紫杉醇脂质体联合表阿霉素方案在乳腺癌新辅助化疗中的近期疗效

[目的]观察紫杉醇脂质体在乳腺癌新辅助化疗中的疗效、毒副反应。[方法]回顾性分析20例局部晚期乳腺癌患者含紫杉醇脂质体方案新辅助化疗的疗效、毒副作用。化疗方案为紫杉醇脂质体加表阿霉素，21d为一周期，术前化疗2～6个周期，评估肿瘤缓解情况及毒副反应。[结果]化疗有效率为90％，其中CR3例，PR15例，SD1例，PD1例，达pCR1例。[结论]紫杉醇脂质体联合表阿霉素方案在乳腺癌的新辅助化疗中疗效肯定．毒副反应低．值得进一步研究。     

多西紫杉醇为主的联合方案治疗62例晚期乳腺癌

[目的]探讨多西紫杉醇为主的联合化疗方案治疗晚期乳腺癌的临床疗效及毒副反应。[方法]62例晚期乳腺癌患者中，43例既往使用蒽环类治疗失败，予多西紫杉醇单药或联合治疗；19例既往未曾采用蒽环类治疗，予多西紫杉醇联合表阿霉素治疗。21～28d为1周期，2周期后评价疗效，有效者化疗4周期以上。[结果]62例患者中，治疗后完全缓解（CR）10例，部分缓解（PR）28例，稳定（SD）14例，进展（PD）10例，有效率为61．3％（38／62）。主要毒副反应为消化道反应和白细胞减少。[结论]多西紫杉醇为主的联合化疗方案治疗晚期乳腺癌疗效确切，毒副反应可耐受。     

多西紫杉醇为主的联合方案治疗62例晚期乳腺癌

[目的]探讨多西紫杉醇为主的联合化疗方案治疗晚期乳腺癌的临床疗效及毒副反应。[方法]62例晚期乳腺癌患者中，43例既往使用蒽环类治疗失败，予多西紫杉醇单药或联合治疗；19例既往未曾采用蒽环类治疗，予多西紫杉醇联合表阿霉素治疗。21～28d为1周期，2周期后评价疗效，有效者化疗4周期以上。[结果]62例患者中，治疗后完全缓解（CR）10例，部分缓解（PR）28例，稳定（SD）14例，进展（PD）10例，有效率为61．3％（38／62）。主要毒副反应为消化道反应和白细胞减少。[结论]多西紫杉醇为主的联合化疗方案治疗晚期乳腺癌疗效确切，毒副反应可耐受。     

多西紫杉醇联合卡培他滨治疗晚期鼻咽癌的临床观察

目的 观察多两紫杉醇联合卡培他滨在晚期鼻咽癌治疗中的疗效及毒副反应.方法 收集我科46例晚期鼻咽癌.患者均采用多两紫杉醇+卡堵他滨联合化疗方案,治疗结束2周后评价疗效并观察其毒剐反应.结果 评价46例,有效率(CR + PR)58.7%(27例),主要毒副反应为骨髓抑制、手足综合征和消化道反应.结论 多西紫杉醇联合卡培他滨治疗晚期局部复发和(或)远处转移性鼻咽癌有较好疗效,毒副反应较轻,患者易于接受,值得在临床上进一步推广应用.     

异环磷酰胺联合自体PHA-LAK细胞治疗晚期复发卵巢上皮癌的疗效观察

目的研究异环磷酰胺(ifosfamide,IFO)联合自体PHA-LAK细胞过继性免疫治疗晚期复发卵巢上皮癌的疗效。方法25例复发的晚期卵巢上皮癌患者经IFO1200mg/(m2·d)连用4d,同时于用IFO后0、4、8h分别静脉推注美司钠400mg;化疗间歇期以PHA-LAK细胞治疗4次。联合治疗2个周期以上。结果25例患者中,完全缓解(CR)3例,部分缓解(PR)8例,稳定(NC)7例,进展(PD)7例,有效率(CR+PR)44%(11/25),中位无进展生存期(TTP)21周,中位生存期(OS)47周。毒副反应主要是消化道反应和骨髓抑制。结论IFO联合自体PHA-LAK细胞治疗复发的晚期卵巢上皮癌有效,毒副反应低,可作为晚期复发卵巢上皮癌的选择方案。     

