TPC化疗方案治疗晚期卵巢癌的疗效观察

目的 探讨拓扑替康 紫杉醇 顺铂(TPC)化疗方案治疗晚期卵巢癌的疗效.方法 对我院74例晚期卵巢癌患者采取回顾性分析的方法,将患者随机分为TPC化疗方案组(治疗组)及常规化疗组(对照组).结果 经治疗,治疗组各项数据均优于对照组,两者之间差异有显著性(P＜0.05).结论 TPC化疗方案治疗晚期卵巢癌的效果满意,毒性反应轻,耐受性好.     

Pulmonary toxicity during prostate cancer treatment with docetaxel and thalidomide

The standard therapies of surgery, radiotherapy, and hormonal manipulations often fail to control metastatic prostate cancer (PC). Docetaxel and thalidomide may have activity in refractory PC. We highlight the potential pulmonary toxicity when docetaxel is combined with thalidomide. We reviewed three examples of docetaxel and thalidomide pulmonary toxicity at the National Cancer Institute (NCI) and summarized the published literature regarding docetaxel and thalidomide pulmonary toxicity. Docetaxel and thalidomide pulmonary toxicity has the following four main presentations: (1). symptomatic effusions; (2). dyspnea on exertion without any objective pathologic evidence; (3). interstitial lung disease; and (4). pulmonary embolus. As chemotherapy becomes more common in the treatment of PC, clinicians must consider possible pulmonary toxicities. If pulmonary symptoms or signs develop, clinicians should consider holding chemotherapy pending a complete evaluation.     

碘油平阳霉素瘤内注射联合反应停治疗复发性中晚期肝癌

目的:为肝动脉化疗栓塞(TACE)治疗后复发而又不再适合行TACE治疗的中晚期肝癌患者探索一种经济安全的治疗手段.方法:将55例行TACE治疗后复发的肝癌患者分为两组.治疗组在B超或CT引导下,将平阳霉素8～16 mg与超液态碘油5～10 mL充分乳化后,经皮肝肿瘤内注射;同时口服反应停50mg,每天3次,共14 d.对照组采用最佳支持治疗,同时口服常用抗癌中成药.以生存时间为主要终点,至疾病进展时间为次要终点.采用SPSS11.5统计软件进行survival分析及X2检验.结果:(1)治疗组与对照组3、6、12个月生存率分别为81.1%、64.9%和9.2% vs 60.0%、36.0%和5.1%,中位生存期为7.92个月 vs 5.25个月.经统计学分析,P=0.0465,两组之间差异有显著性;(2)治疗组病情稳定3个月但6个月后病情发展8例,占29.6%;随访至今无新的病灶产生并稳定6个月以上7例,占25.9%,受益率为55.5(29.6±25.9)%;对照组病情稳定3个月但6个月后病情发展4例.占14.3%,随访至今无新的病灶产生并稳定6个月以上4例,占14_3%,受益率为28.6(14.3±14.3)%.两组受益率比较,P=0.043,差异有显著性.结论:碘油平阳霉素瘤内注射+反应停治疗复发性中晚期肝癌不管是生存时间还是受益率都优于对照组,而且该方法简单易行,经济安全,特别适合于基层医疗单位推广,值得进一步探讨.     

Long-acting octreotide for the treatment and symptomatic relief of bowel obstruction in advanced ovarian cancer

Symptoms of malignant bowel obstruction in patients with recurrent ovarian cancer lead to a poor quality of life. Sandostatin LAR^® Depot (LAR) (Novartis Pharmaceuticals Corp., East Hanover, NJ) is an intramuscular, monthly administered, long-acting form of octreotide. LAR's safety and utility were evaluated in a pilot study enrolling 15 advanced ovarian cancer patients with bowel dysfunction. Once safety with subcutaneous (SQ) octreotide was assessed, patients were given 30 mg LAR on Day 1 and octreotide SQ for 2 weeks. Of 13 evaluable patients, three patients had a major response to LAR treatment with reduction in bowel obstruction symptoms, two had a minor response, four had no response, and four had progressive symptoms. Three patients remained on LAR for more than 9 months. No significant toxicities were attributable to octreotide or LAR. Because three patients received nine or more monthly injections of LAR, possible direct antitumor effects of LAR or synergy with chemotherapy needs to be explored.     

