恩度联合FOLFOX方案治疗老年晚期胃癌的疗效

晚期胃癌的治疗以铂类和氟脲嘧啶为基础化疗方案,奥沙利铂(OXP)/氟脲嘧啶(5FU)/亚叶酸钙(CF)治疗晚期胃癌有效率为45%左右,mTTP 6个月,中位生存期(MS)10个月左右,1年生存率40%,但是对老年胃癌的临床研究不多。本文应用ED联合FOLFOX方案治疗老年晚期胃癌患者,取得了较好     

GEMOX方案与FOLFOX4方案治疗中晚期原发性肝癌的疗效比较

目的对比观察使用GEMOX方案(吉西他滨联合奥沙利铂)和FOLFOX4方案(亚叶酸钙、氟尿嘧啶联合奥沙利铂)治疗中晚期原发性肝癌的临床疗效。方法选取原发性肝癌患者126例,随机分为观察组和对照组,观察组采用GEMOX方案进行治疗,对照组采用FOLFOX4方案治疗,比较两组临床疗效和不良反应。结果 (1)观察组和对照组疾病控制率(DCR)比例较高,分别为63.5%和65.1%,而两组总有效率(RR)和DCR差异无统计学意义(P0.05)。同时,血清甲胎蛋白(AFP)水平均明显降低、肿瘤大小均明显减小(均P0.05);(2)观察组和对照组治疗后白细胞计数、血小板计数均明显降低,谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TB)、直接胆红素(DB)均明显升高,白蛋白(ALB)明显降低(P0.05)。结论 GEMOX方案和FOLFOX4方案治疗中晚期原发性肝癌有显著治疗效果,但在化疗过程中存在明显不良反应。     

榄香烯注射液联合FOLFOX4化疗方案改善中晚期胃癌患者生活质量的作用研究

[目的]探讨榄香烯注射液联合FOLFOX4化疗方案治疗中晚期胃癌的疗效、不良反应及对患者生活质量的改善作用。[方法]收集90例中晚期胃癌患者作为观察对象,回顾性分析其临床资料,按照治疗方案分为对照组和观察组,每组各45例。对照组给予FOLFOX4化疗方案治疗,观察组在对照组基础上联合榄香烯注射液治疗。采用胃癌患者生活质量调查问卷(QLQ-STO22)评价患者生活质量,比较2组患者近期疗效、无进展生存期(PFS)、不良反应和生活质量。[结果]与对照组比较,观察组患者近期治疗总有效率升高(82.2%vs.62.2%),PFS延长[(4.12±0.95)个月vs.(3.18±0.74)个月],不良反应发生率降低(13.3%vs.35.6%),组间比较差异有统计学意义(P<0.05)。生活质量调查问卷显示,与对照组比较,观察组患者治疗后吞咽困难、胃部疼痛、呃逆、饮食受损、焦虑、口干、味觉问题、身体外观及脱发等评分均降低,组间比较差异有统计学意义(P<0.05)。[结论]榄香烯注射液联合FOLFOX4化疗方案能够提高中晚期胃癌患者临床疗效,减少不良反应发生,并有效改善生活质量。     

中晚期胃癌FOLFOX4方案新辅助化疗效果观察

目的探讨FOLFOX4方案新辅助化疗对中晚期胃癌的效果。方法对36例中晚期胃癌患者采用FOLFOX4方案行新辅助化疗2个周期（2周为1个周期）。结果化疗后肿瘤细胞坏死率、根治性手术切除率明显提高（P〈0．05）。结论FOLFOX4方案行新辅助化疗对进展期胃癌疗效较好,可提高手术切除率。     

