以异环磷酰胺为主治疗晚期肺癌42例疗效观察

目的 探讨以异环磷酰胺（ＩＦＯ）为主的化疗方案治疗晚期肺癌的疗效。方法 ４２例晚期肺癌,ＳＣＬＣ组１９例,ＮＳＣＬＣ组２３例,ＳＣＬＣ组以ＩＥ方案（ＩＦＯ＋Ｖｐ－１６）、ＮＳＣＬＣ组以ＩＶＰ方案（ＩＦＯ＋ＶＤＳ＋ＰＤＤ）。结果 全组病人有５例达ＣＲ,１５例达ＰＲ,总有效率（ＲＲ）４０．４７％。其中ＳＣＬＣ组ＲＲ为６３．１５％,ＮＳＣＬＣ组ＲＲ为３４．７８％。本组毒性反应轻微结论以ＩＦＯ为主的化疗方     

NP与NIP方案治疗晚期非小细胞肺癌疗效和毒性观察

目的 比较ＮＰ与ＮＩＰ两方案对非小细胞肺癌（ＮＳＣＬＣ）的治疗效果。方法 治疗晚期非小细胞肺癌６８例,用ＮＰ（ＮＶＢ＋ＤＤＰ）方案治疗和ＮＩＰ（ＮＶＢ＋ＩＦＯ＋ＤＤＰ）方案治疗。结果 ＮＩＰ组和ＮＰ组有效率分别为６０．７％（１７／２８）和４７．５％（１９／４０）,两者差异无显著性（Ｐ〉０．０５,ｘ＾２＝１．１５）。主要毒性反应是骨髓抑制,且以白细胞和血小板下降明显。ＮＩＰ组Ⅲ、Ⅳ度白细胞毒性占７３     

VlP与MVP方案治疗非小细胞肺癌的对照研究

目的：通过前瞻性对照研究,比较ＶＩＰ方案与ＭＶＰ方案治疗晚期非小细胞肺癌的疗效及不良反应。方法：共５３例晚期的非小肺癌患者随机入组,治疗应用ＶＩＰ方案（ＶＤＳ＋ＩＦＯ＋ＤＤＰ）,对照组应用ＭＶＰ方案（ＭＭＣ＋ＶＤＳ＋ＤＤＰ）,每例病人至少化疗２疗程。疗效及不良反应评价均按ＷＨＯ标准进行,每例病人随访生存期。结果：治疗组中１例ＣＲ,１５例ＰＲ,８例ＳＤ,１例ＰＤ,有效率（ＣＲ＋ＰＲ）为６４．０％;对     

IFO联合DDP或VP16治疗晚期肺癌近期疗效分析

目的：观察异环磷酰胺（ＩＦＯ）联合顺铂（ＤＤＰ）或足叶乙甙（ＶＰ１６）治疗晚期肺癌的近期疗效和毒性反应。方法：对４６例晚期肺癌患者,采用异环磷酰胺联合顺铂或足叶乙甙进行化疗。结果：非小细胞肺癌（ＮＳＣＬＣ）３８例,有效率为３９．５％,其中ＩＰ方案２１例,有效率４２．９％;ＩＥ方案１７例,有效率３５．３％。小细胞肺癌（ＳＣＬＣ）８例,有效率为６２．５％,其中ＩＰ方案７例,有效率５７．１％;ＩＥ方案１     

全身化疗加或不加胸腺肽α_1治疗晚期非小细胞肺癌

目的：比较全身化疗加或不加胸腺肽α１（Ｔα１）及小剂量干扰素（ＩＦＮ－α）对晚期非小细胞肺癌（ＮＳＣＬＣ）的疗效、毒性及免疫功能的变化。方法：将３０例晚期ＮＳＣＬＣ患者随机分为治疗组及对照组,分别接受ＭＶＰ方案（丝裂霉素、西艾克、顺铂）加Ｔα１及小剂量 ＩＦＮ－α或单纯 ＭＶＰ方案化疗。结果：治疗组部分缓解率４０．０％,对照组 ２６．０％（Ｐ＞０．０５）,中位缓解期分别为４．５个月及４．２个月。疗后治疗组Ｔ淋巴细胞及Ｔ辅助细胞（Ｔ４）水平明显高于对照组。治疗组除干扰素引起的发热外,其毒性与对照组基本相同。结论：全身化疗同时应用Ｔα１及小剂量ＩＦＮ－Ｑ治疗晚期ＮＳＣＬＣ,其疗效有所提高。且毒性未见增加,Ｔα１对晚期肺癌患者的免疫功能具有一定的调节效用。     

