高能聚焦超声刀联合单药吉西他滨化疗治疗 局部晚期胰腺癌的临床观察

目的 探讨高强度聚焦超声联合单药吉西他滨化疗治疗局部晚期胰腺癌的临床效果及不良反应。方法 将2010年6月至2017年6月六安市人民医院收治的42例局部晚期胰腺癌病人依据治疗措施的不同分为两组,对照组(19例)用单药吉西他滨化疗,吉西他滨1 000 mg/m²静脉滴注。观察组(23例)用单药吉西他滨化疗的同时加高能聚焦超声刀治疗。结果 (1)对照组治疗前功能状态评分(KPS评分)均值为(74.74±9.05)分,治疗后KPS评分均值为(76.32±8.95)分,组内差异无统计学意义(t=1.000,P=0.331);观察组治疗前KPS评分均值为(72.61±10.10)分,治疗后KPS评分均值为(83.48±7.75)分,组内差异有统计学意义(t=4.800,P=0.000),两组组间比较差异有统计学意义(t=2.896,P=0.006)。(2)对照组治疗后的总缓解率为43.75%,观察组为83.33%,组间差异有统计学意义(P=0.030)。(3)对照组治疗后的临床受益率为26.32%,观察组为65.22%,差异有统计学意义(χ²=6.313,P=0.012)。(4)两组不良反应均为Ⅰ~Ⅱ级骨髓抑制,差异无统计学意义(P>0.05)。结论 高能聚焦超声刀联合单药吉西他滨化疗是治疗局部晚期胰腺癌的安全有效方法。     

二次电切联合吉西他滨即刻灌注治疗非肌层浸润性膀胱癌的临床效果

目的 研究二次电切联合吉西他滨即刻膀胱灌注治疗非肌层浸润性膀胱癌的临床效果。方法 选择2011年10月至2014年10月在中国人民解放军联勤保障部队第901医院行经尿道膀胱肿瘤切除术（TURB-t）治疗的52例非肌层浸润性膀胱癌患者,将仅行TURB-t的24例患者为对照组,TURB-t术后且行二次电切的28例患者为观察组,两组患者均使用吉西他滨即刻灌注治疗。分析两组患者肿瘤病灶残留、肿瘤的复发率及进展率情况。结果 对照组患者首次TURB-t术后残留率为8.33%,观察组为14.29%,两组差异无统计学意义（χ²=0.055,P=0.815）。对照组患者12个月内肿瘤复发率为33.33%,观察组为7.14%,两组差异有统计学意义（χ²=4.145,P=0.042）;对照组患者24个月内复发率为50.00%,观察组为17.86%,两组差异有统计学意义（χ²=6.068,P=0.014）。对照组患者24个月内肿瘤进展率为33.33%,观察组为7.14%,两组差异有统计学意义（χ²=4.145,P=0.042）。结论 二次电切能减少肿瘤病灶残留,二次电切联合吉西他滨即刻膀胱灌注治疗能够降低非肌层浸润性膀胱癌的复发率。     

吉西他滨联合奈达铂治疗复发性宫颈癌的临床疗效

目的 研究吉西他滨联合奈达铂治疗复发性宫颈癌的疗效和安全性。方法 将2012年2月-2014年1月上海交通大学附属第六人民医院收治的98例宫颈癌复发患者作为研究对象,通过随机抽样分为治疗组和对照组,每组各49例。治疗组静脉滴注注射用吉西他滨1 g/m²加入0.9%生理盐水100 mL,持续30 min,每个化疗周期前3周的第1天使用;注射用奈达铂80 mg/m²用0.9%生理盐水稀释至500 mL后静脉滴注,滴注时间至少为60 min,每个周期的第1周第1天时使用。对照组吉西他滨使用方法与治疗组一致;注射用顺铂30 mg/m²注入0.9%生理盐水30 mL后静脉滴注,每个周期的第1周前3 d时每天使用。两组都以28 d为1个疗程,并至少治疗2个疗程。治疗结束后,比较两组的临床疗效和毒副作用情况。结果 治疗组和对照组治疗有效率分别为63.27%、55.10%,两组比较差异无统计学意义。在毒副作用方上,两组脱发、白细胞下降、心脏毒性、肺毒性、肝损害以及皮疹的发生率差异无统计学意义。治疗组血小板降低发生率高于对照组,但在恶心呕吐、血红蛋白下降和肾脏损害的发生率均明显低于对照组,两组比较差异有统计学意义（P<0.05）。结论 吉西他滨联合奈达铂或顺铂治疗复发性宫颈癌的临床疗效无差异,但吉西他滨联合奈达铂的毒副反应较小,有利于减少患者化疗痛苦,提高患者依从性。     