Dyspnea in cancer patients

'Dyspnea' is a subjective symptom defined as "an uncomfortable sensation of breathing". It should be distinguished from 'respiratory failure' defined as hypoxia. It is important to know that dyspnea is also related to psychological distress such as anxiety. The important points of management of dyspnea are described here; (1)Treat the underlying causes (e.g. antibiotics for pneumonia, blood transfusion for anemia), (2) pharmacological interventions such as morphine and anxiolytics, (3) non-pharmacological interventions such as oxygen, respiratory rehabilitation and relaxation. Since dyspnea in cancer patients has multidimensional aspects, interdisciplinary team approach for the symptom management is important.     

Successful treatment of advanced ovarian cancer with anlotinib: a case report

Ovarian cancer remains the most lethal gynecological malignant tumor, with relapse occurring in approximately 70% of advanced cases. Anlotinib is an oral small-molecule multi-targeted tyrosine kinase inhibitor that can resist neoangiogenesis and inhibit tumor growth. Previous research demonstrated clinical antitumor activity of anlotinib in various cancers. We report the case of an elderly woman with advanced ovarian cancer who received anlotinib after failure of multiple-line chemotherapy. A partial response was observed after six cycles of anlotinib monotherapy, with a reduction in the size of the metastases and significantly decreased serum CA125 levels from 1832.7 U/mL to 118.7 U/mL. She continued to take anlotinib, with a progression-free survival time of more than 4 months. Only mild hypertension was observed during the treatment. Anlotinib monotherapy may be a novel therapeutic option for patients with advanced ovarian cancer.     

超声引导下活检诊断晚期卵巢癌的临床价值

目的 探讨超声引导下穿刺活检诊断晚期卵巢癌的临床应用价值。 方法 对102例怀疑晚期卵巢癌患者行超声引导下穿刺活检,并将结果与术后病理进行比较分析。结果 穿刺取材满意率93.68%（163/174）,活检成功率91.18%（93/102）。根据卵巢病灶最大径分为3组：>5.0 cm组36例、1.5~5.0 cm组50例、<1.5 cm组16例,三组穿刺诊断准确率分别为94.44%（34/36）、98.00%（49/50）、62.50（10/16）,三组间差异有统计学意义（P<0.05）;<1.5 cm组中采用腹膜活检、卵巢联合腹膜活检者的诊断准确率高于单独卵巢肿物活检者,差异具有统计学意义（P=0.029）。结论 对可疑晚期卵巢癌患者行超声引导下穿刺活检,对于晚期卵巢癌及某些特殊病例的确诊与治疗具有重要的临床意义。     

沙利度胺在局部晚期非小细胞肺癌中抗血管生成作用的研究

目的探讨沙利度胺在治疗局部晚期非小细胞肺癌中的抗血管生成作用。方法以该院2012年10月至2014年1月收治的40例局部晚期非小细胞肺癌患者作为研究对象,分为对照组(单纯同步放、化疗)和治疗组(在对照组基础上联合沙利度胺),每组各20例。同步放疗剂量60Gy,6周30次;化疗方案为PC(紫杉醇45~50mg/m~2,1次/周+卡铂AUC=2,1次/周)/EP(顺铂50mg/m~2第1、8、29、36天+VP16 50mg/m~2第1~5天、第29~33天);沙利度胺每日200mg口服,第1天起持续10周。采用酶联免疫吸附试验检测全部患者0、6、10周血清血管内皮细胞生长因子(VEGF)水平。结果治疗后第10周,治疗组VEGF水平[(220.35±82.61)pg/mL]明显低于对照组[(292.76±152.06)pg/mL],差异有统计学意义(P0.05)。治疗组近期疗效有效率(55%)高于对照组(40%),但差异无统计学意义(P0.05)。治疗组睡眠改善、体质量增加、食欲增加和疼痛缓解情况均优于对照组,差异均有统计学意义(P0.05)。对照组受益4例,治疗组受益17例,差异有统计学意义(χ~2=16.942,P=0.000)。对照组和治疗组治疗后在非血液学毒性和血液学毒性方面差异均无统计学意义(P0.05)。结论沙利度胺联合EP/PC方案同步放、化疗可显著降低血清VEGF水平,提高局部晚期非小细胞肺癌患者临床受益率,且未增加毒副作用。     

Rapid progression of advanced "hormone-resistant" prostate cancer during palliative treatment with progestins for cancer cachexia

We report three patients with advanced "hormone-resistant" prostate cancer, each of whom had rapid progression of the disease during treatment with megestrol acetate for cancer cachexia. All patients had been previously treated with total androgenic deprivation. With progression of the disease, megestrol acetate was given to palliate the cancer-related wasting syndrome. No other antineoplastic drugs were contemporaneously given, and no concomitant condition that could favor the progression of the disease was present. The worsening observed while receiving megestrol acetate, and the atypical withdrawal syndrome occurring after the treatment was stopped, seem to suggest a promoting role of megestrol acetate in advanced "hormone-resistant" prostate cancer. The risk of rapid disease progression overwhelming the anti-cachectic palliative effect should be kept in mind when progestins are administered as a palliative treatment of cancer cachexia in patients with advanced "hormone-resistant" prostate cancer.     

