FOLFOX方案治疗30例晚期胃癌疗效观察

目的：观察每二周高剂量亚叶酸钙（CF）／氟脲嘧啶（5－FU）与草酸铂（L－OHP）方案（FOLFOX方案）治疗晚期胃癌的临床疗效和毒副反应。方法：采用高剂量CF／5－FU／L－OHP深静脉输注方案（CF200mg.m^2-1.d^-1，静滴2小时，第1、2天；5-FU400mg.m^2-1.d^-1,静推，第1天，5－FU1600mg.m^2-1.d^-1，静滴22小时，第1、2天；L－OHP130mg.m^2-1.d^-1，静脉输注4小时，第1天），化疗方案以14天为1周期，重复4周期后间隔1个月评定疗效。结果：全组30例，总有效率为53．3％，18例初治组的有效率为61．11％，其中CR1例。12例复治组的有效率为41．7％，初治组中位缓解期为5个月。复治组的中位缓解期为3个月。Ⅱ、Ⅲ度口腔炎发生率为26．7％，7例出现手足综合征，血液学毒性轻微。结论：每二周高剂量CF／5－FU／L－OHP方案是治疗晚期胃癌有效安全的化疗方案。     

低剂量长疗程5—Fu静脉泵持续点滴治疗老年晚期胃癌的临床研究

目的 评价低剂量长疗程5－Fu静脉泵持续点滴治疗老年晚期胃癌的疗效及毒副反应。方法 21例老年晚期胃癌，使用低剂量5－Fu375mg/天静脉泵持续24小时点滴，连用21天，配合使用小剂量CF25mg、HCPT10mg，每周各连用5天，共用3周。4周为1周期，每例化疗2周期。结果 总有效率66．7％，CR率4．8％，毒副反应主要口腔炎52．4％、口腔溃疡38．1％、腹泻21．4％、便秘16．7％，本组主要为I-Ⅱ级毒 副反应，对症处理均能缓解。恶心、呕吐33．3％，使用止吐药后均能控制。粒细胞下降26．2％，无Ⅲ－Ⅳ级毒副反应。静脉炎14．3％／结论 该方案疗效好，毒副反应不严重，老年病人一般能耐受，值得进一步研究。     

生化调节法治疗晚期恶性肿瘤

目的利用DDP对5-氟脲嘧啶(5-FU)的生化调节作用,观察低剂量5-FU持续输注联合低剂量DDP方案治疗晚期恶性肿瘤的疗效。方法5-FU 250~300mg/(m2.d),使用化疗泵连续静脉输注3~4周,DDP 6mg/(m2.d)静脉注射,每周5天,连用3~4周,休息1个月,2个周期为1个疗程,评价疗效。结果全组共58例,CR 3例,PR 33例,总有效率62.1%,其中胃癌有效率64.3%,肝转移灶有效率65%,未见明显不良反应。结论低剂量DDP对5-FU有生化调节作用,低剂量DDP联合5-FU持续输注是治疗晚期恶性肿瘤有效低毒的化疗方案。     

羟基喜树碱联合5—氟尿嘧啶双周用药治疗晚期胃肠道肿瘤46例

目的：观察羟基喜树碱（HCPT）联合5－氟尿嘧啶（5－FU），大剂量甲酰四氢叶酸（HDCF）双周用药法治疗晚期胃肠道肿瘤的疗效和毒副作用。方法：化疗方案为每日CF200mg/m^2,D1,2天，第一天静脉滴注2小时后，以5－FU300mg/m^3静脉推注，随后以5－FU 1500mg/m^2连续静脉滴注，持续48小时，HCPT 6－8mg/m^2静脉滴注连用5天，每14天为一周期，结果：所有患者均至不完成两周期化疗，全组46例，胃癌中29例，大肠癌17例，总有效率52．2％，胃癌有效率51．7％，肠癌有效率52．9％，主要毒副反应为恶心呕吐和白细胞减少，多数在Ⅰ-Ⅱ度，结论：HDCF／5－FU连续静脉滴注2天，联合HCPT，两周疗法治疗晚期胃癌及大肠癌是有效的，毒性反应低，值得在临床中推广应用。     

