含奥沙利铂方案动脉化疗治疗转移性肝癌

目的　观察经肝动脉灌注奥沙利铂、氟尿苷和表阿霉素治疗转移性肝癌的疗效及毒副反应。方法　 2 3例转移性肝癌经肝动脉灌注奥沙利铂、氟尿苷、表阿霉素和碘油 ,每例完成 2～ 3次后评价疗效及毒副反应。结果　2 3例中部分缓解 11例 ,总有效率 4 7.8% ,1、2年生存率分别为 6 2 .4 %和 4 1.7% ,主要毒副反应为胃肠道反应及骨髓抑制。结论　经肝动脉灌注奥沙利铂、氟尿苷和表阿霉素治疗转移性肝癌安全有效     

吡柔比星联合用药肝动脉化疗栓塞治疗中晚期肝癌近期临床疗效分析

观察吡柔比星联合用药与丝裂霉素联合用药肝动脉灌注化疗栓塞治疗中期期直癌的疗效与毒副反应。方法治疗组：吡柔比星,羟基喜树碱,５氟尿嘧啶,顺铂,治疗４８例肝癌。对照组：丝裂霉素,５ＦＵ,ＯＰＴ,ＤＤＰ,治疗３６例肝癌,直动脉灌注化疗栓塞共８４例中晚期肝癌。     

经肝动脉灌注化疗并栓塞治疗转移性肝癌的临床疗效

分析了１１８例转移性肝癌经肝动脉插管灌注化疗或并栓塞治疗２２４人次的经验以评价其临床疗效。灌注化疗并碘油乳剂及明胶海绵碎屑栓塞７２例，灌注化疗并碘油乳剂栓塞３２例，单纯灌注化疗１４例。结果显示灌注化疗并碘油乳剂及明胶海绵栓塞者疗效最佳，单纯灌注化疗效果较差。肝内单发转移和多血病变姑息效果最好。本组１，３，５年生存率分别为８６．０％，２５．０％及３．０％。作者认为，经肝动脉插管灌注化疗并栓塞治疗是姑息治疗转移性肝癌的较好方法     

肝动脉灌注奥沙利铂合并栓塞治疗晚期肝癌的临床观察

目的：观察奥沙利铂（Oxaliplatin，L-OHP）肝动脉灌注栓塞化疗对晚期原发性和继发性肝癌的临床疗效和毒副作用。方法：32例晚期肝癌患者，其中原发性肝癌20例，转移性肝癌12例，经皮股动脉穿刺插管至腹腔动脉，并超选至肝肿瘤的供血血管后灌注药物，L-OHP 130mg／m^2，氟尿嘧啶脱氧核苷（FUDR）500～750mg／m^2，并以丝裂霉素（MMC）6～8mg/m^2＋超液化碘油10～30ml乳化后进行血管栓塞。对于转移性肝癌在介入化疗后第2天起并给予FUDR350～500mg／m^2、四氢叶酸钙（CF）200mg／m^2静脉滴注，连用3天，间隔4～6周重复给药1次。疗效和毒副反应按WHO实体瘤近期疗效和抗癌药毒性评定标准评定。结果：全组32例均可进行评价。CR2例，PR13例，PD1例，SD16例，有效率（CR＋PR）为46．9％，其中原发性肝癌的有效率为40．0％，转移性肝癌的有效率为58．3％。毒副反应主要是恶心、呕吐、白细胞减少及一过性肝功能损害，末梢神经炎的发生率并不高，程度也不重；未见心脏、肾脏损害。结论：采用以奥沙利铂为主的肝介入疗法治疗晚期肝癌疗效肯定，安全性好，患者可以耐受，值得进一步研究。     

介入球囊间断阻肯动脉血流合并华蟾素灌注治疗晚期肝癌

目的：探讨采用介入球囊间断肝动脉血流合并华蟾素灌注治疗晚期肝癌的疗效。方法：经左锁骨下动脉置入球囊导管于肝动脉血流，合工中药华蟾素混合碘油栓塞，华蟾素肝动脉灌注，治疗１０例晚期肝癌。结果：ＰＲ８例，ＮＣ２例，大部分临床症状得到改善，无明显的副作用。结论：本方法可使肝癌多次缺血并得到药物灌注的双重作用，从而提高了晚期肝癌的临床疗效，延长生存期，尤适合于肿瘤较大，并有一定程度肝功能损害的肝癌患者，此方     

经肝动脉灌注榄香烯联合肝动脉化疗栓塞术治疗不可切除肝癌的疗效观察

目的:观察经肝动脉灌注榄香烯联合肝动脉化疗栓塞术(TACE)治疗不可切除肝癌的近期疗效及不良反应.方法:选取我院2015年1月至2016年10月收治的48例不可切除的肝癌患者,将其随机分为观察组24例和对照组24例,对照组给予TACE治疗(雷替曲塞3 mg/m2、奥沙利铂100 mg/m2、表柔比星40 mg/m2),...     

