吡喃阿霉素与表阿霉素治疗恶性淋巴瘤的临床观察

吡喃阿霉素(THP)与表阿霉素(EADM)同属蒽环类抗肿瘤药物,我们就THP与EADM在治疗恶性淋巴瘤中的疗效和毒副反应做一对比观察,评价其在肿瘤化疗中的价值。 一、材料和方法 1.病例选择:1996年1月～2002年1月住院治疗的恶性淋巴瘤患者52例,随机应用含THP与EADM的化疗方案进     

吡喃阿霉素、表阿霉素为主方案治疗非霍奇淋巴瘤的临床观察

目的:比较含吡喃阿霉素(CTOP)和表阿霉素(CEOP)的方案治疗非霍奇金淋巴瘤的疗效和毒副作用。方法:238例非霍奇金淋巴瘤患者分别接受CTOP和CEOP方案治疗, 每3周为1周期, 最少治疗3周期。结果:CTOP组和CEOP组的完全缓解率分别为46.1 %、44.5 %。总有效率(CR+PR)分别为85.9 %、82.7 %。两组的完全缓解率和总有效率经统计学分析,均无显著性差异(P>0.05)。两组的骨髓、胃肠道、血液和心脏毒性,均无统计学上的差异。脱发发生率分别为31.3 %、62.7 %,CTOP组明显低于CEOP组,两组有显著性差异。结论:CTOP与CEOP相比,疗效相近,脱发反应较轻,远期疗效有待观察。     

吡喃阿霉素、表阿霉素及阿霉素为主联合化疗方案治疗非霍奇金淋巴瘤

目的：分别采用以吡喃阿霉素（THP）、表阿霉素（E－ADM）及阿霉素（ADM）为主的联合化疗方案治疗非霍奇金淋巴瘤,进行疗效及不良反应观察比较,方法采用CHOP方案治疗非霍奇多淋巴瘤68例,分为3组：吡喃阿霉素组23例,表阿霉素组22例,阿霉素组23例。3组治疗有效率（CR＋PR）分别为82．6％、86．4％、82．6％,3组之间无显著性差异。不良反应;肝功能异常,白细胞减少,血小板减少、贫血、恶心呕吐、,3组间比较无关差异。THP组心电图异常及脱发率低于E－ADM组和AMD组。结论吡喷阿霉素、表阿霉素及阿霉素非霍奇多淋巴瘤的疗效无差异,THP组心脏毒性,脱发率低于E－ADM组和ADM组。     

吡喃阿霉素治疗恶性淋巴瘤的临床观察

吡喃阿霉素（THP－ADM）是一种合成的新一代蒽环类抗肿瘤药物，我院自1993年～1995年采用国产吡喃阿霉素（深圳万乐药业生产）为主的化疗方案治疗30例恶性淋巴瘤患者，取得较明显疗效，现报告如下。1材料和方法1．1病人资料30例病人均为本院住院治疗的患者，其中男性17例，女性13例，平均年龄38岁，病程1～3年不等。所有病例均经病理检查诊断为恶性淋巴瘤，其中非何杰金淋巴瘤20例，何杰金氏病10例。1．2化疗方案均采用以吡喃阿霉素为主的ACOPP方案，毗哺阿霉素（A）30mg／m’静滴，第1，8天，环磷酸胺（C）600mg／m‘静滴，第1，8天…     

吡喃阿霉素为主增强剂量TCOP方案治疗非霍奇金淋巴瘤的临床观察

目的：探讨吡喃阿霉素为主增强剂量ＴＣＯＰ方案,治疗非霍奇金淋巴瘤的临床完全缓解率和３ 年生存率及骨髓抑制和心脏毒性等情况。方法：对２２ 例非霍奇金淋巴瘤患者进行吡喃阿霉素为主增强剂量ＴＣＯＰ方案治疗及良好的支持治疗并长期、定期治疗及随访。结果：全组完全缓解率为８６４ ％ ;１ 年生存率为９５５ ％ ,３ 年生存率为７３１％ 。骨髓抑制及心脏毒性等毒副反应未见明显增加。结论：吡喃阿霉素为主增强剂量ＴＣＯＰ方案与传统ＣＨＯＰ方案相比在完全缓解率和３ 年生存率上有明显提高而其骨髓抑制及心脏毒性等毒副反应未见明显增加     

