Evaluation of two modified ECF regimens in the treatment of advanced gallbladder cancer

Gallbladder cancer is a rare disease and it is associated with a poor clinical outcome and survival. A standard therapy for it has not been established yet. The aim of this study is to evaluate efficacy and safety of two modified ECF regimens in advanced gallbladder cancer patients. Clinical data of 38 patients with advanced gallbladder cancer treated with modified ECF regimen were reviewed retrospectively. Of them, 21 patients received an epirubicin, cisplatin, and 5-FU/LV combination therapy. Seventeen patients received a chemotherapy of epirubicin, cisplatin, and capecitabine. Partial response was achieved in fourteen (36.84%) patients with a median duration of 5 months (range, 3–13 months), while stable disease was achieved in eight patients (21.05%). The median time to progression was 4.0 months (95% CI, 3.62–4.58 months). And the median overall survival was 9.8 months (95% CI, 7.26–12.34 months). Responders demonstrated better survival than non-responders (median survival time: 16 vs. 6.9 months, P = 0.008). The median survival time for epirubicin-, cisplatin- and capecitabine-treated patients was 9.2 versus 8.9 months for epirubicin-, cisplatin- and 5-FU/LV-treated patients. There was no statistical difference between both treatment groups in terms of survival time (P = 0.769). Regimen-related toxicity resulted in at least one treatment delay or dosage reduction in 63.2 and 34.2% patients, respectively. There were no chemotherapy-related deaths during the study. Modified ECF regimen with epirubicin, cisplatin and 5-FU/LV or substituting capecitabine for 5-FU/LV is still a potentially effective therapeutic chemotherapy for patients with advanced gallbladder cancer, and toxicity was manageable. There was no remarkable difference in efficacy between the two regimens.

     

晚期原发性胆囊癌的化疗

目的:回顾性分析比较联合化疗及最佳支持治疗对晚期原发性胆囊癌的临床受益反应率及生存期。方法:将39例晚期原发性胆囊癌的患者非随机地分成3组,其中FAP组12例;GFO组8例;BSC组19例。化疗组每3～4周重复1次,治疗2周期后进行疗效评价,采用KaplanMeier法分析患者生存期,Logrank法进行检验。结果:FAP组的客观有效率16.7%(2/12),GFO组为25.0%(2/8),两组相比无显著性差异(P>0.05)。临床受益反应(CBR)率三组分别为25.0%、37.5%和26.3%;如将FAP组和GFO组合并成化疗组,化疗组与BSC组无显著性差异(P>0.05)。化疗组和BSC组的平均生存时间分别为6.7月和5.2月,两组用Logrank检验后无显著性差异(P>0.05)。结论:对于晚期原发性胆囊癌患者,应用FAP和GFO方案化疗并不优于最佳支持治疗。     

Chemotherapy in the treatment of advanced gallbladder cancer

OBJECTIVE: To clarify the role of chemotherapy for advanced gallbladder cancer (GBC). METHODS: We reviewed 89 GBC patients: 21 admitted before 1997 were treated with a combination of cisplatin, epirubicin, and 5-fluorouracil (CEF); 25, admitted subsequently, received a combination of 5-fluorouracil, doxorubicin and mitomycin (FAM), and the remaining 43, ineligible for these trials, received supportive care. We investigated the relation between pretreatment clinical variables and long-term survival in these 89 subjects, and analyzed whether chemotherapy could favor longer survival. RESULTS: There were no significant differences in survival time between the chemotherapy groups, whereas the response rate to the CEF regimen was 4-fold higher than to the FAM regimen (32 vs. 8%). Subgroup analysis suggested that chemotherapy favored longer survival in patients with a performance status (PS) of 0 or 1, but not in patients with a PS of 2. Cox regression analysis suggested a significant hazard reduction by chemotherapy in patients with a PS of 0 or 1, but not in patients with a PS of 2. CONCLUSIONS: GBC patients with poor PS should not be treated with chemotherapy at present. It is essential to design good clinical trials and develop more effective chemotherapy regimens.     

