APP和VPP联合方案治疗晚期食管癌30例分析

目的：探讨晚期食管ＡＰＰ方案治疗的疗效与毒副作用。方法：ＡＰＰ方案（ＡＤＭ＋ＰＹＭ＋ＰＤＤ）与ＶＰＰ方案（ＶＣＲ＋ＰＹＭ＋ＰＤＤ）对照。结果：ＡＰＰ方案治疗１５例，ＣＲ５例（３３．３３％），ＰＲ４例（２６．７％），Ｓ５例（３３．３％），Ｐ１例（６．７％），有效率（ＣＲ－ＰＲ）６０％。ＶＰＰ方案治疗１５例，ＰＲ８例（５３．３％），Ｓ５例（３３．３％），Ｐ２例＊（１３．４％），有效率（ＣＲ＋ＰＲ）５３     

全血细胞减少性急性白血病

本文报道我院１９８８年３月至１９９３年２月未经治疗的全血细胞减少性急性白血病４８例。该组病例症状以贫血、出血、感染较常见。外周血全血细胞减少，而骨髓像大多呈明显活跃或极度活跃。要和再生障碍性贫血、骨髓增生异常综合征、低增生性白血病鉴别。小剂量化疗组１４例（Ａｒａ－ｃ１０ｍｇＢｉｄ×１４～２１天，维甲酸、活性Ｄ３）获ＣＲ３例（２１．４％），ＰＲ２例（１４．３％），死亡４例（２８．６％），总有效率３５．７％；常规方案化疗组２２例（ＡＮＬＬ用ＨＯＡＰ、ＣＯＡＰ、ＨＡ、ＤＡ方案，ＡＬＬ用ＶＡＰ、ＶｍＰ、ＶＬＰ、ＣＯＰ等方案），获ＣＲ９例４０．９％、ＰＲ１例（４．５％），死亡１例（４．５％）总有效率４５．４％。该文提示常规方案化疗比小剂量化疗的疗效好，完全缓解率高，死亡率低。     

深红诺卡菌细胞壁骨架临床疗效观察

目的评价深红诺卡菌细胞壁骨架（Ｎ－ＣＷＳ，胞必佳）治疗中、晚期恶性肿瘤的效果。方法恶性淋巴瘤２８例（霍奇金淋巴瘤５例，非霍奇金淋巴瘤２３例），采用三角肌下缘皮下注射Ｎ－ＣＷＳ结合化疗，并与单用化疗１８例（对照组）进行比较。恶性胸腔积液１５例，采用抽去胸水后胸腔内注入Ｎ－ＣＷＳ。恶性黑素瘤７例，采用皮下注射Ｎ－ＣＷＳ。结果５０例中，完全缓解（ＣＲ）１１例（２２％），部分缓解（ＰＲ）２１例（４２％）；总有效率为６４％。恶性淋巴瘤中，ＣＲ９例，ＰＲ１１例，有效率为７１．４％，而对照组中ＣＲ４例，ＰＲ７例，两者无显著差异。但在Ⅲ、Ⅳ期患者中两者有效率分别为６６．７％（１２／１８）和２７．３％（３／１１），有显著差异。恶性胸腔积液中，ＣＲ２例，ＰＲ８例，有效率为６６．７％。恶性黑素瘤中，ＰＲ２例。约５０％患者经Ｎ－ＣＷＳ治疗后出现免疫指标不同程度的提高。不良反应有发热（２８％，１４／５０）、局部肿胀（５１．４％，１９／３７）、硬结（１６．２％，６／３７）和疼痛（４６．７％，７／１５），但患者均能耐受。结论Ｎ－ＣＷＳ是具有抗肿瘤的免疫治疗药。     

长期口服VP-16联合顺铂治疗肺癌38例疗效分析

长期低剂量口服ＶＰ－１６（５０ｍｇ／ｍ２／ｄ×２１天）联合静滴ＤＤＰ（２０ｍｇ／ｍ２／ｄ×５天）治疗肺癌病人３８例，其中ＳＣＬＣ２４例，ＣＲ４例，ＰＲ１６例，有效率８３．３％；ＮＳＣＬＣ１４例，ＰＲ５例，有效率３５．７％。平均缓解时间ＳＣＬＣ６个月，ＮＳＣＬＣ６．５个月。毒副作用主要表现为骨髓抑制、脱发和胃肠道反应，其它毒性少见。     