不同剂量顺铂联合吉西他滨治疗非小细胞肺癌的比较研究

目的 比较不同剂量顺铂联合吉西他滨治疗非小细胞肺癌的临床疗效。方法 选取2016年2月-2018年2月复旦大学附属中山医院青浦分院收治的150例非小细胞肺癌患者为研究对象,按照化疗药物剂量不同,将150例患者随机平均分为A、B、C三组,每组各50例。A组患者第1~5天每天连续静脉输入15 mg/m²顺铂注射液;B组患者第1~3天每天连续静脉输入25 mg/m²顺铂注射液;C组患者仅第1天静脉输入80 mg/m²顺铂注射液,3组患者均在第1天、第8天和第15天输入1 g/m²注射用盐酸吉西他滨,每4周为1个疗程,共治疗4个疗程。观察3组患者的临床疗效,比较3组治疗前后血清CYFRA21-1、SCC-Ag、生活质量评分的变化情况。结果 治疗后,3组总有效率分别是32.0%、34.0%、38.0%,3组患者的总有效率比较差异无统计学意义。治疗后,3组患者CYFRA21-1、SCC-Ag水平均显著下降（P<0.05）,但3组患者之间比较差异无统计学意义。化疗结束1周后,B组评分略有升高或降低,C组患者评分均有所下降,但A组患者的评分有所提升（P<0.05）;治疗后B、C两组生活质量评分和A组相比差异有统计学意义（P<0.05）。结论 低剂量顺铂联合吉西他滨治疗非小细胞肺癌有较好的临床疗效,可改善患者生活质量,小剂量顺铂连续给药可降低患者化疗的毒副反应,具有一定的临床推广应用价值。     

吉西他滨单药与吉西他滨联合化疗治疗晚期胰腺癌的临床观察

目的分析吉西他滨单药化疗与吉西他滨联合化疗治疗晚期胰腺癌的临床效果。方法120例晚期胰腺癌患者,按照自主抽签法分为对照组和观察组,各60例。对照组应用吉西他滨单药化疗治疗,观察组实施吉西他滨联合化疗治疗。比较两组患者的临床疗效及毒副反应发生情况。结果观察组患者治疗总有效率为93.33%,对照组患者治疗总有效率为78.33%;观察组患者治疗总有效率显著高于对照组,差异有统计学意义(P<0.05)。观察组患者血液系统毒副反应发生率为35.00%,消化系统毒副反应发生率为40.00%;对照组血液系统毒副反应发生率为15.00%,消化系统毒副反应发生率为8.33%;观察组患者血液系统毒副反应发生率及消化系统毒副反应发生率均高于对照组,差异有统计学意义(P<0.05)。结论将吉西他滨作为化疗基础,加用合顺铂、奥利沙铂等药物对晚期胰腺癌患者进行联合化疗,可起到改善病情和提升存活率的效果,在临床中的可行性较大,值得宣传推广。     