紫杉醇为主腹腔灌注和静脉联合化疗治疗晚期卵巢癌疗效

目的:评价卵巢上皮性癌患者术后行紫杉醇和卡铂腹腔灌注 静脉联合化疗的疗效及副反应。方法:32例晚期卵巢上皮性癌术后患者,紫杉醇60mg 卡铂200mg 生理盐水2000ml腹腔灌注(每周1次,连用3次),1周后紫杉醇210mg 卡铂200mg静脉滴注(3周为1疗程,共6个疗程)。结果:Ⅲ期总有效率为75.00%,Ⅳ期为25.00%。结论:紫杉醇静脉和卡铂腹腔灌注联合化疗近期疗效好,毒副反应轻。     

吡喃阿霉素联合方案治疗恶性肿瘤临床观察──附202例临床分析

福州市各大医院协作应用毗吨阿霉素（THP）联合方案治疗各类恶性肿瘤202例，其中术后辅助化疗105例，有观察指标97例。结果揭示THP对多种实体病均有较好疗效，尤其对恶性淋巴瘤（CR＋PR94．1％），乳腺癌（CR＋PR71．4％），有效率明显高于文献中由阿霉素组成的相同联合方案。术后辅助化疗及膀胱癌局部切除术后灌注化疗近期内均未见复发或转移。毒副反应较轻，尤其心脏毒性和脱发。     

TCF方案治疗晚期胃癌的临床观察

目的 观察TCF方案(紫杉醇联合氟尿嘧啶和顺铂)治疗晚期不能手术或手术未能完全切除及术后复发的胃癌患者的疗效和毒性.方法 50例患者分别接受,TCF方案化疗3-6周期,按WHO标准评价疗效及毒副反应.结果 50例均可评价,其中完全缓解(CR)4例8﹪,部分缓解(PR)22例44﹪,稳定(SD)18例36﹪,进展(PD)6例12﹪.中位疾疗进展时间为8.3月,中位生存时间为12.1月.结论 TCF方案治疗晚期胃患者安全有效,毒副反应较轻.     

含盖诺联合化疗治疗鼻咽癌的临床观察

目的 :评价含国产异长春花碱 (盖诺 )的联合化疗方案对鼻咽癌的疗效。方法 :5 8例复治的鼻咽癌患者 ,应用盖诺联合顺铂和 /或异环磷酰胺化疗 ,观察其近期疗效及毒副反应。结果 :2例CR ,2 6例PR ,总有效率 (CR PR)为 48 8%。结论 :盖诺对复治的鼻咽癌有较好疗效 ,其毒副反应可耐受 ,且为可逆性 ,值得临床推广使用。     

以泰索帝为主联合化疗治疗51例晚期妇科恶性肿瘤

[目的]观察以泰索帝为主的联合化疗治疗晚期妇科恶性肿瘤的疗效。[方法]泰索帝组51例晚期妇科恶性肿瘤患者，采用方案为泰索帝75mg／m^2＋顺铂60mg／m^2＋环磷酰胺600mg／m^2。对照组为同期60例中晚期妇科恶性肿瘤患者，方案采用PAC（顺铂＋环磷酰胺＋表阿霉素）及VBP方案（长春新碱＋平阳霉素＋顺铂）。均化疗2～6个周期。[结果]泰索帝组与对照组中位生存期分别为8．5个月和4个月（P〈0．01），有效率（CR＋PR）分别为43．1％与19．8％（P〈0．05）。化疗毒副反应主要是骨髓抑制与脱发。[结论]以泰索帝为主的联合化疗治疗晚期妇科恶性肿瘤尤其是卵巢癌及输卵管癌近期疗效好，毒副反应较轻。     

