多西他赛联合顺铂或卡铂治疗晚期非小细胞肺癌的临床观察

目的:观察多西他赛联合顺铂或卡铂治疗晚期非小细胞肺癌的临床疗效及不良反应.方法:共有56例经病理学和/或细胞学证实的晚期非小细胞肺癌患者入组,多西他赛联合顺铂治疗37例,多西他赛联合卡铂治疗19例,多西他赛75mg/m2,静脉滴注1小时,第1天,顺铂40mg/m2,静脉滴注,第2-3天,或卡铂ACU=5(300-400mg/m2),第2天或第2-3天分次给予,28天为1个周期,化疗2个周期后按WHO标准评价疗效及不良反应.结果:CR 1例,PR 26例,SD 20例,PD 9例,有效率48.2%(27/56),不良反应主要为骨髓抑制、恶心、呕吐和脱发.结论:多西他赛联合顺铂或卡铂治疗晚期非小细胞肺癌疗效确切,不良反应能耐受,值得进一步临床研究.     

吉西他滨联合顺铂或卡铂方案治疗晚期非小细胞肺癌的临床对比观察

目的 本研究旨在观察初治的晚期非小细胞肺癌患者接受吉西他滨加顺铂(GCis)和吉西他滨加卡铂(GCarb)是否具有相同的治疗效果,卡铂能否完全替代顺铂,从而成为晚期非小细胞肺癌患者化疗的标准含铂二药联合方案.方法 吉西他滨1 000 mg/m2,静脉滴注,d1,8;顺铂75 mg/m2,d1或25 mg/m2,d1-3;卡铂AUG=5;每21 d为1周期,分别化疗3～6周期.结果 入组76例均可评价疗效,GCis组:33例中,CR 1例,PR 13例,MR 3例,SD 7例,PD 9例,有效率42.42%(14/33);疾病控制率72.73%(24/33);中位TTP 5个月;中位生存期14个月;1年生存率66.67%(22/33);2年生存率12.12%(4/33).GCarb组:43例中,PR 13例,MR 11例,SD 7例,PD 12例,有效率30.23%(13/43);疾病控制率72.09%(31/43);中位TTP 4个月;中位生存期11个月;1年生存率48.84%(21/43);2年生存率2.33%(1/43).其中中位生存时间(MST)二组差异有统计学意义(χ2=2.45,P=0.017).主要毒副反应为轻中度骨髓抑制和恶心呕吐.结论 两组方案对晚期NSCLC患者有相似的疗效和较好的毒副反应耐受性,总体GCis组略优于GCarb组,卡铂仍不能替代顺铂成为晚期NSCLC标准的一线化疗方案.     

多西他赛联合顺铂或卡铂治疗晚期非小细胞肺癌的临床观察

目的：观察多西他赛联合顺铂或卡铂治疗晚期非小细胞肺癌的临床疗效及不良反应。方法：共有56例经病理学和／或细胞学证实的晚期非小细胞肺癌患者人组,多西他赛联合顺铂治疗37例,多西他赛联合卡铂治疗19例,多西他赛75mg／m^2,静脉滴注1小时,第1天,顺铂40mg／m^2,静脉滴注,第2—3天,或卡铂ACU=5（300—400mg／m^2）,第2天或第2—3天分次给予,28天为1个周期,化疗2个周期后按WHO标准评价疗效及不良反应。结果：CR 1例,PR 26例,SD 20例,PD 9例,有效率48．2％（27／56）,不良反应主要为骨髓抑制、恶心、呕吐和脱发。结论：多西他赛联合顺铂或卡铂治疗晚期非小细胞肺癌疗效确切,不良反应能耐受,值得进一步临床研究。     

吉西他滨联合顺铂或卡铂治疗晚期非小细胞肺癌的近期疗效

目的 :观察吉西他滨 (gemcitabine)联合顺铂与吉西他滨联合卡铂治疗晚期非小细胞肺癌的疗效和毒性反应。方法 :10 6例经病理组织学或细胞学证实的晚期非小细胞肺癌患者分为GP和GC两组 ,GP组应用吉西他滨 10 0 0mg/m2 ,静滴 ,第 1、8天 ;顺铂 30mg/m2 ,静滴 ,第 1～ 3天。GC组应用吉西他滨 10 0 0mg/m2 ,静滴 ,第 1、8天 ;卡铂ACU =5 ,静滴 ,第 1天。 2 1天为 1个周期 ,连用 2个周期评价疗效。结果 :GP组和GC组有效率 (CR PR)分别为 4 8.1%和 4 4 .2 % (P >0 .0 5 ) ;中位疾病进展时间分别为 6 .8个月和 6 .2个月 (P >0 .0 5 ) ;毒性反应中GP组消化道毒副反应较GC组大 ,差异有显著性 ;骨髓毒性两组相当 ,差异无显著性。结论 :吉西他滨联合顺铂及吉西他滨联合卡铂两方案治疗晚期非小细胞肺癌疗效均较好 ,毒性反应轻微 ,患者耐受良好 ,尤其吉西他滨联合卡铂的消化道反应轻 ,患者易于接受 ,值得临床进一步研究。     