吉西他滨联合替吉奥治疗晚期胰腺癌的系统评价

目的 系统评价吉西他滨联合替吉奥治疗晚期胰腺癌的有效性和安全性,为临床用药治疗提供科学依据。方法 计算机检索Cochrane图书馆临床对照试验资料库、EMBASE、PubMed、中国生物医学文献数据库（CBM）、中国期刊全文数据库（CNKI）、维普数据库（VIP）、万方科技等数据库中关于吉西他滨联合替吉奥治疗晚期胰腺癌临床随机对照试验（RCT）,检索时间均从各数据库创建至2019年12月。由两名评价员独立评价文献质量、提取资料并交叉核对,并进行方法学质量评价,采用RevMan 5.2的软件进行Meta-分析。结果 共纳入23篇RCTs,共1 817例患者,其中治疗组920例、对照组897例。Meta-分析结果显示：应用吉西他滨联合替吉奥组总有效率[RR=1.76,95% CI（1.51,2.04）,P<0.000 01]和临床获益率[RR=1.40,95% CI（1.30,1.50）,P<0.000 01]与对照组相比有显著性差异;在安全性方面,治疗组不良反应发生危险度高于对照组。结论 基于现有临床证据,吉西他滨联合替吉奥在治疗晚期胰腺癌方面均较对照组疗效更为显著,是一种较为理想的用药方案。     

替吉奥与卡培他滨在老年晚期胃癌患者中的疗效与安全性的Meta分析

目的 运用Meta分析方法,评价老年晚期胃癌患者一线应用替吉奥（或联合奥沙利铂）与卡培他滨（或联合奥沙利铂）化疗的疗效与安全性。方法 检索Cochrane library、pubmed、ovid（elsevier）、中国期刊全文数据库、维普数据库、万方资源数据和中国生物医学文献数据库系统,对纳入的随机对照试验（RCT）,根据Cochrane Handbook 5.1进行文献质量评价,并运用RevMan 5.0软件进行统计学分析。主要结局指标为有效率、不良反应发生率,采用相对危险度（RR）为效应量,各效应量以95%置信区间（95% CI）表示。结果 共纳入6项RCT,332例老年胃癌患者,其中2项RCT为联合奥沙利铂化疗组,4项RCT为单药治疗组。Meta分析结果显示,无论是否联合奥沙利铂化疗,应用替吉奥与卡培他滨治疗后疗效相当（RR=1.10,95% CI：0.84～1.45,P=0.49）;亚组分析（单药组）,纳入4项RCT,213例患者,结果显示单药组替吉奥与卡培他滨的有效率差异无显著性（RR=1.19,95% CI：0.81～1.74,P=0.92）,但替吉奥组3度以上手足综合症（HFS）的发生率明显低于卡培他滨组（RR=0.11,95% CI：0.01～0.87,P=0.04）。结论 无论是否联合奥沙利铂化疗,替吉奥在老年胃癌患者中在有效率方面与卡培他滨疗效相当,替吉奥单药组3度以上的HFS的发生率明显较低,替吉奥是老年晚期胃癌患者的较佳选择。但由于研究例数较少,该结论有待进一步加大样本量进行证实。     

吉西他滨联合顺铂对肺癌的临床治疗效果及安全性评估

目的 探讨吉西他滨联合顺铂对肺癌的临床治疗效果及安全性评估。方法 选取2017年1月—2018年2月在广州军区广州总医院住院治疗的肺癌患者90例,采用随机数字法分为对照组和观察组,每组各45例。对照组患者给予多西他赛联合顺铂进行化疗,观察组患者给予吉西他滨联合顺铂进行化疗。观察两组患者的临床治疗有效率、疾病控制率及不良反应发生率,并比较化疗前后两组的QOL评分及KPS评分。结果 治疗后,观察组治疗有效率和疾病控制率分别为84.44%和91.11%,对照组患者的治疗有效率和疾病控制率分别为62.22%和73.33%,差异具有统计学意义（P<0.05）。治疗后,两组QOL评分及KPS评分均升高,同组治疗前后比较差异具有统计学意义（P<0.05）,且观察组患者的QOL评分及KPS评分均显著高于对照组,两组比较差异具有统计学意义（P<0.05）。两组患者在胃肠道反应、骨髓抑制、血小板减少、乏力、贫血及发热等不良反应上相比,差异无统计学意义。结论 吉西他滨联合顺铂治疗肺癌的临床效果较好,且安全性较高,值得推广应用。     

