不同剂型紫杉醇联合卡铂治疗晚期卵巢癌患者的临床疗效及对血清人附睾蛋白4、糖类抗原125和T淋巴细胞亚群水平的影响

目的 探讨不同剂型紫杉醇联合卡铂治疗晚期卵巢癌患者的临床疗效及对血清人附睾蛋白4(HE4)、糖类抗原125(CA125)和T淋巴细胞亚群水平的影响.方法 根据治疗方法的不同将100例晚期卵巢癌患者分为观察组(n=55)和对照组(n=45),观察组患者予以紫杉醇脂质体联合卡铂治疗,对照组患者予以紫杉醇注射液联合卡铂治疗.两组患者均每7天用药1次,21天为1个化疗周期,共治疗6个周期.比较两组患者的临床疗效、不良反应发生情况及治疗前后的血清HE4、CA125及T淋巴细胞亚群水平.结果 观察组患者的总有效率为67.27％,与对照组患者的64.44％比较,差异无统计学意义(P﹥0.05).观察组患者的不良反应总发生率为20.00％,明显低于对照组的46.67％,差异有统计学意义(P﹤0.01).治疗1个周期、3个周期、6个周期后,观察组患者的血清HE4和CA125水平均低于同时间点对照组患者,差异均有统计学意义(P﹤0.05).治疗后,两组患者的CD3+、CD4+、CD8+水平及CD4+/CD8+比较,差异均无统计学意义(P﹥0.05).结论 紫杉醇脂质体联合卡铂治疗晚期卵巢癌患者的临床疗效略优于紫杉醇注射液联合卡铂,前者的不良反应较少,安全性更好,且可显著降低患者的血清HE4、CA125水平.     

紫杉醇联合卡铂化疗方案对中晚期宫颈癌患者免疫功能及血清SCC-Ag、TSGF水平的影响

目的探讨紫杉醇与卡铂化疗方案对中晚期宫颈癌患者免疫功能及血清SCC-Ag,TSGF水平的影响。方法选取90例中晚期宫颈癌患者,将患者随机均分为观察组45例和对照组45例。对照组患者采用伊立替康联合卡铂治疗方案,观察组患者采用紫杉醇联合卡铂治疗方案。观察两组患者的临床疗效,出现的不良反应和对患者生存质量的影响,同时对比患者治疗前后免疫功能和血清中SCC-Ag、TSGF的变化。结果观察组患者有效率为64.44%(29/45),高于对照组46.67%(21/45)(χ~2=9.238,P=0.002);观察组治疗后CD3^+,CD4^+和CD4^+/CD8^+升高幅度与CD8^+降低幅度大于对照组(P<0.05);与对照组治疗后比较,观察组治疗后血清中SCC-Ag、TSGF水平更低(P<0.05);治疗后,两组患者的躯体功能、情绪功能、社会功能、疲乏、食欲减退和疼痛方面均有所改善(P<0.05),并且均优于对照组(P<0.05);观察组患者经治疗后出现胃肠道反应、骨髓抑制、血小板下降和白细胞下降等方面的不良反应发生率低于对照组(P<0.05),而呼吸困难与对照组比较,差异不具有统计学意义(P>0.05)。结论紫杉醇联合卡铂治疗中晚期宫颈癌可以改善患者的免疫功能,降低血清SCC-Ag与TSGF的水平,提高患者的生存质量,具有有效率高,不良反应少的特点,对于临床上宫颈癌的治疗具有重要参考价值。     

贝伐珠单抗联合紫杉醇+卡铂治疗晚期卵巢癌患者的疗效分析

目的 探讨贝伐珠单抗联合紫杉醇+卡铂治疗晚期卵巢癌患者的疗效。方法 根据治疗方案的不同将126例晚期卵巢癌患者分为化疗组和贝伐珠单抗组,每组63例。治疗前后,检测两组患者血管内皮生长因子(VEGF)、基质金属蛋白酶2(MMP2)、癌胚抗原(CEA)、糖类抗原125(CA125)、CD4⁺、CD8⁺、CD3⁺水平,记录两组患者的不良反应及无进展生存期,比较两组患者的疗效。结果 治疗后,贝伐珠单抗组患者VEGF、MMP2、CEA、CA125、CD8⁺水平均明显低于化疗组,CD4⁺、CD3⁺水平均明显高于化疗组,差异均有统计学意义(P﹤0.01)。贝伐珠单抗组患者总有效率高于化疗组,无进展生存期长于化疗组,差异均有统计学意义(P﹤0.05)。两组患者不良反应总发生率比较,差异无统计学意义(P﹥0.05)。结论 贝伐珠单抗联合紫杉醇+卡铂化疗可抑制晚期卵巢癌转移及扩散,明显改善患者的免疫功能,延长无进展生存期,疗效确切。     