非小细胞肺癌化学治疗与血清sAPO-1/Fas、NO的变化

目的 观察化疗药物替尼泊甙（ＶＭ－２６）、表阿霉素（ＥＰＩ）、顺铂（ＤＤＰ）治疗非小细胞肺癌的疗效、毒性及治疗前后血清ｓＡＰＯ－１／Ｆａｓ、ＮＯ含量的变化。方法４２例诊断明确的晚期非小细胞肺癌（ＮＳＣＬＣ）患者（鳞癌２８例,腺癌１２例,未分化癌２例）采用ＶＭ－２６、ＥＰＩ、ＤＤＰ联合化疗２个周期。化疗前后分别用比抗体夹心ＥＬＩＳＡ方法测定血清ｓＡＰＯ－１／Ｆａｓ含量和用酶还原法测定血清ＮＯ含量。结     

SERO-EPIDEMIOLOGICAL STUDIES OF EPSTEIN-BARR VIRUS(EBV) INFECTION BY TESTING ANTIBODIES AGAINST EBV SPECIFIC DNASE(EDAb) AS A METHOD FOR EARLY DETECTION OF NASOPHARYNGEAL CARCINOMA(NPC)

ＳＥＲＯＥＰＩＤＥＭＩＯＬＯＧＩＣＡＬＳＴＵＤＩＥＳＯＦＥＰＳＴＥＩＮＢＡＲＲＶＩＲＵＳ（ＥＢＶ）ＩＮＦＥＣＴＩＯＮＢＹＴＥＳＴＩＮＧＡＮＴＩＢＯＤＩＥＳＡＧＡＩＮＳＴＥＢＶＳＰＥＣＩＦＩＣＤＮＡＳＥ（ＥＤＡｂ）ＡＳＡＭＥＴＨＯＤＦＯＲＥＡＲＬＹ...     

去甲长春花碱,异环磷酰胺和顺铂动静脉给药治疗46例非小细？…

目的：观察去甲长春花碱（ＮＶＢ）、异环磷酰胺（ＩＦＯ）和大剂量顺铂（ＤＤＰ）联合动、静脉给药治疗晚期非小细胞肺癌（ＮＳＣＬＣ）的疗效及不良反应。方法：４６例ＮＳＣＬＣ随机分为供瘤动脉给药组（Ａ组）和静脉给药组（Ｂ组）。Ａ组：２６例,ＮＶＢ３０ｍｇ／ｍ＾２,ＤＤＰ８０ｍｇ／ｍ＾２,供瘤支气管动脉灌注,第１天;Ｂ组：２０例,ＮＶＢ３０ｍｇ／ｍ＾２,ＤＤＰ８０ｍｇ／ｍ＾２,静脉点滴,第１天。２组均用ＩＦ     

康莱特注射液联合CEP方案治疗晚期肺癌临床观察

目的　比较单用康莱特注射液（ Ｋ Ｌ Ｔ）、 Ｃ Ｅ Ｐ（ Ｃ Ｔ Ｘ＋ Ｅ Ｐ Ｉ＋ Ｄ Ｄ Ｐ）化疗方案以及 Ｋ Ｌ Ｔ 加 Ｃ Ｅ Ｐ方案治疗晚期肺癌的疗效。方法　７３ 例晚期肺癌随机分成３ 组, Ｋ Ｌ Ｔ 单药组２５ 例, Ｃ Ｅ Ｐ方案化疗组２６ 例, Ｋ Ｌ Ｔ 加 Ｃ Ｅ Ｐ方案联合化疗组 ２２ 例。结果　显示 Ｋ Ｌ Ｔ、 Ｃ Ｅ Ｐ 方案化疗以及 Ｋ Ｌ Ｔ＋ Ｃ Ｅ Ｐ方案联合治疗有效率分别为 ２８．０％ 、３４．６％ 和５４．５％ , Ｃ Ｅ Ｐ方案主要毒副反应是骨髓抑制,其发生率为 ６１．５％ ,较其他两组严重（ Ｐ＜ ０．０１）。结论　 Ｋ Ｌ Ｔ 加 Ｃ Ｅ Ｐ方案治疗晚期肺癌有增效减毒作用,可能是治疗晚期肺癌较好的方案之一     