吉西他滨温敏凝胶注射剂的制备及其含量测定

目的 制备吉西他滨温敏凝胶注射剂,并建立其含量测定方法。 方法 以聚乙二醇/聚酯嵌段共聚物(PLGA-PEG-PLGA)为载体,制备吉西他滨温敏凝胶注射剂,采用¹H NMR、FT-IR对其结构进行表征, HPLC法测定其中药物的含量。 结果 吉西他滨温敏凝胶注射剂中,PLGA-PEG-PLGA的质量分数为20%,吉西他滨含量为40 mg/ml,胶凝温度为(37±0.15) ℃,在接近人体温度时黏度最大;吉西他滨在5~500 μg/ml范围内线性关系良好(r=0.999 8),精密度和重复性良好,溶液24 h内稳定性良好,低、中、高浓度的吉西他滨的回收率分别为(99.5±3.2)%、(100.4±2.4)%、(102.1±2.4)%,n=3。3批样品中吉西他滨的平均含量分别为标示量的(101.87±2.95)%、 (99.4±2.73)%、(98.98±0.71)%,n=3。 结论 采用PLGA-PEG-PLGA聚合物为载体制备的吉西他滨温敏凝胶注射剂质量可控,是一种很有开发前景的抗胰腺癌制剂。     

胆管或胰腺癌并肝功能异常15例应用吉西他滨治疗的剂量选择

目的 肝功能障碍时胆管或胰腺癌病人应用吉西他滨治疗的剂量标准。方法 20112015年间鹤壁市传染病医院收治的胆管或胰腺癌成人病人15例,分为3组,根据其肝功能损伤程度(轻、中、重),依血清胆红素和肝脏转氨酶进行评价。吉西他滨按800或1 000 mg/m²静脉用药1周1次共3周,间隔1周后进行下一周期治疗,共用药4个周期。第一周期中评价病人的不良事件,吉西他滨药物动力学及其无效代谢物,确定最佳初始剂量。结果 15例病人纳入研究。肝功能轻度异常1例,中度异常6例,重度异常8例。15例病人均行胆管引流并接受吉西他滨治疗。1例中度肝功能障碍病人发生3级胆管炎,其接受剂量为1 000 mg/m²。无其他病人发生严重的治疗相关事件。本组病人间吉西他滨的血浆浓度和氟尿嘧啶脱氧核苷的血浆浓度差异无统计学意义。结论 轻或中度肝功能异常的胆管或胰腺癌病人吉西他滨单药治疗初始剂量无需减量。     

Interstitial Pneumonitis from Treatment with Gemcitabine

Introduction:

The use of gemcitabine may lead to numerous adverse effects ranging from mild to very severe, such as interstitial pneumonitis. The diagnosis of this complication is based on multiple laboratory findings, radiographic evidence, and high clinical suspicion. Presented is a case report of a patient who met these criteria and had onset consistent with drug-induced interstitial pneumonitis.

Case Presentation:

A 76-year-old White female was treated with gemcitabine for pancreatic cancer. Two months after the initiation of therapy, she was admitted to the hospital for worsening dyspnea and cough. High clinical suspicion, bilateral interstitial opacities on chest x-ray, worsening pulmonary status, and onset 2 months after initiation of therapy led to the diagnosis of gemcitabine-induced interstitial pneumonitis. Steroid therapy with prednisone was initiated, and the patient’s clinical symptoms and radiographic findings improved.

Discussion:

Gemcitabine-induced interstitial pneumonitis is well described in the literature. It is a rare but serious complication associated with gemcitabine therapy in which patients present with worsening dyspnea. Most patients only require supportive care and discontinuation of the drug for treatment, but in severe cases supplemental oxygen and steroid therapy must be used before resolution of symptoms. It is important to obtain an accurate medication history to evaluate for other potentially pulmonary toxic medications. Radiographic findings such as bilateral infiltrates should be completely resolved after therapy.

