消癌平注射液联合化疗治疗晚期非小细胞肺癌的临床观察

目的观察消癌平注射液联合化疗治疗晚期非小细胞肺癌的临床疗效与安全性。方法 68例非小细胞肺癌患者随机分为治疗组、对照组,治疗组35例采用消癌平注射液联合GP或NP化疗方案;对照组33例单纯采用GP或NP化疗方案,2周期后评价近期疗效、毒副反应及生活质量。结果治疗组、对照组总有效率分别为54.28%、39.40%,比较差异无统计学意义(P>0.05)。治疗组生活质量改善率高于对照组,比较差异有统计学意义(P<0.05)。治疗组毒副反应发生率及程度低于对照组,但比较差异无统计学意义(P>0.05)。结论消癌平注射液联合化疗治疗晚期非小细胞肺癌疗效优于单纯化疗,生活质量显著高于单纯化疗,临床应用安全。     

消癌平注射液联合GP方案治疗晚期非小细胞肺癌疗效观察

目的 观察消癌平注射液联合GP方案治疗晚期非小细胞肺癌的临床疗效.方法将48例晚期非小细胞肺癌随机分为两组,对照组24例应用GP方案化疗,试验组24例应用GP方案化疗联合消癌平注射液,2个周期后评价疗效.结果两组患者近期疗效比较差异无统计学意义(P＞0.05),但试验组患者治疗后生活质量、机体免疫功能明显优于对照组(P...     

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.     

化疗联合鸦胆子油乳注射液治疗晚非小细胞肺癌疗效观察

目的观察鸦胆子油乳注射液联合化疗治疗晚期非小细胞肺癌的临床效果.方法将113例晚期非小细胞肺癌患者随机分为两组,A组应用化疗NP方案,B组应用化疗NP方案联合鸦胆子油乳注射液,治疗4个周期后评价疗效.结果两组患者近期疗效差异无统计学意义 ,B组患者生活质量、机体免疫功能、生存时间明显高于A组,毒副作用低于A组,两组比较差异有统计学意义.结论鸦胆子油乳注射液联合化疗治疗晚期非小细胞肺癌,可以明显提高患者的生活质量,延长生存时间,减轻化疗的毒副作用.     

消癌平注射液联合化疗治疗中晚期肺癌的临床研究

目的:观察消癌平注射液联合化疗治疗非小细胞肺癌的临床疗效。方法:选择非小细胞肺癌患者62例,分为消癌平注射液联合化疗组30例(治疗组)及单纯化疗组32例(对照组),两组化疗均采用GP、CT、NP方案,完成2个周期后进行疗效评价。结果:治疗组有效率为53.3%,对照组为43.8%,两组比较无显著差异(P>0.05);治疗组在生活质量等方面疗效明显优于对照组(P值均<0.05);治疗组NK细胞活性及CD4/CD8比值治疗后明显高于治疗前(P<0.01),对照组NK细胞活性及CD4/CD8比值治疗后低于治疗前(P<0.01)。治疗组毒副反应发生率低于对照组,但无显著性差异(P>0.05)。结论:消癌平注射液联合化疗治疗非小细胞肺癌有较好疗效,能有效改善临床症状,提高免疫功能,值得临床推广使用。     

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。     

化疗联合鸦胆子油乳注射液治疗晚期非小细胞肺癌疗效观察

目的 观察鸦胆子油乳注射液联合化疗治疗晚期非小细胞肺癌的临床效果。方法 将113例晚期非小细胞肺癌患者随机分为两组，A组应用化疗NP方案，B组应用化疗NP方案联合鸦胆子油乳注射液，治疗4个周期后评价疗效。结果 两组患者近期疗效差异无统计学意义，B组患者生活质量、机体免疫功能、生存时间明显高于A组，毒副作用低于A组，两组比较差异有统计学意义。结论 鸦胆子油乳注射液联合化疗治疗晚期非小细胞肺癌，可以明显提高患者的生活质量，延长生存时间，减轻化疗的毒副作用。     

吉西他滨联合消癌平治疗晚期非小细胞肺癌减毒增效的临床研究

目的探讨吉西他滨联合消癌平注射液对初治晚期非小细胞肺癌（NSCLC）患者的临床疗效和毒副反应。方法晚期NSCLC患者76例（ⅢB-Ⅳ期）,分成消癌平联合GP方案组38例（治疗组）和GP方案组38例（对照组）,入组的每例患者接受至少2个周期的治疗,比较两组治疗的近期疗效和毒副反应,以及1、2年的生存率。结果GP方案联合消癌平组和GP方案组近期疗效的有效率分别为52．63％和47．36％,两组中位生存期分别为8．9月和8．7月,1年生存率分别为45．2％和43．5％,2年生存率分别为23．4％和22．9％。两组资料差异均无显著性（P〉0．05）。治疗组在生活质量改善方面疗效明显优于对照组（P〈0．05）。毒副反应方面,治疗组和对照组,均在可耐受的范围内。结论吉西他滨联合消癌平注射液治疗晚期非小细胞肺癌有较好的临床疗效,副作用小,有效改善临床症状,可提高患者生活质量和机体免疫功能,值得临床推广应用。     

局部热疗联合消癌平注射液治疗晚期非小细胞肺癌的临床观察

目的观察局部热疗联合消癌平注射液治疗晚期非小细胞肺癌的临床疗效。方法将68例肺癌随机分为治疗组（36例）和对照组（32例）。治疗组采用局部热疗＋消癌平注射液＋对症治疗;对照组采用消癌平注射液＋对症治疗。局部热疗45 m in/次,每周2次,10次为1疗程;消癌平注射液60 mL/次,静滴,1次/d,15 d为1疗程。完成2个疗程后分别评价两组的疗效和毒副反应。结果治疗组在近期疗效、生活质量、症状改善、0.5年生存率方面优于对照组（P〈0.05）;两组患者1年生存率差异无统计学意义（P〉0.05）。两组均未见明显毒副反应。结论局部热疗联合消癌平注射液治疗非小细胞肺癌疗效较好,值得临床推广应用。     

华蟾素注射液联合化疗治疗中晚期肺癌临床研究

目的:观察华蟾素注射液联合化疗治疗非小细胞肺癌的临疗效.方法:选择非小细胞肺癌患者62例,分为华蟾素注射液联合化疗组30例(治疗组)及单纯化疗组32例(对照组).两组化疗采用NP方案,完成2周期后进行疗效评价.结果:治疗组有效率为53.30%,对照组为43.80%,两组比较无显著差异(P>0.05),治疗组在生活质量等方面效果明显优于对照组(P值均<0.05),治疗组毒副反应发生率低于对照组但无显著性差异(P>0.05).结论:华蟾素注射液联合化疗治疗非小细胞肺癌有较好疗效,能有效改善l临床症状,提高免疫功能,值得临床推广使用.     

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.