两种不同新辅助化疗方案治疗局部晚期乳腺癌的临床疗效比较

背景与目的:新辅助化疗已经成为治疗局部晚期乳腺癌的重要手段,不同化疗方案临床疗效有差异.本研究旨在比较XT方案(卡培他滨联合多西他赛)和传统CEF方案(环磷酰胺、表柔比星、氟尿嘧啶)两种不同的新辅助化疗方案治疗局部晚期乳腺癌的疗效及其不良反应.方法:收集采用xT或CEF方案行新辅助化疗的临床Ⅲ期乳腺癌患者48例,根据化疗方案分组,其中XT组26例,CEF组22例,化疗周期为2～4个,比较两组的近期疗效以及不良反应.结果:XT组的临床有效率(cRR)为88.46%,CEF组的临床有效率为63.64%,两组之间差异有统计学意义(P=0.041).XT组患者获病理完全缓解(pCR)1例(3.85%),CEF组pCR 1例(4.55%),两组差异无统计学意义(P=0.721).主要不良反应为粒细胞减少、恶心呕吐、肝功能损害、脱发、乏力和手足综合征等,但均可耐受.CEF方案的毒性较明显,出现Ⅲ/Ⅳ度的粒细胞减少,恶心呕吐、不同程度的肝功能损害均明显高于XT方案.结论:两种新辅助化疗方案对临床Ⅲ期乳腺癌均有良好的效果,xT组临床有效率优于CEF组,且患者的不良反应较CEF组轻.     

Treatment of advanced breast cancer with two doxorubicin-containing regimens

The Georgetown University Hospital experience in the treatment of advanced breast cancer using either a combination of doxorubicin (adriamycin) and vincristine (AV) or adriamycin and mitomycin-C (AM) is presented. Of 74 previously treated patients with advanced breast cancer, 50 patients were given AV and 24 patients were given AM. Both groups were comparable in regard to number of disease sites, age, prior radiation therapy, disease-free interval after mastectomy, duration of treatment, and estrogen-receptor status. The response rates were 32% and 25% with AV and AM combinations, respectively. Achievement of response was not related to menopausal or estrogen-receptor status. Median time to disease progression was 7.0 and 9.6 months for AV and AM, respectively. Median survivals were not statistically different (9.7 months for AV and 11.1 months for AM). Life-table analysis for responders versus nonresponders within each regimen and between responders in either regimen revealed no statistical differences. Duration of response for each regimen was also equivalent. Toxicity was mild and similar to previous reports using these drugs. However, myelosuppression was significantly greater for premenopausal than postmenopausal patients in the AV group. The possible reasons for this are discussed. Both AM and AV are well-tolerated regimens which provide equivalent but limited response rates, duration of response, and median survival in previously treated women with advanced breast cancer.     

两种不同方案治疗晚期非小细胞肺癌的疗效比较(英文)

Objective: The aim of this study was to analyze and compare the recent efficacy and toxicity of a three-drug platinum-based regimen (A regimen): [cisplatin (DDP) + gemcitabine (GEM) + vinorelbine (NVB)] and a two-drug combination without a platinum drug (B regimen): GEM + NVB, which were used to treat 55 advanced non-small cell lung cancer (NSCLC) patients, in a bid to provide a guidance for clinical treatment. Methods: Twenty-four cases of advanced NSCLC (stage III-IV) patients were treated with A regimen ...     

