果]治疗组有效率、临床受益反应、Ⅲ￣Ⅳ度白细胞减少分别为61.5%、69.2%、11.5%,与对照组的33.3%、40.0%、36.7%比较均有显著性差异(P<0.05);治疗组中位TTP、1年生存率分别为7.2个月、51.2%,与对照组的6.9个月、50.1%相比无显著性差异(P>0.05);对照组治疗后CD3、CD4、CD4/CD8水平明显下降(P<0.05),而治疗组无明显变化。[结论]艾迪注射液联合化疗治疗进展期胃癌,能提高疗效,改善免疫功能,提高生活质量,降低化疗的毒副反应。     

艾迪注射液配合化疗治疗晚期非小细胞肺癌的随机临床研究

目的　比较艾迪注射液加化疗与单纯化疗对晚期非小细胞肺癌的疗效、毒副反应及免疫功能的影响。方法　将 98例晚期非小细胞肺癌患者随机分为两组。治疗组 :化疗同时加用艾迪注射液 60～ 80ml溶于生理盐水 40 0ml中静脉滴注 ,每天 1次 ,连用 8～ 10天。对照组 :单用化疗。化疗方案为NP方案 ,即去甲长春花碱 (NVB)联合顺铂 (DDP)。 3～ 4周为一周期 ,患者至少治疗两周期。结果　治疗组有效率为5 3 .1%,对照组为 44 .9%,差异无显著性 (P >0 .0 5 )。治疗组病变进展率、血液毒副反应、胃肠道反应、治疗前后免疫功能改变均明显低于对照组 ,差异均有显著性 (P <0 .0 5 )。治疗组生活质量KPS评分高于对照组 ,差异有显著性 (P <0 .0 5 )。结论　艾迪注射液配合化疗治疗晚期非小细胞肺癌 ,可降低化疗对患者免疫功能的影响及毒副反应 ,改善患者的生活质量     

斑蝥酸钠维生素B6注射液联合化疗治疗肝癌临床疗效观察

目的观察斑蝥酸钠维生素B6注射液联合化疗治疗肝癌的疗效。方法将76例肝癌患者随机分成治疗组（38例）和对照组（38例）,治疗组给予斑蝥酸钠维生素B6注射液配合化疗进行治疗,对照组单纯给予化疗治疗,观察疗效和不良反应。结果治疗组有效率为42.1%,对照组为39.5%,两组比较差异无统计学意义（P=0.81）;但治疗组稳定率为78.9%,对照组为67.9%,两组比较差异有统计学意义（P=0.048）。治疗组生活质量改善、症状改善、体重增加均优于对照组,差异有统计学意义（P〈0.05）。同时治疗组CD3、CD4、CD4/CD8水平的提高亦明显高于对照组,比较差异有统计学意义（P〈0.05）。治疗组的主要毒副反应明显减轻,尤其在消化道反应和骨髓抑制方面,两组比较差异均有统计学意义（P〈0.05）。结论斑蝥酸钠维生素B6注射液联合化疗治疗肝癌具有提高免疫功能作用,可降低进展率和毒副反应发生率,提高生活质量,值得临床推广应用。     

Development and evaluation of cancer chemotherapy drug information cards (DIC)

Cancer patients often receive multiple drugs. It is often difficult for them to differentiate between signs and symptoms caused by cancer from those induced by medications. Drug information cards (DIC) may serve a useful purpose to circumvent some of these problems. Here I describe DICs and their evaluation by patients. A vast majority (85%) of patients approved of these cards, and 67% would recommend them to others. I conclude that DICs are useful for cancer patients, and their role in nononcologic patients needs evaluation.     

Drug Combinations in the Treatment of Malaria

Summary

The knowledge of the plasmodium life-cycle is essential for the use of antimalarial drugs and their combinations. The antimalarial drugs currently available can act on one or more stages of parasitic development, but only on its proliferative phases. The combinations of drugs in the treatment of malaria aim at three distinct objectives: a) action on different stages of parasitic life-cycle; b) enhancement of antiparasitic activity; and c) prevention of drug resistance.

In this regard, complementary, additive and potentiating combinations have been used, sometimes on an empiric basis. The potentiating combinations seem the most logical and effective, but some of them are not rational due to pharmacokinetic differences between the proposed components.     