力朴素与奈达伯联合先期化疗对晚期卵巢上皮性癌的临床观察

目的观察力朴素与奈达伯联合行新辅助化疗对晚期卵巢上皮性癌近期的疗效及毒副反应。方法晚期卵巢上皮性癌80例，采用力朴素与奈达伯联合化疗方案（力朴素135mg／m2，奈达伯80mg／m2-100mg／m2），全身静脉化疗结合腹腔灌注化疗，3周为一个疗程，于术前完成1—2个疗程治疗后，行体检、影像学检查及手术治疗，从而判断治疗疗效及毒副作用。结果治疗有效率为92．5％（74／80）；白细胞下降发生率为50％（40／80），胃肠道反应发生率为77．5％（62／80）；所有患者均未因毒副反应中断或退出治疗。结论力朴素与奈达伯联合行先期化疗对晚期卵巢上皮性癌效果较好，毒副反应较轻。     

双铂联合氟尿嘧啶二线治疗复发转移食管癌研究

[目的]观察双铂方案二线治疗复发转移食管癌的近期疗效及不良反应。[方法]30例一线化疗后复发转移食管癌患者,进行二线治疗,化疗方案：顺铂25mg/m^2d1,奈达铂25mg/m^2d2,3,氟尿嘧啶0.35g/m^2civ d1～7,3周重复。[结果 ]部分缓解（PR）11例,疾病稳定（SD）8例,疾病进展（PD）11例,有效率（RR）为36.7%,疾病控制率（DCR）为63.3%,中位达进展时间（TTP）为4.3个月（95%CI：1.1～10.5）,中位生存时间（MST）为8.9个月（95%CI：2.1～15.3）。主要不良反应为血液学毒性,Ⅲ～Ⅳ级白细胞减少的发生率分别为13.3%,Ⅲ级口腔炎的发生率为6.7%。[结论]双铂联合氟尿嘧啶二线治疗复发转移食管癌的近期疗效较好,不良反应可耐受。     

白蛋白结合型紫杉醇治疗晚期复治乳腺癌的临床观察

[目的]回顾性观察以白蛋白结合型紫杉醇为主联合化疗治疗晚期复治乳腺癌的有效性和安全性。[方法]经病理组织学检查确诊的Ⅳ期乳腺癌患者23例,接受白蛋白结合型紫杉醇为主的联合化疗方案治疗。用药1个周期后评价不良反应,2个周期后方可评价疗效。[结果]23例可评价病例中,无1例获得CR,PR 7例,SD 13例,PD 3例,客观总有效（RR）率为30.4%;疾病控制（DCR）率为87.0%。中位疾病进展时间为5.3个月,1年生存率为73.9%。主要不良反应为骨髓抑制,其中Ⅲ~Ⅳ度粒细胞减少发生率为47.8%,Ⅲ~Ⅳ度血小板下降发生率为13.0%、Ⅲ度贫血发生率为21.7%;非血液学毒性轻微,可以耐受。[结论 ]白蛋白结合型紫杉醇联合化疗治疗晚期复治乳腺癌,疗效较好,不良反应可以耐受,可以考虑作为晚期复治乳腺癌的解救化疗方案。     

紫杉醇联合顺铂治疗复发性宫颈癌的临床观察

Objective： To observe the efficacy and toxicities of paclitaxel plus cisplatin in the treatment of recurrent cervical cancer. Methods： Twenty-three patients with a diagnosis of recurrent cervical cancer were eligible. Three-weekly chemotherapy regimen consisted of paclitaxel 135-150 mg/m^2 infusion for 3 h on day 1, cisplatin 25 mg/m^2 infusion on day 1 to 3. All patients received at least two cycles treatment. Results： The response rates was 47.8%, including CR 2 cases （8.7%）, PR 9 cases （39.1%）. The major toxicity included neutropenia, nausea vomiting, arthralgia, myalgia and alopecia. Conclusion： Paclitaxel combined with cisplatin is an effective therapy with acceptable adverse reactions for recurrent cervical cancer.     