多西紫杉醇联合顺铂同步放化疗治疗中晚期宫颈癌的临床疗效及不良反应

目的 分析多西紫杉醇联合顺铂同步放化疗治疗中晚期宫颈癌的临床疗效及不良反应。方法 将174例宫颈癌患者根据治疗方法的不同分为观察组(n=88,多西紫杉醇联合顺铂)与对照组(紫杉醇联合顺铂)。比较两组疗效、不良反应及免疫功能指标。结果 观察组患者疾病控制率高于对照组,差异有统计学意义(P<0.05)。对照组患者消化道反应、骨髓抑制发生率均高于观察组,差异均有统计学意义(P<0.05)。治疗后,两组患者CD4⁺、CD4⁺/CD8⁺均较治疗前升高,CD8⁺均较治疗前降低,且观察组患者CD4⁺、CD4⁺/CD8⁺均高于对照组,CD8⁺低于对照组,差异均有统计学意义(P<0.05)。结论 多西紫杉醇联合顺铂同步放化疗治疗中晚期宫颈癌的临床疗效确切,可减少患者不良反应,改善其免疫功能。     

紫杉醇联合卡铂治疗晚期卵巢癌的临床疗效及对肿瘤标志物和不良反应的影响

目的 探讨紫杉醇联合卡铂治疗晚期卵巢癌的临床疗效及对肿瘤标志物和不良反应的影响。方法将176例晚期卵巢癌患者依据治疗方案的不同分为对照组（紫杉醇+顺铂治疗,n=87）和观察组（紫杉醇+卡铂治疗,n=89）。比较两组患者的临床疗效、肿瘤标志物[糖类抗原125(CA125)、血管内皮生长因子（VEGF）、人附睾蛋白4(HE4)]水平、不良反应发生情况及肿瘤远处转移情况。结果 观察组患者总有效率高于对照组,差异有统计学意义（P﹤0.05）。治疗后,两组患者CA125、VEGF及HE4水平均下降,且观察组患者CA125、VEGF及HE4水平均低于对照组,差异均有统计学意义（P﹤0.05）。观察组患者不良反应发生情况优于对照组,差异有统计学意义（P﹤0.05）。两组患者远处转移率比较,差异无统计学意义（P﹥0.05）。结论 紫杉醇联合卡铂治疗晚期卵巢癌的临床疗效显著,可有效降低患者肿瘤标志物水平,减轻不良反应,安全性高。     

紫杉醇联合卡铂治疗卵巢癌的效果分析

目的探讨紫杉醇联合卡铂化疗治疗卵巢癌的效果。方法收集92例卵巢癌患者的临床资料,根据不同的治疗方法,将患者分为对照组与观察组,每组各46例。对照组患者单纯采取卡铂化疗,观察组患者采取紫杉醇联合卡铂化疗。分析2组患者临床疗效与不良反应发生率。结果观察组治疗总有效率为89.13%,对照组总有效率为63.04%,差异有统计学意义(P<0.05)。观察组不良反应发生率为26.09%,对照组为23.91%,差异无统计学意义(P>0.05)。结论紫杉醇联合卡铂治疗晚期卵巢癌的临床效果明显优于单纯卡铂治疗,患者均可耐受出现的不良反应,值得临床推广。     

不同剂型紫杉醇联合顺铂对晚期卵巢癌患者的应用疗效观察

目的 探讨不同剂型紫杉醇联合顺铂治疗晚期卵巢癌患者的临床疗效。方法 选取2016年7月至2021年5月间西北妇女儿童医院收治的116例晚期卵巢癌患者,根据随机信封抽签原则分为研究组和对照组,每组58例。对照组患者采用紫杉醇注射液联合顺铂治疗,研究组患者采用白蛋白结合型紫杉醇联合顺铂治疗,比较两组患者血清肿瘤标志物和T淋巴细胞亚群变化情况。结果 研究组客观有效率为82.8%,高于对照组的62.1%,差异有统计学意义(P<0.05)。两组患者治疗期间的不良反应主要为肝肾反应、胃肠道反应、血液学反应和皮肤反应等,发生率比较,差异均无统计学意义(P>0.05)。治疗后,两组患者卡氏功能(KPS)评分均升高,免疫功能评分均降低,且研究组KPS评分高于对照组,免疫功能评分低于对照组,差异均有统计学意义(均P<0.05)。治疗后,两组患者血清鳞状细胞癌相关抗原和细胞角蛋白19片断抗原水平均低于治疗前,且研究组均低于对照组,差异均有统计学意义(均P<0.05)。治疗后,两组患者CD8⁺T淋巴细胞、CD4⁺CD25⁺     