FOLFOX4方案治疗胃癌62例近期疗效观察

对62例胃癌患者行草酸铂（OXA）＋5-氟尿嘧啶（5-Fu）＋四氢叶酸（CF）方案（FOLFOX4方案）化疗,2周重复一次为一周期。应用4～6个周期后判定疗效。结果62例患者平均治疗9．2个周期,其中完全缓解（CR）4例,部分缓解（PR）26例,稳定（SD）28例,总有效率48．4％,疾病控制率为93．5％,中位至疾病进展时间为9．0个月。单因素分析时CR＋PR者较SD＋PD者转移部位少、肝转移比例高、肺转移比例低;回归分析中仅肝转移影响有效性。主要毒副作用为骨髓抑制,粒细胞下降达80．6％,其次是胃肠道反应,周围神经毒性。认为FOLFOX4方案治疗胃癌,尤其是肝转移患者有较好疗效,毒性反应可耐受。     

进展期胃癌应用FOLFOX4治疗方案的临床研究

目的观察FOLFOX4方案治疗进展期胃癌的临床疗效和毒性。方法采用FOLFOX4方案治疗我科2003年6月-2008年7月确诊的221例老年晚期胃癌患者,4个周期后评定疗效。结果总有效率（CR＋PR）为40.27%（89/221）,完全缓解（CR）24例,部分缓解（PR）65例,最常见的毒性反应为骨髓抑制、神经毒性及胃肠道反应。结论FOLFOX4方案治疗进展期胃癌疗效可靠,毒性反应可以耐受。     

多西他赛联合FOLFOX4方案治疗晚期胃癌40例临床观察

目的探讨多西他赛＋FOLFOX4方案对晚期胃癌的疗效及毒副作用。方法晚期胃癌患者40例,给予以下化疗方案：多西他赛60 mg/m2静脉滴注,第1天;奥沙利铂85 mg/m2静脉滴注,第1天;亚叶酸钙（CF）200 mg/m2静脉滴注,第1、2天;5-氟尿嘧啶（5-Fu）400 mg/m2静脉推注,第1天,5-Fu 600 mg/m2持续静脉滴注46 h。14 d为1个周期,所有患者至少接受3个周期以上的化疗。结果 40例均可评价疗效,总有效率45.0%,中位生存时间9.3个月,中位肿瘤进展时间6.1个月。主要毒副反应为胃髓抑制、腹泻和脱发。结论多西他赛联合FOLFOX4方案治疗晚期胃癌的近期疗效好,毒副作用可以耐受。     

恩度与化疗联合治疗晚期消化道肿瘤的临床疗效

<正>消化道肿瘤中最常见的是食管癌、胃癌、肠癌、胰腺癌和阑尾癌等,临床上主要表现为特异性吞咽疼痛,并伴有恶心、呕吐、腹痛、食欲不振、吐血和便血等,对患者带来了严重的身心伤害。特别是晚期消化道肿瘤,其危害性更重,可严重缩短生存期限〔1〕。近年来,消化道肿瘤的发病人数不断增加,死亡率不断上升,因此对于消化道肿瘤患者进行及时有效地治疗是改善生活质量和延长生存期限的唯一方法〔2〕。目前,临床上对于晚期消化道肿瘤一般是采用以化疗为主,其他治疗为辅的综合     

FOLFOX4方案联合肠外营养支持治疗老年晚期大肠癌的疗效

目的探讨FOLFOX4方案联合肠外营养支持治疗老年晚期大肠癌的疗效观察。方法将该院2010年3月至2012年7月收治的68例晚期大肠癌患者随机分为对照组和观察组,两组均给予FOLFOX4方案治疗,仅观察组在化疗基础上给予肠外营养支持;分析化疗3个周期后的总体、不同部位的近期疗效(采用RECIST标准评价有效率RR和临床获益率DCR)和不良反应(WHO抗癌药物毒性反应)并观察不同化疗周期的营养指标(清蛋白ALB、前清蛋白PA、血清总蛋白TP、转铁蛋白TF)和免疫指标(总淋巴细胞计数TLC和免疫球蛋白IgG、IgA、IgM)的变化情况。结果观察组的RR和DCR均无统计学差异(P>0.05);两组的不良反应多为1²级,发生率最高均为26.47%,其中对照组为恶心呕吐,而观察组为血小板减少和纳差,且两组大肠癌常见不良反应的发生率上无统计学差异(P>0.05);两组化疗前的营养指标和免疫指标均无统计学差异,除化疗1个周期的TLC外,观察组化疗后的营养指标和免疫指标均优于对照组(P<0.05)。结论 FOLFOX4方案联合胃肠外营养支持治疗老年晚期大肠癌的效果较好,同时可改善由化疗和病程进展导致的营养不良和免疫功能迅速降低。     