Evaluation of the efficacy of modified De Gramont and modified FOLFOX4 regimens for adjuvant therapy of locally advanced rectal cancer

Objective: To evaluate the efficacy of modified De Gramont (mDG) and FOLFOX4 (mFOLFOX4) regimens in patients with locally advanced rectal cancer (LARC). Methods: Patients that received adjuvant chemotherapy (CT) for the treatment of LARC (stage II and III) were retrospectively evaluated. Results: A total of 231 patients were examined. Median age was 58 (range, 18-83) and, of these patients, 36 (15.6%) had stage II and 195 (84.4%) had stage III disease. While the patients with stage II disease received only mDG regimen (36, 100.0%), of the patients with stage III disease, 71 (36.5%) received mDG and 124 (63.5%) received mFOLFOX4 regimen. Patients with stage III disease showed recurrences more often, but this difference was not statistically significant. Similarly, for the patients with stage III disease, there was no statistically significant relation between the adjuvant CT regimen received and the rate of recurrence. In patients with stage II disease, who received mDG, median DFS was 101 months and median OS was 106 months. For the patients with stage III disease, the patients that received mDG showed a median DFS of 78 months and a median OS of 96 months, while the patients that received mFOLFOX4 had a median DFS of 51 months and a median OS of 78 months. Although, for the patients with stage III disease, there are major differences between the two different regimens of CT in terms of DFS and OS, this difference was not statistically significant.When the results were evaluated from the perspective of toxicity, the patients that received mFOLFOX4 showed more toxicity. Neurotoxicity, which was seen in the patients that were given mFOLFOX4, was the most prominent toxicity. Conclusions: mDG and mFOLFOX4 regimens are applicable regimens as adjuvant CT for the treatment of LARC.     

不同化疗方案在晚期胃癌患者中的疗效对比

目的：比较SP与FOLFOX4两种化疗方案治疗晚期胃癌的临床疗效。方法选取84例晚期胃癌患者,按照随机数字表法分为SP组与FOLFOX4组,每组42例。SP组患者接受SP化疗方案,FOLFOX4组患者接受FOLFOX4化疗方案,比较两组患者的临床疗效、中位疾病进展时间、中位生存时间及两组患者化疗过程中出现的不良反应。结果 SP组患者临床有效率为55.00%,FOLFOX4组患者临床有效率为46.15%,两组疗效比较差异无统计学意义（P﹥0.05）;两组患者中位疾病进展时间及中位生存时间比较差异均无统计学意义（P﹥0.05）;在不良反应发生方面,SP组白细胞减少、恶心呕吐、腹泻发生率低于FOLFOX4组,差异有统计学意义（P﹤0.05）;贫血、手足综合征、肝功能异常、口腔黏膜炎等不良反应,两组比较差异无统计学意义（P﹥0.05）。结论 SP方案与FOLFOX4方案在治疗晚期胃癌方面均具有较好的临床疗效,且SP方案患者白细胞减少、恶心呕吐、腹泻等不良反应发生率低,值得临床上进一步研究应用。     

四种不同方案治疗晚期非小细胞肺癌的疗效比较

目的 比较CAP、EP、MVP和VIP四种不同方案治疗晚期非小细胞肺癌的效果。方法统计学分析各应用回顾性分析,总结出每个方案的近期和远期疗效,做统计学处理。结果 近期疗效:四种方案的有效率分别为CAP 32.1％、EP 37.8％、MVP 46.3％、VIP 52.5％,经组间比较,P值均>0.05,差异无显著性。远期疗效:有效病例治疗后中位生存期分别为CAP 7.8个月、EP 8.0个月、MVP10.0个月和VIP 10. 8个月。毒副反应:骨髓抑制方面以VIP为重,EP最轻。消化道反应以CAP和VIP为重,MVP最轻。结论 四种方案治疗晚期非小细胞肺癌,有效率各组间差异无显著性。但以VIP和MVP的有效率更高,中位生存期更长,仍可作为首选方案。EP方案的毒副反应较轻,适用于全身状况较差、体质较弱的患者。     