顺铂联合5-氟尿嘧啶治疗41例晚期鼻咽癌疗效观察

目的评价PF方案（顺铂及5-氟尿嘧啶）以不同给药方法治疗肝、肺转移晚期鼻咽癌患者的疗效及毒副反应。方法回顾性研究41例接受PF方案治疗鼻咽癌肝、肺转移病例。按不同给药方法分为两组：A组22例,5-Fu 3.0g／m^2 120小时持续静脉输注;B组19例,5-Fu 00mg／m^2 5天间断静脉输注。所有患者至少接受两个疗程化疗。结果A组有效率86％。（CR3例,PR16例）,B组有效率52％（CR1例,PR9例）具有统计学意义（P〈0．05）。毒副反应多为Ⅰ°～Ⅱ°。两组比较无统计学意义（P〉0．05）。结论PF方案5-Fu持续静脉输注法治疗晚期鼻咽癌疗效优于5-Fu间断静脉输注法。     

每月二次高剂量CF／5—FU／OXA方案治疗晚期难治性胃肠道癌

目的 观察每月二次高剂量CF／5－FU／草酸铂（OXA）方案治疗晚期难治性胃肠道癌的临床疗效。方法 采用高剂量CF／5－FU／OXA深静脉输注方案,化疗方案以14天为1周期,重复5周期后间隔1个月评定疗效。结果 全组32例,总有效率为56.25%。20例晚期胃癌中,CR2例,PR11例,NC4例,PD3例,有效率为65.00％。其中肝脏转移灶的缓解率达78.57%（11／14）。12例晚期大肠癌中,CR0例,PR5例,NC2例,PD5例,有效率为41.67%。胃癌和大肠癌的中位缓解期分别为5个月、8.5个月。Ⅱ、Ⅲ度口腔炎发生率为25.00%,2例出现手足综合征,血液学毒性轻微。结论 每月二次高剂量CF／5－FU／OXA方案是治疗晚期难治性胃肠道癌有效安全的化疗方案。     

草酸铂、氟脲嘧啶为主化疗方案治疗晚期消化道肿瘤

目的：探讨草酸铂（OXA）、氟脲嘧啶（5－FU）为基础的化疗方案在晚期消化恶性肿瘤治疗中不同的应用方法。方法：110例治疗方案如下：1．OXA＋5FU／CF方案（CF甲酰四氢叶酸），OXA130mg.m^-2静滴d1；CF100mg.m^-2.d^-1静滴2hr，接用5－FU0．5g.m^-2.d^-1静滴6－8hr,d1-5,q3wks,治疗33例；2．FOLFOX方案，OXA130mg.m^-2.d1;CF200mg.m^-2.d^-1静滴2hr，接用5－FU400mg.m^-2.d^-1静推，再5－FU1．6g.m^-2.d^-1持输22小时d1-2,q2wks，治疗43例；3．OXA＋5－FU低剂量长时间持输，OXA100mg静滴d1,d8,d15;5-FU250mg.m^-2.d^-1持输21d,q4wks,治疗23例；4．OXA＋希罗达（CAP）方案，OXA130mg.m^-2静滴d1；希罗达1g,一天2次口连续14d,q3wks，治疗6例；5．OXHLV5FU3方案，即OXA＋5－FU／CF加羟基喜树碱（HCPT），OXA130mg.m^-2静滴d1；CF200mg.m^-2.d^-1静滴2hr，接用5－FU400mg.m^-2.d^-1静推，再5－FU1．6g.m^-2.d^-1持输22hr，d1-3,HCPT10mg.d^-1,d1-5,q3wks,治疗5例。结果：各方案的总有效率（CR＋PR）分别为30．3％（10／33）／51．2％（20／43）／39．1％（9／23）／66．7％（4／6）／100％（5／5）；外周神经感觉异常发生率达71．8％（79／110）。结论：以草酸铂、氟脲嘧啶为基础的化疗方案是较理想的治疗方案，治疗应个体化，神经副作用绝大多数为可逆性，耐受良好。     