胃癌血清肿瘤标志物单项及联合检测的临床意义

胃癌是消化道常见的恶性肿瘤之一,其症状的非特异性常被临床忽视而延误治疗,内窥镜等检查方法不适于普查.血清肿瘤标志物的检测较为便捷,且随着研究的不断深入,发现血清肿瘤标志物对于胃癌的筛选、辅助临床诊断、治疗后随访、复发检出、疗效评价及监测预后等有着重要的临床意义.     

Efficacy and safety of traditional Chinese medicine injections combined with FOLFOX4 regimen for gastric cancer: A protocol for systematic review and network meta-analysis

Background:Traditional Chinese medicine injections (TCMJs) combined with FOLFOX4 regimen could achieve favorable effects in the treatment of gastric cancer. However, the efficacy and safety of different TCMJs combined with FOLFOX4 in the treatment of gastric cancer have not been fully clarified. Due to the fact that there are as many as 10 kinds of TCMJs, how to choose an appropriate TCMJ has become an urgent clinical problem. The objective of this network meta-analysis is to explore the optimal options among different TCMJs for gastric cancer.Methods:PubMed, Web of Science, Scopus, Cochrane Library, Embase, China Scientific Journal Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Wanfang Data were searched to identify randomized controlled trials which focused on TCMJs combined with FOLFOX4 against gastric cancer from its inception to September 2021. Subsequently, 2 researchers will be independently responsible for literature screening, data extraction, and assessment of their quality. Standard pair-wise and Bayesian network meta-analysis will be performed to compare the efficacy and safety of different TCMJs combined with FOLFOX4 regimen via Stata 14.0 and WinBUGS1.4 software.Results:The results of this meta-analysis will be submitted to a peer-reviewed journal for publication.Conclusions:The conclusion of this systematic review will provide evidence for selecting an optimal TCMJ combined with FOLFOX4 for patients with gastric cancer.     

The efficacy and safety of bevacizumab combined with FOLFOX regimen in the treatment of advanced colorectal cancer: A systematic review and meta-analysis

Background:It is necessary to systematically evaluate the clinical efficacy and safety of bevacizumab (BEV) combined with 5-fluorouracil + leucovorin + oxaliplatin (FOLFOX) regimen in the treatment of advanced colorectal cancer.Methods:We searched the PubMed et al databases for randomized controlled trials (RCTs) on the BEV combined with the FOLFOX regimen in the treatment of advanced colorectal cancer up to January 20, 2021. The Cochrane Collaborations’ risk of bias tool was used for the quality assessment of included RCTs. Revman5.3 software was used for meta-analysis.Results:Eleven RCTs with a total of 3178 patients with advanced colorectal cancer were included, meta-analysis results showed that the objective response rate (odds ratio [OR] = 3.15, 95% confidence intervals [CI]: 2.25–4.40, P < .001) and cancer control rate (OR = 2.73, 95% CI: 1.91–3.90, P < .001) of BEV + FOLFOX were higher than that of FOLFOX group. And the incidence of gastrointestinal adverse reactions (OR = 1.29, 95% CI: 1.07–1.55, P = .008) in the BEV + FOLFOX group was higher than that of the FOLFOX group, there were no significant differences in the incidence of leukopenia (OR = 1.04, 95% CI: 0.72–1.50, P = .83), hypertension (OR = 3.92, 95% CI: 0.81–18.88, P = .09) and neurotoxicity (OR = 1.00, 95% CI: 0.8–1.27, P = .98) between the 2 groups.Conclusion:BEV combined with the FOLFOX regimen is more effective than the FOLFOX regimen alone in the treatment of advanced colorectal cancer, but it may also increase the risk of gastrointestinal adverse reactions.     