老年人急性非淋巴细胞白血病化疗疗效观察

报道了五年间收治的老年急性非淋巴细胞白血病（ＡＮＬＬ）２１例，采用ＤＡ（ＶＰ１６）与ＨＡ（ＶＰ１６）联合化疗，依据不同剂量，将其分为二组，二组总有效率为６６．６％。其中中等剂量组１４例，８例ＣＲ，平均生存时间为２６７天；２例（１８％）ＰＲ：小剂量组７例，２例（２８．５％）ＣＲ，２例（２８．５％）ＰＲ；结果提示：对老年白血病患者治疗应个体化，一般情况好者应在强有力支持治疗情况下采用中等剂量的化疗，相反宜小剂量化疗     

用POC方案联合化疗治疗晚期鳞癌48例近期疗效分析

用ＰＯＣ方案（ＰＹＭ，ＶＣＲ，ＣＢＤＣＡ）治疗鳞状细胞癌４８例，其中食管鳞状细胞癌３０例，肺鳞癌１８例。获ＣＲ２例占４．１％，ＰＲ２１例占４３．７％，Ｓ１６例占３３％，Ｐ９例占１９％，有效率（ＣＰ＋ＰＲ）４７．８％。疗效较好，且消化道反应、肾功能损害和神经系统毒性明显减低，因此易为病人接受，有进一步研究的价值。     

吡柔比星（THP－ADM）联合化疗治疗上皮性卵巢癌临床观察

作者应用（ＴＨＰ－ＡＤＭ）联合用药治疗上皮性卵巢癌２８例、输卵管癌１例，原发腹膜浆液性腺癌１例。初治病例２３例，复治７例，重点分析疗效及心脏毒性反应。初治者ＣＲ５６．５％（１３／２３），ＰＲ３４．８％（８／２３），ＣＲ＋ＰＲ９１．３％。复治者ＣＲ２８．６％（２／７），ＰＲ２８．６％（２／７），ＣＲ＋ＰＲ５７．１％，总有效率ＣＲ＋ＰＲ８３．３％。结论：ＴＨＰ联合化疗治疗上皮性卵巢癌疗效肯定，心脏毒性低，轻度心功能不良者可采用ＴＨＰ联合化疗。     

p53蛋白、雌激素受体、孕激素受体在非小细胞肺癌中的表达及临床意义

目的 检测非小细胞肺癌（ＮＳＣＬＣ）中ｐ５３蛋白、雌激素受体（ＥＲ）和孕激素受体（ＰＲ）表达与临床病理和预后的相关性。方法 应用免疫组织化学ＳＰ法检测１４７例ＮＳＣＬＣ癌组织标本中ｐ５３、ＥＲ、ＰＲ的表达。结果 ｐ５３蛋白总阳性率为６１．２％（９０／１４７）,鳞癌、腺癌、鳞腺癌、大细胞癌阳性率分别为６３．５％（４０／６３）、５７．６％（３３／６６）、６６．７％（１０／１４）、５０％（２／４）。腺癌     

HDCF/5-Fu、DDP联合方案治疗晚期鼻咽癌的近期疗效分析

为了提高５－Ｆｕ＋ＤＤＰ方案治疗复发、转移性鼻咽癌的临床疗效，对２８例晚期ＮＰＣ患者给予２个以上疗程的ＨＤＣＦ／５－Ｆｕ＋ＤＤＰ方案化疗，结果ＣＲ２例、ＰＲ１１例、ＭＲ６例、ＳＤ４例、ＰＤ５例，总有效率为（ＣＲ＋ＰＲ）４６．４％，中位缓解期５．４个月（２～１６个月）。毒性反应主要有ＷＢＣ下降、恶心呕吐、口腔粘膜溃烂等。ＨＤＣＦ／５－Ｆｕ＋ＤＤＰ方案较传统的单用５－Ｆｕ＋ＤＤＰ方案疗效有明显提高，但毒性反应亦较重     

