磷酸雌二醇氮芥联合非那雄胺治疗激素难治性前列腺癌疗效观察

目的 观察联合应用磷酸雌二醇氮芥(EMP)和非那雄胺治疗激素难治性前列腺癌的疗效.方法 1999年7月至2006年1月联合应用EMP和非那雄胺治疗激素难治性前列腺癌14例.治疗方案EMP 280 mg,每日2次;非那雄胺5 mg,每日1次,28 d为一疗程,连续应用直至毒副反应无法耐受或治疗失败.疗效判断标准血前列腺癌胚抗原(PSA)下降＞50%且维持1个月以上为有效,软组织转移灶疗效分为痊愈、好转、稳定和进展.结果 14例随访3～24个月,平均13个月.PSA有效率57.1%(8/14),有效患者PSA从治疗前(53.6±42.3)ng/ml下降至治疗后3个月(12.8±9.5)ng/ml,平均有效时间9个月.软组织转移灶好转者3例,转移灶分别从治疗前2.0 cm×2.5 cm、3.5 cm ×4.5 cm、4.5 cm ×4.0 cm缩小为1.0 cm×1.0 cm、2.0 cm×2.5 cm、2.0 cm×3.0 cm,有效持续时间分别为5、9、12个月.结论 联合应用EMP和非那雄胺治疗激素难治性前列腺癌有一定疗效.     

磷酸雌二醇氮芥治疗晚期前列腺癌的临床观察

目的通过观察磷酸雌二醇氮芥治疗晚期前列腺癌的效果及其副作用.方法从1991年2月～1998年4月对36例晚期前列腺癌行去势术并每日口服磷酸雌二醇氮芥治疗,观察其疗效.结果36例前列腺癌中,有25例为CR,5例为PR,有效率达83%.盆腔淋巴结转移8例,7例转移肿大淋巴结消失,有效率(7/8)88%.骨转移16例,其中12例骨转移灶消失,有效率(12/16)75%.结论磷酸雌二醇氮芥治疗中低分化的晚期前列腺癌效果非常显著,明显改善病人生活质量.     

FOLFOX4方案治疗晚期胃癌的临床观察

目的:观察FOLFOX4方案治疗晚期胃癌的近期疗效和毒副反应.方法:26例晚期胃癌患者,采用FOLFOX4方案,即:奥沙利铂(L-OHP) 85mg/m2静脉点滴2小时,第1天;亚叶酸钙(CF)200mg/m2静脉点滴, 2小时, 第1,2天;氟脲嘧啶 (5-Fu)400mg/m2静脉推注, 第1,2天, 5-Fu 600mg/m2微泵持续静脉滴注22小时, 第1,2天;2周重复.4个周期后评价疗效和毒性.结果:全组26例均可评价,其中完全缓解(CR)1例,部分缓解(PR)13例,无变化(NC)8例,进展(PD)4例,总有效率(CR+PR)46.1%.中位生存时间(MST)为10个月.毒副反应主要是骨髓抑制,中性粒细胞减少发生率达84.6%,其次为胃肠道反应,恶心呕吐发生率88.5%,腹泻46.1%,无Ⅲ度～Ⅳ度胃肠道反应;本组患者未见明显心功能及肝肾功能损害.结论:FOLFOX4方案治疗晚期胃癌的近期疗效较好,毒副反应可以耐受,值得进一步研究应用.     

三维适形放射治疗前列腺癌的疗效

目的:目的:评价三维适形放射治疗前列腺癌的疗效.方法:回顾分析本院放射治疗41例前列腺癌患者,其中3DCRT组18例,常规放疗组23例.所有患者均采用6/15MV X线,1.8-2.0Gy/次,每周5次.3DCRT组肿瘤剂量DT70-78 Gy,常规放疗组肿瘤剂量DT65-72Gy.结果:3DCRT组与常规放疗组的3、5年生存率分别为83.3%、66.7%和69.6%、56.5%(P>0.05),两组2级以上急性胃肠道和泌尿系统反应发生率分别为27.8%和60.9%(P<0.05),2级以上慢性胃肠道和泌尿系统反应发生率分别为5.6%和21.7%(P>0.05).结论:三维适形放射治疗前列腺癌有提高生存率的趋势,副反应可接受,未发生严重晚期副反应.     