奥沙利铂联合希罗达或替加氟方案治疗老年晚期胃癌的临床观察

目的比较老年晚期胃癌应用奥沙利铂联合希罗达或替加氟方案化疗的疗效和安全性。方法 72例老年晚期胃癌按收治的时间顺序交替分为两组,A组用奥沙利铂联合希罗达方案化疗,B组用奥沙利铂联合替加氟加亚叶酸钙方案化疗,两组均化疗3个周期,比较两组的疗效和毒副反应。结果 A组化疗有效率36.1%,B组有效率38.9%,两组间疗效差异无统计学意义;两组初治均比复治有效率略高,但差异无统计学意义。毒副反应主要为血液学毒性、胃肠道反应和外周神经毒性、手足综合征。两组的白细胞减少及外周神经毒性无统计学差异。A组共发生血小板减少共12例,发生率33.3%,其中有2例Ⅲ度血小板减少;B组发生血小板减少共6例,发生率16.7%,未发生Ⅲ、Ⅳ度血小板减少。A组血小板减少发生率明显高于B组,两组有显著统计学差异(P<0.005)。B组胃肠道反应发生率为77.8%,且有2例Ⅲ度胃肠道反应,明显高于A组的61.1%,两者差异有统计学意义(P<0.05)。A组共发生手足综合征12例,其中2例为Ⅲ度,发生率为33.3%;B组共发生手足综合征5例,均为Ⅰ度,发生率为13.9%,两组手足综合征的发生率差异有统计学意义(P<0.05)。结论老年晚期胃癌应用奥沙利铂联合希罗达或替加氟方案化疗均取得较好的疗效,耐受性可。希罗达组的血液学毒性及手足综合征发生率较高,卡莫氟组胃肠道反应高于对照组。     

外周穿刺中心静脉导管在胃肠癌FOLFOX6化学治疗方案中的临床应用

目的探讨外周穿刺中心静脉导管(PICC)在胃肠癌FOLFOX6化学治疗方案中的临床应用.观察其疗效和不良反应.方法 59例胃肠癌行FOLFOX6方案化学治疗患者,采用经外周静脉中心静脉置管(PICC)结合便携式化学治疗泵给药.方案为:奥沙利铂100 mg/m2静脉点滴2 h,第1天;亚叶酸钙400 mg/m2静脉点滴2 h,第1天;5-氟脲嘧啶(5-FU)400 mg/m2静推,第1天;后以5-FU 2.4 g/m2,入化学治疗泵持续静脉输注46 h,每2周重复.结果全组有效率49.2%(29/59),完全缓解10例、部分缓解19例、稳定17例、疾病进展13例.不良反应主要是外周神经炎、胃肠道反应、骨髓抑制,所有反应在停止治疗后可恢复.平均PICC置管时间为62 d;其中10.2%出现静脉炎,3.4%出现导管堵塞,6.8%出现导管移位,未出现严重相关并发症.结论胃肠癌患者采用经PICC管结合化学治疗泵FOLFOX6方案化学治疗,不仅提高化学治疗效果,降低不良反应,同时提高患者生活质量,值得临床推广.     

