羟基喜树碱、依托泊苷、5-氟尿嘧啶联合治疗老年人晚期胃癌40例

目的：探讨羟基喜树碱（ＨＣＰＴ）、依托泊苷（ＶＰ１６）、５－氟尿嘧啶（５－ＦＵ）联合方案治疗老年人晚期胃癌的疗效和毒副作用。方法：比较ＦＣＰＴ＋ＶＰ１６＋ＣＦ＋５－ＦＵ（ＥＬＦＨ）方案与ＨＣＰＴ＋５－ＦＵ＋ＶＰ１６（ＥＦＨ）方案。结果：ＥＬＦＨ组４２例有效率为５２．４％。ＥＦＨ组４０例有效率为４２．５％,两组疗效比较差异无显著性。ＦＬＦＨ组毒副反应较ＥＦＨ组发生率高,主要为骨髓抑制、恶心呕吐、口腔     

口服大剂量CF加PF方案与PF方案联合放射治疗晚期鼻咽癌疗效比较

目的：对比观察口服大剂量醛氢叶酸,５－ＦＵ,ＤＤＰ（ＰＦＬ）与ＰＦ方案联合治疗晚期及复发转移的鼻咽癌的疗效。方法 １９９６～１９９８年间,１００例局部晚期及复发转移的鼻咽癌,非随机分为ＣＦ组（ＰＦＬ方案）５１例,对照组（ＰＦ方案）４９例。晚期初治采用放化疗综合治疗（Ｃ＋Ｒ）复发转移采用单纯化疗（Ｃ）。结果 ＣＦ组初治２８例,其ＣＲ率,有效率分别为６４．２％,８５．７％,中位生存期２１月（４－３３月     

国产澳沙利铂治疗大肠癌Ⅱ期临床研究

目的：评价国产注射用奥沙利铂单药及与５－氟尿嘧啶（５－Ｆｕ）－四氢叶酸（ＣＦ）联合用于治疗大肠癌的疗效及毒副反应。方法：收治带瘤大肠癌患４９例,按随机方法,分别入单药组１１例（单用奥沙利铂）,联合组２０例（奥沙利铂＋５－Ｆｕ＋ＣＦ）,和对照组１８例（５－Ｆｕ＋ＣＦ）。结果：单药组有效率２７．３％,联合组３０．０％,对照组５．６％,单药组和联合组疗效高于对照组,且奥沙利铂对大肠癌常见转移部位如肝脏     

腹腔内热灌注化疗预防进展期胃癌术后腹腔复发的临床研究

目的：评价腹腔内热灌注化疗对侵及浆膜的进展癌根治术后预防腹腔复发的疗效。方法：１９９４年１２月～１９９６年１２月９６例可切除的进展期胃癌患者随机分成治疗组和对照组。治疗组５２例应用ＤＤＰ８０ｍｇ＋ＭＭＣ１０ｍｇ＋５－ＦＵ１．０加５主生理盐水（０．９％）１５００ｍｌ加热至４３℃，进行腹腔灌注，连用４～６周，对照组４４例常规给予口服优福定。结果：治疗组和对照组３年生存率分别为６１．５％４５．５％（Ｐ〈     

129例晚期胃癌化疗结果观察

通过对１２９例晚期胃癌化疗结果总结，证明文中报道的治疗晚期胃癌的三组化疗方案总疗效为３８．７％（５０／１２９），与文献报道的治疗晚期胃癌较好化疗方案有效率近似。三组化疗方案以ＭＦＡ（ＭＭＣ，５－Ｆｕ，ＡＤＭ）方案疗效稍高（且有两例完全缓解），有效率４４．１％（１５／３４）。ＤＶＭＦ（ＤＤＰ，ＶＣＲ，ＭＭＣ，５－Ｆｕ）方案和ＤＶＭ＋５－Ｆｕ衍生物（ＵＦＴ或ＦＴ－２０７或ＦｕｄＲ）方案有效率分别为４０．２％（２７／６７）和２８．６％（８／２８）。进一步分析治疗结果显示：化疗对贲门部癌较胃部癌疗效稍高，对术后复发转移病人的疗效较初治病人稍高，治疗胃腺癌的疗效较低分化腺癌的疗效稍高。     