高剂量吡喃阿霉素的CTOP方案治疗非霍奇金淋巴瘤

目的　观察高剂量吡喃阿霉素组成的CTOP方案治疗非霍奇金淋巴瘤的疗效及不良反应。方法　 60例初治非霍奇金淋巴瘤随机分为两组 ,分别接受常规剂量吡喃阿霉素的CTOP(THP 40mg/m2 )和高剂量吡喃阿霉素的CTOP(THP 60mg/m2 )方案化疗至少 2个疗程 ,观察疗效及不良反应。结果　高剂量吡喃阿霉素的CTOP与常规剂量吡喃阿霉素的CTOP方案相比完全缓解率有所提高(3 6 6%vs 2 0 % ) ,达到完全缓解的时间也缩短 ,但差异均无显著性 (P >0 0 5 )。提高吡喃阿霉素的剂量强度后并未增加心脏毒性、脱发及骨髓抑制等不良反应的发生 ,两组的不良反应的发生率及严重程度相仿 ,差异无显著性。结论　高剂量吡喃阿霉素组成的CTOP方案治疗非霍奇金淋巴瘤可提高疗效而不加重不良反应 ,高剂量吡喃阿霉素可安全使用。     

国产表阿霉素为主的联合方案治疗非霍奇金淋巴瘤临床观察

目的观察国产表阿霉素治疗非霍奇金淋巴瘤的疗效和毒副反应.方法治疗组37例采用环磷酰胺(CTX)750 mg/(m2·d),静脉滴注,d1;国产表阿素(EPI)70 mg/(m2·d),静脉推注,d1;长春新碱(VCR)1.4 mg/(m2·d),静脉推注,d1;强的松(Pred)60 mg/(m2·d),口服,d1～5.每21 d为一个疗程,每例患者至少接受4个周期的化疗.对照组以进口表阿霉素替代国产表阿霉素,治疗非霍奇淋巴瘤38例,进行随机对照,观察两组的疗效及毒副反应.结果国产表阿霉素为主的方案组,完全缓解率为43.2%(16/37),部分缓解率为37.8%(14/37),总有效率为81.1%.与进口表阿霉素为主的对照组比较,疗效相似,差异无显著性(P＞0.05).两组毒副反应主要为Ⅰ～Ⅱ度,治疗组与对照组白细胞减少发生率分别为59.5%和60.5%;恶心呕吐发生率分别为 67.6%和68.4%;心脏毒性轻微,发生率分别为 8.1%和7.9%;脱发发生率分别为94.6%和94.7%,对肝肾功能影响均较轻微.结论国产表阿霉素治疗非霍奇金淋巴瘤的疗效和毒副反应与进口表阿霉素相似,值得临床应用.     

吡喃阿霉素与阿霉素治疗乳腺癌近期疗效的对比观察

吡喃阿霉素 (吡柔比星 ,THP- ADM)是一种半合成的新蒽环类抗肿瘤抗生素 ,其化学结构与阿霉素 (ADM)相似 ,其抗肿瘤活性与 ADM相当或稍高 ,不良反应明显低于 ADM。我们从 1 995年 2月～1 998年 2月对比观察了 THP- ADM,ADM在治疗乳腺癌的近期疗效和不良反应 ,现将观察结果报告如下。1　临床资料1 .1　 THP- ADM组　全组 40例 ,均为女性 ,年龄2 5～ 69岁 ,平均 47岁。其中单纯癌 2 0例 ,浸润性导管癌 1 0例 ,粘液腺癌 5例 ,髓样癌 3例 ,硬癌 2例。按 TNM国际分期 : 期 8例 , 期 1 8例 , 期 1 4例。K氏评分均在 70分以上。初治 2…     