经肝动脉灌注化疗配合栓塞术治疗原发性肝癌的临床分析

寿光市人民医院肿瘤科对47例有介入化疗治疗适应证的原发性肝癌患者行肝动脉灌注化疗及栓塞治疗，部分患者应用草酸铂为主的联合化疗方案经肝动脉灌注，结果总结报道如下。     

介入球囊间断阻断肝动脉血流合并华蟾素灌注治疗晚期肝癌

目的 :探讨采用介入球囊间断阻断肝动脉血流合并华蟾素灌注治疗晚期肝癌的疗效。方法 :经左锁骨下动脉置入球囊导管于肝动脉内 ,间断阻断肝动脉血流 ,合并中药华蟾素混合碘油栓塞 ,华蟾素肝动脉灌注 ,治疗 10例晚期肝癌。结果 :PR 8例 ,NC 2例 ,大部分临床症状得到改善 ,无明显的副作用。结论 :本方法可使肝癌多次缺血并得到药物灌注的双重作用 ,从而提高了晚期肝癌的临床疗效 ,延长生存期 ,尤适合于肿瘤较大 ,并有一定程度肝功能损害的肝癌患者 ,此方法值得进一步观察和研究     

奥沙利铂联合表柔比星经肝动脉化疗栓塞术治疗原发性肝癌的临床观察

目的 探讨奥沙利铂联合表柔比星经肝动脉化疗栓塞术(TACE)治疗原发性肝癌的疗效.方法 将原发性肝癌患者80例随机分为对照组和观察组,均40例.对照组应用单纯肝动脉栓塞治疗,观察组给予奥沙利铂联合表柔比星经TACE治疗.比较2组血清中癌胚抗原(CEA)和甲胎蛋白(AFP)水平、不良反应、疗效及治疗后1年内死亡率.结果 治疗后6周,观察组患者血清中CEA和AFP水平显著低于对照组(P<0.01).观察组患者的总缓解率为62.50%,显著高于对照组为37.50%(P<0.05).观察组患者的恶心呕吐发生率明显高于对照组(P<0.05),2组发热等其他不良反应发生率差异无统计学意义(P>0.05).对照组1年内有10例死亡(25.00%),观察组死亡2例(5.00%),2组差异有统计学意义(χ2=4.793,P<0.05).结论 奥沙利铂联合表柔比星经肝动脉化疗栓塞术治疗原发性肝癌疗效确切,且安全性好.     

奥沙利铂单药治疗复治晚期结直肠癌患者的Ⅱ期临床试验

背景与目的：奥沙利铂是治疗晚期结直肠癌有效的二线药物,但是由我国开发的奥沙利铂疗效及毒副作用如何,有待于临床试验研究。本试验目的是观察国产奥沙利铂单药治疗复治晚期结直肠癌患者的疗效及不良反应。方法：对复治的结直肠癌患者(既往化疗无效的晚期患者)进行奥沙利铂单药治疗。奥沙利铂130mg／m^2,静脉滴注2h,第1天,每3周重复。结果：共31例患者进入临床试验,可评价疗效者28例。1例CR,3例PR,总有效率为14．3％(按照ITT计算为12．9％)。主要的不良反应为轻度的感觉神经毒性、轻中度的骨髓抑制及恶心呕吐。结论：国产奥沙利铂治疗复治晚期结直肠癌患者有一定的疗效,不良反应较轻。     

Complete remission in a case of sigmoid colon cancer with multiple liver metastases-treatment with arterial chemotherapy and percutaneous microwave coagulation therapy