术前5-FU持续静脉输注联合CF治疗Ⅱ期乳腺癌的近期疗效分析

目的：探讨长时间静脉输注５－ＦＵ加口服甲酰四氢叶酸钙（ｃａｌｃｉｕｍ ｆｏｌｉｎａｔｅ,ＣＦ）片剂,在Ⅱ期乳腺癌术前新辅助化疗中的应用,并与ＣＭＦ方案进行疗效及毒副反应比较。方法：以随机对照研究,对两组共７０例乳腺癌患者术前化疗疗效及毒副反应进行观察、比较与分析。结果：５－ＦＵ静滴加口服ＣＦ组有效率达７１．９％,ＣＭＦ组３１．６％。结论：５－ＦＵ静滴加口服ＣＦ方案作乳腺癌术前新辅助化疗疗效明显,毒副反应可耐受,值得在临床进一步探索。     

放疗联合化疗治疗复发直肠癌的临床研究

目的 探讨放疗联合化疗治疗是复发直肠癌的临床效果。方法 对２９例根治术后复发的直肠癌进行了放射治疗，其中１６例同时给予大剂量醛氢叶酸（ＣＦ），氟脲嘧啶（５－ＦＵ）的全身化疗（观察组）１３例单纯放疗（对照组）。结果 观察组中局部症状缓解率较对照组高，两组有效率分别为８１．２５％，４６．１６％，有显著性差异（Ｐ〈０．０５），完全缓解分别为１８．７５％，７．６９％两组放疗引起的局部毒性反应相似，结论，Ｃ     

顺铂或卡铂加氟脲嘧啶对中晚期鼻咽癌诱导化疗的疗效对比

为比较两种铂类药物单疗程治疗鼻咽癌的临床疗效及毒副作用，作者于１９９６年３月～１０月，将３４例有颈淋巴结转移的中晚期鼻咽癌患者分为两组（每组各１７例）分别采用ＣＢＰ３００ｍｇ／ｍ２，第１天，５－Ｆｕ１０００ｍｇ／ｍ２，第１～５天或ＤＤＰ１００ｍｇ／ｍ２，第１天５－Ｆｕ１０００ｍｇ／ｍ２，第１～５天两种化疗方案进行放疗前单疗程诱导化疗。ＣＢＰ组ＣＲ＋ＰＲ（ＯＲ）为５２．９４％，ＤＤＰ组为６４．７１％，Ｐ＞０．０５，无显著性差异。两组ＷＢＣ值多在第３周最低，第４周回升。ＣＢＰ＋５－Ｆｕ组ＷＢＣ均值从第１周起均较ＤＤＰ＋５－Ｆｕ组低，按ＷＨＯ毒性与分级标准，两组ＷＢＣ值下降分级比较，３＋４度者，ＣＢＰ＋５－Ｆｕ组４７．０６％（８／１７），ＤＤＰ＋５－Ｆｕ组１１．７６％（２／１７），Ｐ＜０．０５，有显著性差异。本组资料提示ＣＢＰ与ＤＤＰ对中晚期ＮＰＣ诱导化疗疗效相近，ＣＢＰ不需水化，可在门诊执行，两组对ＷＢＣ的抑制均在第３周最重，且ＣＢＰ对ＷＢＣ影响要较ＤＤＰ严重     

骨髓增生异常综合征患者体外CFU—GM,CFU—L培养和细胞遗传学研究

研究了４２例骨髓增生异常综合征患者体外ＣＦＵ－ＧＭ、ＣＦＵ－Ｌ培养和细胞遗传学改变。结果显示，患者ＣＦＵ－ＧＭ明显低于正常对照组（Ｐ〈０．０１），但高于再生障碍性贫血（ＡＡ）（Ｐ〈０．０１），ＣＦＵ－Ｌ高于正常对照组和ＡＡ组（Ｐ〈０．０１）。患者５２．４％存在染色体异常，常见为：＋８、－２２、－Ｘ、－Ｙ、－２０、－７／７ｑ＾－。ＣＦＵ－ＧＭ减低、ＣＦＵ－Ｌ增高和染色体异常者疗效较正常者差。表明ＣＦ     

化疗药物对人乳腺癌细胞株MCF-7的药效动力学研究

目的：用ＭＴＴ法研究经疗药物氟尿嘧啶（５－ＦＵ）、阿霉素（ＡＤＭ）、丝裂霉素（ＭＭＣ）、甲氨蝶呤（ＭＴＸ）对人乳腺癌细胞株（ＭＣＦ－７）的药效动力学特征。方法：ＭＣＦ－７１细胞株在含有不同药物浓度的培养基中孵育不同时间,用ＭＴＴ法测定的抑制率。结果：ＭＣＦ－７朱对化疗药物的敏感性依次为ＡＤＭ、５－ＦＵ、ＭＭＣ,对ＭＴＸ不敏感,低浓度时５－ＦＵ＋ＡＤＭ及５－ＦＵ＋ＭＴＸ的联合用药表现了很强的协同作用     