改良EOF方案治疗晚期胃癌32例临床观察

为了观察改良EOF方案治疗晚期胃癌的疗效、不良反应及生存情况,采用EOF方案治疗晚期胃癌患者32例,表柔比星60 mg/m2,d1, 奥沙利铂130 mg/m2, d1,5-FU 3 000 mg/m2持续静脉滴入120 h, 每3周重复化疗,观察有效率、生存情况及不良反应.改良EOF方案治疗晚期胃癌有效率46.9%,中位生存时间10.1个月(95%CI:7.9～12.3个月),1年生存率40.6%.中位无进展生存时间6.9个月(95%CI:5.7～8.1个月).不良反应主要为中性粒细胞减少、贫血、血小板减少、胃肠道反应、脱发和外周神经毒性等,多为Ⅰ～Ⅱ度.初步研究结果提示,改良EOF方案治疗晚期胃癌有效率与传统EOF方案相似,毒副反应可以耐受,治疗方便,临床可进一步扩大病例研究.     

贲门癌一线化疗后维持治疗的临床观察

目的:探讨卡培他滨维持治疗晚期贲门癌的疗效和不良反应.方法:82例初治晚期贲门癌患者,经一线化疗后达疾病控制患者分别进入维持组或观察组,维持组39例患者给予单药卡培他滨化疗,剂量为1000 mg/m2,口服2次/d,d 1~14,每3周为1个周期,用药时间至疾病进展或出现不能耐受的不良反应;观察组43例患者临床随访.观察两组中位无疾病进展时间、中位总生存期及维持组治疗前后的不良反应.结果:随访期间两组客观有效率差异无统计学意义(P=0.505).维持组中位无进展生存时间9.0个月,观察组6.5个月,两组比较差异有统计学意义(P=0.001),维持组中位总生存时间17个月,较观察组12.5个月有所延长(P<0.001).不良反应包括骨髓抑制、胃肠道反应、疲劳、手足综合征、外周神经毒性及口腔炎等,维持组治疗后只有手足综合征的发生高于治疗前(P=0.001).结论:一线化疗达疾病控制后以卡培他滨维持治疗能够延长晚期贲门癌患者无进展生存期和总生存期,不良反应较轻.     

周剂量多西他赛联合顺铂、5-FU治疗晚期食管癌的临床观察

目的:观察周剂量多西他赛联合顺铂、5-FU治疗晚期食管癌的临床疗效及不良反应。方法:47例晚期食管癌患者,应用多西他赛30mg/m2静脉滴注第1、8、15天,顺铂20mg/m2静脉滴注第1-5天,5-FU500mg/m2静脉滴注第1-5天,每28天重复。治疗2个周期评价疗效,每周期评价毒性。结果:47例患者均可评价疗效。获CR 3例,PR 21例,总有效率(CR+PR)为51.06%。所有患者中位疾病进展时间为149天,中位生存时间274天。主要不良反应为骨髓抑制,出现Ⅲ/Ⅳ度中性粒细胞减少13例(27.7%),Ⅲ度血小板减少3例(6.4%),Ⅲ度贫血5例(10.6%),无治疗相关性死亡。结论:周剂量多西他赛联合顺铂、5-FU治疗晚期食管癌疗效较好,毒性可以耐受,值得临床进一步研究。     