奈达铂或顺铂联合多西他赛治疗晚期非小细胞肺癌的临床观察

目的评价奈达铂(NDP)或顺铂(DDP)联合多西他赛(TXT)治疗晚期非小细胞肺癌的疗效和不良反应。方法 96例初治的晚期非小细胞肺癌随机分为2组,试验组患者采用奈达铂加多西他赛(TN组),TXT 75mg/m2、d1;NDP 80mg/m2,分3d静脉注射,21d为1个周期。对照组患者采用顺铂加多西他赛(TP组),TXT 75mg/m2,DDP 80mg/m2,分3d静滴,21d为1个周期。结果 TN组中,CR 1例,PR 21例,有效率(CR+PR)为45.8%。TP组中,CR 2例,PR 19例,有效率为43.8%,两组间差异无统计学意义(P>0.05)。试验组白细胞与血小板减少与对照组比较,差异无统计学意义(P>0.05)。试验组消化道反应明显小于对照组(P<0.05)。结论奈达铂联合化疗治疗晚期非小细胞肺癌的疗效与顺铂相似,消化道反应小于顺铂组。奈达铂联合多西他赛化疗治疗晚期非小细胞肺癌有效,不良反应轻。     

吉西他滨联合顺铂或奥沙利铂治疗晚期非小细胞肺癌87例

[目的]比较吉西他滨联合顺铂或奥沙利铂治疗晚期非小细胞肺癌(NSCLC)的疗效和毒副反应。[方法]87例晚期NSCLC患者分为两组:顺铂组42例,吉西他滨1000mg/m2,d1,d8;顺铂25mg/m2,d1～d3。奥沙利铂组45例,吉西他滨1000mg/m2,d1,d8;奥沙利铂130mg/m2,d1。28d/周期。评价有效率、疾病进展时间和毒副反应。[结果]顺铂组与奥沙利铂组的有效率分别为28.6%和31.1%(P=0.8),中位疾病进展时间分别为6.2个月(4.0~8.5个月)和5.7个月(4.5~7.8个月)(P=0.07)。两组主要毒副反应为胃肠道反应、周围神经毒性及骨髓毒性。顺铂组胃肠道反应的发生率(81.0%)明显高于奥沙利铂组(51.1%)(χ2=8.6,P=0.0)。奥沙利铂组的周围神经毒性的发生率(57.8%)明显高于顺铂组4.8%(χ2=28.0,P=0.0)。[结论]吉西他滨联合顺铂或奥沙利铂是晚期NSCLC的有效方案,均可作为晚期NSCLC的一线治疗方案。     

增加晚期癌症病人卡铂和环磷酰胺剂量的探索性研究

全组32例经病理学证实的晚期实体恶性肿瘤病人.男性19例,女性13例.中位年龄60岁(42～71岁).9例先前接受过不含顺铂的化疗,1例接受过含顺铂的化疗;PS(ECOG标准)0～2.将病例随机分成高剂量和低剂量两组.低剂量18例,卡铂400mg/m~2,环磷酰胺800mg/m~2;高剂量组14例,卡铂550mg/m~2,环磷酰胺1100mg/m~2.用法是:卡铂加入500ml盐水中,静脉输注半小时以上;在输注卡铂之前,输注盐水8小时以上;输注卡铂之     

吉西他滨联合铂类治疗64例晚期非小细胞肺癌临床疗效研究

目的:比较吉西他滨(gemcitabine)联合顺铂(cisplatin)、卡铂(carboplatin)和奥沙利铂(oxaliplatin)三种化疗方案对晚期非小细胞肺癌(NSCLC)的疗效和毒性反应。方法:经病理和细胞学证实的64例晚期NSCLC患者随机分为吉西他滨 顺铂(gemcitabine cisplatin,Gcis)、吉西他滨 卡铂(gemcitabine carbopl-atin,Gcarb)和吉西他滨 奥沙利铂(gemcitabine oxaliplatin,GLOHP)三组。三组均选用吉西他滨1000mg/m2静脉滴注第1、8天。GCis组:顺铂70mg/m2静脉滴注,第1天;GCarb组:卡铂AUC4～6(初治6,复治4～5),静脉滴注,第1天;GLOHP组:奥沙利铂LOHP130mg/m2静脉滴注,第1天。三组均21天为一周期,连续使用2～3周期评价疗效和毒副反应。结果:Gcis、Gcarb、GLOHP三种方案治疗晚期非小细胞肺癌的有效率分别为52.38%(11/21)、50.00%(10/20)和60.87%(14/23)(P>0.05)。三种方案毒副反应主要为可耐受的骨髓抑制、消化道反应、脱发和外周神经毒性等。结论:吉西他滨联合三种不同铂类的化疗方案均为治疗晚期非小细胞肺癌较为安全有效的化疗方案。     

