培美曲塞、多西他赛分别联合顺铂治疗晚期非小细胞肺癌的临床疗效及安全性分析

目的:分析培美曲塞、多西他赛分别联合顺铂治疗晚期非小细胞肺癌的临床疗效及安全性.方法:选取2018年1月至2020年1月收治的晚期非小细胞肺癌患者74例,随机分为研究组和对照组(n=37),分别静脉滴注培美曲塞(500 mg·(m2)-1,Qd)+顺铂(75 mg·(m2)-1,Qd)以及多西他赛(75 mg·(m2)...     

多西他赛单药与多西他赛联合异环磷酰胺治疗复发性非小细胞肺癌的临床研究

目的评价多西他赛联合异环磷酰胺（IFO）方案与多西他赛单药治疗复发性非小细胞肺癌的疗效和不良反应。方法应用多西他赛单药方案（T）与多西他赛联合异环磷酰胺（IFＯ）方案（TI）治疗复发性非小细胞肺癌共55例。其中T组28例，TI组27例。2组病例的临床资料具有可比性。结果T、TI两组有效率分别为25％（7／28）、22％（6／27），两组间临床近期疗效无显著差异（P〉0．05）。两组主要毒性反应均表现为骨髓抑制和消化道反应，其中骨髓抑制两组的发生情况相似，无显著差异（P〉0．05）。消化道反应T组明显低于TI组，有显著差异（P〈0．05）。结论多西他赛单药与TI方案在复发性非小细胞肺癌治疗的疗效上无显著性差异。多西他赛单药仍是标准治疗方案。     

多西他赛联合奈达铂治疗晚期非小细胞肺癌临床疗效探讨

目的探讨多西他赛联合奈达铂治疗晚期非小细胞肺癌的临床疗效。方法将我院收治的84例晚期非小细胞肺癌患者随机分为多西他赛联合奈达铂治疗组（观察组）和多西他赛联合顺铂治疗组（对照组）,每组各42例,观察两组患者的临床疗效及不良反应。结果两组患者在近期疗效方面的差异无统计学意义（P＞0.05）。观察组患者治疗后的不良反应发生率为14.3%,显著低于对照组患者的50.0%,组间差异有统计学意义（P<0.05）。结论多西他赛联合奈达铂治疗晚期非小细胞肺癌临床疗效好,不良反应少,安全性高,值得临床进一步推广使用。     

伊立替康或多西他赛联合奥沙利铂治疗晚期非小细胞肺癌的临床观察

目的：观察伊立替康或多西他赛联合奥沙利铂治疗晚期非小细胞肺癌（NSCLC）的近期疗效及毒副作用。方法1晚期非小细胞肺癌68例中,伊立替康联合奥沙利铂组（A组）36例,采用伊立替康100mg／m2,第1、8天;奥沙利铂130mg／m2,第2天,静脉滴注。多西他赛联合奥沙利铂组（B组）32例,采用多西他赛75mg／m2,第1天;奥沙利铂130mg／m2,第2天,静脉滴注。21天为1周期,连用2周期后评定疗效。结果：A组和B组有效率分别为41．67％和31．25％,两组差异无统计学意义（P〉0．05）。A组迟发性腹泻和胆碱性综合征发生率明显高于B组（P〈0．01）,但A组粒细胞减少发生率明显低于B组（P〈0．05）。结论：伊立替康或多西他赛联合奥沙利铂治疗晚期非小细胞肺癌有较好的疗效,不良反应可以耐受,安全性好,可以考虑作为晚期非小细胞肺癌治疗方案之一。     

恩度联合多西他赛、卡铂（DC）方案治疗晚期非小细胞肺癌的护理体会

目的探讨恩度联合化疗治疗晚期非小细胞肺癌的护理方法。方法对40例行恩度联合化疗治疗的患者,针对不同的心理特点给予相应的心理护理和健康教育,使用时严格按照恩度的应用程序和方法,做好药物的保管、配制,按要求调整输液速度,密切观察不良反应,及时作出处理和相应的护理措施。结果 40例患者均未出现严重的毒副反应。结论使用恩度联合化疗只要护理得当,不良反应较轻,患者能耐受。     