The preventive effect of allopurinol spray on stomatitis induced by anti-cancer drugs

The present study was conducted to evaluate the effect of allopurinol spray on stomatitis induced by chemotherapy for esophageal cancer. The chemotherapeutics used consisted of 5-FU + CDDP (FC) given to 40 patients and 5-FU + ND (FN) given to 9 patients. Allopurinol solution for spray was prepared using a gelatin agent as base. The allopurinol spray was used 3-5 times daily before and after chemotherapy. The Japan Society for Cancer Therapy's criteria for stomatitis were used. With FN-therapy, no stomatitis was observed. With FC-therapy, 9 of 40 patients developed stomatitis of grade 1 (8 patients) or grade 2 (1). The incidence of stomatitis was 18.4% with all therapies and 22.5% with FC-therapy. The average graded toxicity was 0.20 for all therapies and 0.25 for FC-therapy. These results suggest that allopurinol spray is markedly effective for the prevention of stomatitis induced by chemotherapy. In addition, allopurinol spray is portable and convenient, and resulted in less nausea or vomiting than mouthwash.     

以紫杉醇为主的联合化疗方案治疗进展期胃癌随机对照研究

背景与目的:治疗晚期胃癌目前尚无公认的金标准方案。Ⅱ期临床研究发现紫杉醇类药物对胃癌有较好疗效。本研究对比亚叶酸钙/5-氟尿嘧啶(CF/5-FU)联合顺铂(DDP)、紫杉醇(Taxol)联合CF/5-FU、紫杉醇联合草酸铂(Oxaliplatin,OXA)方案治疗晚期胃癌的临床疗效与不良反应。方法:在福建省6家医院进行前瞻性、开放、随机对照研究,将符合入选标准的患者根据随机号码分入CF/5-FU DDP、CF/5-FU Taxol及Taxol OXA3个组,用双周方案进行全身化疗(CF0.2g/m2,静滴,d1、2;5-FU2.0/m2,持续静脉滴注48h;DDP50mg/m2,静滴,d1;Taxol100mg/m2,静滴,d1;OXA100mg/m2,静滴,d1),配合每周一次DDP40mg/m2腹腔灌注化疗。按WHO标准评价疗效及不良反应。结果:2002年5月至2004年5月,入选180例合格病例,随机分入对照组(CF/5-FU DDP组)60例,研究组120例(研究Ⅰ组:CF/5-FU Taxol组及研究Ⅱ组:Taxol OXA组各60例)。其中166例(92.22%)接受了至少2个周期的化疗,152例(84.44%)完成4个周期的化疗,103例(57.22%)完成了8个周期的化疗。166例可评价疗效,Taxol OXA组疗效较对照组好(P<0.05)。在术前初治患者中,研究组Ⅰ组和Ⅱ组的疗效明显优于对照组(50.00%、80.00%与20.75%,P<0.05);在腹膜后淋巴结转移的患者中,研究组疗效明显优于对照组(65.96%、85.71%与36.36%,P<0.05);而在肝转移的患者中,研究组与对照组疗效近似(28.57%、39.13%与34.62%,P>0.05)。与对照组相比较,研究组患者中任何程度的恶心、呕吐、食欲差、口腔炎及肾功能减退发生率均较低,但骨髓抑制及末梢神经损害相对较严重,并有7例(5.88%)发生不同程度的过敏反应,其中严重过敏反应3例(2.52%)。无治疗相关死亡。结论:晚期胃癌患者采用含紫杉醇方案化疗虽然骨髓抑制较重,但总体疗效优于CF/5-FU DDP方案,不良反应可以耐受。本研究推荐以紫杉醇为主的联合化疗方案作为晚期胃癌的一线化疗方案。     

Prevention of stomatitis induced by anti-cancer drugs

A randomized control trial study was carried out to evaluate the effect of allopurinol mouth wash on stomatitis induced by chemotherapy in gynecologic patients. Chemotherapeutics used consisted of 5-FU+CDDP (PF) given to 10 patients and vincristine and actinomycin-D+cyclophosphamide (VAC) given to 5. Allopurinol mouth wash was prepared for patients to rinse their mouth with the solution 4-5 times daily before and after treatment with anti-cancer drugs. The Japan Society For Cancer Therapy's criteria for stomatitis were used. In the control group, stomatitis occurred in 9 of the 10 patients receiving PF therapy and in all of the 5 receiving VAC. In contrast, stomatitis was observed in only 2 of the 10 patients receiving PF therapy and 2 of the 5 VAC in the allopurinol-treated group. Allopurinol mouth wash showed a marked effect on stomatitis induced by chemotherapy.     

