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1.
The aim of this study was to evaluate the predictive value of five different biological factors in breast cancer patients treated with neoadjuvant anthracycline-based chemotherapy: (1) tumour grade scored according to the Elston-Ellis classification, (2) hormonal receptor (HR) status; (3) tumour cell proliferation evaluated by Ki-67 staining, (4) HER-2 and topoisomerase II alpha (TopoIIalpha) expression evaluated by immunohistochemistry (IHC), (5) HER-2 and TopoIIalpha amplification evaluated by real-time polymerase chain reaction (PCR). 119 patients with operable breast cancer were treated with six cycles of FEC (100 5-fluorouracil (5-FU) 500 mg/m2, Epirubicin 100 mg/m2, Cyclophosphamide 500 mg/m2). Tumour response was assessed clinically and by computed tomography (CT) scan, then by pathological assessment. The clinical overall response (OR) was 80%, with 19% of complete responders (CR). The radiological OR was 71%, with 16% of CR. A pathological CR was demonstrated in 13% of the patients according to the Sataloff classification. In the multivariate analysis, the absence of HR expression and Ki-67 > or = 20% were predictive for a clinical CR. A high tumour grade was predictive for a pathological CR. Overexpression or amplification of HER2 or Topollcalpha were not predictive of response.  相似文献   

2.
Purpose:To examine the activity and safety of two sequentiallyscheduled chemotherapy regimens comprising four cycles of paclitaxel (pctx)200 mg/m2/3 hours then four cycles of cisplatin (cisDDP) 100mg/m2, and vice versa, in patients with previouslyuntreated advanced ovarian cancer. Patients and methods:Between January 1994 and February 1996, werecruited 30 patients to the pctx-then-cisDDP regimen and 29 tocisDDP-then-pctx, in parallel phase II trials. Results:Both regimens were predictably active with responses seenin 22 of 30 patients (OR 74%; CR 27%, PR 47%) treatedwith pctx-then-cisDDP, as against 13 of 21 patients (OR 62%; CR38%, PR 24%) treated with cisDDP-then-pctx. The OR rate to fourcycles of pctx (induction) was 43%, with 27% diseaseprogression; the OR to four cycles of cisDDP (induction) was 57%, with5% progression. However, progression rates across both induction andconsolidation phases were 16% (pctx-then-cisDDP) and 29%(cisDDP-then-pctx). Both regimens were unacceptably neurotoxic, 11 patientssuffering grade 3 sensory neurotoxicity (5 on pctx-then-cisDDP, 6 oncisDDP-then-pctx) and 20 having grade 3 deafness (9 on pctx-then-cisDDP, 11on cisDDP-then-pctx). Conclusion:The activity of these sequential regimens justifiestheir further development using the less neurotoxic platinum analoguecarboplatin, perhaps combining paclitaxel with other platinum non-crossresistant drugs.  相似文献   

3.
In an earlier study of previously untreated patients with chronic lymphocytic leukemia (CLL), we used a concomitant combination of chlorambucil and 2-chlorodeoxyadenosine and reported overall (OR) and complete (CR) remission rates of 80% and 20%, respectively. After a median follow-up of 5 years, more than 80% of the responders have had a relapse. In the current phase II study of 27 previously untreated patients with CLL, we used a sequential combination of six cycles of intravenous cyclophosphamide (1 g/m2) plus oral prednisone (100 mg/m2 per day for 5 days) followed by two to six cycles of 2-chlorodeoxyadenosine (5 mg/m2 per day for 5 days). The OR and CR rates were 96% and 33%, respectively. After a median follow-up of 29 months, 35% of the responders have had a relapse. Progression-free survival was significantly better in CR patients than in those with partial remission. However, minimal residual disease was phenotypically detected in four of the nine CR patients. Despite the fact that the current OR and CR rates are superior to those seen in a historical cohort treated with a concomitant schedule, a longer follow-up period is needed to assess the durability of these remissions, and a controlled trial is necessary to estimate the impact on overall survival and toxicity.  相似文献   

4.
采用ADMV(ADM+DDP+MMC+MMC+VP-16)方案联合化疗,对62例中晚期非小细胞肺癌近期疗效观察,CR2例,PR18例,NR32例,PD10例,总有效率(CR+PR)32.26%(20/62)。化疗毒副反应主要是消化道反应(59.68%)及骨髓抑制(白细胞下降占61.29%)。  相似文献   

