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1.
目的用药物敏感试验预测胃癌腹水癌细胞对抗癌药物的敏感性,观察其在指导胃癌合并恶性腹水腹腔内化疗的价值。方法选择47例腹水癌细胞阳性胃癌患者,随机分离19例的腹水癌细胞,用三磷酸腺苷(ATP)法分别检测其对卡铂、泰素、5氟尿嘧啶、顺铂、阿霉素、羟基喜树碱、甲氨蝶呤、丝裂霉素、氮烯咪胺的敏感性,各选择最敏感的1种药物对患者进行腹腔内化疗。观察治疗后腹水完全缓解率、腹水癌细胞转阴率,并与28例顺铂单药腹腔内化疗组比较。结果19例腹水癌细胞对抗癌药物敏感的例数分别为卡铂7例、泰素6例、5氟尿嘧啶6例、顺铂6例、阿霉素5例、羟基喜树碱5例、丝裂霉素5例,对甲氨蝶呤和氮烯咪胺均不敏感。治疗后药物敏感试验组腹水完全缓解率为57.9%,高于顺铂组的28.6%(P<0.05);药物敏感试验组腹水中癌细胞转阴率为68.4%,高于顺铂组的32.1%(P<0.05)。结论用药物敏感试验指导胃癌合并恶性腹水腹腔内个体化化疗,可提高恶性腹水的完全缓解率和腹水中癌细胞转阴率,该治疗方法具有临床实用价值。  相似文献   

2.
目的 :通过体外药敏试验 ,研究胰腺癌细胞对化疗药物的敏感性 ;筛选敏感的化疗药物 ,指导临床化疗方案的制定 ,并讨论胰腺癌化疗个体化方案的意义。方法 :用MTT比色法检测 40例原代培养的胰腺癌细胞对氨甲蝶呤、5 氟脲嘧啶、丝裂霉素、长春地辛、羟基喜树碱、依托泊甙、顺铂、表阿霉素、吡柔比星和健择等 1 0种药物的敏感性。结果 :以上 1 0种药物对 40例原代胰腺癌细胞生长抑制率分别为 2 8 6± 1 7 9%、41 3± 2 0 7%、45 4± 2 3 0 %、38 4± 2 4 6 %、37 3± 2 1 5 %、39 5± 2 0 7%、37 0± 1 9 0 %、33 7± 2 1 0 %、38 4± 1 8.3%和 42 8± 1 9.5 % ,共有 33例 (83 % )筛选到了抑制率 >60 %的药物。结论 :体外培养的胰腺癌细胞对 1 0种化疗药物的敏感性较差 ;不同的胰腺癌细胞对不同的药物敏感。通过体外药敏试验筛选敏感药物行个体化化疗是提高胰腺癌化疗效果的一条有希望的途径  相似文献   

3.
采用肝动脉化疗栓塞术(TACE)治疗肝肿瘤已取得明显疗效并提高了生存率.目前临床采用阿霉素、顺(卡)铂和(或)丝裂霉素C作为肝癌介入化疗药物,这些药物在杀死癌细胞的同时,可引起正常肝细胞损害等不良反应.而肝癌患者常伴有肝炎、肝硬化等所致的肝功能不全,TACE无疑使患者肝功能进一步恶化,可降低患者的生存质量,影响其生存期。  相似文献   

4.
[目的]评价中药艾迪注射液联合三氧化二砷(As2O3)行肝动脉插管化疗栓塞(TACE)在原发性肝癌(HCC)患者中的临床治疗效果。[方法]将80例HCC患者随机分为2组各40例,均接受超选择性TACE术。治疗组给予艾迪注射液100 ml加0.9%氯化钠500 ml静脉滴注(静滴),d1~d21;静滴同时进行肝动脉介入治疗,药物为As2O3注射液10 mg;对照组采用常规化疗药物(5-氟尿嘧啶1 000 mg,顺铂50~70 mg,阿霉素40~50 mg,丝裂霉素8~16 mg),经导管向供血动脉内注入碘油-化疗药物乳化剂,随后用明胶海绵(GS)或聚乙烯醇(PVA)微球栓塞该动脉。2组均4周为1个疗程,共治疗4个疗程。[结果]治疗组40例中,完全缓解(CR)10例,部分缓解(PR)18例,无变化(SD)8例,恶化(PD)2例,死亡2例,总有效率为70.0%,甲胎蛋白(AFP)下降率为80.0%,肿瘤缩小率为77.5%,中位生存期为15个月。对照组40例中,CR 6例,PR 10例,SD 10例,PD 10例,死亡4例,总有效率为40.0%,AFP下降率为37.5%,肿瘤缩小率为55.0%,中位生存期为8.5个月。2组中度以上不良反应率分别为7.5%和35.0%。[结论]艾迪注射液联合As2O3行TACE是一种安全、有效的治疗HCC的方法。  相似文献   