A 59-year-old man was admitted to our hospital for advanced sigmoid colon carcinoma with synchronous multiple liver metastases. The patient received sigmoidectomy with regional lymph node dissection on June 8, 1998. We started intra-arterial combination chemotherapy on July 1, 1998. MMC (4 mg/body) was administered via rapid intra-arterial infusion on day 1. After MMC administration, 5-day intra-arterial continuous infusion of 5-FU at 500 mg/body/day was performed with oral administration of LV (30 mg/body/day). The treatment cycle was defined as every three weeks. The patient was treated with 4 courses of chemotherapy. From September 30, he received intra-arterial infusion of bolus MMC 4 mg/body, LV 6 mg/body and 5-FU 1,000 mg/body/4 hrs every two weeks with oral administration of Tegafur-uracil 400 mg/day. After 4 intra-arterial chemotherapy sessions, the metastatic liver tumors disappeared except for a focus in the right lobe. Therefore we decided to give the remnant liver metastasis percutaneous microwave coagulation therapy (PMCT). He obtained a complete remission in the liver metastases after two PMCT (70 W, 60 sec) sessions. Intra-arterial chemotherapy is effective for unresectable metastatic liver tumors from colon cancer. If a patient shows a partial response on the metastatic tumors through the chemotherapy, one must consider other modalities such as PMCT.     

妊娠合并宫颈癌13例临床分析

[目的]探讨妊娠合并宫颈癌的临床特征及诊治方式。[方法]回顾性分析13例妊娠合并宫颈癌患者的临床特征、诊治经过和随访情况。[结果]13例患者,妊娠期诊断7例（孕周为18~38周,中位孕周29周）,产后6个月内诊断6例。5例ⅠA1期,均为无任何症状仅在产检时发现;ⅠB1期3例、ⅠB2~ⅡA期3例均有接触性出血或不规则阴道出血症状;ⅡB期和ⅢB期各1例,均有持续阴道出血症状。妊娠期5例ⅠA1期及1例可疑ⅠB1期行延迟治疗;2例ⅠB1期和3例ⅠB2~ⅡA期行综合治疗。[结论]宫颈细胞学筛查对妊娠合并宫颈癌患者早诊断、早治疗具有重要意义,应作为首次产检的常规项目;在妊娠中晚期发现ⅠA期和ⅠB1期宫颈癌可以考虑延迟治疗。     

A case of gastric cancer associated with synchronous liver metastasis successfully treated with combination therapy of systemic and hepatic arterial infusion chemotherapy

A 56-year-old man who underwent distal gastrectomy at another hospital was admitted to our hospital because of advanced gastric cancer with synchronous liver metastasis. As we considered that the metastatic liver tumor was unresectable one, an intra-arterial catheter was inserted and weekly chemotherapy including methotrexate (MTX) (intra-venous) and 5-fluorouracil (5-FU) (intra-arterial) was started. The metastatic liver tumor was gradually reduced and resulted in partial response (PR) after 12 courses. Eight months later, the size of the metastatic liver tumor increased and lung metastasis occurred, so we started a new regimen of chemotherapy using CPT-11 (intra-venous) and CDDP (intra-arterial). After 4 courses of this regimen, we gained PR both in the metastatic liver and lung tumor. This case indicates that the combination therapy of systemic and hepatic arterial infusion chemotherapy is a treatment option in cases of advanced gastric cancer with liver metastasis.     

Intra-arterial cellular immunochemotherapy for unresectable pancreatic cancer with liver metastasis

PURPOSE: To date, no treatment has had a significant impact on pancreatic cancer with liver metastasis. We performed locoregional cellular immunochemotherapy for unresectable pancreatic cancer with liver metastasis. SUBJECTS AND METHODS: A 71-year-old man was diagnosed for unresectable stage IVb pancreatic cancer. This patient was given intra-arterial infusion of gemcitabine (GEM) 400 mg/body and intravenous infusion GEM 600 mg/body, simultaneously. The day after GEM infusion, he was given intra-arterial autologous tumor cell activated T lymphocytes (AuTL). RESULTS: Tumor markers, such as CEA and CA19-9, had decreased a little. Primary tumor and metastatic liver tumor were reduced, but he died due to intra-abdominal dissemination within 5 months after diagnosis of unresectable pancreatic cancer. CONCLUSIONS: Reduced primary pancreatic tumor and metastatic liver tumor was obtained by locoregional cellular immunochemotherapy. But we could not control intra-abdominal dissemination. In conclusion, we suggest that intra-abdominal AuLT infusion in combination with intra-arterial AuLT infusion may be advisable to patients for unresectable pancreatic carcinoma with intra-abdominal dissemination.     