5.
A hospital-based case-control study of multiple myeloma in whites (100 cases and 100 controls from seven Baltimore hospitals) was conducted to examine a number of postulated risk factors. Cases and controls were matched on age, sex, hospital, and year of diagnosis. Distributions by marital status and religious affiliation were found to be similar. Educational levels of cases were similar to controls except for postcollege schooling, where there was a slight excess of cases (6%) compared to controls (3%). No statistically significant associations were found between multiple myeloma and prior history of medical conditions believed to cause prolonged stimulation of the immune system including chronic bacterial infections [odds ratio (OR) = 0.8], autoimmune disorders (OR = 1.0), allergy-related disorders (OR = 1.0), or lymphoid tissue surgery (OR = 1.2). Statistically significant positive associations were found for occupational exposure to petroleum products (OR = 3.7; 1.3-10.3) and asbestos (OR = 3.5; 1.0-12.0). No increased risk was found for cigarette smoking or alcohol consumption or for employment in a variety of industries and occupations implicated in earlier studies. A significantly elevated risk was found for prior use of laxatives (OR = 3.5; 1.1-11.1), and elevated (OR greater than or equal to 1.8) but nonsignificant risks were found for use of other medications including diphenylhydantoin, phenobarbital, diazepam, propranolol, ibuprofen, and diet drugs and stimulants. These findings require clarification in larger, population-based studies.  相似文献   

6.
目的 探讨不同剂量TP方案化疗联合同步放疗治疗局部晚期食管癌疗效及毒副反应。方法 53例局部晚期食管癌患者分成三组:大剂量紫杉醇+顺铂联合放疗组(以下简称大剂量组:DDP 100 mg/m2,d1;PTX 175 mg/m2 ,d1)18例;小剂量紫杉醇+顺铂联合放疗组(以下简称小剂量组:DDP 20 mg/m2 ,d1-5;PTX 20 mg/m2 ,d1、3、5)16例;单纯放疗组19例。化疗21天为1个周期;放疗采用三维适形放疗,常规分割,总剂量60 Gy/6 W。结果 大剂量组、小剂量组、单纯放疗组完全缓解(CR)率、有效率(CR+PR)及1年生存率分别为58.8%、81.3%、26.3%;88.2%、93.8%、57.9%及94.1%、100%、73.7%。三组比较,大、小剂量组CR率、CR+PR率均较单纯放疗组有统计学差异,P<0.05;小剂量组与单纯放疗组在1年生存率上差异有统计学意义,P<0.05。毒副反应大剂量组在骨髓抑制、胃肠道反应、脱发,较小剂量组、单纯放疗组差异有统计学意义,P<0.05。结论 小剂量TP方案化疗联合同步放疗治疗局部晚期食管癌,疗效较好,毒副反应可以耐受。  相似文献   

7.
Surgical treatments for early gastric cancer, such as endoscopic procedures, are currently performed as standard therapy. However, when surgery is not possible due to physical or mental conditions, effective chemotherapy with minimum side effects is a second choice, although a suitable regimen has yet to be recommended. We thus retrospectively evaluated the Int FP regimen for 10 early gastric cancer patients. The results show an efficacy ratio of 100% (CR 8 cases, PR 2 cases). The two PR cases subsequently underwent surgical treatment. The 1-, 3-, and 5-year survival rates of all cases were 100%, 90% and 60%, respectively. The 1-, 3-, and 5-year survival rates of patients with chemotherapy alone were 100%, 87.5% and 50%, respectively, although none of the patients died of cancer (5-year survival rate of 100%). One out of the 8 CR cases relapsed 7 months after achieving CR. This patient then received chemotherapy with the same regimen, achieving a second CR and survived for 66 months without disease. All cases developed hematological toxicities, although they were all under grade 2 except for 2 cases which were grade 3 (decrease of WBC or Hb). Non-hematological toxicities were seen in 7 cases, all under grade 2. These results, although from a limited number of subjects, indicated that the IntFP regimen is safe and may contribute to achieving pathological CR and long-term survival of patients with early gastric cancer.  相似文献   