5.
目的观察以奥沙利铂(OXA)为基础的联合化疗对晚期肝细胞癌(HCC)的疗效及药物毒性反应。方法纳入本院自2009年6月-2013年6月收治的30例已发生远处转移的晚期HCC患者,随机分为Cape OX方案组15例:奥沙利铂联合卡培他滨(OXA+CAP);FOLFOX方案组15例:奥沙利铂联合亚叶酸钙和氟尿嘧啶(OXA+CF+5-FU)。在治疗2个周期后,参照实体肿瘤评价标准1.1(RECIST 1.1)进行短期疗效评价,计算总体有效率(OR),至随访结束时统计所有对象的总生存时间(OS)和肿瘤进展时间(TTP),并绘制Kaplan-Meier曲线,统计毒副反应发生例数。采用χ2检验和Mann-Whitney U检验进行统计分析;总生存时间和肿瘤进展时间采用时序检验(log-rank检验)进行分析。结果 Cape OX组OR为13.3%,OS平均10.4个月,TTP平均5.0月;FOLFOX组OR为6.7%,OS平均9.0个月,TTP评价4.7个月,2组3项指标对比差异无统计学意义(P值分别为0.543、0.606、0.769)。Cape OX组在胃肠道及骨髓抑制方面的毒性反应较FOLFOX组低,差异有统计学意义(P值分别为0.006、0.002)。结论以OXA为基础的联合化疗方案对晚期HCC患者有效,不同联合方案间疗效差异无统计学意义,方案选择应结合患者具体情况。  相似文献   

6.
正门静脉癌栓是肝癌重要并发症。来自日本的Nagamatsu H等作了一项前瞻性多中心试验,评估了将顺铂联合5-氟尿嘧啶悬浮在碘油中的肝动脉灌注化疗栓塞术治疗肝癌患者门静脉癌栓的疗效。共纳入52例肝癌门静脉癌栓患者,均接受将顺铂联合5-氟尿嘧啶悬浮在碘油中的肝动脉灌注化疗栓塞术。主要有效终点为无进展生存期,次要终点为总体生存期、肿瘤应答率、安全性和耐受性,并对生存的独立因素进行了评价。研究结果显示,中位无进展生存期和总生存期分别为8.6和27.0个月。10例患  相似文献   

7.
目的观察奥沙利铂、氟尿嘧啶联合表柔比星经肝动脉化疗栓塞术(TACE)治疗原发性肝癌合并HIV/AIDS的疗效。方法采用随机数字表法将该院2013-06~2018-12收治的100例原发性肝癌合并HIV/AIDS患者分为观察组和对照组,每组50例。观察组采用奥沙利铂、氟尿嘧啶联合表柔比星经TACE治疗。对照组采用奥沙利铂和氟尿嘧啶经TACE治疗。比较两组临床疗效及不良反应情况。结果观察组临床疗效优于对照组,差异有统计学意义(P0.05),两组不良反应发生率比较差异无统计学意义(P0.05)。结论奥沙利铂、氟尿嘧啶联合表柔比星经TACE治疗原发性肝癌合并HIV/AIDS具有良好的疗效及较高的安全性,值得临床推广。  相似文献   