三种化疗方案治疗晚期胃癌的疗效分析

目的：比较TPF（paclitaxel＋DDP＋5-FU）、HPLF（HCPT＋DDP＋CF＋5-FU）和FOLFOX4（oxaliplatin＋CF＋5-FU）三种化疗方案治疗晚期胃癌的临床疗效和不良反应。方法：回顾性分析65例晚期胃癌患者,根据化疗方案分为TPF方案组（21例）、HPLF方案（19例）和FOLFOX4方案组（25例）,对三组疗效和不良反应进行比较。结果：TPF组、HPLF组、FOLFOX4组有效率分别为57．14％、52．63％和56％,三组疗效相比无统计学差异（P〉0．05）;中位进展时间（TTP）分别是6．6月、6．1月和6．2月（P〉0．05）;三组不良反应主要为胃肠道反应、外周神经毒性和脱发,除TPF组与FOLFOX4组外周神经毒性差异有显著性（P〈0．05）外,余均无统计学差异（P〉0．05）。结论：三种方案均是治疗晚期胃癌较为有效的化疗方案,但TPF方案治疗晚期胃癌耐受性较好,生活质量较高,值得临床推广。     

三种化疗方案治疗晚期胃癌的疗效分析

目的:比较TPF(paclitaxel+DDP+5-FU)、HPLF(HCPT+DDP+CF+5-FU)和FOLFOX4(oxaliplatin+CF+5-FU)三种化疗方案治疗晚期胃癌的临床疗效和不良反应.方法:回顾性分析65例晚期胃癌患者,根据化疗方案分为TPF方案组(21例)、HPLF方案组(19例)和FOLFOX4方案组(25例),对三组疗效和不良反应进行比较.结果: TPF组、HPLF组、FOLFOX4组有效率分别为57.14%、52.63%和56%,三组疗效相比无统计学差异(P>0.05);中位进展时间(TTP)分别是6.6月、6.1月和6.2月(P>0.05);三组不良反应主要为胃肠道反应、外周神经毒性和脱发,除TPF组与FOLFOX4组外周神经毒性差异有显著性(P<0.05)外,余均无统计学差异(P>0.05).结论:三种方案均是治疗晚期胃癌较为有效的化疗方案,但TPF方案治疗晚期胃癌耐受性较好,生活质量较高,值得临床推广.     

含长春瑞滨方案治疗晚期乳腺癌的临床观察

目的观察和比较长春瑞滨为基础的两组联合化疗方案二线治疗蒽环和紫杉类药物耐药的晚期乳腺癌的有效率、中位疾病进展时间（mTTP）和不良反应,同时探讨联合化疗对老年乳腺癌的作用及安全性。方法对蒽环类和紫杉类药物失败的晚期乳腺癌患者53例采用长春瑞滨联合顺铂（NP）或联合卡培他滨（NX）方案治疗,其中有8例为老年乳腺癌（≥70岁）,采用NX方案。结果 NP组23例,CR2例（8.7%）,PR10例（43.5%）,总有效率为52.2%,mTTP为8个月（95%CI为6.16～8.80个月）。NX组（〈70岁）22例,CR2例（9.1%）,PR12例（54.5%）,总有效率为63.6%,mTTP为8.5个月（95%CI为6.71～9.29个月）。两组有效率差异无显著性（P=0.436）。8例老年乳腺癌（≥70岁）中,CR1例,PR3例,SD2例,PD2例,mTTP为6.5个月（95%CI为3.16～12.09个月）。两种化疗方案不良反应主要有骨髓抑制及消化道反应,在〈70岁患者中NX方案恶心呕吐发生率较NP方案低,差异有显著性（P=0.04）。NX方案还可见皮肤色素沉着及手足综合征。结论含长春瑞滨方案对蒽环类和紫杉类药物失败的晚期乳腺癌均有较好的疗效,但NX方案消化道反应发生率较低。NX方案对于老年晚期乳腺癌治疗具有一定的疗效和安全性。     