老年人急性非淋巴细胞白血病化疗疗效观察

报道了五年间收治的老年急性非淋巴细胞白血病（ＡＮＬＬ）２１例，采用ＤＡ（ＶＰ１６）与ＨＡ（ＶＰ１６）联合化疗，依据不同剂量，将其分为二组，二组总有效率为６６．６％，其中中等剂量组１４例，８例ＣＲ，平均生存时间为２６７天，２例（１８％），ＰＲ，小剂量组７例，２例（２８．５％），ＣＲ，２例（２８．５％）ＰＲ，结果提示：对老年白血病患者治疗应个体化，一般情况好者应在强有力支持治疗情况下采用中等剂量的化疗     

CAP方案治疗晚期膀胱癌30例疗效分析

目的：观察ＣＡＰ方案对晚期膀胱癌的疗效和不良反应。方法：ＣＴＸ６００～８００ｍｇ／ｍ２静注ｄ１,ＡＤＭ３０～４０ｍｇ／ｍ２静注ｄ１,ＤＤＰ２０ｍｇ／ｍ２静滴ｄ１～５,３周为一周期。结果：ＣＲ８例（２６６％）,ＰＲ１２例（４０％）,ＮＣ６例（２０％）,ＰＤ４例（１３３％）。结论：ＣＡＰ方案对治疗晚期膀胱癌有效,不良反应少。     

High-dose combination chemotherapy with autologous bone marrow transplantation in breast carcinoma

Twelve patients with breast carcinoma were treated with high-dose combination chemotherapy supported by autologous bone marrow transplantation (ABMT). Seven of them had advanced metastatic disease and received 12 cours of A treatment, response rate (CR +PR) was 71.5% (CR: 1, PR: 4, NC: 2 and PD: 0) and it should be noted that all 4 patients who had received adriamycin 150 mg+5-fluorouracil 1,500 mg divided in two consecutive days or equivalent high-dose of other chemotherapeutic regimen responded (CR: 1 and PR: 3). To the therapy Five other patients received ABMT-supported adjuvant chemotherapy because of high risk of recurrence. One of them died of unrelated cause and other 4 are free of disease at 11, 14, 17 and 17 months following this treatment. A major toxicity was of myelosuppression and nadirs of neutrophils were 100-1,800 on days 9-19 (median: 400 on day 12), neutrophils recovered rather rapidly to levels of greater than or equal to 1,000, greater than or equal to 1,500 and greater than or equal to 2,000 by day 15, 16 and 17, respectively. High-dose combination chemotherapy with ABMT seemed quite effective in advanced breast carcinoma and a similar approach in adjuvant setting has also been suggested.     

吉西他滨加奥沙利铂治疗老年晚期非小细胞肺癌的临床观察

目的:观察吉西他滨加奥沙利铂治疗老年非小细胞肺癌的近期疗效和毒性反应。方法:吉西他滨1000mg/m2,静脉滴注,第1、8天;奥沙利铂130mg/m2,静脉滴注,第1天,21天为一个周期。结果:全组35例共化疗92个周期。CR 2.9%(1/35)、PR 40%(14/35)、NC 25.7%(9/35)、PD 31.4%(11/35),有效率CR PR42.9%(15/35),临床受益率CR PR NC 68.6%(24/35)。中位缓解期6.5个月。主要毒副反应为骨髓抑制,Ⅲ级~Ⅳ级白细胞减少14.3%(5/35),Ⅲ级~Ⅳ级血小板减少11.4%(4/35)。神经毒性发生率71.4%,均为轻度。结论:吉西他滨加奥沙利铂对老年晚期非小细胞肺癌有效率较高,临床受益率大,毒性反应可耐受。     