8.
目的 对比来曲唑和氨鲁米特治疗妇女绝经后晚期乳腺癌患者的有效性和耐受性。 方法 采用开放、随机、多中心对照研究。患者随机分组接受口服来曲唑2.5mg.d-1或氨鲁米特1g.d-1的对照治疗。 结果 来曲唑组(n=59)有效率23.73%(CR 2例,PR 12例,ITT有效率21.88%),SD 20.31%(13例)。氨鲁米特组(n=54)有效 率11.11%(CR 1例,PR 5例,ITT有效率10.17%),SD 20.34%(12例),2组疗效无统计学差异(P>0.05)。来曲唑组和氨鲁米特 组不良反应发生率分别为18.64%和42.11%,与治疗相关的不良反应发生率分别为13.56%和33.33%。比较2组总的和与治疗 相关的不良反应发生率均以来曲唑组明显较低,P值均为0.002。 结论 来曲唑对绝经后、ER/PR阳性或不明的晚期乳腺癌患者有效率为23.73%,与氨鲁米特比较无统计学差异。但来曲唑不良 反应较氨鲁米特明显低,可以代替氨鲁米特用于晚期绝经后受体阳性或不明乳癌患者的治疗。  相似文献   

9.
根据肿瘤细胞药敏结果指导治疗急性白血病40例   总被引:1,自引:0,他引:1       下载免费PDF全文
 目的:了解肿瘤细胞药敏试验在治疗急性白血病中的临床意义。方法:取患者外周血或骨髓2ML进行离心、冲洗干燥处理后进行计数。结果:治疗组40例,32例获完全缓解,其中19例一疗程完全缓解,13例2疗程完全缓解,完全缓解率30%。2例部分缓解。对照组35例中22例完全缓解,完全缓解率为62.8%,6例部份缓解,二组完全缓解率对比有显著性差异(0.05>P>0.01)。结论:根据肿瘤细胞药敏结果指导治疗急性白血病疗效满意。  相似文献   

10.
目的对比来曲唑和氨鲁米特治疗妇女绝经后晚期乳腺癌患者的有效性和耐受性。方法采用开放、随机、多中心对照研究。患者随机分组接受口服来曲唑2.5mg.d~(-1)或氨鲁米特1g.d(-1)的对照治疗。结果来曲唑组(n=59)有效率23.73%(CR 2例,PR 12例,ITT 有效率21.88%),SD 20.31%(13例)。氨鲁米特组(n=54)有效率11.11%(CR 1例,PR 5例,ITT 有效率10.17%),SD 20.34%(12例),2组疗效无统计学差异(P>0.05)。来曲唑组和氨鲁米特组不良反应发生率分别为18.64%和42.11%,与治疗相关的不良反应发生率分别为13.56%和33.33%。比较2组总的和与治疗相关的不良反应发生率均以来曲唑组明显较低,P 值均为0.002。结论来曲唑对绝经后、ER/PR 阳性或不明的晚期乳腺癌患者有效率为23.73%,与氨鲁米特比较无统计学差异。但来曲唑不良反应较氨鲁米特明显低,可以代替氨鲁米特用于晚期绝经后受体阳性或不明乳癌患者的治疗。  相似文献   

11.
经皮股动脉植入导管药盒系统治疗转移性肝癌   总被引:1,自引:0,他引:1       下载免费PDF全文
 目的 探讨经皮股动脉植入导管药盒系统的临床疗效。方法  30例转移性肝癌采用经皮股动脉植入导管药盒系统。依据肿瘤供血特点 ,在透视监控下 ,施行导管药盒系统植入式。结果 CR3例、PR1 4例、CR+PR5 6 .7% ,半年生存率 1 0 0 % ,1年生存率 5 3.3% (1 6 / 30 ) ,2年生存率1 6 .7% (5 / 30 ) ,无 1例严重并发症发生。结论 经皮股动脉植入导管药盒系统治疗转移性肝癌是安全可行 ,有效的。  相似文献   