深部热疗联合化疗治疗晚期卵巢癌近期疗效临床观察

目的探讨深部热疗联合全身化疗治疗晚期卵巢癌的临床近期疗效与相关毒副反应。方法将73例晚期卵巢癌患者随机分为深部热疗联合全身化疗组(治疗组)36例和单纯全身化疗组(对照组)37例,均给予紫杉醇+顺铂/卡铂方案化疗,热疗为腹盆腔深部热疗。治疗结束时,评价两组近期疗效,并观察毒副反应。结果治疗组和对照组的有效率及临床受益率分别是63.4%vs.51.4%(P=0.279),80.6%vs.70.3%(P=0.308);总有效率比较为77.8%vs.56.8%(P=0.056);CA125下降率分别为72.2%vs.54.1%(P=0.108),均无显著性差异。腹水控制率分别为70.6%vs.38.9%(P=0.044),差异有统计学意义。两组毒副反应主要是骨髓抑制、胃肠道反应、脱发、神经毒性等,大多为Ⅱ^Ⅲ度。治疗组及对照组发生Ⅲ+Ⅳ度骨髓抑制、胃肠道反应分别为38.9%vs.45.9%、19.4%vs.27.0%,差异无统计学意义(P=0.922,P=0.425)。热疗副反应轻,表现为轻度烫伤,不增加化疗的副作用。结论深部热疗联合全身化疗能一定程度提高晚期卵巢癌近期疗效,可缓解患者腹水引起的腹胀等临床症状,治疗相关毒副反应可耐受。     

沙利度胺联合放疗治疗老年晚期胃癌患者临床疗效及安全性分析

目的探讨沙利度胺联合放疗方案治疗晚期胃癌的临床疗效及安全性,为晚期胃癌治疗提供一定参考。方法选取我院收治的89例老年晚期胃癌患者,根据非随机临床同期对照研究及自愿原则将患者分为观察组(n=47)和对照组(n=42),对照组采用调强放疗技术进行治疗,观察组在对照组基础上同时服用沙利度胺治疗。对比两组临床疗效及不良反应,检测血管生成相关指标,评价患者生活质量。结果观察组疾病治疗有效率和疾病控制率均高于对照组,血清血管内皮生长因子(VEGF)、神经纤毛蛋白-1(NRP-1)水平均低于对照组(P<0.05);观察组总生存期及无进展生存期均长于对照组(P<0.05)。结论沙利度胺联合放疗治疗老年晚期胃癌患者肿瘤生长得到明显抑制,临床疗效较好,患者生活质量更高,生存期更长,不良反应较少,安全性较高,值得在临床治疗中推广。     

沙利度胺抑制卵巢癌细胞株SKOV3体外生长机制的研究

目的:探讨沙利度胺(Thal)单药及联合顺铂(cDDP)、5-氟尿嘧啶(5-FU)、依托泊苷(VP-16)对卵巢癌细胞株SKOV3体外增殖的抑制作用.方法:(1)MTT法检测细胞增殖抑制:(2)流式细胞术检测细胞周期:(3)半定量RT-PCR检测血管内皮生长因子(VEGF)mRNA、过氧化物酶体增殖物激活受体γ(PPAR-γ)mRNA的表达.结果:(1)MTT法示Thal单药及联合用药对细胞增殖有抑制作用,且呈浓度和时间依赖性.(2)流式细胞术示Thal能阻滞细胞于G<,0>/G<,1>期,联合用药可增强cDDP、5-FU、VP-16的疗效,显著阻滞细胞于S期.(3)半定量RT-PCR示200、100、50 μg/mL Thal能抑制VEGF mRNA表达;所有浓度Thal均不影响PPAR-γ mRNA的表达.结论:Thal可抑制卵巢癌细胞株SKOV3体外增殖、阻滞细胞周期、抑制VEGF mRNA表达.联合用药可增强cDDP、5-FU、VP-16的疗效.