A phase II study of epirubicin in malignant lymphoma

A new anthracycline analog, epirubicin (4'-epi-Adriamycin) was evaluated at eleven institutes in a phase II clinical study in patients with malignant lymphoma. Epirubicin was administered intravenously mainly with using the following two regimens; 50 to 60 mg/m2 every three weeks and 40 mg/m2 weekly. A total of 46 cases were entered into the study and 41 cases were evaluable. Clinical responses, complete plus partial remissions, were observed in 27 cases (65.9%) with 8 of these showing complete remission. There was no significant difference of response between the two regimens. Response rates taking into account previous chemotherapy were 90.9% (10/11) in previously nontreated cases, 61.9% (8/13) in cases previously treated with non-anthracyclines and 52.9% (9/17) in cases treated with anthracyclines. The major adverse effect was bone marrow suppression; leukopenia was observed in 83.8%, anemia in 60.5% and thrombocytopenia in 15.4%. Other adverse effects frequently observed were anorexia (59.0%), nausea-vomiting (48.8%) and alopecia (55.6%). These adverse effects seemed milder than those produced by doxorubicin. The results indicated that epirubicin seemed to be a markedly useful drug against malignant lymphoma.     

吡柔比星联合COP四周方案治疗侵袭性非霍奇金淋巴瘤骨髓浸润

 目的　观察吡柔比星（THP）联合COP 4周方案（CTOP-28）诱导缓解治疗侵袭性非霍奇金淋巴瘤（NHL）骨髓浸润的近期疗效和患者不良反应。方法　回顾性分析2002年1月至2007年1月收治的初治侵袭性NHL骨髓浸润患者65例,比较CHOP 3周方案（CHOP-21）和CTOP-28方案的近期疗效和不良反应。CHOP-21方案：环磷酰胺750 mg／m2 （第1天）、长春新碱1.4 mg／m2 （最大量2 mg,第1天）、多柔比星50 mg／m2 （第1天）、泼尼松100 mg（第1天至第5天）;CTOP-28方案：环磷酰胺750 mg／m2 （第1、15天）、长春新碱1.4 mg／m2 （最大量2mg, 第1、8、15、22天）、吡柔比星25 mg／m2 （第1、2、15、16天）、泼尼松40 mg／m2 （第1天至第28天）。结果　CHOP-21方案组30例完全缓解12例（40 %）,CTOP-28方案组35例完全缓解28例（80 %）,后者显著高于前者（P＜0.05）。CTOP-28方案Ⅲ、Ⅳ度血液毒性的发生率（100.0 %）显著高于CHOP-21方案（50.0 %）（P＜0.05）;CTOP-28方案心脏毒性发生率（8.57 %）与CHOP-21方案相当（10.0 %）（P＞0.05）,均为Ⅰ、Ⅱ度毒性;胃肠毒性和肝肾脏毒性两种方案相当,均为Ⅰ、Ⅱ度;两种方案均未出现治疗相关死亡。结论　THP联合COP 4周方案是治疗初始侵袭性NHL骨髓浸润的高效、安全的方法。     

FMD方案治疗惰性淋巴瘤的临床观察

 目的　分析FMD方案初治惰性淋巴瘤的疗效及毒副作用。方法　24例确诊惰性淋巴瘤患者初治采用FMD方案：氟达拉滨（Flu）25～30 mg·m-2·d-1,静脉滴注30 min,第1天至第3天;米托蒽醌（Mit）10 mg·m-2·d-1,静脉滴注30 min,第1天;地塞米松（Dxm）40 mg／d,静脉滴注,第1天至第5天。结果　24例患者中,完全缓解（CR）54.1 ％,部分缓解（PR）29.1 ％,有效率为83.2 ％。主要毒副作用是骨髓抑制。结论　FMD方案初治惰性淋巴瘤临床效果好,患者可以耐受,是一种安全有效的较理想的方案     

DCF和ECF方案治疗进展期胃癌的疗效观察

目的研究多西紫杉醇（希存）联合顺铂及5-Fu治疗进展期胃癌的近期疗效及不良反应。方法58例进展期胃癌患者随机分两组,DCF方案为治疗组（30例）,ECF方案为对照组（28例）。结果DCF方案组有效率为36.6%（11/30）,对照组有效率28.5%（8/28）,两者差异无显著性（P〉0.05）。毒副反应主要表现为白细胞减少、恶心、呕吐和脱发,两组相比较差异无显著性。结论DCF方案治疗晚期胃癌疗效较好,毒副反应可耐受。     