Determinants of the Cancer Drug Funding Process in Canada

Background: Canada has a publicly funded healthcare system with a complex drug funding process. After Health Canada approval to market a drug, the pan-Canadian Oncology Drug Review (pCODR) (now renamed the CADTH reimbursement review) makes a non-binding funding recommendation to the Canadian provinces (except Quebec), which each then decide whether the drug will be publicly funded. We identified the determinants of funding in this process. Methods: We analyzed drugs for advanced lung (n = 15), breast (n = 8), colorectal (CRC) (n = 7), melanoma (n = 10), and neuroendocrine (NET) (n = 3) cancers undergoing the funding decision process from 2011 to 2019. Determinants of funding assessed in the model included list price, cancer type, drug class, and pCODR recommendation. The primary outcome was the correlation between list price and time to funding (TTF: Health Canada approval to first provincial funding). Secondary outcomes included an exploratory analysis of predictors of drug funding. Results: We analyzed 43 drugs: targeted agents 72%, immunotherapy 20%, chemotherapy 7%. A total of 72% were funded in at least one province. Median TTF was 379 days (IQR 203–601). Median list price (28-day course) was CAD 8213 (IQR CAD 5391–9445). Higher list price was not correlated with TTF (correlation coefficient −0.20, p = 0.28). There was no association between list price and pCODR recommendation or the decision to fund in at least one province. A positive pCODR recommendation correlated with the provinces’ funding decisions (p < 0.001), where 89% of drugs with a positive recommendation were funded and 100% of drugs with a negative recommendation were not funded. Tumor type was predictive of TTF (p < 0.001): CRC drugs were the slowest at a median of 2541 days (IQR 702–4379), and NETs were the quickest at a median of 0 days (IQR 0–502). Cancer type predicted decision to fund in at least one province (p = 0.005), with funding for 100% of NET drugs at the high end and 29% of CRC drugs at the low end. Drug class was predictive of TTF (p = 0.01): 465 days (IQR 245–702) for targeted agents, 443 days (IQR 298–587) for chemotherapy, and 339 days (IQR 164–446) for immunotherapy. Conclusions: Determinants of drug funding included cancer type, drug class, and pCODR recommendation but not list price. Factors other than cost were more heavily weighted in the funding decisions of cancer drugs in Canadian provinces.     

长春瑞滨联合顺铂治疗多柔比星耐药的晚期转移性乳腺癌疗效观察

观察长春瑞滨(NVB)联合顺铂(DDP)治疗多柔比星(ADM)耐药的晚期转移性乳腺癌的疗效及毒性。32例既往使用ADM治疗后复发转移的晚期乳腺癌患者,其中单纯癌5例,浸润性导管癌25例,大汗腺样癌1例,硬癌1例。采用NVB25mg/m2,静脉滴入,d1、d8;DDP25mg/m2,静脉滴入,d1～d3。21d为1个周期,每2～3个周期评定疗效。完全缓解(CR)1例,部分缓解(PR)17例,稳定(SD)7例,进展(PD)7例,总有效率为56.3%(18/32)。主要毒性为骨髓抑制,Ⅲ～Ⅳ度白细胞下降发生率为53.1%(17/32)。其他为恶心、呕吐、贫血、静脉炎等。初步研究结果提示,NVB联合DDP治疗ADM耐药的晚期转移性乳腺癌疗效确切,毒性反应可耐受,值得临床应用。     

长春瑞滨联合顺铂治疗多柔比星耐药的晚期转移性乳腺癌疗效观察

观察长春瑞滨（NVB）联合顺铂（DDP）治疗多柔比星（ADM）耐药的晚期转移性乳腺癌的疗效及毒性.32例既往使用ADM治疗后复发转移的晚期乳腺癌患者,其中单纯癌5例,浸润性导管癌25例,大汗腺样癌1例,硬癌1例.采用NVB 25 mg/m^2,静脉滴入,d1、d8;DDP 25 mg/m^2,静脉滴入,d1～d3.21 d为1个周期,每2～3个周期评定疗效.完全缓解（CR）1例,部分缓解（PR）17例,稳定（SD）7例,进展（PD）7例,总有效率为56.3%（18/32）.主要毒性为骨髓抑制,Ⅲ～Ⅳ度白细胞下降发生率为53.1%（17/32）.其他为恶心、呕吐、贫血、静脉炎等.初步研究结果提示,NvB联合DDP治疗ADM耐药的晚期转移性乳腺癌疗效确切,毒性反应可耐受,值得临床应用.     