Conclusion:

Radiographic findings, clinical symptoms, and clinical suspicion can lead to early recognition of interstitial pneumonitis from gemcitabine. Physician awareness of this adverse effect and early recognition are keys to providing prompt treatment in resolving symptoms and decreasing mortality.Key Words: gemcitabine, pneumonitis, pulmonary toxicityGemcitabine is an antineoplastic agent used for the treatment of cancers such as non-small-cell lung and pancreatic cancer. Antineoplastic agents are vital to patient outcomes due to the high mortality rate of untreated forms of cancer. Gemcitabine is a pyrimidine antimetabolite that inhibits DNA synthesis thus affecting many organ systems. Common adverse events include myelosuppression, dyspnea, nausea, and vomiting. The severity and duration of dyspnea vary based on individual factors. A severe form of lung toxicity associated with gemcitabine is known as interstitial pneumonitis, which involves acute or chronic interstitial fibrosis of the lung with the tissues becoming stiff and scarred. The fibrosis of the lung interferes with the patient’s ability to breathe. The incidence of interstitial pneumonitis from gemcitabine is estimated at 1% to 2% when the drug is used as a single agent in treatment.¹ The incidence may increase when combined with other agents potentially associated with pulmonary toxicity and should be treated early to improve chances of recovery. Underlying pulmonary dysfunction increases the risk of gemcitabine-induced pulmonary toxicity. ²The exact mechanism of lung toxicity remains unknown; however, proposed mechanisms have been documented in the literature. One proposed mechanism of toxicity is the release of cytokines in the body, which could result in damage to areas throughout the body. This process could lead to capillary leak syndrome or pulmonary edema. ³The diagnosis of interstitial pneumonitis is difficult due to the multiple etiologies of lung dysfunction and should include other likely diagnoses consistent with bilateral interstitial opacities on chest x-ray and worsening respiratory status. Myelosuppression, a common and well-documented adverse event with gemcitabine use, increases the likelihood of acquiring an infection that could decrease lung function. ⁴This article follows a patient who presented with increased cough and dyspnea that progressed to respiratory failure. The patient was diagnosed with interstitial pneumonitis likely secondary to gemcitabine. This case report follows the progression of the illness, the treatment, and her response to treatment.     

替吉奥联合吉西他滨与单药吉西他滨治疗进展期胰腺癌的疗效比较

目的 评价吉西他滨单药以及与替吉奥联合治疗局部晚期或转移性胰腺癌的有效率、临床受益反应（评价指标包括患者的疼痛强度、止痛药物消耗量、体力状况评分和体重变化）、生存时间和不良反应。方法 回顾性分析2009年1月至2011年10月收治的62例晚期胰腺癌患者,分为吉西他滨单药组（30例）和吉西他滨＋替吉奥联合组（32例）。单药组：吉西他滨1 000 mg·m-2、第1,8天,静脉滴注30 min,每3周重复。联合组：吉西他滨用法同单药组,替吉奥口服2次·d-1,第1~14天,每3周重复。结果 62例患者均可评价客观疗效,可评价临床受益反应者56例（单药组27例,联合组29例）。单药组和联合组有效率分别为23.3％和31.3％（P〈0.05）,临床受益率分别为59.2%和72.4%（P〉0.05）。2组6个月生存率分别为60.0%和68.7%（P〉0.05）,1年生存率分别为26.6%和31.2%（P〉0.05）。中位无疾病进展时间（PFS）分别为3.9个月和5.4个月（P〈0.05）,中位总生存时间分别为7.8个月和9.1个月（P〉0.05）。2组不良反应比较差异无统计学意义（P〉0.05）。结论 吉西他滨联合替吉奥与单药吉西他滨治疗晚期胰腺癌安全有效,前者有效率优于后者。在延长生存期方面也显示出一定的优势,但该差异无统计学意义。     