重组人血管内皮抑素联合吉西他滨、顺铂方案双途径给药治疗晚期非小细胞肺癌的临床研究

目的　研究重组人血管内皮抑素（恩度）联合吉西他滨＋顺铂方案双途径给药治疗中晚期非小细胞肺癌（ＮＳＣＬＣ）的有效性和安全性。方法　选择ＮＳＣＬＣ患者４０例,分为恩度联合ＧＰ方案双途径给药治疗组（试验组）和单纯ＧＰ方案双途径治疗组（对照组）,每组２０例。试验组方案为：吉西他滨１０００ｍｇ／ｍ２＋顺铂５０ｍｇ／ｍ２＋恩度３０ｍｇ,肿瘤靶动脉灌注ｄ１;恩度１５ｍｇ静滴,ｄ２～ｄ１３;吉西他滨１０００ｍｇ／ｍ２静滴,ｄ８。对照组仅用ＧＰ方案动脉灌注,剂量、方法同试验组,静脉化疗用吉西他滨单药,方法、剂量同试验组。比较两组患者的有效率（ＲＲ）、疾病控制率（ＤＣＲ）、１年生存率、无进展生存期（ＰＦＳ）、总生存期（ＯＳ）和毒副反应等方面的差异。结果　试验组与对照组比较,ＲＲ分别为４５％和１０％（Ｐ＜０.０５）,ＤＣＲ分别为１００％和９０％（Ｐ＞０.０５）,１年生存率分别为５５％和３０％（Ｐ＞０.０５）,ＰＦＳ分别为７.５个月和５.９个月（Ｐ＜０.０５）,ＯＳ分别为１２.７个月和１２.３个月（Ｐ＞０.０５）。两组均未出现严重毒副反应,且组间比较差异无统计学意义。结论　恩度联合ＧＰ方案双途径治疗晚期ＮＳＣＬＣ临床疗效确切,用药安全,无进展生存时间有所延长,但总体生存期改善不明显,其最佳用药方式有待进一步深入研究。     

CE方案治疗132例肺癌临床观察

对１３２例肺癌病人采用ＣＥ方案治疗２个或３个周期，观察疗效和毒副反应。总有效率为４７．０％，其中小细胞肺癌３７例，有效率为８３．８％，腺癌６２例，有效率为３３．９％，鳞癌３３例，有效率为３０．３％。毒副反应主要是骨髓抑制，消化道及肝肾毒性较轻。结果表明，ＣＥ方案治疗小细胞肺癌可获得较高疗效，对非小细胞肺癌的疗效与其它常用方案相近，毒副反应较轻。     

血清中神经特异性烯醇化酶水平对晚期非小细胞肺癌化疗疗效的影响

目的探讨血清中神经特异性烯醇化酶(NSE)水平对晚期非小细胞肺癌(NSCLC)化疗疗效的影响 .方法用放免法检测142例NSCLC治疗前NSE水平,选择阳性病例60例,随机分为两组,A组选用VDS(或NVB) DDP化疗方案,B组选用Vp-16 DDP化疗方案,评价3周期化疗后的疗效,随访生存率.结果 A组近期化疗有效率为51.2%,1年生存率为16.7%;B组近期化疗有效率为76.7%,1年生存率40.0%,两组差异有显著性(P＜0.05).结论血清NSE水平升高的晚期NSCLC患者选用常用的SCLC化疗方案较为合适.     

口服VP16联合DDP方案治疗非小细胞肺癌

作者自１９９３年１月采用口服ＶＰ１６联合ＤＤＰ方案治疗非小细胞肺癌（ＮＳＣＬＣ）３５例，所有病例均由组织学检查证实。结果ＣＲ１例、ＰＲ１６例、Ｓ８例、Ｐ１０例，有效率（ＣＲ＋ＰＲ）４８．６％。全组中位生存期９．８个月。恶心、呕吐发生率为７８．３％，粘膜炎为１０．４％，白细胞和血小板降低发生率分别为５８．１％和１５．２％，大多为轻、中度。作者认为ＶＰ１６对小细胞肺癌（ＳＣＬＣ）的疗效有显著的时间依赖性，长时间、低剂量口服ＶＰ１６对ＳＣＬＣ有较好的疗效，但对ＮＳＣＬＣ的疗效是否更好，本文尚未证明。然而，方便给药，利于门诊化疗是其优点。     