转移性结直肠癌西妥昔单抗治疗的疗效及安全性

[目的]观察西妥昔单抗对K-ras野生型转移性结直肠癌的疗效和不良反应。[方法]对34例接受西妥昔单抗单药(1例)或联合化疗(33例)治疗的K-ras野生型转移性结直肠癌患者进行疗效及不良反应分析。[结果]34例患者均可评价疗效及不良反应。全组有效率41.2%,中位无进展生存时间6.5个月,中位生存时间16.9个月。7例一线治疗患者有效率57.1%,中位无进展生存时间7.2个月,中位生存时间21.4个月。21例二线治疗患者,有效率38.1%,中位无进展生存时间6.9个月,中位生存时间15.7个月。6例三线或三线以上患者,有效率33.3%。最常见的不良反应为皮肤毒性,其次骨髓抑制,大多为Ⅰ～Ⅱ度。[结论]国人K-ras野生型转移性结直肠癌患者中,西妥昔单抗联合化疗在一线、二线及多线治疗中均获得较好的客观缓解及疾病控制,同时不良反应可耐受。     

奥沙利铂联合5-氟尿嘧啶、亚叶酸钙治疗晚期胃癌的临床疗效观察

目的探讨奥沙利铂(OXA)联合氟尿嘧啶(5-Fu)和亚叶酸钙(CF)静脉滴注治疗晚期胃癌的临床疗效和不良反应。方法治疗组36例晚期胃癌患者,第1天奥沙利铂85mg/m2,静脉滴注2h静脉滴注,亚叶酸钙(CF)400mg/m2,静脉滴注2h后,氟尿嘧啶(5-Fu)400mg/m2,静脉推注15min;再用氟尿嘧啶(5-Fu)2400mg/m2,持续静脉滴注泵连续滴注46h。每2周重复1次,化疗3个周期后评价疗效;对照组32例晚期胃癌患者,亚叶酸钙(CF)100mg/m2,静脉滴注2h,d1-5,氟尿嘧啶(5-Fu)500mg/m2,静脉滴注6h,d1-5,顺铂(DDP)20mg/m2,静脉滴注2h,d1-5,每3周重复1次,化疗2个周期后评价疗效。结果治疗组完全缓解1例,部分缓解16例,有效率为47.2%,中位疾病进展时间为5.5个月,中位生存期为10.8个月,不良反应主要为感觉神经毒性。对照组部分缓解13例,有效率为40.6%,中位疾病进展时间为4.0个月,中位生存期为8.8个月,不良反应主要为恶心呕吐。结论奥沙利铂联合氟尿嘧啶和亚叶酸钙治疗晚期胃癌近期疗效较好,不良反应轻。     

Sorafenib联合化疗治疗进展期肾癌Ⅱ期临床研究

[目的]探讨Sorafenib联合吉西他滨、5-Fu治疗晚期肾细胞癌的疗效及安全性。[方法]入组转移性肾细胞癌患者19例，其中既往细胞因子治疗失败者15例。化疗方案采用吉西他滨1g／m^2，d1.8,5-Fu 400mg／m^2静脉推注d1，随后5-Fu 2．1g／m^2 46h化疗泵泵入，每4周为1个周期。同时Sorafenib治疗，400mg／次，口服，2次／d，持续使用至疾病进展或出现不可耐受的毒副反应。[结果]19例患者均可评价疗效。客观有效率37％（7／19），临床受益率79％（15／19）。6个月的PFS百分比为37％（7／19），并且该7例患者目前均无疾病进展。常见毒副作用为Ⅲ-Ⅳ度的骨髓抑制、Ⅱ度以上的手足综合征、Ⅱ度以上的胃肠道反应、Ⅱ度以上的皮疹、Ⅰ-Ⅱ度脱发、Ⅰ-Ⅱ度高血压。[结论]研究提示Sorafenib联合吉西他滨．5-Fu治疗晚期肾细胞癌表现出了较好的疗效和一定的安全性。     