以多西他赛为主二联与三联疗法对老年低分化胃癌的疗效对比分析

目的对比以多西他赛为主二联和三联疗法对老年低分化胃癌的临床效果。方法将60例老年低分化胃癌患者随机分成三联化疗组和二联化疗组,每组30例。二联化疗组给予多西他赛联合奥沙利铂方案化疗,三联化疗组给予多西他赛联合奥沙利铂、替吉奥方案化疗。对两组近期疗效、KPS评分、肿瘤进展时间(TTP)、生存时间(OS)及不良反应进行比较。结果二联化疗组客观缓解率、临床获益率为36.7%、63.3%,三联化疗组客观缓解率、临床获益率为33.3%、70.0%,差异无统计学意义(P0.05);治疗后,二联化疗组KPS评分为(71.5±6.6)分,显著性低于三联化疗组的(79.5±7.9)分,差异有统计学意义(P0.05);二联化疗组TTP为8.5个月,三联化疗组TTP为8.7个月,差异无统计学意义(P0.05);二联化疗组OS为13.4个月,三联化疗组OS为15.1个月,差异无统计学意义(P0.05);二联化疗组不良反应(白细胞降低、贫血、乏力)率显著低于三联化疗组,差异有统计学意义(P0.05)。结论相比于多西他赛为主三联疗法,多西他赛为主二联疗法对对老年低分化胃癌效果同样显著,且不良反应较少,适合老年人使用。     

榄香烯口服乳联合SOX方案对晚期胃癌患者外周血TAP水平的影响

目的:了解榄香烯口服乳联合SOX方案对晚期胃癌患者外周血中肿瘤异常蛋白(TAP)表达情况的影响,并探讨其临床意义.方法:选取2018年6月-2019年12月住院治疗的76例晚期胃癌患者为研究对象,按随机数字表法分为观察组及对照组,各38例.对照组予以SOX方案化疗,观察组在该基础上加用榄香烯口服乳治疗.治疗2个周期后,...     

沙利度胺联合吉西他滨及奥沙利铂方案治疗中晚期肝癌的临床对照研究

目的观察沙利度胺联合吉西他滨及奥沙利铂组成的Gemox方案治疗中晚期肝癌前后VEGF的变化及不良反应。方法56例中晚期肝癌患者,随机分为两组,治疗组29例采用沙利度胺联合吉西他滨及奥沙利铂组成的Gemox方案治疗,对照组27例采用吉西他滨联合奥沙利铂的Gemox方案治疗。治疗2个周期后观察临床疗效,并检测治疗前后VEGF水平的变化。结果两组有效率分别为51.72%和44.44%,差异无统计学意义(P>0.05)。治疗组治疗后VEGF较治疗前明显下降,对照组治疗前后VEGF变化的水平不明显(P>0.05)。两组不良反应的发生无明显差异,治疗组KPS评分明显高于对照组。结论沙利度胺联合Gemox方案有望提高中晚期肝癌的治疗有效率,降低血清VEGF,且能改善患者的一般状况,提高患者对全身化疗的耐受性。     

腹腔镜D2根治术联合完整系膜切除术治疗进展期胃癌的临床疗效分析

目的分析腹腔镜D2根治术联合完整系膜切除术(CME)治疗进展期胃癌的临床疗效。方法回顾性分析2018-01~2018-12于郑州大学第二附属医院行腹腔镜治疗的80例胃癌患者的临床资料,根据接受术式不同分为研究组(采用腹腔镜下D2根治术+CME治疗)和对照组(采用腹腔镜下标准D2根治术治疗),每组40例。比较两组手术时间、术中出血量、淋巴结清扫个数、术后功能恢复情况、术后并发症发生率以及术后1年生存情况。结果与对照组相比,研究组手术时间更短,术中出血量更少,淋巴结清扫个数更多,差异有统计学意义(P<0.05)。研究组首次排气时间、首次进食时间和住院时间显著短于对照组(P<0.05),腹腔引流管引流量显著少于对照组(P<0.05)。研究组术后并发症发生率显著低于对照组(22.50%vs 52.50%;χ²=10.912,P=0.000)。在随访过程中,研究组有8例(20.00%)出现肿瘤复发,对照组有16例(40.00%)出现肿瘤复发;研究组有2例(5.00%)死亡,对照组有5例(12.50%)死亡。log-rank检验结果显示,两组术后生存情况差异无统计学意义(χ²=2.735,P=0.143)。结论与标准D2根治术相比,D2根治术+CME术式手术时间更短,术中出血量更少,淋巴结清扫更彻底,术后肠道功能恢复更快,且术后并发症更少,值得临床推荐。     