Phase II trial with ISIS 5132 in patients with small-cell (SCLC) and non-small cell (NSCLC) lung cancer. A European Organization for Research and Treatment of Cancer (EORTC) Early Clinical Studies Group report

Two multicentre phase II trials were designed to determine if tumour responses can be achieved in progressive small-cell lung cancer (SCLC) or non-small cell lung cancer (NSCLC) patients treated with ISIS 5132, an inhibitor of C-raf kinase mRNA expression (CGP 69846A; ISIS Pharmaceuticals Inc, Carlsbad, CA), and to further characterise the safety of the compound. Between August 1998 and November 1999, 26 patients (18 NSCLC, 8 SCLC) were entered. Out of these, 23 were eligible, 22 (18 NSCLC, 4 SCLC) were treated with ISIS 5132 (2 mg/kg/day, 21 days continuous intravenous (i.v.) infusion every 4 weeks) and were evaluable for toxicity and 18 (15 NSCLC, 3 SCLC) were evaluable for efficacy. For the whole group haematological toxicity did not exceed grade 2. One patient experienced a grade 4 increased prothrombin time. Non-haematological toxicity was mild to moderate, with the observation of asthenia and nausea and vomiting. Progressive disease (PD) was diagnosed in 10 patients (8 NSCLC and 2 SCLC). 8 more patients (7 NSCLC, 1 SCLC) were considered as treatment failures. In conclusion, this study using ISIS 5132 with this dose and schedule of administration excludes a 20% response rate with 95% confidence intervals for NSCLC and cannot draw any conclusions for SCLC patients as only a few were involved in the study.     

VP和MVP方案治疗晚期非小细胞肺癌疗效的随机对照研究

通过比较VP和MVP两组方案治疗晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的疗效和毒性,探讨MVP方案中MMC的应用价值。58例晚期NSCLC患者入组,其中VP方案组(VDS+DDP)28例,MVP方案组(MMC+VDS+DDP)30例,每例患者至少化疗3个周期。疗效及不良反应评价均按WHO标准进行。结果显示,VP组和MVP组有效率分别为46·4%(13/28)和50·0%(15/30),差异无统计学意义,P>0·05;1年生存率、中位生存期在MVP和VP组分别为30·0%(9/30)和39·3%(11/28),9·6和11·5个月。主要毒副反应均为骨髓抑制和胃肠道反应,但MVP组明显较重。初步研究结果提示,MMC的加入对MVP方案无益,毒性相对增加,应予舍弃。     

Phase II study of second-line gemcitabine in sensitive or refractory small cell lung cancer

Small cell lung cancer (SCLC) is highly sensitive to chemotherapy. Despite a dramatic initial response, however, most patients relapse. Given the activity of gemcitabine in non-small cell lung cancer (NSCLC), and early clinical trials suggesting activity of gemcitabine in chemo-naive SCLC patients, we conducted a phase II study to determine the efficacy and toxicities of gemcitabine in SCLC patients who have failed first-line chemotherapy. Gemcitabine 1250 mg/m(2) was given intravenously on days 1 and 8, every 3 weeks. Eligibility criteria included prior treatment with only one chemotherapy regimen and Eastern Cooperative Oncology Group (ECOG) performance status of 0-2. Patients with brain metastases were eligible. RESULTS: Between April 1998 and October 2001, 27 patients were enrolled: 15 patients with sensitive (S) disease (recurred>3 months after first-line chemotherapy) and 12 patients with refractory (R) disease (failed<3 months after first-line chemotherapy). Median age was 61 (range 45-74). All patients had received prior platinum-based therapy involving etoposide and either cisplatin or carboplatin. There were one early death and two early withdrawals because of toxicity. No responses were observed. Of 24 patients who received at least two cycles of gemcitabine, only three achieved stable disease after six cycles while 21 progressed. The median time to progression (TTP) was 6 weeks in S group, 5.6 weeks in R group, and 6 weeks overall. After a minimum potential follow-up of almost 1 year for all patients, the median survival was 8.8 months in S group, 4.2 months in R group, and 6.4 months for the whole group. One-year survival rate was 33.3% in S group, 16.7% in R group, and 25.4% for all patients. Myelosuppression was the most commonly observed adverse effect, with grade 3/4 neutropenia in 30%, and grade 3 thrombocytopenia in 30%. One patient (3.7%) developed neutropenic fever. Respiratory failure and death, possibly related to pulmonary toxicity, was observed in one patient (3.7%). CONCLUSION: monotherapy gemcitabine as second-line agent has limited activity in previously treated SCLC.     