吉西他滨为基础的化疗方案治疗进展期胰腺癌的临床研究

背景与目的:进展期胰腺癌预后差.吉西他滨可以改善胰腺癌患者的生存质量,但吉西他滨联合方案疗效是否优于单药,还存在争议,国内更缺乏相关的临床研究.本研究目的是比较吉西他滨为基础的联合化疗方案与吉西他滨单药治疗进展期胰腺癌的疗效.方法:回顾性分析2000～2005年收治的40例经临床或病理确诊的进展期胰腺癌临床资料,其中吉西他滨单药组15例,吉西他滨剂量为1 000 mg/m2,每周1次,连用7周,休息2周,之后每周1次,连用3周,4周重复;吉西他滨联合治疗组25例,联合化疗方案包括吉西他滨1 000 mg/m2,每周1次,连用2周,分别联合:(1)氟尿嘧啶425～600 mg/m2,静脉滴注或持续静脉泵入,d1-5,3周重复;(2)顺铂60～75 mg/m2,分第1、2天,3周重复;(3)奥沙利铂85～130 mg/m2,d1,3周重复;(4)卡培他滨l000 mg/m2,2次/天,d1-14,3周重复.采用Kaplan-Meier生存曲线分析患者的生存期,并比较两组间的临床受益反应、中位疾病进展时间、中位生存时间和不良反应.结果:吉西他滨联合组与单药组患者的临床受益反应均得到改善(56.0% vs.46.7%),但疾病控制率、中位生存时间、临床受益反应在两组之间差异无统计学意义(P＞0.05),不良反应的发生率也相似(P＞0.05).对Ⅲ～Ⅳ期患者进行分层分析,发现吉西他滨联合组疾病控制率高于单药组(75.0% vs.45.5%),但无统计学意义(P=0.13).结论:吉西他滨联合方案与单药治疗进展期胰腺癌相比,疗效、临床受益反应、中位生存时间两组相似.     

吉西他滨单药治疗老年晚期非小细胞肺癌的临床观察

目的观察吉西他滨单药周剂量治疗老年晚期非小细胞肺癌的疗效和不良反应。方法对45例老年晚期非小细胞肺癌患者(年龄≥65岁)应用吉西他滨800¹000 mg/m2,第1、8天,31000 mg/m2,第1、8天,3⁴周为1个周期,至少治疗2个周期评价疗效和不良反应。结果全组总有效率为26.7%(12/45),临床受益率为71.1%(32/45),无疾病进展生存时间为4.2个月,中位生存时间为8.3个月,1年生存率为31.1%(14/45),主要不良反应为骨髓抑制、胃肠道反应、皮疹和肝肾功能受损。结论吉西他滨单药周剂量治疗老年晚期非小细胞肺癌耐受性较好,生活质量较高。     

磷酸雌二醇氮芥治疗雄激素非依赖性前列腺癌

单用磷酸雌二醇氮芥或磷酸雌二醇氮芥联合其他化疗药物是目前国外学者治疗雄激素非依赖性前列腺癌常选用的治疗方案 ,但国内报道尚不多见。我们自 1998年 4月—2 0 0 0年 1月用磷酸雌二醇氮芥治疗 9例雄激素非依赖性前列腺癌 ,报告如下。材料和方法一　研究对象　本组 9例 ,年龄 6 3— 84岁 ,平均 72岁 ,所有病人均行前列腺穿刺活检 ,病理证实是前列腺癌 ,病理分级 :Ｇ1 1例 ,Ｇ2 2例 ,Ｇ36例 ;临床分期 :Ｃ期 2例 ,Ｄ期 7例 ,Ｄ期病人均有骨转移。治疗前血ＰＳＡ 2 4μｇ Ｌ～ 15 0 μｇ Ｌ ,所有病人血睾酮均维持去势水平 (5例药物去势者…     

Phase II evaluation of docetaxel plus one-day oral estramustine phosphate in the treatment of patients with androgen independent prostate carcinoma