应用CD-DST法比较吡柔比星和表柔比星在乳腺癌中敏感性的研究

目的 通过对比乳腺癌原代培养细胞对吡柔比星和表柔比星的药物敏感性,来评估吡柔比星和表柔比星在乳腺癌中敏感性的差别,并进一步指导临床化疗药物的选择.方法 收集天津医科大学附属肿瘤医院乳腺中心129例原发性乳腺癌患者的新鲜癌组织,采用胶原凝胶体包埋肿瘤细胞原代培养法培养原代乳腺癌细胞,检测其对吡柔比星和表柔比星的敏感性.结...     

Effect of pirarubicin for elderly patients with malignant lymphoma

To determine the effect of a chemotherapy regimen containing pirarubicin, a multicenter clinical trial was performed in naive patients > or = 65 years with malignant lymphoma, between January 1990 and December 1992. The total number of patients was 37 (median age 74.2 years). One of three different types of chemotherapy regimens, which was administered every 3 to 5 weeks, was chosen for each patient at random. Regimen A (THP-COP) included pirarubicin (30 mg/m2; day 1), cyclophosphamide (500 mg/m2; day 1), vincristine (1 mg/m2; day 1) and prednisolone (30 mg/m2; days 1-5), regimen B, modified "CHOP", included doxorubicin (30 mg/m2; day 1), cyclophosphamide (500 mg/m2; day 1) vincristine (1 mg/m2; day 1) and prednisolone (30 mg/m2; days 1-5); regimen C (THP-COPE) included etoposide (80 mg/m2; day 1) in addition to regimen A. The complete response (CR) rate was 60.0%, 45.5% and 62.5% with regimen A, B and C. The partial response (PR) rate with regimen A was 20.0%, 18.2% with B and 25.0% with C. The 50% survival period with regimen A was more than 1,000 days, with C 643 days but it was only 365 days with B. The adverse effects related to these treatments occurred more frequently in regimen B than A and C showing a statistically significant difference. We concluded that chemotherapy regimens containing pirarubicin are useful and safe for the elderly patients with malignant lymphoma.     

A comparative study of proliferation-associated parameters in B-cell non-Hodgkin lymphoma.

The prognostic value of three proliferation-associated parameters, the frequency of cells in S-phase, mitotic index (MI) and serum deoxythymidine kinase levels (S-TK), was examined in 106 primary cases of B-cell non-Hodgkin lymphomas (NHL), 76 'low grade' NHL and 30 'high grade' NHL and compared with morphology and clinical variables. All three proliferation factors displayed large differences in the mean values of the two groups 'low grade' and 'high grade' NHL, and all revealed significant prognostic information. In 'low grade' NHL, the information decreased with follow-up time. A correlation (r = 0.7) was noted between S-phase values and MI but not between S-TK and the two others. In the entire patient material and in the two prognostic groups defined by morphology, S-TK gave the best prognostic information. MI gave better prognostic information than S-phase values in the whole material and in 'low grade' NHL, whereas the reverse appeared to be true for 'high grade' NHL. In the multivariate analyses, no other parameter apart from S-TK provided any further prognostic importance in the cases of 'high grade' NHL, whereas in that of 'low grade' NHL, MI, stage, age and histology had independent importance.     