肝动脉内持续输注5-氟尿嘧啶治疗原发性肝癌

目的 观察5-氟尿嘧啶(5-Fu)肝动脉内持续输注联合低剂量顺铂(DDP)(肝动脉内FP方案化疗)治疗原发性弥漫型肝癌的近期疗效和生存质量。方法 治疗组31例接受肝动脉内持续输注5-Fu 500mg／d,连用3～4周,DDP5mg／(m^2.d),静脉输注,每周用5天,连用3～4周为一疗程。共用2疗程。对照组接受常规介入治疗。结果 治疗组有效率54．83％,进展率19．36％,卡氏评分提高率54．84％。结论 肝动脉内FP方案是姑息治疗原发性弥漫型肝癌的有效方案。     

羟基喜树碱、氨甲蝶呤、5—氟毛嘧啶与醛氢叶酸钙联合化疗治疗晚期肺腺癌

目的：本文观察了羟基喜树碱（HCPI）,氨甲蝶呤（MTX）,5－氟脲嘧啶（5－Fu)和醛氢叶酸钙（LV）联合方法治疗晚期肺腺癌的疗效及毒副作用,方法：化疗方案为羟基喜树碱8mg/m^2静脉滴注,第1－5天,氨甲喋呤100mg静脉推注,第1日,醛氢叶酸钙150mg/m^2第2－4天,静脉洋注,5－氟脲嘧啶500mg/m^2静脉滴注,第1－5天,28d为1周期,连用2个周期以上,结果：HMLF方案治疗晚期肺腺癌51例,总有效率49％,1年生存率41％,中位生存期为11个月,主要毒副作用为轻度的血液和消化道反应,结论：羟基喜树碱为主的HMLF方案是治疗晚期肺腺癌有效且毒性产小的联合化疗方案。     

LD-FP方案治疗晚期胃癌50例观察

目的 评价小剂量5-Fu持续输注联合小剂量顺铂方案(LD-FP)治疗晚期胃癌的客观疗效和毒副反应。方法 PDD10mg，d1～5，5-Fu0．375，d1～21静脉泵持续24h输注。每4周为1个周期，每例2个周期。结果 总有效率56．0％、CR8．0％，初治优于复治，复治亦有一定疗效。毒副反应：恶心、呕吐24．0％、口腔溃疡28．0％、腹泻18．0％均较轻，对症处理均能缓解，静脉炎14．0％，粒细胞下降26．0％，无Ⅲ～Ⅳ级毒副反应。结论 LD-FP方案治疗晚期胃癌疗效好，毒副反应轻，费用较低，年老体弱者都能耐受。     

Phase II trial of docetaxel in patients with recurrent malignant glioma: a study of the National Cancer Institute of Canada Clinical Trials Group

Summary Background. We conducted a phase II study to determine the response to, and toxicity of, docetaxel (Taxotere; Rhône Poulenc Rorer Pharmaceuticals, Inc) in patients with recurrent malignant glioma. Patients and methods. Eighteen patients with recurrent malignant glioma were treated with 100 mg/m² (no prior chemotherapy) or 75 mg/m² (prior adjuvant chemotherapy) of docetaxel intravenously over 1 hour, every 3 weeks. Premedication with dexamethasone, diphenhydramine and ranitidine or cimetidine was given to all patients. Five (28%) had gioblastoma multiforme (GBM) and the rest other malignant gliomas. Eleven (61%) had an ECOG performance status of 0 or 1, and 13 (72%) were on corticosteroids at the start of treatment. Rigorous response criteria were used. All were eligible and évaluable for response. Results. No complete or partial responses were observed; the objective response rate was 0% (95% confidence interval: 0–15.3%). Patients received a median of 2 cycles (range, 1–6). Grade 3 or 4 neutropenia occurred in 17 (94%) patients and was associated with fever that required intravenous antibiotics in 4 (22%) patients. An additional patient received intravenous antibiotics for an infection not associated with neutropenia. Six (33%) patients had mild hypersensitivity reactions. Onychodystrophy, peripheral edema and peripheral neuropathy were uncommon and mild. Conclusions. Docetaxel has no significant activity in patients with recurrent malignant glioma.     