BACKGROUND: Recent clinical trials have shown antitumor activity with the combination of docetaxel plus estramustine phosphate (EMP) in the treatment of patients with androgen independent prostate carcinoma (AIPC). However, the most commonly employed treatment schedules with EMP have been associated with significant gastrointestinal, cardiovascular, and thromboembolic toxicity. The authors hypothesized that the therapeutic index of the combination of docetaxel plus EMP for patients with prostate carcinoma could be enhanced by reducing the incidence and severity of EMP-associated toxicity, which could be accomplished by shortening the duration of exposure to EMP. To preserve the therapeutic synergism between docetaxel and EMP, they designed a regimen employing higher doses of oral EMP administered on the day of the docetaxel infusion. METHODS: From June 1, 1998 through September 28, 2000, 42 patients with AIPC were registered to receive docetaxel (70 mg/m2 intravenously over 1 hour) and EMP (280 mg orally every 6 hours x 5 doses) every 21 days, up to a maximum of 6 cycles. Dexamethasone was administered prior to docetaxel and coumadin 2 mg orally every day was taken during the study treatment period. Patient characteristics included a median age of 68 years, a median Eastern Cooperative Oncology Group performance status of 1, a median prostate specific antigen (PSA) level at study entry of 110.5 ng/mL, and a median of 2 prior hormonal manipulations. Ten patients (25%) had received prior chemotherapy, and 14 patients (33%) had received prior palliative radiation therapy. RESULTS: Forty patients were evaluable for response and toxicity. Eighteen patients (45%; 95% confidence interval, 29-62%) had a decline > 50% in PSA level that lasted > 4 weeks with a median time to PSA progression and a median duration of PSA response of approximately 4.0 months. Four of 20 patients (20%) had partial soft tissue responses. Ten of 17 symptomatic patients (59%) had improvement in pain. The median survival for all patients was 13.5 months. The most prominent Grade 3 and 4 toxicities were reversible myelosuppression and fatigue. Nausea, emesis, diarrhea, and peripheral edema were minimal. No thromboembolic or hepatic complications were seen. CONCLUSIONS: Docetaxel plus 1 multidose day of oral EMP was active in patients with AIPC and was associated with an acceptable toxicity profile. Overall, the therapeutic index of this regimen compared favorably with regimens that employed a longer administration of EMP.     

Clinical evaluation of effects and improvement in quality of life from palliative therapy of combination chemotherapy with Furtulon and consecutive low-dose cisplatin in cases of unresectable advanced gastrointestinal carcinoma

Combination chemotherapy of Furtulon/low-dose cisplatin (CDDP) was administered to 13 patients with unresectable advanced gastrointestinal carcinoma (including 4 cases of gastric cancer, 6 of colorectal cancer, 1 of pancreatic cancer, 1 of hepatic cancer, and 1 of esophageal cancer). All patients were unresectable due to poor performance status (PS > 3) or metastasis. They were treated with Furtulon 1,200 mg/day orally on days 1-10 followed by 4 drug-free days, every 2 weeks, and CDDP 3.5 mg/m2/day, on days 1-5 by i.v. followed by 2 drug-free days every 4 weeks repeatedly. An average of 2-3 cycles were used. Six out of 13 patients had a partial response, 5 had no change, and 2 had progressive disease. The response rate was 46% and median survival time was 320 days. After chemotherapy, there was an increase in appetite and body weight in 11 patients (85%), and the patients maintained a good performance status and quality of life. Moreover no renal dysfunction occurred after treatment with CDDP. There was no high-grade toxicity over grade 2, only slight nausea, vomiting and diarrhea. From the present study, combination chemotherapy of Furtulon/low-dose CDDP seems to be effective for patients with advanced gastrointestinal cancer, and to have improved their quality of life (QOL).     

Dose escalation study of intravenous estramustine phosphate in combination with Paclitaxel and Carboplatin in patients with advanced prostate cancer.