Predictive and prognostic value of serum AFP level and its dynamic changes in advanced gastric cancer patients with elevated serum AFP

AIM To investigate predictive and prognostic value of serum alpha-fetoprotein(AFP) level and its dynamic changes in patients with advanced gastric cancer with elevated serum AFP(AFPAGC).METHODS One hundred and five patients with AFPAGC were enrolled in the study, and all of them underwent at least one cycle of systemic chemotherapy at our institute and had serum AFP ≥ 20 ng/m L at diagnosis or recurrence. Clinicopathologic features, serum AFP level at diagnosis and changes during treatment, first-line chemotherapy regimens, efficacy and toxicity, and survival information were collected. A Person's χ~2 or Fisher's exact test was used to measure the differences between variables. Survival prognostic factors were investigated using the Kaplan-Meier method and Cox regression.RESULTS Median serum AFP level was 161.7 ng/m L(range, 22.9-2557110 ng/m L). Objective response rates(ORR) was significantly lower in the AFP ≥ 160 ng/m L group than in the AFP 160 ng/m L group(30.4% vs 68.3%, P 0.001). ORR to doublet regimens was significantly lower in the AFP ≥ 160 ng/m L group, whereas ORR to triplet regimens was similar between the two groups. Liver metastasis rate was significantly higher in the AFP ≥ 160 ng/m L group than in the AFP 160 ng/m L(69.8% vs 50.0%, P 0.001). Overall survival(OS) in the two cohorts did not show any significant difference(P = 0.712). Dynamic changes of AFP were consistent with response to chemotherapy, and median OS of patients with a serum AFP decline ≥ 50% and those with a serum AFP decline 50% was 17.5 m and 10.0 m, respectively(P = 0.003). Hepatic(P = 0.005), peritoneal(P 0.001), non-regional lymph node metastasis(P 0.001), and portal vein tumor thrombus(PVTT)(P = 0.042) were identified as independent prognostic factors for AFPAGC. CONCLUSION Real-time examination of AFP has great predictive and prognostic value for managing AFPAGC. For those with markedly elevated AFP, triplet regimens may be a better choice.     

Irinotecan-involved regimens for advanced gastric cancer: a pooled-analysis of clinical trials

AIM:To assess the efficiency and toxicities of irinotecan (CPT-11)-involved regimens in patients with advanced gastric cancer.METHODS:Randomized phases Ⅱ and Ⅲ clinical trials on chemotherapy for advanced gastric cancer were searched from MEDLINE,EMbase,Cochrane Controlled Trials Register,and EBSCO.Relevant abstracts were manually searched.A total of 657 patients were analyzed for their overall response rate (ORR),time to treatment failure (TTF),overall survival (OS) rate,and toxicities.Overall survival rate,reported as hazard ratio (HR) with 95% CI,was used as the primary outcome measure.RESULTS:Four randomized controlled trials on chemotherapy for advanced gastric cancer were detected.The CPT-11-containing combination chemotherapy was not significantly advantageous over the non CPT-11containing combination chemotherapy for OS rate (HR =1.12,95% CI:0.92-1.36,P=0.266) and ORR [risk ratio (RR)=1.23,95% CI:0.71-2.14,P=0.458].However,the CPT-11-containing combination chemotherapy was significantly advantageous over the non CPT-11-containing combination chemotherapy for TTF (HR=1.35,95% CI:1.12-1.64,P=0.002).Grade 3/4 haematological toxicity (thrombocytopenia:RR=0.20,95% CI:0.09-0.48;P < 0.001) and gastrointestinal toxicity (diarrhea:RR=4.09,95% CI:2.42-6.93,P < 0.001) were lower in patients with advanced gastric cancer after CPT11-containing combination chemotherapy than after non CPT-11-containing combination chemotherapy.CONCLUSION:CPT-11-containing combination chemotherapy is advantageous over non CPT-11-containing combination chemotherapy for TTF with no significant toxicity.CPT-11-containing combination chemotherapy can be used in treatment of advanced gastric cancer.