12.
The clinical application of photodynamic therapy (PDT) began in the late 1970's. Hematoporphyrin derivative has been used as a photosensitizer and recently Photofrin II (Dihematoporphyrin ether, DHE) was also developed as a second generation photosensitizer. The argon dye laseris used to excite the photosensitizer, however an eximer dye laser was recently developed as more effective laser. In a multicenter research study project team (7 institutions) on photodynamic therapy organized by the Ministry of Health and Welfare, 133 cases of gastric cancer (including 120 cases of early stage cancer), 209 cases of lung cancer (69 cases of early stage cancer), 66 cases of esophageal cancer (22 cases of early stage cancer), 68 cases of bladder cancer (68 cases of early stage cancer), and 86 cases of other organ cancers were treated. In early stage cancer cases 77.3% showed complete remission (CR) but among those the recurrence was 15.7% in lung cancer cases and opposed to 100% CR and 22.2% recurrence in gastric cancer cases, 80% CR and no recurrence in esophageal cancer cases, and 68.6% CR and 58.3% recurrence in bladder cancer cases. Especially in limited lesions less than 1 cm in diameter, the CR was obtained in 100% and the recurrence was recognized in only 1 (2.6%) of 28 lung cancer lesions, 100% CR and no recurrence was obtained in 30 lesions of gastric cancer and also 100% CR with no recurrence was recognized in 16 lesions in bladder cancer. This study suggests that PDT has the potential to cure early stage cancer lesions.  相似文献   

13.
目的:分析我中心2007年至2013年确诊的34例Burkitt淋巴瘤(BL)的病理、临床特征及12例临床特点和预后关系。方法:回顾分析2007年-2013年我中心确诊的34例BL(占淋巴瘤总数1.43%,B细胞淋巴瘤2.03%)的病理资料及12例接受治疗的患者临床资料,治疗方法为[hyperCVAD(A+B)±R(利妥昔单抗)]±自体造血干细胞移植(allo-HSCT),观察短期疗效[完全缓解(CR)和部分缓解(PR)]和长期疗效[包括1年和2年总生存率(OS)及无进展生存率(PFS)],分析预后影响因素。结果:34例患者中男∶女=10∶7,中位年龄23.5岁(3~74岁),0~14岁29.4%(10/34),15~22岁23.5%(8/34),大于22岁47.1%(16/34)。全身各脏器均可发病,主要以浅表淋巴结、脑部及鼻咽部为主。Ki-67指数均大于95%以上;c-myc阳性77%(10/13)。其中12例在我中心接受治疗,Ⅱ期1例(8.4%),Ⅲ-Ⅳ期11例(91.7%)。诱导治疗:11例(91.7%)采用hyperCVAD(A+B)方案化疗,3疗程后2例达PR,9例(82%)达CR。9例达CR的患者中有1例采用CHOPE方案巩固化疗,1年内复发;5例采用hyperCVAD(A+B)巩固化疗6疗程,1例1年后复发,2年OS及PFS分别为100%、80%。3例采用hyperCVAD(A+B)+利妥昔单抗(R)方案巩固化疗6疗程,2年OS及PFS均为100%,PFS较未用R组高。3例在巩固、维持治疗后序贯allo-HSCT,随访至2年无复发,病情稳定,OS及PFS均为100%。随访2年无复发8例,年龄小于15岁占50%(4/8),15~22岁占37.5%(3/8),大于22岁占12.5%(1/8)。结论:BL主要发生在儿童和青少年,男性高于女性,可累及全身各个器官,诊断时临床分期常较高,需要高强度、高频率、足疗程、规律化疗,尤其是儿童及青少年患者。利妥昔单抗和大剂量化疗药物协同使用,序贯自体造血干细胞移植巩固治疗能提高OS率与PFS,但仍需要临床大样本研究。  相似文献   