PURPOSE: The purpose is to determine a safe weekly dose of i.v. estramustine phosphate (EMP) to combine with weekly paclitaxel and monthly carboplatin in patients with advanced prostate cancer. EXPERIMENTAL DESIGN: Patients with advanced prostate cancer (castrate and noncastrate) were administered escalating doses of weekly 1-h infusion of i.v. EMP (500-1000-1500 mg/m(2)) in combination with weekly paclitaxel (100 mg/m(2) over 1 h) and i.v. carboplatin (area under the curve 6 mg/ml-min every 4 weeks). Four weeks of therapy were considered one cycle. In the first three cohorts, EMP was given i.v. 3 h before paclitaxel. Cohorts 4 and 5 reversed the administration order: EMP (doses 1000-1500 mg/m(2)) was given immediately after the end of paclitaxel infusion. Plasma levels of EMP and its metabolites, estramustine and estromustine, were monitored at time 0, at 120 min, and approximately at 20, 21, and 168 h from the start of EMP infusion. Paclitaxel concentrations were determined at basal (0), 30, 60, 90, and 120 min and 18 h after the start of paclitaxel infusion, and a concentration-time curve was estimated. Pharmacokinetic evaluation was performed in cycles 1 and 2 during the first week of therapy. RESULTS: Nineteen patients were entered on the initial three dose levels (cohorts 1-3). Dose-limiting transient hepatic toxicity was encountered in cohort 3 (EMP = 1500 mg/m(2)). An additional 13 patients were treated with paclitaxel (100 mg/m(2)) first, followed by i.v. EMP at 1000 mg/m(2) (cohort 4), and 1500 mg/m(2) (cohort 5). No dose-limiting toxicities were seen, and cohort 5 was determined safe for Phase II studies. Thromboembolic events were observed in 9% of patients (no prophylactic coumadin was used). Plasma concentrations of EMP and metabolites increased proportionally with dose. In all cohorts, there was a slight decrease in EMP and estramustine plasma concentrations between cycles 1 and 2. Although not significant, higher levels of estromustine at cycle 2 were observed in comparison to cycle 1. Decreased clearance of paclitaxel leading to higher than expected paclitaxel plasma concentrations was observed during the first cycle of therapy. Paclitaxel plasma concentrations were lower during cycle 2. In 17 patients with androgen-independent disease, 59% had >/=50% posttherapy decline in PSA and 22% showed measurable disease regression. CONCLUSIONS: The regimen of weekly i.v. EMP in combination with paclitaxel and carboplatin can be safely administered with hepatic toxicity being transient and reversible. Pharmacokinetic results suggest that EMP competitively inhibits the biotransformation of paclitaxel after the first administration. This effect is counterbalanced, after repeated administrations, by a possible induction of the metabolic system caused by EMP. Phase II testing is ongoing to evaluate the efficacy of this combination.     

Validity of two-hour continuous hepatic arterial infusion chemotherapy with low-dose 5-FU for unresectable liver metastasis from colorectal cancer

The significance of hepatic arterial infusion chemotherapy for unresectable liver metastases from colorectal cancer was evaluated in 50 patients, who received either of the following regimens: 1 shot 5-FU + epirubicin + MMC (FAM group); hepatic arterial infusion of 5-FU for 2 hours + MMC (MF group); hepatic arterial infusion of 5-FU for 2 hours (5-FU group). There were no differences in the clinicopathological backgrounds of the patients among the groups. The mean survival time was 10.3 months, 16.0 months and 16.2 months in the FAM, MF and 5-FU groups. The effective percentages were 0%, 40% and 31% in the FAM, MF and 5-FU groups and the survival time of the effective cases was 18.1 months and 21.8 months in the MF and 5-FU groups. The MF group and 5-FU group showed significant improvement in prognosis. Concerning side effects, myelo-suppression and gastrointestinal toxicity appeared frequently in the MF group. In conclusion, 2-hour continuous hepatic arterial infusion with low-dose 5-FU for unresectable liver metastases from colorectal cancer may be helpful for improvement of prognosis.     

Phase I clinical and pharmacologic trial of intravenous estramustine phosphate.