紫杉醇联合奥沙利铂与紫杉醇联合顺铂治疗老年晚期非小细胞肺癌疗效观察(附72例)

目的:观察和比较紫杉醇(PTX)联合奥沙利铂(L-OHP)与紫杉醇联合顺铂(DDP)治疗老年晚期非小细胞肺癌的疗效及不良反应.方法:经病理组织学或细胞学确诊为晚期非小细胞肺癌的老年患者(年龄≥70岁)72例为研究对象,分为紫杉醇联合奥沙利铂(PO)组及紫杉醇联合顺铂(PC)组,紫杉醇给予周剂量60mg/m2,第1、8、15天静脉滴注3h,紫杉醇用药前1h、30min分别静推地塞米松10mg,用药前30min肌注非那根25mg,静滴西米替丁40mg以预防过敏反应;奥沙利铂65 mg/m2,第1、8天静脉滴注2h;顺铂25 mg/m2,第1-3天静脉滴注; 28天为1周期,每例患者至少治疗2周期以上,按照RECIST标准评价疗效和不良反应.结果:PO组35例:完全缓解(CR)1例,部分缓解(PR)10例,稳定(SD)14例,总有效率为31.4%; PC组37例:完全缓解0例,部分缓解10例,稳定13例,总有效率为27.0%;最常见的不良反应为骨髓抑制、消化道反应、肾功能损害、神经毒性等,其中PO组的神经毒性发生率显著高于PC组;PC组Ⅲ-Ⅳ度胃肠道反应和肾毒性显著多于PO组.结论:PO 方案与PC方案治疗老年晚期非小细胞肺癌的疗效相似,但PO方案较PC方案的不良反应轻,老年患者更容易耐受,是老年晚期非小细胞肺癌较理想的化疗方法.     

多西紫杉醇联合顺铂与紫杉醇联合顺铂一线治疗晚期非小细胞肺癌的随机临床对照研究

背景与目的多西紫杉醇是二线治疗晚期非小细胞肺癌的有效药物,近年来多项临床试验显示其在一线治疗晚期非小细胞肺癌的疗效与目前常用的一线方案相似。本研究拟比较多西紫杉醇联合顺铂(DC)与紫杉醇联合顺铂(PC)一线治疗晚期非小细胞肺癌的疗效、毒副反应及生存情况。方法细胞学或病理学确诊的90例初治晚期非小细胞肺癌患者随机分为DC组与PC组。DC组:多西紫杉醇75mg/m~2,静脉滴注1小时,第1天,顺铂75mg/m~2,分成两天静脉滴注,第2～3天。PC组:紫杉醇150mg/m~2,静脉滴注3小时,第1天;顺铂75mg/m~2,分成两天静脉滴注,第2-3天。顺铂用药时需水化。两种方案均为21天重复。至少完成2周期化疗的患者进行疗效、毒副反应评价,并分析生存情况。结果DC组总有效率为31.1%,中位生存期为10.2个月,中位疾病进展时间为4.4个月,1年和2年生存率分别为35.6%、8.9%;PC组总有效率为33.3%,中位生存期为10.4个月,中位疾病进展时间为4.9个月,1年和2年生存率分别为37.8%、11.1%。两组的总有效率、中位生存期、中位疾病进展时间及1、2年生存率差异均无统计学意义(P>0.05)。两组Ⅲ度和Ⅳ度毒副反应为白细胞减少、贫血、恶心、呕吐及脱发,差异无统计学意义(P>0.05)。结论多西紫杉醇联合顺铂方案与紫杉醇联合顺铂方案比较,疗效与生存相似,毒副反应较轻,耐受性好,是一线治疗非小细胞肺癌的有效方案。     

Bis(4,7-dimethyl-1,10-phenanthroline) sulfatooxovanadium(I.V.) as a novel antileukemic agent with matrix metalloproteinase inhibitory activity.