含蒽环类药物不同方案乳腺癌辅助化疗疗效与心脏毒性对比临床观察

目的比较表阿霉素和吡柔比星两种不同蒽环类药物辅助化疗治疗乳腺癌的临床疗效以及心脏毒性。方法收集2007年1月到2009年12月收治的女性Ⅱ~ⅢB期原发性乳腺癌患者83例,选择的病例均已行乳腺癌改良根治术或保乳术并且术后应用CTF方案或者CEF方案辅助化疗,其中CTF组42例,CEF组41例。化疗周期均为6个,每21 d一次,分析比较两组的临床疗效以及毒副反应。结果截至2010年8月,中位随访26个月,CTF组和CEF组的1年无病生存率分别为97.3%和95.0%;1年总体生存率均为100%,两组的1年无病生存率和总体生存率无统计学差异。主要毒副反应为白细胞减少、恶心呕吐、肝肾功能损害、脱发等,但均可耐受。CEF组的不良反应较明显,恶心呕吐,脱发,心脏毒性均明显高于CTF组(P值分别为0.001、0.002和0.021)。结论 CTF辅助化疗方案与CEF方案相比,疗效不变,毒副反应尤其是心脏毒性更轻。     

A comparative study of doxorubicin and epirubicin in patients with metastatic breast cancer

Seventy-seven patients with progressive metastatic breast cancer refractory to prior therapy participated in a prospective randomized trial designed to compare the efficacy and toxicity of doxorubicin and epirubicin administered as single agents. In arm 1, 60 mg/m2 of doxorubicin and, in arm 2, 90 mg/m2 of epirubicin were administered by 48-h continuous i.v. infusion every 3 weeks. In arm 3, 90 mg/m2 of epirubicin was administered by bolus every 3 weeks. Patients in the three groups had similar characteristics, except that in arm 3 more patients were premenopausal, had more extensive disease, and fewer patients had been exposed to doxorubicin. Objective remission rates were 29, 26, and 13%, respectively for the three arms. Median response durations ranged from 4-6 months. No significant differences occurred in response rate, remission duration, or survival among patients in the three arms. The incidence of gastrointestinal toxicity and alopecia was evenly distributed. Hematologic toxicity was more severe in arms 2 and 3, and there was a higher incidence of infectious complications in arms 2 and 3 compared to arm 1 (p = 0.05). Two episodes of congestive heart failure occurred in arm 1, one in arm 2, and three in arm 3. Although the total cumulative anthracycline dosage was highest in the arm 2 group, they had the lowest incidence of cardiac toxicity. Epirubicin by bolus and doxorubicin administered by continuous infusion have similar potential for cardiac toxicity. Epirubicin administered by continuous infusion appears less cardiotoxic than doxorubicin by either method of administration or epirubicin given by bolus. Epirubicin appears equally active and less cardiotoxic than the parent compound doxorubicin in patients with metastatic breast cancer.     

ProMACE-CytaBOM方案与CHOP方案治疗非霍奇金淋巴瘤的随机对照研究

背景与目的:CHOP方案一直是治疗中、高度恶性非霍奇金淋巴瘤(non鄄Hodgkin蒺slymphoma,NHL)的基本方案,近年有文献报道ProMACE鄄CytaBOM方案可以提高中、高度恶性NHL的完全缓解(completeresponse,CR)率及生存率。本研究中我们比较ProMACE鄄CytaBOM方案与CHOP方案治疗中、高度恶性NHL的疗效与安全性,为中、高度恶性NHL的规范治疗提供依据。方法:选择经病理组织学证实的中、高度恶性NHL的患者146例,随机分为ProMACE鄄CytaBOM组和CHOP组两组,分别采用上述两种方案治疗。两组生存率采用Kaplan鄄Meier法分析,组间比较采用χ2检验。结果:ProMACE鄄CytaBOM组CR29例(39.7%),部分缓解(partialresponse,PR)28例(38.4%),缓解率(responserate,RR,CR+PR)为78.1%(57/73);CHOP组CR23例(31.5%),PR21例(28.8%),RR为60.3%(44/73);两组比较有显著性差异(P<0.05)。ProMACE鄄CytaBOM组患者1、3、5年生存率分别为89.3%、76.2%和45.7%,CHOP组分别为82.1%、51.4%和32.3%,两组比较有显著性差异(P<0.05)。两组出现的主要不良反应是白细胞下降、血小板下降及恶心等,两组比较无显著性差异(P>0.05)。两组各有1例治疗相关性死亡病例。结论:与CHOP方案相比,ProMACE鄄CytaBOM方案疗效较好,不良反应可以耐受,可作为治疗中、高度恶性NHL的