PURPOSE: To determine the dose-limiting toxicities, maximum-tolerated dose, and pharmacokinetics of intravenous estramustine phosphate (IV EMP). PATIENTS AND METHODS: A total of 31 patients with hormone-refractory prostate cancer received IV EMP as a 30- to 90-minute infusion weekly (n = 28) or for 3 consecutive days followed by a single weekly dose (n = 3). IV EMP dose was escalated from 500 to 3,000 mg/m(2). Pharmacokinetics of EMP and the metabolites estramustine (EaM), estromustine (EoM), estradiol, and estrone were assessed after weeks 1 and 4 of treatment. RESULTS: The initial IV EMP infusion caused perineal discomfort that was ameliorated by lengthening the infusion time. Other common toxicities were grade 1 to 2 hepatotoxicity, nausea or vomiting, and fatigue or malaise. Lower-extremity thrombosis occurred in one patient, and two others developed upper-extremity thrombosis associated with venous infusion catheters. Dose-limiting fatigue and hypotension occurred at 3,000 mg/m(2), and cumulative fatigue developed after multiple cycles at 2,500 mg/m(2). Mean EMP clearance, estimated steady-state volume of distribution, and elimination half-life were 3.7 L/h, 10.6 L, and 3.7 hours, respectively. Variability of EMP clearance was 21%, and variation in area under the curve per dose for the metabolites was 28% to 36%. Elimination half-lives of EoM and EaM were 110 hours and 64 hours, and peak plasma concentrations of these active metabolites exceeded 10 micromol/L after IV EMP doses greater-than-or-equal 2,000 mg/m(2). CONCLUSION: High-dose IV EMP can be administered safely as a weekly short infusion to patients with HRPC. High peak concentrations of active metabolites after IV EMP may provide an advantage over oral EMP in antimicrotubule drug combinations.     

Chemotherapy with low-dose CDDP and continuous 5-FU for the treatment of advanced gastric cancers]

INTRODUCTION: 5-fluorouracil (5-FU) has been widely used for the treatment of gastrointestinal cancers. On the basis of recent findings, low-dose Cisplatin (CDDP) and continuous venous infusion of 5-FU have shown additive or synergistic antitumor effects in experimental models. We evaluated clinical effects of low-dose CDDP and 5-FU (low-dose FP therapy) in patients with advanced gastric cancers. PATIENTS AND METHODS: In December 1993 and June 1998, 52 patients with advanced gastric cancer were entered in this study. Patients were considered eligible if they had a bidimensionally measurable tumor. 5-FU (160 mg/m2/day) was continuously infused over 24 hours using an implantable port, and CDDP (3 mg/m2/day) was infused for half an hour. The administration schedule consisted of 5-FU for 7 consecutive days and CDDP for 5 days followed by a 2-day rest every four weeks according to response and tolerance. RESULTS: Low-dose FP therapy was given 44 patients (85%). The response rate was 65.9% and median survival time was 249 days. The responder group showed good survival compared with the non-responder group. The regimen was tolerable, and the most common toxicity was anorexia (40.3%). Three patients suffered from grade 3 anorexia, leukopenia and mucositis. On the other hand, renal dysfunction occurred in 50% (two of four patients administered over 1,000 mg CDDP). These results raise the possibility that the dose-limiting factor of low-dose FP therapy may account for the total dosage of CDDP. CONCLUSION: Low-dose FP therapy promises to be effective in the clinical management of advanced gastric cancer.     

Extramedullary plasmacytoma: tumor occurrence and therapeutic concepts.