两周CHOP方案治疗非霍奇金淋巴瘤临床疗效观察

目的：评价两周CHOP方案治疗非霍奇金淋巴瘤（NHL）的疗效及不良反应。方法：对2000年1月至2004年10月68例非霍奇金淋巴瘤随机分为两周方案组（CHOP／2W）及三周方案组（CHOP／3W）．每组34例．全部经病理及免疫组化证实全部采用CHOP方案化疗，CTX 750mg／m^2 d1、ADM 50mg／m^2d1、VCR1．4mg/m^2d1、PDN 100mg d1-5。两周方案组，从第5天至第11天开始行G-CSF预防白细胞下降。结果：两周方案有效率为97．1％，三周方案有效率为79．4％（P〈0．05）。两组患者的不良反应均无明显差异（P〉0．05），结论：两周方案治疗NHL是一种安全、有效的治疗方案。     

改良Hyper-CVAD/MA方案治疗儿童淋巴母细胞性淋巴瘤的疗效观察

目的观察改良Hyper-CVAD/MA方案在儿童淋巴母细胞性淋巴瘤（LBL）初始治疗中的临床疗效。方法总结改良Hyper-CVAD/MA方案（分为A方案和B方案）初始治疗11例儿童LBL患者的临床资料。结果11例患者共完成A方案41例次,B方案40例次,鞘内注射34例次。化疗相关不良反应主要为骨髓抑制100%（81/81）、胃肠道反应39.5%（32/81）、细菌感染33.3%（27/81）、肝损害14.8%（12/81）,均未影响化疗进程。1~2疗程化疗后完全缓解（CR）27.3%（3/11）,部分缓解（PR）45.4%（5/11）,疾病稳定（SD）27.3%（3/11）;3~4疗程后CR 72.7%（8/11）,PR 18.2%（2/11）,SD 9.1%（1/11）;6~8疗程后CR 81.8%（9/11）,PR 9.1%（1/11）,疾病进展（PD）9.1%（1/11）,总体缓解率为90.9%。中位随访时间19月,平均（23.6±15.4）月,无病生存9例,带瘤生存1例,死亡1例。结论改良Hyper-CVAD/MA方案初始治疗儿童LBL患者疗效满意,化疗相关不良反应易耐受。     

Cyclophosphamide, adriamycin and cisplatinum combination chemotherapy for advanced urothelial and prostatic carcinoma

Between 1980 and 1985, 17 patients with advanced urothelial carcinoma and 13 with metastatic prostatic carcinoma refractory to hormonal therapy were treated with a combination chemotherapy of cyclophosphamide (CPM), adriamycin (ADM) and cis-diammine-dichloroplatinum (CDDP) to evaluate its antitumor effect and toxicity. ADM (1 mg/kg) on day 1, CPM (2 mg/kg) on days 2 through 5 and CDDP (1.5 mg/kg) on days 6 and 7 were administered every 3 weeks. Of the 17 patients with urothelial carcinoma, 13 were eligible for evaluation. One patient achieved CR with a disease-free interval lasting for 29 months, one showed PR (duration of response 2 months), 4 NC and 7 PD, with an overall response rate of 15% (2/13). Of the 13 patients with prostatic carcinoma, 11 could be evaluated. No patients achieved CR, one had PR (duration of response 5 months), 2 NC and 8 PD, with an overall response rate of 9% (1/11). No statistically significant difference in survival was noted between responders (CR + PR) and non-responders (NC + PD) to the combination chemotherapy, irrespective of whether they had metastatic urothelial or prostatic carcinoma. Myelosuppression was frequently noted, with sepsis occurring in one patient. No mortality attributable directly to this regimen was noted.     

化学药物治疗上腔静脉综合征疗效分析

目的：探讨化学药物治疗恶肿瘤所致上腔静脉综合征（SVCh）的疗效。方法：本组SVCS35例，均为恶性肿瘤继发。其中肺癌22例，恶性淋巴瘤10例，食管癌3例，均采用含阿霉素、顺铂、足叶乙甙等多药联合方案化疗，配以脱水、利尿、抗感染等治疗。结果：CR20例，PR11例，总有效率（CR＋PR）88．6％。其中，对化疗敏感的小细胞肺癌及恶性淋巴瘤总有效率达100％。结论：作者认为化学药物治疗恶性肿瘤所致的上腔静脉综合征疗效确切、显著，能较好缓解肿瘤危象。     