奥沙利铂治疗结直肠癌的随机多中心Ⅱ期临床试验

Objective: To evaluate the efficacy and safety of Oxaliplatin in the patients with colorectal cancer. Methods: In a multicenter randomized control study, a total of 144 patients were divided into four groups: Oxaliplatin (Haitong) 5-FU, CF(group A) 41 cases; 5-FU CF (group B) 41 cases; Oxaliplatin (Haitong) 5-FU, CF (group C) 31 cases; Oxaliplatin (positive drug) 5-FU CF (group D) 31 cases. Oxaliplatin combination regimen: L-OHP 130 mg/m2 i.v. infusion 2 h d1; CF 200 mg/m2i.v. 2h d1-d5; 5-FU 300 mg/m2 i.v. infusion 4h d1-d5 (after CF). 5-FU CF combination regimen: CF 200 mg/m2 i.v. infusion 2 h d1-d5, 5-FU 300 mg/m2 i.v. infusion 4h d1-d5 (after CF), the schedule was repeated every 3 weeks. The total cycles were 3. Results: After three circles treatment, overall response rate of 4 groups was 24.4% (group A), 2.4% (group B), 25.8%(group C) and 19.4% (group D), respectively. The response rate was significantiy different between group A and group B (P＜0.01), but no significant difference was observed between group C and group D (P＞0.05). Conclusion: The Oxaliplatin(Haitong) for injection combination regimen is effective in the treatment of colorectal cancer.     

奥沙利铂联合氟尿嘧啶和甲酰四氢叶酸治疗局部进展期胃癌临床研究

目的:评价奥沙利铂、5氟尿嘧啶(5FU)和甲酰四氢叶酸(CF)联合新辅助化疗治疗局部进展期胃癌的近期疗效和毒副反应。方法:选择2000年3月～2004年4月我科住院的胃癌患者42例入组,术前接受化疗,方案为:奥沙利铂130mg/m2,d1;5FU500mg/m2,d1～d3;CF300mg/d,d1～3。每3个周为1个周期,共2个周期。观察新辅助化疗后肿瘤原发病灶的缓解情况,并观察毒副反应。结果:42例患者中有38例获得手术切除,其中26例获得根治性切除,19例肿瘤原发病灶明显缩小,14例肿瘤TNM分期降低。毒副反应主要为白细胞减少、腹泻、恶心、呕吐、脱发、肝功能异常,经对症及营养支持治疗后均能缓解。结论:奥沙利铂联合5FU与CF新辅助化疗在局部进展期胃癌的治疗中近期疗效显著,耐受性良好。     

奥沙利铂联合亚叶酸钙及5-氟尿嘧啶治疗晚期大肠癌的临床观察

目的观察奥沙利铂(L-OHP)联合亚叶酸钙(CF)及5-氟尿嘧啶(5-Fu)治疗晚期大肠癌的疗效及不良反应。方法将我院2002年10月~2005年10月收治的65例晚期大肠癌,随机分为A组和B组,A组奥沙利铂130mg/m2静脉滴注2小时,第1天;亚叶酸钙200mg/m2持续静滴24小时,第1~5天;5-氟尿嘧啶500mg/m2持续静滴24小时,第1~5天;每3周重复。B组羟基喜树碱(HCPT)8mg/m2静脉滴注,第1~5天;亚叶酸钙200mg/m2,静脉滴注2小时,第1~5天;5-氟尿嘧啶500mg/m2持续静滴24小时,第1~5天,每3周重复。所有病例均接受2周期化疗。结果A组CR2例,PR12例,SD11例,DD8例,总有效率42.4%,B组CR1例,PR5例,SD16例,PD10例,总有效率18.8%,A组的主要不良反应是周围神经炎及恶心呕吐、骨髓抑制。结论奥沙利铂联合亚叶酸钙及5-氟尿嘧啶疗效优于羟基喜树碱、亚叶酸钙、5-氟尿嘧啶联合化疗,不良反应轻,值得临床推广。     

A multicenter randomized phase Ⅱ trail of Oxaliplatin in the patients with colorectal cancer