8.
目的观察选择性支气管动脉灌注吉西他滨、奥沙利铂(GEMOX方案)并联合吉西他滨静脉滴注化疗治疗晚期非小细胞肺癌(NSCLC)的疗效和不良反应。方法对38例晚期NSCLC患者第1 d经支气管动脉注入吉西他滨、奥沙利铂,第8 d予吉西他滨静脉滴注化疗,21~28 d为一个周期,完成2~3周期后评价其疗效及不良反应。结果 38例中完全缓解(CR)0例,部分缓解(PR)23例,总有效率60.5%。主要不良反应为骨髓抑制、消化道反应等,不良反应多为Ⅰ~Ⅱ度。结论基于GE-MOX方案的支气管动脉灌注联合全身化疗治疗晚期非小细胞肺癌疗效好、不良反应可耐受。  相似文献   

9.
l病例很自例1男,63岁.原发性右肝癌(巨块型)累及右肾上腺,行肿瘤切除及肝动脉门静脉留置埋格式给药装置(imPlantabl。drugdeivnySystem,IDffi),术后13rno于199408-14再次入院.血AFP1962.IM/L;CT及胸片未见肝肺占位;肝功能TBil25.35t,ll,ol/L,A38.799/L,G40.15g/L,ALT41.5IU/L,AgE63.5IU/L.经保肝、支持治疗15d后化疗:顺铂(DDP)30gh肝动脉(dl,d3,d5)及门静脉(d7)推注;5一氛尿呼唤(5-Fu)1000gd门静脉(dl,d3,d5)及肝动脉(d7,dg)滴注;羟基喜树碱sgd肝动脉(dl~v)推注.化…  相似文献   

10.
目的探讨肝动脉门静脉输注自体LAK细胞在肝癌肝脏灌注化疗中的临床价值。方法病理证实的原发性肝癌患者92例,14例肝动脉门静脉输注自体LAK细胞及化疗药物,78例肝动脉门静脉输注化疗药物作为对照。结果自体LAK细胞加化疗组CR6例,PR6例,有效率85.7%;对照组CR17例,PR28例,有效率57.7%;两组间疗效有显著性差异(P<0.05)。结论肝动脉门静脉输注自体LAK细胞可以提高肝癌肝脏灌注化疗的效果,经埋植式给药装置肝动脉门静脉输注自体LAK细胞及化疗药物治疗中晚期肝癌的研究具有实际临床意义。  相似文献   

11.
The sensitivity to 1-hexylcarbamoyl-5-fluorouracil (HCFU) of 25 colorectal cancer tissues was compared with that of six antitumor drugs: carboquone (CQ), Adriamycin (ADM), mitomycin C (MMC), aclacinomycin A (ACR), cisplatin (DDP), and 5-fluorouracil (5-FU), using the in vitro succinate dehydrogenase inhibition (SDI) test. Chemosensitivity was determined to be positive when the succinate dehydrogenase (SD) activity of the drug-exposed cells, at ten times the peak plasma concentration, was decreased to below 50 percent of that of control cells on day 3 of exposure. Decrease in SD activity was remarkable in cases of exposure to HCFU, compared with six other drugs. The sensitivity rates were 32 percent for CQ, 40 percent for ADM, 24 percent for MMC, 28 percent for ACR, 32 percent for DDP, 16 percent for 5-FU, and 68 percent for HCFU. The sensitivity rate for at least one of the six drugs (CQ, ADM, MMC, ACR, DDP, and 5-FU) was 52 percent, but was 80 percent when HCFU was taken into account. Since colorectal cancer tissues are resistant to various antitumor drugs, the chemosensitivity test of HCFU should aid in determining the effects of a particular drug for an individual patient.  相似文献   

12.
AIM: To evaluate the effect of combined antisense oligonucleotides targeting midkine (MK-AS) and chemotherapeutic drugs [cisplatin(DDP), 5-fluorouracil (5-FU) and adriamycin (ADM)] on inhibition of HepG2 cell proliferation, and to analyze the efficacy of MK-AS used in combined ADM in in situ human hepatocellular carcinoma (HCC) model. METHODS: HepG2 cells were treated with MK-AS and/or chemotherapeutic drugs mediated by Lipofectin, and cell growth activity was determined by MTS assay. An in situ HCC model was used in this experiment. MK- AS, ADM and MK-AS + ADM were given intravenously for 20 d, respectively. The animal body weight and their tumor weight were measured to assess the effect of the combined therapy in vivo. RESULTS: Combined treatment with MK-AS reduced the IC50 of DDP, 5-FU and ADM in HepG2 cells. MK-AS significantly increased the inhibition rate of DDP, 5-FU and ADM. Additionally, synergism (Q 1.15) occurred at a lower concentration of ADM, 5-FU and DDP with combined MK-AS. Combined treatment with MK-AS and ADM resulted in the more growth inhibition on in situ human HCC model compared with treatment with chemotherapeutic drugs alone. CONCLUSION: MK-AS increases the chemosensitivity in HepG2 cells and in situ human HCC model, and the combination of MK-AS and ADM has a much better in vitro and in vivo synergism.  相似文献   