多西紫杉醇联合顺铂对晚期鼻咽癌诱导化疗的近期疗效

为了探讨多西紫杉醇（多帕菲DOC）＋顺铂（DDP）放疗前诱导化疗对晚期鼻咽癌的近期疗效并评价毒副反应，2004年10月～2005年10月我院收治的Ⅲ、ⅣA期鼻咽癌分为诱导化疗＋放疗组（C＋R组）30例，单纯放疗组（R组）30例，诱导化疗＋放疗组（C＋R组）予DP方案（DOC＋DDP）诱导化疗1个周期，DOC75mg／m^2，静脉滴入，d1，DDP80mg／m^2，静脉滴入，d3，化疗后2d予根治性放疗，单纯放疗组仅予根治性放疗。结果C＋R组，CR86．7％（26／30），PR10．0％（3／30），RR96．7％（29／30）；R组CR63．3％（19／30），PR16．7％（5／30），RR80．0％（24／30）。C＋R组CR和RR明显高于R组，x^2=11．27，P=0．001，x^2=7．01，P=0．034。主要毒副反应是骨髓抑制、消化道反应和肝功能损害。初步研究结果提示，DOC＋DDP放疗前诱导化疗明显改善了晚期鼻咽癌的近期疗效，毒副反应可耐受，长期疗效有待于临床进一步观察。     

Treatment Access,Health Economics,and the Wave of a Magic Wand

New drugs are expensive, in part due to excessive drug development costs. Governments are trying to reduce drug prices. This can delay access to effective agents. A country’s access to new drugs correlates with prices they agree to pay. After Health Canada approves a drug, the Canadian Agency for Drug and Technologies in Health (CADTH) assesses it. CADTH’s approval is usually contingent on it costing ≤CAD 50,000 per quality adjusted life year (QALY) gained. This value (unchanged from the 1970s) is inappropriately low. An inflation-adjusted CAD 50,000 1975 QALY should translate into a CAD 250,000 2021 QALY. CADTH’s target also does not consider that drug development costs have risen much faster than inflation or that new precision therapies may only be used in small populations. In a separate process, proposals from the Patented Medicines Price Review Board (PMPRB) would decrease initial Canadian drug prices by 20%, but prices would fall further as sales increased, with ultimate price reductions of up to 80%. PMPRB claims its proposal would not reduce drug access, but multiple analyses strongly suggest otherwise. Government price controls target the symptom (high prices), not the disease. They translate into shortages without solving the problem. CADTH and PMPRB approaches both threaten access to effective drugs.     

奈西雅预防治疗化疗所致胃肠道反应的临床研究

目的:观察奈西雅防治化疗药物引起的胃肠道反应的疗效及其不良反应。方法:采用开放式的研究,对86 例患者化疗同时给予奈西雅(0. 3 mg,静脉推注,d1~d3),观察化疗不同时间其对食欲不振、恶心、呕吐等的预防和治疗作用。结果:奈西雅防治化疗药物尤其是顺铂和(或)表阿霉素的胃肠道不良反应有较好疗效,有效率分别为53 .5%~90 .6%;对顺铂引起的迟发性呕吐亦有一定的防治作用;不良反应轻,主要为便秘、头痛、口干、头重、发热感等。结论:奈西雅能有效防治化疗药物所致的胃肠道反应,疗效维持时间长,不良反应轻,为较好的化疗止吐剂。     

高分子纳米粒子对于肿瘤耐药的逆转作用

肿瘤多重耐药是目前临床治疗的一大障碍,这是致使患者化疗失败,疾病进展,最终死亡的主要原因之一.纳米粒子因其独特的结构特征及理化性质,可以改变化疗药物的药代动力学及药效学,从而在一定程度上逆转肿瘤组织多重耐药.值得关注的是目前已有研究报道纳米粒子用于临床某些复发转移性肿瘤如乳腺癌、卵巢癌等的临床II期试验,并取得令人兴奋的效果.在纳米粒子逐渐走向临床的前景下,对于其如何逆转肿瘤耐药,获得人们越来越多的关注,本综述将针对这一问题进行详细的论述.