泰索帝联合顺铂与吉西他滨联合顺铂治疗非小细胞肺癌的临床观察

目的 探讨泰索帝联合顺铂与吉西他滨联合顺铂治疗非小细胞肺癌（NSCLC）的疗效、生存期及毒副作用。方法 28例经组织学或细胞学确诊的未曾治疗的晚期非小细胞肺癌（NSCLC），随机分为泰索帝联合顺铂（DC）治疗组（14例）、吉西他滨联合顺铂治疗组（GC）（14例）。结果 DC组有效率为42．85％（CR2例，PR4例），一生存率57．1％，中位生存期（MST）8．5个月，TTP 5．05个月，中位缓解期（MRT）9．5个月。GC组有效率为38．46％（CRI例，PR4例），一生存率38．5％，中位生存期（MST）8个月，TTP 3．89个月，中位缓解期（MRT）8．26个月。WHO血液学毒性评价，Ⅲ／Ⅳ度中性粒细胞下降，DC组：21．4％，GC组：为15．4％；Ⅲ／Ⅳ度血小板减少，DC组：7．1％，GC组：15．4％；Ⅲ／Ⅳ度血红蛋白下降，DC组：7．1％，GC组：7．7％；Ⅱ-Ⅳ度感觉神经病变发生率：DC组：14．3％；GC组：7．7％，；胃肠道反映，Ⅱ／Ⅲ呕吐发生率DC组：（14．3％）明显优于GC组：（53．8％）（P〈0．05）。结论 DC、GC方案对非小细胞肺癌，显示了相似的有效率，中位生存期及1年生存率。DC组胃肠道反应，Ⅱ／Ⅲ呕吐发生率明显低于GC组，为耐受性较好的治疗晚期NSCLC化疗方案。     

多西他赛在控制晚期非小细胞肺癌恶性胸腔积液的 疗效和安全性评估

目的 研究多西他赛在控制晚期非小细胞肺癌恶性胸腔积液的疗效和安全性。方法 将2016年1月~12月本院接收的晚期非小细胞肺癌恶性胸腔积液患者152例,根据按照电脑随机分组原则分为两组,每组76例。两组均行胸腔穿刺术,对照组给予培美曲塞,观察组给予多西他赛治疗。将两组患者的临床疗效、不良反应发生情况和ECOG评分进行比对。结果 观察组晚期非小细胞肺癌恶性胸腔积液患者的临床总有效率89.47%,高于对照组的65.79%,差异有统计学意义（P＜0.05）;胃肠道反应、胸痛、肾毒性不良反应的发生率和治疗后ECOG评分均低于对照组,差异有统计学意义（P＜0.05）。结论 多西他赛应用在晚期非小细胞肺癌恶性胸腔积液患者中取得疗效确切,临床安全性较高。     

长春瑞滨联合顺铂一线治疗晚期非小细胞肺癌疗效观察

目的观察长春瑞滨联合顺铂治疗Ⅲb或Ⅳ期初治非小细胞肺癌（NSCLC）的疗效和毒副作用。方法初治的Ⅲb或Ⅳ期初治非小细胞肺癌（NSCLC）23例,采用长春瑞滨（盖诺）25mg／m^2d,也静滴,顺铂30mg／m^2静滴第1-3d,21d为1个周期。结果23例患者中,CR病例1例,PR11例,SD9例,PD2例,客观有效率（CR＋PR）为52．16％中位生存期11．8个,1年生存率35％（8／23）中位肿瘤进展时间7个月,毒副作用为白细胞下降和消化道反应。结论长春瑞滨联合顺铂一线治疗晚期NSCLC有效率较高,有生存优势,毒副作用可耐受。     