13.
目的探讨应用三磷酸腺苷生物荧光肿瘤化疗药敏检测(ATP-TCA)法指导非小细胞肺癌(NSCLC)个体化新辅助化疗的临床疗效。方法79例Ⅱ~Ⅲ期NSCLC患者,分为试验组40例,行ATP—TCA体外药敏检测,根据检测结果,选择敏感化疗方案行个体化新辅助化疗,体外无效者不行新辅助化疗;对照组39例选择常规第三代含(顺)铂两药联合化疗方案行新辅助化疗。结果试验组标本可评估率为92.5%,体外无效13.5%;四种化疗方案的体外有效率依次为吉西他滨+顺铂81.1%,多西他赛+顺铂(DP)78.4%,长春瑞滨+顺铂(NP)62.2%及柴杉醇+顺铂(TP)59.5%,各组比较差异无统计学意义。试验组临床有效率78.1%,手术完全切除率93.8%,对照组分别为64.1%和82.9%,差异无统计学意义。病理学疗效评价,试验组有效率78.1%,对照组54.3%,差异有统计学意义,与临床疗效评价不完全一致。结论根据ATP-TCA药敏检测结果指导NSCLC患者个体化新辅助化疗,结合病理组织学分级评价辅助化疗效果,有可能提高化疗疗效,减少无效化疗。  相似文献   

14.
目的 探讨MTT法体外药物敏感性试验在胰腺癌化疗药物选择中的作用.方法 取156例胰腺癌患者的肿瘤组织进行体外原代细胞培养,以MTT法检测吉西他滨(GEM)、5氟脲嘧啶(5-FU)、丝裂霉素(MMC)、奥沙利铂(L-OHP)、伊立替康(CPT-11)、顺铂(DDP)对癌细胞的抑制率.按照实体瘤体外敏感标准,以抑制率>70%为高度敏感,50%~70%为中度敏感,<50%为不敏感(耐药).结果 156例胰腺癌标本经病理证实为导管癌135例、腺鳞癌13例、黏液腺癌8例.胰腺导管癌对6种药物均高度敏感;胰腺黏液腺癌和腺鳞癌对5种药物(分别除L-OHP和GPT-11外)高度敏感.GEM对胰腺癌细胞的抑制率高于MMC、L-OHP及CPT-11(P<0.05),与5-FU和DDP无显著差异.其他5种药物之间无显著差异.不同类型的胰腺癌细胞对6种化疗药物的敏感性高低排序不同,导管癌对药物敏感性依次为GEM>DDP>5-FU>CPT-11>MMC>L-OHP;黏液腺癌为GEM、CPT-11>DDP、5-FU、MMC>L-OHP;腺鳞癌依次为L-OHP>GEM>5-FU、MMC>DDP>CPT-11.结论MTT体外药物敏感性试验有助于胰腺癌化疗药物的正确选择,具有一定临床应用价值.  相似文献   