We have examined the in vitro anticancer activity of METVAN [bis(4,7-dimethyl-1,10 phenanthroline) sulfatooxovanadium(IV); VO(SO(4))(Me(2)-Phen)(2)] against acute lymphoblastic leukemia (ALL; NALM-6 and MOLT-3), acute myeloid leukemia (AML; HL-60), Hodgkin's disease (HS445), and multiple myeloma (ARH-77, U266BL, and HS-SULTAN) cell lines as well as primary leukemic cells from patients with ALL, AML, and chronic acute myeloid leukemia (CML). METVAN induced apoptosis in NALM-6, MOLT-3, and HL-60 cells in a concentration-dependent fashion with EC(50) values of 0.19 +/- 0.03 microM, 0.19 +/- 0.01 microM, and 1.1 +/- 0.2 microM, respectively. METVAN induced apoptosis at low micromolar concentrations in primary leukemic cells from patients with ALL, AML, and CML. METVAN inhibited the constitutive expression of matrix metalloproteinase (MMP)-9 protein and its gelatinolytic activity in HL-60 cells and MMP-2 as well as MMP-9 gelatinolytic activities in leukemic cells from ALL, AML, and CML patients. Furthermore, METVAN inhibited the leukemic cell adhesion to the extracellular matrix proteins laminin, type IV collagen, vitronectin, and fibronectin and the invasion through Matrigel matrix. Further preclinical development of METVAN may provide the basis for the development of more effective chemotherapy programs.     

Phase I trial of N-(phosphonacetyl)-L-aspartate.

A Phase I clinical trial of N-(phosphonacetyl)-L-aspartate, an antimetabolite which inhibits a key enzyme in the de novo pathway of pyrimidine biosynthesis, was conducted. N-(Phosphonacetyl)-L-aspartate was given as an i.v. 15-min infusion once daily for five days; cycles of treatment were repeated every three weeks. Thirty-four patients received treatment. Dose-limiting toxicity was observed at 1500 to 2000 mg/sq m/day and was manifested by skin rash, diarrhea, and stomatitis. Rash and diarrhea usually began during the first week of treatment and persisted up to Day 17 of a cycle of therapy. No consistent hematopoietic, hepatic, or renal toxicity was observed. One partial response in a patient with colon carcinoma was seen and continues at more than eight months. Stable disease was observed in three patients with colon carcinoma, two patients with hypernephroma, one patient with pancreatic carcinoma, and one patient with melanoma. The predictability and reversibility of toxicity and the suggestion of antitumor activity in humans are observations which support the further evaluation of N-(phosphonacetyl)-L-aspartate in Phase II studies.     

Arbeitsgemeinschaft Urologische Onkologie (AUO) in der Deutschen Krebsgesellschaft e.V.

Zusammenfassung Mit derzeit knapp 85.000 uroonkologischen Neuerkrankungen pro Jahr stellt die Uroonkologie einen wesentlichen Bestandteil in der urologischen Tätigkeit dar. Am 29. Juni 1989 wurde die Arbeitsgemeinschaft Urologische Onkologie (AUO) in der Deutschen Krebsgesellschaft gegründet, um diesem Teilgebiet die notwendige Aufmerksamkeit widmen zu können. Bereits zur Gründung steckte sich die AUO das hohe Ziel, Forschungstätigkeit in der Uroonkologie unter einem Dach zu versammeln und für eine hohe Qualität klinischer Studien zu sorgen.     

Radiological Aspects of the Pulmonary Complications Resulting from Intermittent Positive Pressure Ventilation (I.P.P.V.)

The use of intermittent positive pressure ventilation is associated with a number of pulmonary complications which are of radiological importance. These complications are grouped into three categories. In the first category are cases of asthma which require resuscitation with intermittent positive pressure ventilation. These cases may develop severe air trapping which can progress to pulmonary interstitial emphysema, although the latter complication is known to develop without a respirator being used. The second category includes pulmonary oedema, and there is brief reference to the effects of oedema of the bronchial mucosa. In an appendix to the paper the possible relationship of pulmonary oedema to the body handling of salt and water when intermittent positive pressure ventilation is used is examined. The analysis of accurately recorded fluid balance data did not reveal any statistical association between the retention of sodium, potassium or water, or any combination of these three and the presence of pulmonary oedema. The third category is represented by the serious condition of obliterative pneumonitis (respirator lung syndrome). In all three categories the clinical and radiological findings and, where relevant, the pathological findings, are described. During the year 1967 it was found that of a total of 267 admissions five developed pulmonary interstitial emphysema, four during intermittent positive pressure ventilation therapy. Two died. Sixty-nine cases (26%) developed pulmonary oedema, and in 15 cases there seemed no adequate explanation for the oedema other than factors associated with the use of a respirator. The number of cases of pulmonary oedema closely related to the use of intermittent positive pressure ventilation is considered to be higher than 15, however. Two adults and two children under 10 years of age developed fatal obliterative pneumonitis confirmed by necropsy.     

A Comparison of Different Doses of Non-Ionic Contrast Media in I.V. Urography

This study attempts to find out what is the appropriate dose of non-ionic contrast media to provide an acceptable study at the lowest possible cost. 139 adults with normal renal function were studied. Four different dose regimes were employed and a standardised set of I.V.U. films were obtained. These were reviewed by two independent assessors who were unaware of the dose regime used. Each I.V.U. was scored on a modified Fry regime. This survey showed a clear relationship between quality and dosage.