小剂量阿司匹林所致出血等不良反应状况调查

【】 目的 调查分析小剂量阿司匹林对心脑血管病一级预防、二级预防的疗效和出血等不良反应。方法 自行设计问卷调查表,采取面对面回答的方式填写调查表,并查阅患者的就诊病历、检验报告等核实患者提供的基本信息(包括疾病诊断、用药情况), 回顾调查分析2010年1月到2012年12月我院门诊和住院及社区使用小剂量阿司匹林预防心脑血管病的患者1000例。结果 与LDA相关的不良反应发生者共计236例(23.6%);其中消化道不良反应127例(12.7%)[包括消化道出血75例(7.5%)],脑出血12例(1.2%),鼻腔出血15例(1.5%),牙龈出血10例(1.0%),皮肤黏膜出血18例(1.8%),血尿9例(0.9%),眼睛球结膜出血45例(4.5%)。老年人460例中不良反应发生者共计147例(31.96%),其中严重的脑出血10例(2.17%),严重的消化道出血59例(12.83%);非老年人540例中不良反应发生者共计89例(16.48%),其中严重的脑出血2例(0.37%),严重的消化道出血16例(2.96%)。总不良反应发生率老年人与非老年人两者比较,差异有统义计学意义(X ₂ =3.98 P < 0. 05);严重的出血发生率老年人与非老年人两者比较,差异有统义计学意义(X ₂ =42.38 P < 0. 001)。结论 小剂量阿司匹林(50-325mg/d)依然存在安全性问题;其出血及消化道等不良反应值得临床密切关注。应用小剂量阿司匹林预防心脑血管病应注意预防出血等不良反应的发生。对老年人服用小剂量阿司匹林要给予特别关注和严密监测。     

包裹5-氟尿嘧啶的二氧化硅纳米颗粒的制备及细胞毒性研究

目的 制备包裹5-氟尿嘧啶的二氧化硅(5-Fu/SiO₂)纳米颗粒,并对其药剂学参数及体外细胞毒性进行研究。方法 利用反相微乳化法制备5-Fu/SiO₂纳米颗粒,对5-Fu投入量及反应时间等合成条件进行优化,考察纳米颗粒的稳定性及体外释药行为,并采用MTT法对其体外细胞毒性进行研究。结果 当5-Fu投入量为1.33 mg及反应时间为24 h时,5-Fu/SiO₂纳米的载药率及包封率达到最高,分别为1.03%及24.77%,同时该纳米在48 h内释放率达到41.31%,7 d内粒径无明显变化。细胞毒性实验表明,5-Fu/SiO₂纳米对人肝癌细胞具有明显的抑制效果,而空白SiO2纳米对细胞活性影响较小。结论 成功制备了稳定性好、缓释时间长的5-Fu/SiO₂纳米颗粒,为开发5-Fu缓释剂型提供了新的思路。     

Different types of opioid receptors mediating analgesia induced by morphine,DAMGO, DPDPE,DADLE and β-endorphin in mice

Summary The effects of intracerebroventricular (i.c.v.) administration of d-Phe-Cys-Tyr-d-Try-Orn-Thr-Pen-Thr-NH₂ (CTOP), a selective mu-opioid receptor antagonist, (Allyl)2-Tyr-Aib-Aib-Phe-Leu-OH (ICI 174864) and (N,N-Bisallyl-Tyr-Gly-Gly--(CH₂S)-Phe-Leu-OH (ICI 154129), selective delta-opioid receptor antagonists on blocking analgesia induced by -endorphin, morphine, d-Ala²-NMePhe⁴-Gly-ol-enkephalin (DAMGO), d-Ala²-d-Leu⁵-enkephalin (DADLE) and d-Pen²-enkephalin (DPDPE) administered i.c.v. were studied in male ICR mice. The analgesia was assessed by the tail-flick and paw-licking (hot-plate) tests. The potencies of opioid agonists injected i.c.v. for producing analgesia were DAMGO > DADLE > -endorphin > morphine > DPDPE. Intracerebroventricular administration of CTOP (0.05 g) selectively antagonized inhibition of the tail-flick and paw-licking response induced by morphine, DAMGO or DADLE but not -endorphin or DPDPE. ICI 174864 (5 g) and ICI 154129 (5 g) injected i.c.v. selectively antagonized analgesia induced by DPDPE or DADLE but not -endorphin, morphine or DAMGO injected i.c.v. These results indicate that analgesia induced by morphine and DAMGO is mediated by the stimulation of mu-opioid receptors while analgesia induced by DPDPE is mediated by the stimulation of delta-opioid receptors. DADLE-induced analgesia is mediated by the stimulation of both mu- and delta-opioid receptors. Analgesia induced by -endorphin is mediated by neither munor delta-opioid receptors.Abbreviations i.c.v. intracerebroventricular - i.t. intrathecal - CTOP d-Phe-Cys-Tyr-d-Try-Orn-Thr-Pen-Thr-NHZ - DAMGO d-Ala²-NMePhe²-Gly-ol-enkephalin - DADLE d-Ala²-d-Leus-enke-phalin - DPDPE dd-Pen²-dd-Pen⁵-enkephalin - ICI 174864 (Allyl)2Tyr-Aib-Aib-Phe-Leu-OH - ICI 154129 (N,N-Bisallyl-Tyr-Gly-Gly-(CH₂S)-Phe-Leu-OH     