紫杉醇联合顺铂治疗晚期非小细胞肺癌临床观察

目的:探讨紫杉醇联合顺铂化疗对晚期非小细胞肺癌(NSCLC)患者的疗效,以及对机体免疫功能的影响。方法:回顾分析2009-01/2009-12采用紫杉醇联合顺铂的化疗方案治疗87例晚期NSCLC的临床资料。结果:观察组完全缓解(CR)20.69%,部分缓解(PR)25.29%,无变化(NC)31.03%,进展(PD)22.99%,总有效率45.98%。随访6～12月,缓解期为8.9个月,1年生存率为43.68%。全组在治疗中,未出现因化疗毒性而终止治疗者。但出现不同程度的毒副反应,恶心、呕吐7例,中性粒细胞减少5例,水肿4例,皮疹瘙痒2例,均对症治疗后好转。观察组治疗前化疗前CD4+、CD4+/CD8+阳性细胞比例低于对照组(P0.05),差异有统计学意义。化疗后CD4+、CD4+/CD8+阳性细胞比例较化疗前均显著升高(P0.05),差异有统计学意义。结论:紫杉醇联用顺铂是治疗非小细胞肺癌的有效方案,毒副反应可以耐受,使用安全,并且可减少化疗对非小细胞肺癌患者细胞免疫功能的影响。     

Psychometric properties of the Vanderbilt ADHD diagnostic parent rating scale in a referred population

OBJECTIVE:s To determine the psychometric properties of the Vanderbilt Attention Deficit/Hyperactivity Disorder Parent Rating Scale (VADPRS), which utilizes information based on the Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. (DSM-IV). The VADPRS was created to collect uniform patient data and minimize the time burden of lengthy interviews. METHODS: Participant data (N = 243) was used from the first 2 years of a longitudinal study on communication among physicians, teachers, and parents in diagnosing, treating, and managing children with attention deficit/hyperactivity disorder (ADHD). The reliability, factor structure, and concurrent validity of the VADPRS were evaluated and compared with ratings of children in clinical and nonclinical samples on the Vanderbilt ADHD Teacher Rating Scale and the Computerized Diagnostic Interview Schedule for Children-IV, Parent version. RESULTS: The internal consistency and factor structure of the VADPRS are acceptable and consistent with DSM-IV and other accepted measures of ADHD. CONCLUSION: The VADPRS is a reliable, cost-effective assessment for ADHD in clinical and research settings.     

多西他赛联合顺铂及氟尿嘧啶(DCF)改良方案治疗晚期胃癌疗效观察

目的 研究多西他赛联合顺铂及氟尿嘧啶改良方案(mDCF)治疗晚期胃癌的疗效及安全性.方法 2006年1月起,采用改良DCF方案治疗45例晚期胃癌患者.化疗方案:多西他赛60 mg/m2,d1;顺铂12 mg/m2,d1 ～5;氟尿嘧啶2500 mg/m2,持续输注(civ) 120 h;每21天一个周期.主要研究终点:无进展生存期(PFS).次要研究终点:总生存期(OS),总缓解率(ORR)及不良反应.结果 接受一线解救化疗患者40例,完全缓解0例(0％),部分缓解7例(17.5％),疾病稳定19例(47.5％),疾病进展14例(35.0％),总缓解率17.5％(95％ CI 7.5％ ～30.0％),疾病控制率65.0％ (95％ CI 50.0％ ～77.5％).中位PFS 5.2个月(95％ CI 3.6～6.8月),中位OS 11.0个月(95％CI6.9～15.1月).接受二线解救化疗患者5例,疾病稳定3例,疾病进展2例,中位PFS 5.3个月(95％ CI 0 ～11.3月),中位OS 8.5个月(95％ CI0～17.1月).主要不良反应为血液学毒性,Ⅲ～Ⅳ度粒细胞减少及粒细胞减少伴发热发生率分别为26.7％及11.1％,Ⅲ～Ⅳ度恶心、呕吐及腹泻发生率分别为8.9％、8.9％及11.1％.结论 改良DCF方案有效,不良反应可耐受.     