三氧化二砷注射液治疗中晚期原发性肝胆癌的临床研究

目的 评价三氧化二砷（As2O3)治疗原发性肝胆癌的疗效和不良反应。方法 中晚期原发性肝胆癌共33例,其中肝癌29例,胆囊癌4例。单药As2O3注射液15mg,静脉滴注,1次／d,连用14－21d为一周期,间歇2周重复。结果 总缓解率15．2％,其中原发性肝癌PR4例,NC21例,PD4例。缓解率13．8％;胆囊癌CR1例,NC2例,PD1例。主要不良反应为轻度的骨髓抑制和肝功能损害。结论 As2O3治疗原发性肝胆癌有较好疗效,不良反应少,值得进一步深入研究。     

Combination chemotherapy for advanced breast cancer: two regimens containing adriamycin

Forty-eight women with advanced metastatic carcinoma of the breast were treated with one of two combination chemotherapy regimens: 1) adriamycin and cyclophosphamide or 2) adriamycin, cyclophosphamide, methotrexate and 5-fluorouracil. The response rate in the two-drug treatment group was 50% and in the four-drug treatment group, 55%. The median duration of response was ten months in both treatment groups. Dramatic responses were seen in patients with visceral metastases. Patients who responded to chemotherapy had a significantly longer survival than nonresponders (p less than 0.01). The long interval between adriamycin doses (six weeks) in the four drug regimen did not adversely effect the response rate--an important finding in view of the dose-related cardiac toxicity of this agent.     

以国产紫杉醇为主治疗晚期肺癌31例

目的 评价以紫杉醇为主的化疗方案治疗晚期肺癌的疗效和毒副反应。方法 紫杉醇135－175mg/m^2，第1天给药，21天重复；或紫杉醇45－70mg/m^2，第1、8、15天给药，21天或28天重复，分别与铂类、异环磷酰胺联合治疗31例晚期非小细胞肺癌（ⅢB期2例，Ⅳ期25例）、小细胞肺癌（广泛期1例，局限期3例）。结果 可评价疗效者29例，无完全缓解病例，部分缓解率为31.0%（9／29）。初治、复治者有效率分别为38.5%(5/31)、25.0%(4/16)(P=0.668）。非小细胞肺癌有效率为24.05(6/25），小细胞肺癌有效率3／4。全组毒性反应主要为血液学毒性（28／31，90.3%）和恶心／呕吐（28／31，90.3％），结论 以国产紫杉醇为主联合化疗对晚期肺癌有较好疗效，不良反应可耐受。     

两种化疗方案治疗结直肠癌术后放疗后复发患者的临床观察

目的观察L-OHP+5-Fu+CF与5-Fu+CF两种化疗方案的疗效和毒副反应,及患者对两种方案的接受程度。方法将53例患者分为两组,L-OHP+5-Fu+CF治疗组(简称A组)29例,5-Fu+CF治疗组(简称B组)24例。结果治疗后两组均未出现完全缓解病例。A组PR 7例,有效率24.1%;B组PR 5例,有效率20.8%。A组化疗后患者自觉症状缓解率为82.8%(24/29),B组62.5%(15/24)。A组患者对化疗的接受率为35.9%(11/29),B组75.0%(18/24)。A组1,2,3年生存率分别为86.2%、48.3%和31.0%,B组分别为83.3%、41.7%和25.0%。毒副反应B组高于A组,以末梢神经毒性,白细胞、红细胞下降及恶心、呕吐为主,程度多为Ⅰ、Ⅱ级,多数患者可耐受。结论两组化疗方案相比较,在疗效方面,L-OHP+5-Fu+CF方案并未优于5-Fu+CF方案,但L-OHP+5-Fu+CF组毒副反应高于5-Fu+CF组,两组均可耐受。     

CapeOX和SOX化疗方案治疗晚期结直肠癌的疗效观察

目的 探讨奥沙利铂+卡培他滨(CapeOX方案)和奥沙利铂+替吉奥(SOX方案)化疗治疗晚期结直肠癌的临床疗效.方法 选取2015年1月至2017年1月间大连大学附属新华医院收治的100例晚期结直肠癌患者,采用随机数字表法分为观察组和对照组,每组50例.观察组患者采用CapeOX方案化疗,对照组患者采用SOX方案化疗,...