奥沙利铂联合HLF方案治疗晚期胃癌的临床研究

  目的 研究奥沙利铂（L-OHP）联合HLF[羟基喜树碱（HCPT）+ 5-氟尿嘧啶（5-Fu）／醛氢叶酸（LV）]方案治疗晚期胃癌的近期疗效及其安全性。方法 37例晚期胃癌患者均经病理学证实（男27例，女10例），以联合HLF方案予全身化疗，每4周为1周期，每例至少接受2～3周期（中位数5周期）化疗。按照WHO标准进行疗效评价。结果 37例中完全缓解（CR）1例（2.7 %），部分缓解（PR）13例（35.1 %），总有效（RR = CR+PR）率为37.8 %（14／37），Karnofsky提高20分以上者占45.9 %（17／37）。主要毒副反应为骨髓抑制和消化系统反应，恶心、呕吐发生率较高；神经毒性大多为Ⅰ~ Ⅱ度，对症处理后均能缓解。所有患者均未因严重不良反应中断或退出治疗，无化疗相关死亡病例。中位随访时间15.6个月，中位疾病进展时间（TTP） 6.2个月，中位生存期（OS） 9.2个月。结论 L-OHP联合HLF方案治疗晚期胃癌近期疗效肯定，毒副反应较轻。     

培美曲塞二钠单药治疗老年非小细胞肺癌21例

[目的]观察培美曲塞二钠单药治疗老年非小细胞肺癌的临床疗效和不良反应。[方法]经病理学或细胞学确诊的老年（65～80岁）晚期ⅢA～Ⅳ期非小细胞肺癌43例,21例患者接受培美曲塞二钠500mg/m2治疗,静脉滴注,d1;22例患者接受吉西他滨1000mg/m2治疗,d1、8、15。21d为1个周期,接受2个周期以上化疗,每2个周期评估疗效、不良反应。[结果]培美曲塞二钠组和吉西他滨组临床获益率分别是57.14%和59.09%（P=0.897）,中位生存期分别是9.5个月和8.9个月（P=0.813）,1年生存率分别是28.6%和27.3%（P=0.9244）。两组主要的不良反应是骨髓抑制和胃肠道反应,其中培美曲塞二钠组中性粒细胞降低发生率明显低于吉西他滨组（Ⅰ～Ⅱ度：19.05%vs59.09%,P=0.0073,Ⅲ～Ⅳ度：9.52%vs27.27%,P=0.0261）;培美曲塞二钠组胃肠道反应发生率也明显低于吉西他滨组（Ⅰ～Ⅱ度：14.29%vs59.09%,P=0.0017;Ⅲ～Ⅳ度：4.76%vs40.91%,P=0.0050）。[结论]培美曲塞二钠和吉西他滨单药治疗老年非小细胞肺癌疗效均较好,但培美曲塞二钠不良反应低于吉西他滨。     

A study of recurrent pancreatic cancer with metastatic liver tumors after pancreatectomy

BACKGROUND: Pancreatectomy is the best treatment for pancreatic cancer. However, there is a high risk of post-operative complications, such as local recurrence, metastatic lymphadenopathy, carcinomatosa peritonitis and liver metastasis. Presently, there is no significant treatment that has yet had a strong impact on recurrent pancreatic cancer. This study was conducted concerning recurrent pancreatic cancer with metastatic liver tumors after pancreatectomy. SUBJECTS AND METHODS: Between April 1998 and March 2005, our institute treated recurrent pancreatic cancer patients with liver metastasis. This study consisted of groups who received therapy and those who did not, and their subsequent survival rate was also studied. RESULTS: Nine cases had a recurrent pancreatic cancer with metastatic liver tumors. According to the treatment modality, the study population was classified into two groups: one group consisted of 4 patients with no treatment and the other group consisted of 5 patients who received treatment with gemcitabine (GEM). The mean survival rate for the group who received no treatment was 6.6 months. The mean survival rate for the group who received the treatment was 22.3 months. In addition, one year survival rate for those who received no treatment was 0%. The one year survival rate for those who received the treatment was 75%. The group with treatment showed better results in overall mean survival rates, as well as a higher one-year survival rate than the group with no treatment. The GEM administration included both intraarterial infusion and intravenous infusion. CONCLUSIONS: Prolongation of the survival period was obtained by administration of GEM for recurrent pancreatic cancer with metastatic liver tumors and inoperable advanced pancreatic cancer. We attempted to utilize the active treatment for recurrent pancreatic cancer with metastatic liver tumors. Thus, it was indicated that the therapy can be effective against recurrent pancreatic cancer with metastatic liver tumors.