Brief report: psychometric evaluation of the severity of illness scale in a pediatric oncology sample

OBJECTIVE: To examine the psychometric properties of the Severity of Illness Scale (SOIS), a measure that focuses on the medical severity of illness of children with cancer, from the point of view of medical personnel. METHODS: Following pretesting, the SOIS was administered to nurses and physicians of 55 pediatric cancer patients at three time periods: entry into study, 2-week follow-up, and 3-month follow-up. Validity determination included analyses of relapse status and bone marrow transplant. Test utility was determined via a respondent questionnaire. RESULTS: Test-retest reliability coefficients were .96 and .92 for 2-week and 3-month time periods. Interrater reliability, assessed by comparing physician ratings to nurse ratings, was .89. Evidence for criterion-related validity revealed that the SOIS discriminates both bone marrow transplant and relapse status. Physicians and nurses rated the SOIS positively for brevity, ease of completion, and usefulness in depicting medical severity of disease. CONCLUSIONS: There is preliminary evidence for the psychometric utility of the Severity of Illness Scale for a pediatric cancer population. The inclusion of illness parameters in current models of risk and resiliency dictate the need for such a measure.     

Effect of TOP2A and ERCC1 gene polymorphisms on the efficacy and toxicity of cisplatin and etoposide-based chemotherapy in small cell lung cancer patients

IntroductionThe main treatment regimen for small cell lung cancer (SCLC) involves platinum-based chemotherapy (cisplatin or carboplatin) and etoposide. Single nucleotide polymorphisms (SNPs) in TOP2A and ERCC1 genes were tested as prognostic and predictive factors in non-small cell lung cancer (NSCLC). There are limited data about the clinical relevance of these genetic alterations in SCLC. We undertook this retrospective study to determine the influence of SNPs in TOP2A (rs34300454; rs13695; rs11540720) and ERCC1 (rs11615; rs3212986) genes on the efficiency and toxicity of chemotherapy with platinum and etoposide in SCLC Caucasian patients.Material and methodsThe studied group included 103 Caucasian SCLC patients (65 male, 38 female, median age 65 ±7.5 years). Detailed clinical-demographical data were collected and response to treatment was monitored. DNA was isolated from peripheral blood leukocytes using QIAamp DNA Mini Kit. Single nucleotide polymorphisms were analyzed using TaqMan hydrolyzing probes in real-time PCR technique on an Eco Illumina device.ResultsPatients with C/C genotype in rs13695 of the TOP2A gene had significantly lower risk of neutropenia during chemotherapy than C/T heterozygous patients (p = 0.02, χ² = 5.51, OR = 2.676, 95% CI: 1.165–6.143). Patients harbouring homozygous C/C genotype in rs3212986 of the ERCC1 gene had significantly higher risk of anaemia during chemotherapy, than heterozygous C/A patients (p = 0.045, χ² = 4.01, OR = 0.417, 95% CI: 0.175–0.991). Furthermore, heterozygous G/A genotype in rs11615 of the ERCC1 gene was associated with significant shortening of OS (9 vs. 12 months) compared to homozygous A/A genotype (p = 0.01, χ² = 6.31, HR = 1.657, 95% CI: 1.0710–2.5633).ConclusionsSNPs in ERCC1 and TOP2 genes may be associated with the toxicities and survival of SCLC patients treated with cisplatin and etoposide.     

Cross-cultural adaptation,reliability, and validity of the Turkish version of the obesity-specific quality of life questionnaire: quality of life,obesity, and dietetics (QOLOD) rating scale

Background/aim Obesity is one of the main public health issues in many countries including Turkey. The aim of the study is to test cross-cultural adaptation, reliability, and validity of QOLOD rating scale in the Turkish language. Materials and methods This methodological study was conducted among the overweight and obesity people between February-March, 2018 in Ankara Atatürk Training and Research Hospital. The data was collected through self-report and face to face interviews. The QOLOD rating scale has 36 items, a 5-point Likert scale (1–5) is used for each question. Results In the study, of the 180 participants, 101 (56.1%) were female, 79 (43.9%) were male, and the mean age was 43.36 ± 14.28 (min-max 18–87) years. According to the CFA, the Turkish version of QOLOD rating scale shows a multidimensional structure consisting of 34 items. Two items (item 11 and item 35) were excluded from the scale according to the CFA. Cronbach’s Alpha value changes between 0.927–0.930.Conclusion Finding shows that the Turkish version of QOLOD rating scale had sufficient validity and reliability for Turkish population, had strong psychometric characteristics.     