14.
Liang CH  Liu Q  Zhou FJ  Gao X  Chen LW 《癌症》2007,26(5):484-488
背景与目的:前列腺癌(prostate cancer)是欧美发达国家老年男性的常见恶性肿瘤之一,中国前列腺癌的发病率较低,但逐年上升.国内前列腺癌的病因学研究主要集中于上海、武汉和北京等地区,而来自广东地区的报道较少.本研究旨在探讨广东地区前列腺癌与家族史和婚育史的病因学关联.方法:在中山大学4所附属医院开展一项病例对照研究(1:2配对),匹配条件为年龄组(±5岁)、性别、民族和居住地类型相同.调查以面谈为主,辅以调查病历记录,采用条件Logistic回归法分析数据.结果:本次调查共获得有效资料186份,其中前列腺癌患者62例,良性前列腺增生的患者62例和其他疾病对照62例.以前列腺增生为对照,遗精年龄小于15岁者患前列腺癌的危险是18岁以上者的6.37倍(95%CI=0.63~63.95);与30岁以上首次进行性生活者相比,首次性生活年龄小者患前列腺癌的危险增高,20~24岁组OR=2.25(95%CI=0.75~6.71),25~29岁组OR=2.34(95%CI=0.89~6.13);60岁以后失去性生活者是前列腺癌的保护因素,60~69岁OR=0.51(95%CI=0.20~1.27),70岁及以上组OR=0.31(95%CI=0.08~1.24).以其它疾病为对照,有一个一级亲属患恶性肿瘤者患前列腺癌的危险是无恶性肿瘤家族史的2.25倍(95%CI=0.69~7.31);首次性生活年龄小于20岁者患前列腺癌的危险是30岁及以上者的5.07倍(95%CI=0.50~51.46);而60岁以后失去性生活者是前列腺癌发生的保护因素,60~69岁组OR=0.55(95%CI=0.24~1.26),70岁及以上组OR=0.41(0.11~1.47).结论:首次遗精年龄和首次性生活年龄较早均为前列腺癌的危险因素,有恶性肿瘤家族史者患前列腺癌的危险增加.  相似文献   

15.
目的 探讨小剂量(LD)-高三尖杉酯碱+阿糖胞苷(HA)方案诱导治疗急性髓系白血病(AML)(除外M3)的临床效果.方法 对52例接受LD-HA方案诱导治疗的AML患者资料进行回顾性分析,并依据分子生物学和细胞遗传学危险度分级,观察临床疗效、不良反应,随访长期生存,以同期49例伊达比星+阿糖胞苷(IA)方案治疗患者为对照.结果 1个疗程后,LD-HA组总有效(OR)率为71.2%(37/52)[完全缓解(CR)率50.0%(26/52),部分缓解(PR)率21.2%(11/52)],IA组OR率为53.1%(26/49)[CR率44.9%(22/49),PR率8.2%(4/49)],两组OR率差异无统计学意义(P=0.068).按危险度分层,LD-HA组高危组的OR率高于IA组[100%(11/11)比66.7%(12/18)],差异有统计学意义(P<0.05);LD-HA组和IA组的低危组和中危组OR率差异无统计学意义(P>0.05).LD-HA组心脏毒性及骨髓抑制均较IA组轻,不适合标准方案的AML患者亦对其耐受良好.结论 LD-HA方案诱导治疗AML时,高危组OR率高,化疗相关不良反应发生率低,安全性较高.与标准方案相比,LD-HA对于高危AML患者可能更有效.  相似文献   

16.
Sixty-two patients with squamous cell carcinoma of the head and neck were administered a mean total dose of 75.9 g carmofur (HCFU) in combination with a mean total dose of 49.0 Gy irradiation therapy. The primary sites of cancer were: larynx 29 cases, oral cavity 11 cases, nasal and paranasal cavity 7 cases, hypopharynx 5 cases, nasopharynx 5 cases, epipharynx 3 cases, and others 2 cases. The clinical stages were: stage I II cases, stage II 15 cases, stage III 17 cases, and stage IV 19 cases. In 57 evaluable patients having measurable lesions, overall response rate, including 26 complete responses (CR) and 16 partial responses (PR), was 73.7%. Average doses of HCFU were 13.1 g at PR, 27.8 g at CR, and those of irradiation were 27.7 Gy at PR, 48.5 Gy at CR. The median duration of PR was 44.8 weeks and that of CR was 47.0 weeks, the overall response interval being 47.7 weeks. Of the 62 patients, 25 (40.3%) complained of side effects including pollakisuria (9 cases), appetite loss (6 cases), stomatitis (5 cases), and so on.  相似文献   