白蛋白结合型紫杉醇联合卡铂在晚期、复发性上皮卵巢癌治疗中的应用价值

目的观察白蛋白结合型紫杉醇联合卡铂治疗晚期、复发性上皮卵巢癌的近期疗效和安全性。方法选取86例晚期、复发性上皮卵巢癌患者,随机分成2组。对照组采用溶剂型紫杉醇联合卡铂治疗,观察组采用白蛋白结合型紫杉醇联合卡铂治疗,21天为1个疗程,6个疗程后对治疗的有效性进行评价。结果观察组患者客观缓解率高于对照组(51.16%vs30.23%),差异存在统计学意义(P<0.05),观察组中位生存时间高于对照组(6.8月vs3.6月),死亡例数少于对照组(3例vs5例),差异均有统计学意义(P<0.05)。化疗后,观察组患者生活质量改善率优于对照组(60.47% vs 41.86%),差异有统计学意义(P<0.05)。结论白蛋白结合型紫杉醇联合卡铂治疗晚期、复发性上皮卵巢癌近期疗效较好,不良反应能耐受,值得临床上推广。     

紫杉醇脂质体联合卡铂与紫杉醇联合卡铂治疗卵巢癌的疗效比较

目的探讨和比较紫杉醇脂质体联合卡铂与紫杉醇联合卡铂治疗卵巢癌的疗效。方法选取2012年5月至2015年5月间收治的60例卵巢癌患者,按照随机数字表法分为研究组和对照组,每组30例。研究组患者采用紫杉醇脂质体联合卡铂治疗,对照组患者采用紫杉醇联合卡铂治疗,比较两组的疗效及不良反应。结果研究组患者的总有效率为73.3%(22/30),对照组为70.0%(21/30),差异无统计学意义(P>0.05)。研究组患者的过敏反应、白细胞减少、血红蛋白减少、血小板减少、皮疹、肌痛、胃肠道反应发生率均显著低于对照组,差异有统计学意义(P<0.05),但两组患者的脱发发生率差异无统计学意义(P>0.05)。结论紫杉醇脂质体联合卡铂治疗卵巢癌与紫杉醇联合卡铂治疗卵巢癌疗效相当,但不良反应少。     

贝伐珠单抗联合卡铂+多西他赛治疗卵巢癌和宫颈癌的临床疗效

目的 探讨贝伐珠单抗联合卡铂+多西他赛治疗卵巢癌和宫颈癌的临床疗效。方法 根据治疗方式的不同将90例卵巢癌和宫颈癌患者分为对照组和观察组,每组45例,对照组患者给予卡铂+多西他赛治疗,观察组患者给予贝伐珠单抗联合卡铂+多西他赛治疗。比较两组患者临床疗效、血清肿瘤标志物[糖类抗原125(CA125)、肿瘤特异性生长因子(TSGF)、转化生长因子-β1(TGF-β1)、人附睾蛋白4(HE4)]水平、免疫功能指标(CD3⁺、CD4⁺、CD8⁺,计算CD4⁺/CD8⁺)及不良反应发生情况。结果 观察组患者的治疗总有效率为82.22%,明显高于对照组患者的51.11%,差异有统计学意义(P﹤0.01)。治疗后,两组患者血清CA125、TGF-β1、TSGF、HE4水平均低于本组治疗前,且观察组患者CA125、TGF-β1、TSGF、HE4水平均低于对照组,差异均有统计学意义(P﹤0.05)。治疗后,两组患者CD3⁺、CD4⁺水平和CD4     

Treatment with antioxidant and other nutrients in combination with chemotherapy and irradiation in patients with small-cell lung cancer.