ERCC1在非小细胞肺癌个体化治疗中的研究进展

非小细胞肺癌的发病率和病死率近年呈上升趋势,化学治疗(化疗)是治疗非小细胞肺癌的主要手段;但是由于耐药的存在,化疗疗效有效率有限,目前一线化疗联合方案的有效率仅为20%~40%。近年来随着肿瘤分子生物学的发展,已发现ERCC1等基因的表达水平和化疗药物疗效及预后密切相关,ERCC1的表达水平有可能成为预测疗效进行个体化治疗的重要指标。根据基因表达水平及药物敏感情况选择个体化的化疗方案是肿瘤学研究和临床肿瘤化疗的趋势。     

Regimens with intraperitoneal cisplatin plus intravenuous cyclophosphamide and intraperitoneal carboplatin plus intravenuous cyclophosphamide are equally effective in second line intraperitoneal chemotherapy for advanced ovarian cancer

PurposeWe compared response, survival and side effects of regiments with intravenous cyclophosphamide followed by intraperitoneal cisplatin versus intravenous cyclophosphamide followed by intraperitoneal carboplatin as second line treatment in one center retrospective study.Material and MethodsInclusion criteria were: relapse or recurrence of the disease after surgery and first line treatment; stage III histologicaly documented serous epithelial ovarian cancer after one or more prior regiments of chemotherapy. Recurrence were confirmed throughout restaging laparotomy or second look laparotomy. Patients from one of the groups received 90mg/m2 cisplatin on the first day and 750mg/m² cyclophosphamide intravenously, while the second group members AUC 6 carboplatin intraperitoneally and 750mg/m² cyclophosphamide intravenously. Four courses were administrated for each patient.ResultsOf the 49 patients in the cisplatin group the response rates were 21 (43%), 10 (20%) and 18 (37%) in the groups of pathologic complete response, pathologic partial response and progressive disease, respectively. The median survival from the initiation of intraperitoneal chemotherapy was 59 months. Of the 25 patients in the carboplatin group the response rates were 10 (40%), 4 (16%) and 11 (44%) respectively. The median survival -51 months. The differences between the groups were not statistically significant p>0.05 either in response or in toxicity.ConclusionsThe results of our research including relatively long survival from intraperotoneal chemotherapy initiation confirm that carboplatin treatment is as good as cisplatin in second line intraperitoneal chemotherapy for ovarian cancer.     

IGFBP-2、-3、-5表达变化与非小细胞肺癌患者化疗敏感性的关系

目的探讨胰岛素样生长因子结合蛋白(insulin-like growth factor-binding protein,IGFBP)家族成员表达与非小细胞肺癌(non-small cell lung cancer,NSCLC)患者化疗效果的关系。方法收集40例NSCLC,所有患者均接受含铂药物的一线化疗方案,根据化疗疗效将患者分为化疗敏感组和不敏感组。采用酶联免疫法和免疫组化法检测两组患者血清和癌组织中的IGFBP-2、IGFBP-3和IGFBP-5的表达;分析IGFBP-3表达水平与NSCLC临床病理特征的关系;利用单因素分析和Logic多因素回归分析IGFBP-3低表达和NSCLC患者化疗不敏感的关系。结果化疗敏感组患者的血清和癌组织中IGFBP-2和IGFBP-5水平略高于化疗不敏感组,但二者差异无统计学意义(P0.05);化疗敏感组患者的血清和癌组织中的IGFBP-3显著高于化疗不敏感组,二者差异有统计学意义(P0.05)。NSCLC中发生淋巴转移和肿瘤直径较大的患者,其IGFBP-3低表达。单因素分析显示IGFBP-3低表达与化疗不敏感密切相关(OR=6.333,95%CI=1.543~26.003,P0.05)。Logistic回归多因素显示IGFBP-3低表达是患者发生化疗不敏感的独立危险因素(OR=4.093,95%CI=1.532~8.191,P0.05)。结论 IGFBP-3低表达可能引起NSCLC患者的化疗耐受,其可作为判断NSCLC患者化疗效果和预后的临床指标。