Paclitaxel by 72-hour continuous infusion followed by bolus intravenous ifosfamide or epirubicin: results of two phase I studies

STUDY PURPOSES: To determine the maximum-tolerated dose (MTD) of paclitaxel administered by 72-hour continuous infusion followed by bolus intravenous ifosfamide on days 4 and 5 or epirubicin on day 4, every 21 days. To assess the toxicity and preliminary activity in patients with advanced refractory solid tumors. PATIENTS AND METHODS: Sixteen patients with progressive disease after standard chemotherapy for advanced disease were treated with the combination paclitaxel-ifosfamide and 10 patients with the combination paclitaxel-epirubicin. RESULTS: In the first phase I study the MTDs were: paclitaxel 135 mg/m2 and ifosfamide 2.5 mg/m2/day; hematologic toxicity was the dose-limiting toxicity (DLT) during the first cycle of therapy at dose level 4. Paclitaxel administered at 135 mg/m2 and epirubicin 50 mg/m2 were the MTDs in the second phase I study; grade 4 stomatitis was the DLT of this combination. CONCLUSIONS: Paclitaxel by 72-hour continuous infusion followed by bolus ifosfamide was a manageable regimen with an acceptable hematologic toxicity in the absence of neurotoxicity. Preliminary activity of this combination was encouraging in a group of patients with ovarian cancer. The optimal way to combine paclitaxel and epirubicin and the best schedule relative to such a long paclitaxel infusion time in this combination regimen remain to be determined.     

Ifosfamide, paclitaxel and cisplatin first-line chemotherapy in advanced, suboptimally debulked epithelial ovarian cancer.

BACKGROUND: The combination of paclitaxel with a platinum analogue is the preferred chemotherapy regimen in the treatment of advanced epithelial ovarian carcinoma. The alkylating agent ifosfamide has shown activity in refractory or recurrent ovarian cancer. We conducted a Phase II study with the combination of ifosfamide, paclitaxel, and cisplatin for the treatment of newly diagnosed patients with advanced, suboptimally debulked ovarian carcinoma. METHODS: Thirty-five consecutive patients with advanced ovarian carcinoma (International Federation of Gynecology and Obstetrics [FIGO] Stage III or IV) and residual disease larger than 2 cm after staging laparotomy and cytoreductive surgery were treated with paclitaxel, 175 mg/m(2), as a 3-hour intravenous infusion on Day 1, cisplatin 75 mg/m(2) intravenously over 2 hours on Day 2, and ifosfamide 1500 mg/m(2) intravenously over 1 hour on Days 1-3 (with sodium 2-mercaptoethane sulfonate [MESNA] uroprotection). Courses were administered every 3 weeks on an outpatient basis. Granulocyte-colony stimulating factor was given at a dose of 5 microg/kg/day on Days 7-11. RESULTS: Among 26 patients with measurable disease, 22 (85%) achieved an objective response including 15 complete and 7 partial responses. With a minimum follow-up of 46 months, the median overall survival was 52.8 months (range, 5.3-56.6+ mos), whereas the median time to progression for all patients was 22.2 months. The median remission duration for women with measurable disease who responded to treatment was 12.6 months. The treatment was tolerated relatively well without toxic deaths; the most common toxicity was Grade 3 or 4 neutropenia that occurred in 42% of patients. Significant peripheral neuropathy (Grade 2 or higher) developed in 35% of patients. CONCLUSION: The combination of ifosfamide, paclitaxel, and cisplatin is a well-tolerated outpatient regimen with significant activity in the treatment of newly diagnosed FIGO Stage III or IV epithelial ovarian carcinoma. Further evaluation is justified to clearly define the role of ifosfamide as an additional agent to the current platinum and paclitaxel regimens.     

贝伐珠单抗联合紫杉类药物一线治疗局部复发或转移性乳腺癌患者的安全性及疗效

[目的]研究贝伐珠单抗联合紫杉类药物一线治疗Her-2阴性的局部复发或转移性乳腺癌患者的安全性和疗效。[方法]32例Her-2阴性的复发或转移性乳腺癌患者,一线接受贝伐珠单抗联合紫杉类方案的化疗,直至疾病进展或不良反应不能耐受或患者要求出组。研究者选择化疗方案：贝伐珠单抗15mg／kg静滴d1,多西他赛75mg／m^2,静滴d1,21d为一个周期;或贝伐珠单抗10mg／kg静滴d1,15紫杉醇80mg／m^2,静滴d1,8,15,为一个周期。每3个周期评价疗效。[结果]32例可评价疗效和副作用,PR16例,SD15例,PD1例,总有效率50％,中位TTP为7.25个月。3级以上不良反应为阴道出血、粒细胞下降以及腹泻。[结论]贝伐珠单抗联合紫杉类药物治疗晚期乳腺癌不良反应可以耐受,具有一定疗效。     