Evaluation of combined chemotherapy including high-dose cisplatin in the treatment of malignant tumors

The results of 63 patients with advanced malignant tumors treated by combined chemotherapy including high-dose cisplatin (HD-DDP) (single dose 50-100 mg/m2) are reported. The remission rates and duration of the remission for various malignant tumors were: 40% (10 PR out of 25 patients) and 3-8 months for non-small cell lung cancer (NSCLC) treated by PMFV (DDP, MMC, 5FU and VCR) regimen; 87% (4 CR and 9 PR out of 15) and 3-14 months for breast cancer treated by PCMF (DDP, CTX, MTX and 5FU) regimen; 100% (1 CR and 3 PR out of 4) and 3-10 months for testicular cancer treated by PPV (DDP, Pingyangmycin and VCR) regimen; 57% (1CR and 3 PR out of 7) and 5-12 months for malignant melanoma treated by PBDV (DDP, BCNU, DTIC and VCR) regimen; 33% (2 PR out of 6) and 5 months for esophageal cancer treated by PPV regimen. In 6 patients with other malignant tumors, the remission rate was 50% (3 PR). The results show that the combined regimens including HD-DDP in the treatment of breast cancer and NSCLC (remission rate 87% and 40%, respectively) are better than that including low-dose DDP (17% and 7%) (P less than 0.001, P less than 0.01) and that including adriamycin (30% and 13%) (P less than 0.001, P less than 0.05). In the treatment, obvious gastrointestinal reaction, leukopenia, thrombocytopenia and mild functional damage of the liver and kidney were observed.     

CHOP方案治疗鼻咽癌的疗效评价

目的探讨CHOP方案治疗鼻咽癌的近期疗效和毒副反应。方法共治疗鼻咽癌患者85例,采用CHOP方案者为治疗组共49例,其中初治40例,放疗后复发转移9例。采用PF(DDP+5Fu)方案者为对照组共36例,其中初治32例,放疗后复发转移4例。结果治疗组49例中CR12例,PR26例,NC11例,CR率为24.5%,CR加PR共38例,有效率为77.6%;对照组36例中CR4例,PR24例,NC7例,PD1例,CR加PR共28例,CR率为11.1%,有效率为77.8%。CHOP方案与PF方案近期疗效无显著性差异(P>0.05),治疗组毒副反应轻于对照组,特别是胃肠道反应恶心、呕吐。结论CHOP方案为鼻咽癌有效低毒化疗方案。     

Treatment of patients with relapsed and resistant non-Hodgkin's lymphoma using total body irradiation, etoposide, and cyclophosphamide and autologous bone marrow transplantation.

PURPOSE: Patients with non-Hodgkin's lymphoma (NHL) who do not achieve a complete response (CR) after induction chemotherapy or who relapse after achieving a CR are rarely cured of their disease by the usual salvage therapy. Success of high-dose cytotoxic therapy with an autologous bone marrow transplant (AuBMT) is limited. We describe the results of a prospective single-institution study using a new conditioning regimen for patients with relapsed or resistant NHL who underwent AuBMT. PATIENTS AND METHODS: Forty-four patients were reinduced with cytotoxic therapy and then evaluated for response. All patients received the conditioning regimen of hyperfractionated total body irradiation (TBI), etoposide (VP-16), and cyclophosphamide (CTX) followed by autologous bone marrow reinfusion. RESULTS: The disease-free survival (DFS) rate was 57% with a median follow-up of 42+ months. The only variable significantly associated with DFS was the patient's remission status at AuBMT. Patients who underwent AuBMT in CR had a DFS of 80%, whereas patients who underwent AuBMT in partial response (PR) or with progressive disease (PD) had a DFS of 60% and 11%, respectively (P = .002). The major toxicity was hemorrhage at the site of bulky disease, especially in patients with residual mediastinal and/or pulmonary disease. CONCLUSION: Planned reinduction cytotoxic therapy followed by TBI, VP-16, and CTX with AuBMT is an effective treatment for patients with relapsed and resistant NHL.