15.
目的比较经肝动脉和门静脉移植自体骨髓干细胞治疗失代偿期肝硬化患者的疗效和安全性。方法回顾性分析2006年12月至2012年5月50例住院患者资料,门静脉治疗组失代偿期肝硬化患者25例和肝动脉治疗组25例,两组基线特征差异无统计学意义。门静脉治疗组在基础治疗基础上在超声介入下经皮经肝穿刺至门静脉,注入自体骨髓干细胞治疗;肝动脉治疗组在基础治疗基础上在放射介入下经股动脉插管至肝固有动脉注入自体骨髓干细胞治疗。治疗后第2、4、8周检测两组患者Au、AST、TBil、凝血酶原活动度(VIA)和白蛋白(Alb)水平变化。同时观察临床症状的改善情况及术后的不良反应。组间比较采用成组t检验,治疗前后比较采用配对t检验,计数资料采用卡方检验。结果门静脉组有22例(88.0%)患者乏力、纳差症状有明显改善,肝动脉组有21例(84.0%),两组间比较差异无统计学意义(P〉0.05);治疗后8周,门静脉和肝动脉组患者血清Alb水平分别为(34.4±7.8)g/L和(33.8±8.0)g/L,较治疗前[分别为(27.1±8.9)g/L和(26.8±9.6)g/L]有显著提升(P均〈0.05),但两组间差异无统计学意义(P〉0.05);两组VFA分别为(58.0±13.1)%和(56.9±12.8)%,较治疗前[分别为(45.5±12.3)%和(47.0±11.6)%]有显著提升(P均〈0.05),但两组间差异无统计学意义(P〉0.05);血清ALT、AST、TBil在两组间变化差异无统计学意义;两组甲胎蛋白(AFP)分别为(10.3±5.9)ng/ml和(8.9±4.3)ng/ml,差异无统计学意义(P〉0.05),未发现严重的不良反应及并发症。结论经门静脉和肝动脉移植自体骨髓干细胞治疗失代偿期肝硬化是一种较安全、有效的方法.两组间疗效相比差异无统计学意义。  相似文献   

16.
目的 探讨应用胰腺癌多细胞团簇做化疗药物敏感试验的可行性.方法 应用胶原凝胶微滴三维培养胰腺癌细胞株SW1990、PCT-3和ASPC-1细胞.在形成多细胞团簇后,采用CD-DST法和CCK-8法测定其对不同浓度的5-氟尿嘧啶(5-FU)、健择(GEM)及奥沙利铂(OXA)3种化疗药物的敏感性,并与分散细胞模型进行比较.结果 形成多细胞团簇的3种胰腺癌细胞对不同浓度5-FU、GEM及OXA三种药物的敏感性均较分散细胞的敏感性显著下降(P<0.05).50μg/ml 5-FU对SW1990、PCT-3、ASPC-1多细胞团簇的抑制率分别为(53.96±4.32)%、(58.49±5.98)%、(49.57±4.36)%;25 μg/ml GEM对SW1990、PCT-3、ASPC-1细胞团簇的抑制率为(53.02±4.06)%、(61.90±4.89)%、(38.09±4.88)%,10 μg/ml OXA对3种细胞团簇的抑制率为(57.33±6.27)%、(50.90±4.90)%、(47.26±4.29)%,均显著低于对分散细胞的抑制率(P<0.05).结论 肿瘤细胞形成细胞团簇后对抗肿瘤药物的敏感性明显降低,耐药性增加,更符合体内状态.  相似文献   

17.
BACKGROUND/AIMS: Advanced hepatocellular carcinoma (HCC) with portal vein invasion and/or intrahepatic metastasis has an unfavorable prognosis even after radical hepatic resection. The aim of this study was to evaluate the effectiveness of a novel postoperative adjuvant chemotherapy given through the hepatic artery and based on biochemical modulation using cisplatin (CDDP) and 5-fluorouracil (5-FU). METHODOLOGY: Fifteen patients with advanced HCC with portal vein invasion into the main trunk and/or intrahepatic metastases of more than 3 segments were included in this study. After radical hepatic resection, the patients were divided to two groups: the adjuvant chemotherapy group (n=7) given the novel arterial infusion regimen with CDDP and 5-FU, and the control group (n=8) given no adjuvant chemotherapy. RESULTS: Three-year survival rate of the adjuvant chemotherapy group tended to be significantly longer compared to that for the control group (p < 0.05). Most of the tumor recurrence was in the remnant liver, 5 cases in both of the groups. Significant difference of the recurrence patterns was recognized, rather than difference of the disease-free survival rate between the two groups. All of the intrahepatic recurrences are multiple in the control group, but in the adjuvant chemotherapy group, 2 cases of the recurrences showed a localized tumor surgically resected. It is noteworthy that the occurrence of multiple recurrence was significantly later in the adjuvant chemotherapy group compared to the control group (18.9 months vs. 6.5 months; p<0.05). CONCLUSIONS: Our data suggest that this novel adjuvant chemotherapy can improve the postoperative prognosis of patients with the advanced HCC.  相似文献   