吉西他滨单药及联合奥沙利铂治疗非小细胞肺癌的疗效观察比较

目的:比较单药吉西他滨与吉西他滨联合奥沙利铂治疗非小细胞肺癌的疗效。方法:将75例非小细胞肺癌随机分为两组,21例单纯应用吉西他滨化疗(单药组),54例采用吉西他滨联合奥沙利铂化疗(联合组),对其疗效及毒副反应进行观察。结果:单药组和联合组有效率分别为23.8%和40.7%(χ2=1.881,P>0.05),WBC减少总的发生率57.1%和55.6%(χ2=0.015,P>0.05),PLT减少总的发生率52.4%和35.2%(χ2=1.863,P>0.05)。结论:单药吉西他滨与吉西他滨联合奥沙利铂治疗非小细胞肺癌安全有效,后者在临床有效率方面优于前者,但是该差异无显著性。     

Gemcitabine in bladder cancer

Gemcitabine, a deoxycytidine analogue, is an inhibitor of DNA synthesis. With myelosupression being its most serious toxicity, gemcitabine has, however, a favourable toxicity profile. It was tested in urothelial bladder cancer at different stages of the disease. In superficial Bacillus Calmette-GuErin (BCG)-resistant bladder cancer as well as in BCG-intolerant patients, intravesical gemcitabine instillation has demonstrated a significant activity. In the adjuvant setting, the combination of gemcitabine and cisplatin (GC) has proved to be a feasible protocol. In locally advanced and metastatic disease, GC is admitted as a standard alternative first-line regimen. Gemcitabine is also an interesting choice for unfit patients when used as a single treatment or in combination with other chemotherapeutic agents as carboplatin or taxanes. This article reviews most of the studies performed in order to promote the usefulness of gemcitabine in bladder cancer.     

盐酸吉西他滨的合成

2-脱氧-2，2-二氟-D-赤型-呋喃戊糖-1-酮-3，5-二苯甲酸酯经四氢锂铝还原、甲磺酰化得2-脱氧-2，2-二氟-D-呋喃核糖-3，5-二苯甲酸酯-1-甲磺酸酯，与胞嘧啶缩合后在含氨甲醇中脱保护基，成盐后于含水丙酮中结晶分离得盐酸吉西他滨，总收率14％。     

Gemcitabine and urothelial tumours

Since 1985, standard chemotherapy of metastatic urothelial tumours has been based on a combination of methotrexate, vinblastine, doxorubicin and cisplatin (M-VAC protocol). Two major lessons have been learned from the use of M-VAC, namely, clear evidence of chemo-sensitivity, and an absence of chemo-curability associated with notable toxicity. Three phase II studies using gemcitabine monotherapy have demonstrated promising efficacy with an objective response rate of 22-28%, and a satisfactory toxicity profile. Three further phase II studies have confirmed the efficacy of gemcitabine in association with cisplatine (GC protocol), with a response rate of 42-66%, of which 18-28% were complete responses. The main adverse effects were haematological, including neutropenia, or grade 3 or 4 thrombocytopenia without any symptoms of fever or significant haemorrhage. Current research with gemcitabine in the treatment of urothelial tumours is aimed at optimising administration of the GC protocol, investigating the use of gemcitabine in association with other cytotoxic agents such as taxanes, or expanding the use of this drug as adjuvant therapy. The results of a phase III study to compare the efficacy and toxicity of the M-VAC and GC protocols are eagerly awaited.     

吉西他滨联合奈达铂治疗老年晚期非小细胞肺癌的临床观察

目的 观察吉西他滨( GEM)联合奈达铂(NDP)治疗老年晚期非小细胞肺癌( NSCLC)的效果及药物毒性反应,分析、评价GEM联合NDP治疗老年晚期NSCLC的临床效果.方法 选择我院2009年6月-2011年6月收治的70例经病理或细胞学证实的晚期NSC LC患者,将其随机分为2组:观察组35例,采用GEM+ NDP方案;对照组35例,采用GEM+顺铂(DDP)方案;治疗2周期后进行疗效评估.结果 观察组有效率为40.0％,中位生存期为8.7月,1年生存率为33.5％;而观察组有效率为42.8％,中位生存期为9.2月,1年生存率为32.7％;尽管观察纽有效率高于对照组,但两组差异无显著性(P＞ 0.05).对照组白细胞减少、血红蛋白减少及血小板减少发生率分别为54.3％、34.2％、57％,而观察组发生率分别为57％、42.8％、62.9％,尽管观察组骨髓抑制发生率较对照组稍高,但二者差异无显著性(P＞ 0.05);GN组胃肠道反应发生率较GP组明显低,具有统计学意义(P＜0.05);两组肝肾功能损害发生率较低,差异无显著性(P＞ 0.05).结论 以铂类为基础的联合化疗疗效肯定,GEM联合NDP与GEM联合DDP疗效相当,但NDP胃肠道反应较低,肝肾毒性较低,患者耐受性及依从性较高.     