Eighteen non-randomized patients with small cell lung cancer (4 women and 14 men, mean age 60.4, SD 7.8 years) received in addition to conservation small cell lung cancer treatment antioxidant treatment with vitamins, trace elements and fatty acids. All patients were out-patients who, except for one were also treated with chemotherapy and/or irradiation at regular intervals at a university of central hospital. Five patients (28%) were in an advanced stage of the disease. At the end of the follow-up period (31.7.90) the median survival time for the whole group was 505 days. Fourteen (77%) of the patients survived for more than 12 months and six patients (33%) for more than two years. One patient (5%) survived more than five years. Eight patients (44%) were still alive with a mean survival time of 32 months at the end of the study. Ten patients succumbed earlier from progression of the disease. Antioxidant treatment, in combination with chemotherapy and irradiation, prolonged the survival time of patients with small cell lung cancer compared to most published combination treatment regimens alone. We also noticed that the patients receiving antioxidants were able to tolerate chemotherapy and radiation treatment well. Surviving patients started antioxidant treatment in general earlier than those who succumbed.     

Compliance with guidelines and correlation with outcome in patients with advanced germ-cell tumours

PurposeTo evaluate prior compliance with guidelines in patients treated with salvage chemotherapy for advanced germ-cell tumours (GCT).Patients and methodsData concerning the initial management of patients requiring salvage chemotherapy for GCT at Institut Gustave Roussy between 2000 and 2010 were obtained and correlated with recommendations for treatment. Criteria of non-compliance were defined based on guidelines. Compliance with guidelines, predictive factors for non-compliance and the impact on outcome were analysed.ResultsAmong 82 patients treated in the salvage setting, guidelines to initial treatment were followed in only 41 cases (50%). The most common non-compliance criteria were non-adherence to the planned dose (16%), an inappropriate interval between first-line chemotherapy cycles (16%), the lack of post-chemotherapy surgery (16%) and a long interval to post-chemotherapy surgery (48%). Compliance with standard care was better in cancer centres than in other hospitals (private or public) (Odd Ratio (OR): 6.9, P = 0.001). A poor-risk status according to the International Germ Cell Cancer Collaborative Group (IGCCCG) was also predictive of compliance in univariate but not in multivariate analysis. No significant difference in outcome after salvage chemotherapy was observed. Patients relapsing after non-compliant first-line therapy tended to be more easily salvaged, which is consistent with the fact that their initial treatment was inadequate. Some of these relapses were therefore probably not due to true biologically refractory disease.ConclusionGuidelines for first-line treatment are adhered to in only half the patients requiring salvage chemotherapy. As the only predictive factor for non-compliance was the treating centre, centralisation of patients with GCT in well-trained hospitals should be recommended.     

Treatment with cisplatin and etoposide in patients with neuroendocrine tumors

BACKGROUND: Patients with malignant endocrine pancreatic tumors (EPTs) are responsive to combinations of chemotherapy with streptozotocin and 5-fluorouracil/doxorubicin, whereas patients with malignant carcinoids are not. For both categories of patients, alpha-interferon and/or somatostatin analogs can produce long-lasting responses. Cisplatin in combination with etoposide has been suggested to be effective in patients with malignant neuroendocrine carcinomas. The authors used this therapy as second-line or third-line treatment in patients with poorly differentiated and/or rapidly progressing disease. METHODS: Thirty-six patients with histopathologically verified malignant neuroendocrine tumors were included: Eighteen tumors were of foregut origin, of which 5 were atypical, and 15 tumors were EPTs, of which 4 were poorly differentiated endocrine carcinomas. Three tumors were of midgut origin. The median patient age was 47.5 years. The median duration of disease from the time of diagnosis was 12 months. All patients had metastatic disease. Thirty of 36 patients had received previous treatment. Etoposide was given at a dose of 100 mg/m(2) per day for 3 days, and cisplatin was given at a dose of 45 mg/m(2) on Days 2 and 3 as a continuous intravenous infusion that was repeated every 4 weeks. RESULTS: Ten of 18 patients with foregut carcinoids (56%) responded radiologically and/or biochemically, with a median duration of 9 months; and 7 of 14 patients with EPTs (50%) responded radiologically and/or biochemically, with a median duration of 9 months. No difference in response was seen between patients with atypical or typical foregut carcinoids or between patients with well differentiated or poorly differentiated endocrine pancreatic carcinoma. Nineteen of 36 patients (53%) experienced World Health Organization (WHO) Grade 1-2 nephrotoxicity, and 23 patients (64%) suffered from WHO Grade 3-4 neutropenia. CONCLUSIONS: The combination of cisplatin and etoposide can produce significant responses in patients with heavily pretreated and poorly differentiated/rapidly progressing neuroendocrine tumors. The toxicity is considerable, and nephrotoxicity is the dose limiting factor.     