Local hyperthermia, radiation, and chemotherapy in recurrent breast cancer is feasible and effective except for inflammatory disease

Purpose: To investigate the feasibility and effectiveness of radiochemothermotherapy (triple-modality therapy) in patients with inoperable recurrent breast cancer.

Patients and Methods: Patients with inoperable recurrent lesions, World Health Organization (WHO) performance status of 2 or greater, life expectancy of more than 3 months, adequate bone marrow, hepatic and renal function were eligible for this Phase I/II study. Conventionally fractionated or hyperfractionated radiotherapy (RT) was performed. Once-weekly local hyperthermia (HT) combined with chemotherapy (CT; epirubicin 20 mg/m², ifosfamide 1.5 g/m²) was applied within 30 min after RT.

Results: Twenty-five patients, all heavily pretreated (18/25 preirradiated), received a mean total dose of 49 Gy. The median number of HT/CT sessions was 4. Skin toxicity was low, whereas bone marrow toxicity was significant (leucopenia Grade 3/4 in 14/1 patients). The overall response rate was 80% with a complete response (CR) rate of 44%. Response rates in patients with noninflammatory disease (n = 14; CR 10 patients, partial response [PR] 3 patients) were far better than in patients with inflammatory disease (n = 11; CR 1 patient, PR 6 patients).

Conclusions: In patients with recurrent breast cancer, triple-modality therapy is feasible with acceptable toxicity. High remission rates can be achieved in noninflammatory disease, however, local control is limited to a few months. Whether the addition of chemotherapy has a clear-cut advantage to radiothermotherapy alone remains an open question.     

异环磷酰胺联合方案治疗复发或耐药性妇科恶性肿瘤疗效分析

目的：评价异环磷酰胺（IFO）方案对复发或耐药性妇科恶性肿瘤的疗效和毒性反应。方法：以IFO为主联合化疗，治疗35例以往多药程联合化疗失败或复发的卵巢，宫颈，宫内膜及阴道恶性肿瘤。结果：完全缓解9例，部分缓解11例，总有效率为57．1％（20／35），主要毒性反应为骨髓抑制，消化道反应和脱发。结论：IFO联合方案对多药耐药性妇科恶性肿瘤均显示出较好疗效，是目前治疗耐药或复发性妇科恶性肿瘤的有效方案。     

脂质体紫杉醇联合顺铂及氟尿嘧啶一线治疗43例晚期胃癌的临床研究

[目的]评价脂质体紫杉醇（力扑素）联合顺铂、氟尿嘧啶（5-Fu）组成的PCF方案一线治疗43例晚期胃癌的临床疗效和毒副反应。[方法]脂质体紫杉醇135～175mg/m2,静滴3h,d1;顺铂20mg/m2,静滴2h,d1～5;5-Fu750mg/m2持续静脉滴注d1～5。21d为1个周期。按RECIST标准评定疗效,按WHO标准评价毒副反应,Kaplan-Meier法绘制生存曲线。[结果]全组共完成化疗167个周期,中位治疗3个周期。39例患者完成2个周期以上化疗并可评价疗效,其中CR1例,PR19例,SD11例,PD8例,总有效率51.3%。中位无进展生存时间6.0个月,中位总生存时间11.5个月,1年生存率41.0%。主要的Ⅲ~Ⅳ级血液学毒性为白细胞减少及中性粒细胞减少,发生率分别为16.2%和25.6%。全组仅1例发生过敏反应。无患者因毒性反应而停药,无治疗相关性死亡发生。[结论]脂质体紫杉醇联合顺铂及氟尿嘧啶一线治疗晚期胃癌疗效肯定,毒副反应轻,对患者生活质量改善明显。