18.
AIM To compare the therapeutic effect andsignificances of multimodality treatment forhepatocellular carcinoma (HCC) with tumorthrombi in portal vein (PVTT).METHODS HCC patients (n=147) with tumortrombi in the main portal vein or the first branchof portal vein were divided into four groups bythe several therapeutic methods. There wereconservative treatment group in 18 out ofpatients (group A); and hepatic artery ligation(HAL) and/or hepatic artery infusion (HAI)group in 18 patients (group B), in whompostoberative chemoembolization was doneperiodically; group of removal of HCC with PVTTin 79 (group C) and group of transcatheterhepatic arterial chemoembolization (TACE) orHAI and/or portal vein infusion (PVI) afteroperation in 32 (group D).RESULTS The median survival period was 12months in our series and the 1-, 3-, and 5-yearsurvival rates were 44.3%, 24.5% and 15.2%,respectively. The median survival times were 2,5, 12 and 16 months in group A, B, C and D,respectively. The 1-, 3- and 5-year survival rateswere 5.6%, 0% and 0% in group A; 23.2%,5.6% and 0% in group B; 53.9%, 26.9% and16.6% in group C; 79.3%, 38.9% and 26.8% ingroup D, respectively. Significant differenceappeared in the survival rates among the groups (P<0.05).CONCLUSION Hepatic resection with removalof tumor thrombi and HCC should increase thecurative effects and be encouraged for theprolongation of life span and quality of life forHCC patients with PVTT, whereas the besttherapeutic method for HCC with PVTT is withregional hepatic chemotherapy orchemoemblization after hepatic resection withremoval of tumor thrombi.  相似文献   

19.
目的观察门静脉免疫化疗对原发性肝癌切除后患者预后的影响。方法收集湖北医药学院附属太和医院2010年1月-2013年6月住院的48例手术切除并行术后门静脉免疫化疗患者,对其临床资料进行回顾性分析,并与同期未行门静脉免疫化疗的59例患者进行对比。计量资料的分析采用两样本资料的t检验,率的检验采用卡方检验。生存分析采用Kaplan-Meirer法计算平均生存时间,采用log-rank检验分析不同组之间的差异性。将107例患者合并,采用Cox回归模型分析对可能影响预后的因素进行多因素分析。结果免疫化疗组和对照组的1、2、3年的无瘤生存率分别为87.5%(42/48)和67.8%(40/59)(χ2=5.739,P=0.017)、52.1%(25/48)和32.2%(19/59)(χ2=4.320,P=0.038)、16.7%(8/48)和10.2%(6/59)(χ2=0.982,P=0.322),平均生存时间分别为(32.4±2.3)个月和(24.7±2.3)个月(χ2=4.044,P=0.044)。合并门静脉癌栓者术后行门静脉免疫化疗其平均生存时间(12.4±1.3)个月,而未行门静脉免疫化疗者为(4.8±0.4)个月(χ2=15.535,P0.001)。经Cox回归分析显示,肿瘤的分化程度、肿瘤的大小、肝功能分级、是否存在门静脉癌栓是影响肝细胞切除术后复发的独立危险因素,而是否采用门静脉免疫化疗对影响肝癌术后的复发时间有重要影响,具有统计学意义(P0.001)。结论门静脉免疫化疗可改善原发性肝癌切除后的无瘤生存率和生存时间。  相似文献   

20.
目的观察不同浓度几种化疗药物对人肝癌BEL-7404细胞端粒长度的影响。方法采用Southern Blot.ting及凝胶电泳法测定不同化疗药物对人肝癌BEL-7404细胞端粒限制片断长度(TRF)变化影响。结果TRF随化疗药物浓度的增加而逐渐缩短:低浓度组(A、B组)中DDP,MMC,ADM对BEL-7404细胞表现出明显的抑制性,与对照组比较有统计学差异(P〈0.05);VCR对BEL-7404细胞的端粒长度均不具抑制性。高浓度组(C组)DDP、ADM、MMC、VCR中的平均TRF与对照组比较均有统计学差异,与低浓度组比较进一步缩短(P〈0.05)。结论上述药物对端粒的抑制作用呈浓度效应关系。  相似文献   

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