Objective： To evaluate the efficacy and safety of Oxaliplatin in the patients with colorectal cancer. Methods： In a multicenter randomized control study, a total of 144 patients were divided into four groups： Oxaliplatin （Haitong） ＋ 5-FU, CF （group A） 41 cases; 5-FU ＋ CF （group B） 41 cases; Oxaliplatin （Haitong） ＋ 5-FU, CF （group C） 31 cases; Oxaliplatin （positive drug） ＋ 5-FU ＋ CF （group D） 31 cases. Oxaliplatin combination regimen： L-OHP 130 mg/m2 i.v. infusion 2 h dl; CF 200 mg/m2 i.v. 2 h d1-d5; 5-FU 300 mg/m2 i.v. infusion 4 h d1-d5 （after CF）. 5-FU ＋ CF combination regimen： CF 200 mg/m^2 i.v. infusion 2 h d1-d5, 5-FU 300 mg/m^2 i.v. infusion 4h d1-d5 （after CF）, the schedule was repeated every 3 weeks. The total cycles were 3. Results： After three circles treatment, overall response rate of 4 groups was 24.4% （group A）, 2.4% （group B）, 25.8% （group C） and 19.4% （group D）, respectively. The response rate was significantly different between group A and group B （P 〈 0.01）, but no significant difference was observed between group C and group D （P 〉 0.05）. Conclusion： The Oxaliplatin （Haitong） for injection combination regimen is effective in the treatment of celorectal cancer.     

A controlled evaluation of an allopurinol mouthwash as prophylaxis against 5-fluorouracil-induced stomatitis

Pursuant to a promising report suggesting that an allopurinol mouthwash could have a protective effect against 5-fluorouracil (5-FU)-induced stomatitis, the authors performed a randomized, placebo-controlled, double-blind, crossover study. Seventy-seven patients, receiving their first 5-day course of chemotherapy with 5-FU +/- leucovorin, were assigned to use a mouthwash containing 20 mg of allopurinol or a placebo. The mouthwash was administered every hour for four doses commencing with each chemotherapy dose. The severity of subsequent mucositis was graded (on a 0-4 scale) by the attending physician and also by a patient-completed questionnaire. There was trend toward less mucositis in the placebo group with mean physician-judged mucositis scores of 1.3 for placebo and 1.8 for allopurinol (P = 0.07) and mean patient-judged mucositis scores of 1.5 for placebo and 1.9 for allopurinol (P = 0.15). There were no substantial differences in mucositis attributable to the two mouthwashes in the patients who crossed-over on their second cycle of chemotherapy. These data demonstrate that the tested allopurinol mouthwash regimen does not offer any protective effect against 5-FU-induced mucositis.     

奥沙利铂联合亚叶酸钙/5-氟脲嘧啶持续滴注治疗晚期胃肠癌

目的：观察奥沙利铂(L-OHP)联合亚叶酸钙(CF)、5-氟脲嘧啶(5-Fu)方案治疗晚期胃肠癌的近期疗效.方法：22例晚期胃肠癌患者,其中胃癌15例,大肠癌7例,化疗前均经锁骨下静脉留置中心静脉导管。L-OHP 130mg／m^2,静滴3小时,第1天;CF100mg／天,静滴2小时,第1～5天;5-FU500mg,静注,第1天,500mg／天,微量泵持续静脉滴注120小时：21天为1周期。结果：全组患者获得CR2例,PR10例,总有效率为54．5％。其中胃癌的有效率为53．3％;大肠癌的有效率为57．1％。骨髓抑制的发生率为59．1％,Ⅲ／Ⅳ度者仅1例;胃肠道反应主要为口腔粘膜炎与腹泻,发生率为54．5％,无Ⅲ／Ⅳ度胃肠道反应;突出的毒性反应是L—OHP引起的外周感觉神经异常,发生率为59．1％(13／22)：结论：L—OHP联合CF／5-FU持续滴注120小时的化疗方案治疗晚期胃肠癌近期疗效较高,耐受性好,值得进一步观察。     

顺铂腹腔内滴灌联合全身化疗治疗晚期胃癌临床观察

为了研究顺铂（DDP）腹腔内滴灌配合草酸铂（L-OHP）联合亚叶酸钙（CF）及5-氟尿嘧啶（5-FU）全身化疗治疗晚期胃癌的疗效,对入选的65例晚期胃癌患者以L-OHP联合CF及5-FU双周方案给予全身化疗,并配合每周1次DDP单药腹腔灌注化疗。完成治疗的60例患者中,CR4例,PR34例,总有效率CR＋PR为63%;各种病理分型均有较好疗效;从转移的情况来看,伴有腹水者疗效较好。初步研究结果提示,DDP腹腔内滴灌配合L-OHP联合CF及5-FU全身化疗治疗晚期胃癌,疗效可靠,毒副反应可以耐受,值得临床推广应用。