BACKGROUND: Extramedullary plasmacytoma (EMP) is a rare entity belonging to the category of non-Hodgkin lymphoma. EMPs make up 4% of all plasma cell tumors and occur mainly in the upper aerodigestive tract (UAD). Seven patients with EMP included in this evaluation were under the authors' care and have been clinically followed since 1990. Because there are no general guidelines for the treatment of patients with EMP, the authors tried to obtain detailed data about the occurrence of this disease and also reviewed the therapies that have been used. To do so, they evaluated all EMP cases published in the medical literature until now and included their own experience. METHODS: Based on the clinical course and follow-up of their own EMP patients, the authors evaluated and reinvestigated all EMP cases cited in MEDLINE, Index Medicus, DIMDI (Deutsches Institut fur medizinische Dokumentation und Information, Cologne, Germany), and the reference lists of the publications found through these sources. RESULTS: In a detailed literature search, more than 400 publications between 1905 and 1997 were found, and these revealed that EMP mainly occurs between the fourth and seventh decades of life. Seven hundred fourteen cases (82.2%) were found in the UAD, and 155 cases (17.8%) were found in other body regions. The following therapeutic strategies were used to treat patients with EMP of the UAD: radiation therapy alone in 44.3%, combined therapy (surgery and radiation) in 26.9%, and surgery alone in 21.9%. The median overall survival or recurrence free survival was longer than 300 months for patients who underwent combined intervention (surgery and radiation). This result was statistically highly significant (P = 0.0027, log rank test) compared with the results for patients who underwent surgical intervention alone (median survival time, 156 months) or radiation therapy alone (median survival time, 144 months). In most cases of non-UAD EMP, surgery was performed (surgery alone, 55.6%; surgery and radiation combined, 19.8%; radiation alone, 11.1%), but there were no statistical differences in survival (P = 0.62). Overall, after treatment for EMP in the UAD, 61.1% of all patients had no recurrence or conversion to systemic involvement (i.e., multiple myeloma, MM); however, 22.0% had recurrence of EMP, and 16.1% had conversion to MM. After treatment for EMP in non-UAD areas, 64.7% of all patients had no recurrence or MM, 21.2% had recurrence, and 14.1% had conversion to MM. CONCLUSIONS: The current investigation provides evidence that surgery alone gives the best results in cases of EMP of the UAD when resectability is good. However, if complete surgical tumor resection is doubtful or impossible and/or if lymph node areas are affected, then combined therapy (surgery and radiation) is recommended. These results, which were obtained from retrospective studies, should be confirmed in randomized trials comparing surgery with combined radiation therapy and surgery.     

奥曲肽治疗晚期原发性肝癌的临床观察

目的 :观察生长抑素类似物奥曲肽治疗晚期肝癌的疗效及不良反应。方法 :全组共收集 4 5例患者。治疗组2 0例 ,,使用奥曲肽 0 1mg ,皮下注射 ,每 8小时一次 ,每周 5天 ,直至进展。对照组 2 5例 ,接受积极的支持治疗。 2个月进行 1次评价。结果 :治疗组 1例PR ,对照组 0例PR ,无显著性差异 (P >0 0 5 )。治疗组中位生存期为 7个月 ,对照组中位生存期为4个月 ,无显著性差异 (P >0 0 5 )。治疗组中位TTP为 5个月 ,对照组中位TTP为 3个月 ,有显著性差异 (P <0 0 5 )。生活质量治疗组较对照组有较明显提高 ,上消化道出血的发生治疗组明显减少。无明显副作用。结论 :奥曲肽治疗晚期肝癌有一定疗效。     

Good tolerance of weekly irinotecan in a patient with metastatic colorectal cancer on chronic hemodialysis

Pharmacokinetic properties of many antineoplastic agents or their metabolites change with organ dysfunction. Unfortunately, chemotherapy doses determined in phase I and II studies in patients with normal hepatic and renal reserves are not usually applicable to those with hepatic and/or renal dysfunction. Considering the high incidence of colorectal adenocarcinoma, it is not unusual for a colorectal cancer patient to be on chronic hemodialysis. We report a patient with metastatic colorectal cancer on chronic hemodialysis who tolerated weekly irinotecan at 50 mg/m2 well without significant toxicity. We briefly discuss therapeutic dose modification in such patients.     

Syndrome of inappropriate antidiuretic hormone secretion associated with hepatic arterial infusion of vinblastine in three patients with breast cancer

We report the occurrence of the syndrome of inappropriate antidiuretic hormone secretion in 3 patients with breast carcinoma metastatic to the liver who received hepatic arterial infusion of vinblastine at lower doses than those previously associated with this effect. Leukopenia was severe in all patients, who additionally experienced hypokalemia with excessive kaliuresis. The etiology of the observed hypokalemia is unclear. We suspect that vinblastine may induce renal tubular dysfunction. These toxicities appear dose-related.