Gemcitabine Treatment of Rat Soft Tissue Sarcoma with Phosphatidyldiglycerol-Based Thermosensitive Liposomes

Purpose

The pyrimidine analogue gemcitabine (dFdC) is frequently used in the treatment of patients with solid tumors. However, after i.v. application dFdC is rapidly inactivated by metabolization. Here, the potential of thermosensitive liposomes based on 1,2-dipalmitoyl-sn-glycero-3-phosphodiglycerol (DPPG₂-TSL) were investigated as carrier and targeting system for delivery of dFdC in combination with local hyperthermia (HT).

Methods

DPPG₂-TSL were prepared by the lipid film hydration and extrusion method and characterized by dynamic light scattering, thin layer chromatography, phosphate assay and HPLC. In vivo experiments were performed in Brown Norway rats with a syngeneic soft tissue sarcoma. Local HT treatment was performed by light exposure.

Results

DPPG₂-TSL were stable at 37°C in serum and showed a temperature dependent dFdC release >40°C. Plasma half-life of dFdC was strongly increased from 0.07 h (non-liposomal) to 0.53 h (liposomal, vesicle size 105 nm) or 2.59 h (liposomal, 129 nm). Therapy of BN175 tumors with dFdC encapsulated in DPPG₂-TSL + HT showed significant improvement in tumor growth delay compared to non-liposomal dFdC without HT (p?p?p?Conclusions Gemcitabine encapsulated in DPPG₂-TSL in combination with local HT is a promising tool for the treatment of solid tumors. Therefore, these encouraging results ask for further investigation and evaluation.     

吉西他滨奥沙利铂治疗非小细胞肺癌

目的 评价吉西他滨联合奥沙利铂和吉西他滨联合顺铂治疗晚期非小细胞肺癌的近期疗效与不良反应.方法 40例非小细胞肺癌患者随机分组采用吉西他滨联合奥沙利铂(简称GO方案组和吉西他滨联合顺铂(简称GP方案组)方案治疗晚期非小细胞肺癌患者,21～28 d为一个周期,完成3个周期治疗后评价疗效并观察不良反应.结果 GO方案组20例,CR1例,PR8例,有效率为45%;GP方案组20例,CR1例,PR7例,有效率为40%(P＞0.05).两组不良反应比较:白细胞减少、血小板减少等不良反应相似;GO组脱发、胃肠道反应较GP组减少(P＜0.05).结论 两方案治疗晚期非小细胞肺癌近期疗效相近;白细胞下降、血小板减少等毒副反应相似,而胃肠道反应、脱发等不良反应差别有统计学意义,但均可耐受.     

放疗联合吉西他滨治疗中晚期宫颈癌的临床疗效观察

目的观察吉西他滨联合放疗治疗中晚期宫颈癌的临床疗效。方法选取包头医学院第二附属医院自2006年1月至2008年12月收治的126例中晚期宫颈癌患者随机分为观察组(联合治疗组)和对照组(单纯吉西他滨治疗组)各63例,观察比较两组的治疗效果。结果观察组CR3例,PR28例,总有效率为49.2%;对照组CR1例,PR12例,总有效率为20.6%。两组比较差异显著(P<0.01),具有统计学意义;观察组骨髓抑制、放射性直肠炎不良反应发生率极高,与对照组相比差异显著(P<0.01)。结论吉西他滨联合放疗治疗中晚期宫颈癌临床效果理想,但应注意治疗过程中不良反应情况。