17.
乳腺癌肺转移的放化疗评价   总被引:6,自引:0,他引:6  
目的以乳腺癌肺转移患者进行放、化疗评价。方法68例乳腺癌肺转移病人中8例为单发转移灶,行局部放疗合并化疗;60例为多发转移灶,给予CMF、CAF、CAP三阶梯方案化疗。结果8例单发转移灶放疗后CR3例,PR3例,合并化疗后CR62.5%,PR37.5%;60例多发转移灶病人先予CMF方案,CR28.3%,PR23.3%,缓解率51.7%,无效病人依次使用CAF、CAP方案,CR分别为11.6%,19.0%。三方案毒性反应依次增加。结论放疗对局部转移灶的控制是重要的,CMF应为乳腺癌肺转移的首选方案,CMF、CAF、CAP依次使用有利于提高完全缓解率,延长生存期。  相似文献   

18.
目的:评价培美曲塞(pemetrexed,PEM)联合奈达铂(nedaplatin,NDP)方案一线治疗晚期肺腺癌的疗效及安全性。方法:采用培美曲塞联合奈达铂治疗93例Ⅲb、Ⅳ期肺腺癌患者,所有患者化疗至少2周期后评价客观有效率(RR)、疾病控制率(DCR)、无疾病进展时间(PFS)、1年及2年生存率,并观察患者的不良反应。结果:93例患者中,完全缓解0例(0.0%),部分缓解48例(51.6%),稳定26例(28.0%),进展19例(20.4%),客观有效率(RR)为51.6%,疾病控制率(DCR)为79.6%,中位无进展时间(mPFS)为6.3个月,中位总生存时间(mOS)为18个月,1年、2年生存率分别为62%、27%,主要毒副反应为骨髓抑制及胃肠道反应。不良反应可耐受。结论:培美曲塞联合奈达铂方案一线治疗晚期肺腺癌有效、耐受性良好。  相似文献   

19.
High-dose chemotherapy with autologous bone marrow transplantation is used in the treatment of relapsed or high-risk Hodgkin''s disease. As prospective randomised studies have proved difficult to accrue to, current recommendations are based on the reports of large series of prospectively collected data. We have looked at the outcome of 89 patients treated in this way at a single institution and have developed an index to predict outcome. Of 89 patients, with a median age of 29 years (range 15-51 years), eight patients were in first complete remission/partial remission (CR/PR), 17 in second or later CR, 37 were responding relapses, 13 resistant relapses, 11 primary refractory and three untested relapses. Combinations of melphalan, BCNU and etoposide were given in all cases except in ten patients who received melphalan alone. The median follow-up was 43 months (range 6-77 months). A total of 24 patients were in CR at the time of autologous bone marrow transplantation (ABMT), 33 achieved CR with ABMT, 16 PR, to give a response rate to ABMT of 49/65 = 74% (95% CI 60-83%) with a CR rate of 51% (CI 36-62%). In a Cox''s multivariate analysis the most important factors in predicting outcome after ABMT were response to treatment before entry, number of previous treatments and previous chemosensitivity. Using these factors we devised a prognostic index which reliably selects a group of patients (65%) with at least a 70% chance of being progression free from 1 year onwards. Patients who have never achieved a CR and have received three or more chemotherapy regimens do not benefit from high-dose chemotherapy as used in this study.  相似文献   

20.
  目的 研究影响急性早幼粒细胞白血病(APL)长期生存的相关因素。方法 回顾性分析62例APL的临床资料,应用Log-Rank检验和COX回归模型对62例患者的性别、年龄、初诊时白细胞计数、初诊时血小板计数、初诊时血清乳酸脱氢酶水平、诱导缓解方案、获得缓解所需时间、缓解后治疗方案进行单因素和多因素分析。结果 62例患者中位随访31(6~102)个月,5年预计总体生存率(OS)为(77.1±6.2)%,5年预计无复发率(RFS)为(71.4±3.68)%。单因素分析显示,初诊时白细胞计数、诱导缓解方案、获得缓解所需时间、缓解后治疗方案是影响APL患者长期生存的主要因素;多因素分析显示,初诊时白细胞计数、缓解后治疗方案是影响APL患者长期生存的独立因素。结论 APL患者获得完全缓解后,应用全反式维甲酸(ATRA)+三氧化二砷(As2O3)+化疗的序贯治疗方案将显著延长患者的生存时间。  相似文献   

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