急性心肌梗死患者应用质子泵抑制剂的利用评价及用药分析

目的：分析急性心肌梗死患者质子泵抑制剂（PPI）的使用情况,建立药物利用评价标准。方法：收集我院心血管内科2013年1月~2014年6月出院的急性心肌梗死患者的病例资料,对PPI的使用情况进行分析。结果：共纳入291例患者,PPI使用率91.4%,平均用药（10.3±4.2） d,给药方式口服、静脉继以口服为主,静脉途径多用泮托拉唑,平均剂量（54.0±19.2） mg·d^-1,口服途径多用雷贝拉唑,平均剂量（18.1±4.2） mg·d^-1。结论：我院心梗患者PPI使用率高、疗程较长,选药品种及用法用量基本合理;需加强对给药剂量和疗程的控制。     

Tachykinin antagonists inhibit the morphine withdrawal response in guinea-pigs

Summary This study was an investigation of the effects of the tachykinin antagonists, spantide and (d-Pro⁴, d-Trp^{7, 9, 10})substance P 4-11, injected intracerebroventricularly (ICV), on the locomotor and behavioural responses of guinea-pigs to substance P (SP) injected ICV and to naloxone-induced morphine withdrawal. SP, 50 nmol, produced increased locomotor activity and behaviour that mimicked the response induced by injection of naloxone hydrochloride, 15 mg/kg, in guinea-pigs treated 2 h previously with morphine sulphate, 15 mg/kg. Spantide or (d-Pro⁴, d-Trp^{7, 9, 10})SP4-11, 10 nmol, reduced the locomotor and behavioural responses to SP and to morphine withdrawal. The results support the suggestion that SP or a related tachykinin might be a mediator of the opioid withdrawal response in the central nervous system as has been proposed for the enteric nervous system.     

Phase II evaluation of dianhydrogalactitol in the treatment of advanced non-squamous cervical carcinoma

Summary In an on-going Phase II evaluation, dianhydrogalactitol (NSC 132313) was administered intravenously to 28 patients with advanced or recurrent non-squamous cell carcinoma of the cervix. The initial dosage was 60 mg/m²/wk with escalation to 75 mg/m²/wk if there were no adverse effects. Twenty-seven patients were evaluable for toxicity and response. There was one complete response and one partial response. Adverse effects were not infrequent but tolerable.     

Aziridinylbenzoquinone (AZQ) in the treatment of recurrent pediatric brain and other malignant solid tumors

Summary To assess the response rates and toxicity of AZQ in children with recurrent brain and other malignant solid tumors, a phase II study was implemented by the Pediatric Oncology Group. Eligible patients received AZQ 18 mg/M²/week i.v. for 4 doses followed by a 2 week rest period. Each dose was given over four hours (1/3 over the initial 20 minutes). After the first year, the dosage was reduced to 13 mg/M² due to myelotoxicity resulting in treatment delays. No objective responses were observed in 73 evaluable children with various noncentral nervous system tumors. Of the 91 patients with brain tumors, there were 4 CR's and 2 PR's in patients with astrocytoma, ependymoma, glioblastoma multiforme, oligodendroglioma, brain stem glioma and intracranial yolk sac tumor (median duration, 10 months; range, 2–20+ months). Three of 4 CR's were achieved with a dosage of 18 mg/M²/week. An additional 13 children with brain tumors experienced stable or improved disease (duration, 2–36 + months; median 7.5 months). The principal toxicity was myelosuppression which was cumulative but there were also 3 allergic reactions to AZQ. We conclude that for selected brain tumors, the rates of objective response and stable disease plus the duration of responses support further assessment of AZQ in combination with other agents. Furthermore, the 18 mg/M² dosage may provide better responses. Address for offprints: Pediatric Oncology Group, Operations Office, 4949 West Pine Boulevard, St. Louis, MO 63108, USA     