Chemotherapy with mitomycin C and capecitabine in patients with advanced colorectal cancer pretreated with irinotecan and oxaliplatin

AIMS AND BACKGROUND: To assess the activity and tolerability of the combination of mitomycin C and capecitabine in patients with metastatic colorectal cancer after failure of irinotecan and oxaliplatin-containing regimens. METHODS: We retrospectively reviewed 28 patients with pretreated advanced colorectal cancer who had been treated with mitomycin C, 6 mg/m2 on day 1, and capecitabine, 1900 mg/m2 on days 1-14, every 3 weeks. Tumor assessment was performed every 3 cycles, toxicity assessed at each cycle. RESULTS: Main patient characteristics were median age, 61 years (range, 35-73); male/female ratio, 16/12; single metastatic site involvement, 5/28 (18%); > or =3 metastatic sites, 10/28 (36%). Ninety-six courses of therapy were given (median number, 3; range, 1-9). Twenty-six patients were assessable for response, and all were assessable for toxicity. There was 1 partial response (4%) and 12 had stable disease (43%). Median time to progression was 2 months (range, 1-9) and median overall survival was 6 months (range, 1-29+), with a 1-year overall survival rate of 25%. The regimen was very well tolerated without significant hematological toxicity. CONCLUSIONS: Our results are disappointing. Despite the good safety profile, they do not support further investigation or the routine use of this regimen in this setting.     

Treatment with lenalidomide and dexamethasone in patients with multiple myeloma and renal impairment

Renal impairment (RI) is a common complication affecting patients with multiple myeloma (MM). Timely identification of MM-related RI and early treatment with novel antimyeloma agents can reverse renal damage in a high proportion of patients and improve outcomes. The IMiDs® immunomodulatory compound lenalidomide (Len) in combination with dexamethasone (Dex) is an effective and well-tolerated regimen for patients with relapsed or refractory (RR) MM. A retrospective analysis of Phase III data has shown that Len/Dex remains effective and well-tolerated in patients with moderate or severe RI, albeit with an increase in myelosuppression. This analysis demonstrated that in a high proportion of patients Len/Dex treatment can reverse MM-related RI and restore normal function. Lenalidomide has a predominantly renal route of excretion and in patients with RI the plasma concentration and half-life of the drug are significantly increased. As a consequence, lower starting doses are required in patients with RI to avoid over-exposure and an increased risk of adverse events, while maintaining good therapeutic index. A prospective cohort study in 50 patients with RRMM has reported that when Len/Dex dosing was adjusted according to renal function, response rates and survival outcomes were similar in patients with and without RI, and there was no increase in adverse events in patients with RI. Further clinical studies are required to confirm the efficacy and tolerability of Len/Dex regimens in MM patients with RI, and to evaluate the impact of reversing renal damage in terms of patient survival.     

Distress overlaps with anxiety and depression in patients with head and neck cancer

Psychological problems in cancer patients often go unrecognized until they are specifically sought. This is more in patients with depression as they are reluctant to complain about their symptoms. The present study was carried out to evaluate the relation of distress with anxiety and depression in 123 patients with head and neck cancers using Distress Inventory for Cancer version 2 (DIC2) and the Hospital Anxiety and Depression scale (HADS). The mean DIC 2 scores were 24.6 while that of subscales ranged from 2.6 to 11.0. Fifteen patients were found to have clinical caseness for anxiety while 12 (10%) were caseness for depression. Total distress, emotional and social distress subscales were found to have positive correlation with anxiety and depression suggesting a possible overlap of two constructs. In multivariate analysis only belief in god was found to significantly affect the distress. Results of present study suggest significant psychological morbidity in head neck cancer patients undergoing curative treatment. This is the first study reporting on the psychometric properties of distress inventory on cancer version 2 since its validation, the results suggest a possible overlap of two constructs similar to that seen with other tools on distress and this may have major implications for clinical practice.     

Excretion of nitrates with saliva and urine and nitrite excretion with saliva in patients with chronic gastritis and duodenal ulcer

The study assessed excretion of nitrates in urine and saliva and that of nitrites with saliva of patients suffering gastric and duodenal ulcer. In both study groups, a positive correlation was established between nitrate concentration in saliva, on the one hand, and that in urine, and nitrite level in urine, on the other. The groups failed to show a difference in nitrate concentrations in either urine or saliva. Since retention of nitrates in the body of chronic gastritis patients held as precancer of the stomach proved no higher than that in patients with duodenal ulcer, the authors cast doubt on endogenous nitroso compounds as a cause of gastric cancer in cases of chronic gastritis.