A Phase II Trial of Etoposide, Leucovorin, 5-FU, and Interferon Alpha 2b (ELFI) + G-CSF for Patients with Pancreatic Adenocarcinoma: a Southwest Oncology Group Study (SWOG 9413)

Background. Chemotherapeutic treatments using combinationsof etoposide, leucovorin and 5-FU (ELF) have shown activity inthe treatment of gastrointestinal malignancies. Interferon alpha2b is known to have antiproliferative effects on several celllines and has well documented in vitro evidence ofsynergism with 5-FU. It was postulated that the combination ofELF and interferon alpha 2b would improve response rates andsurvival in patients with pancreas cancer. Methods. Fifty-five eligible patients with locally-advancedor metastatic pancreatic adenocarcinoma received a regimenconsisting of: IV leucovorin at 300 mg/m²/day on Days 1-3(of 28-day cycle), IV etoposide at 80 mg/m²/day on Days 1-3, IV 5-FU at 500 mg/m²/day on Days 1-3, subcutaneousinterferon alpha 2b at 3 million units TIW, and subcutaneousG-CSF at 5 g/kg/day on Days 4-14 (or until WBC exceeds10,000/l). Patients with no evidence of disease progressioncontinued on treatment for a total of 6 cycles. Results. Complete response was demonstrated in 1 patient,partial response in 5 patients (11% confirmed response rate).The median survival was 5 months, and the six-month survival ratewas 40%. Ten patients completed all 6 cycles of treatment.Toxicity-related dose delays and reductions were necessary formost patients. Conclusions. Although the combination of ELF and interferonalpha 2b (ELFI) has modest activity in pancreatic cancer, it isa toxic and complex regimen that is not superior to othercurrently available approaches for the chemotherapeuticmanagement of pancreatic cancer. ELFI cannot be recommended asa standard therapy.     

A triplet chemotherapy regimen of cisplatin,fluorouracil and paclitaxel for locoregionally recurrent nasopharyngeal carcinoma cases contraindicated for re-irradiation/surgery

Objective: Salvage treatment for locoregionally recurrent nasopharyngeal carcinoma remains a significant challenge. The present study was conducted to evaluate the efficacy, toxicity and prognostic factors of a triplet chemotherapy regimen involving cisplatin, fluorouracil and paclitaxel (TPF) for locoregionally recurrent nasopharyngeal carcinoma (NPC) cases contraindicated for re-irradiation/surgery.

Methods: Patients with locoregionally recurrent NPC unsuitable for re-irradiation/surgery were treated with TPF therapy. The chemotherapy drugs were administered as follows: 135 mg/m² paclitaxel on day 1, 25 mg/m²/day cisplatin on days 1–3, followed by continuously infused intravenous fluorouracil for 120 h at a variable dosage from 600 to 800 mg/m²/day, depending on prior radiation.

Results: Twenty-seven patients were enrolled. The overall response was 66.7%. The median progression-free survival (PFS) and overall survival (OS) were 8.5 and 27.2 months, respectively. Toxicity was mild to moderate. Neutropenia and leukopenia were the primary grade 3–4 chemotherapy toxicities. 6 patients who regained the potential for re-radiotherapy or surgery showed significantly better outcomes than those treated with chemotherapy alone (median PFS: 20.8 vs. 7.1 months, P = 0.005; median OS: 54.2 vs. 20.6 months, P = 0.021).

Conclusion: TPF triplet chemotherapy showed a high response rate for locoregionally recurrent NPC with an acceptable toxicity profile.