顺铂或卡铂加足叶乙甙治疗晚期肺癌105例临床分析

我所自1992年1月至1995年8月，用顺铂或卡钻加足叶乙甙治疗晚期肺癌105例，其中小细胞肺癌49例，非小细胞肺癌56例。顺铂组有效率小细胞肺癌为72．0％，非小细胞肺癌为38．5％；卡钥组有效率小细胞肺癌为79．2％，非小细胞肺癌为26．7％。两方案的主要毒性为胃肠道毒性和骨髓抑制，胃肠道毒性顺钥组较卡铂组为重，而骨髓抑制以卡铂组为明显。本文结果提示顺铂或卡铂加足叶乙甙治疗小细胞肺癌的有效率高，可作为治疗小细胞肺癌的首选方案。治疗非小细胞肺癌的有效率顺铂组稍高于卡铂组，但两组疗效均欠理想，为寻找治疗非小细胞肺癌更为有效的化疗方案，仍有待临床进一步探讨。     

Do patients with weight loss have a worse outcome when undergoing chemotherapy for lung cancers?

To examine whether weight loss at presentation influences outcome in patients who received chemotherapy for lung cancer or mesothelioma. Multivariate analysis of prospectively collected data 1994-2001. Data were available for age, gender, performance status, histology, stage, response, toxicity, progression-free and overall survival. The outcomes of patients with or without weight loss treated with chemotherapy for small cell lung cancer (SCLC; n=290), stages III and IV non-small-cell lung cancer (NSCLC; n=418), or mesothelioma (n=72) were compared. Weight loss was reported by 59, 58 and 76% of patients with SCLC, NSCLC and mesothelioma, respectively. Patients with weight loss and NSCLC (P=0.003) or mesothelioma (P=0.05) more frequently failed to complete at least three cycles of chemotherapy. Anaemia as a toxicity occurred significantly more frequently in NSCLC patients with weight loss (P=0.0003). The incidence of other toxicities was not significantly affected by weight loss. NSCLC patients with weight loss had fewer symptomatic responses (P=0.001). Mesothelioma patients with weight loss had fewer symptomatic (P=0.03) and objective responses (P=0.05). Weight loss was an independent predictor of shorter overall survival for patients with SCLC (P=0.003, relative risk (RR)=1.5), NSCLC (P=0.009, RR=1.33) and mesothelioma (P=0.03, RR=1.92) and an independent predictor of progression-free survival in patients with SCLC (P=0.01, RR=1.43). In conclusion, weight loss as a symptom of lung cancer predicts for toxicity from treatment and shorter survival.     

MVP与EP方案治疗晚期非小细胞肺癌疗效对比观察

目的观察比较MVP方案EP方案两种不同化疗方案治疗晚期非小细胞肺癌(NSCLC)的疗效和毒性.方法晚期NSCLC899例,用MVP方案31例,用EP方案58例,进行有效率和毒性的统计.结果MVP组有效率35.5%(11/31),EP组有效率31.0%(18/58),两组无显著性差异(P＞0.05).两组剂量限制毒性均为骨髓抑制,白细胞下降占66.2%,Ⅲ～Ⅳ度下降MVP组为6.5%,EP组为6.7%.其次为胃肠道毒性和脱发,均为Ⅰ～Ⅱ度.结论MVP方案治疗晚期NSCLC的疗效和毒性与EP方案相仿,均为治疗晚期非小细胞肺癌安全有效的化疗方案.     

参麦注射液联合化疗治疗晚期非小细胞肺癌

 目的 探讨参麦注射液（SMI）联合化疗治疗晚期非小细胞肺癌（NSCLC）的疗效。方法 晚期NSCLC 76例，治疗组40例，采用常规化疗配合参麦注射液，并与单纯化疗的36例作对照，观察两组的体力状况、疗效、一年生存率、骨髓抑制情况等。结果 除近期疗效（CR+PR）之外，治疗组和对照组的Karnofsky评分提高＋稳定率为75.0 % v 47.2 %、疗效稳定以上率（CR+PR+NC）为72.5 % v 47.2 %，一年生存率为43.3 % v 30.9 %，之间的差异均有统计学意义，治疗组白细胞、血小板治疗前后比较，差异均无统计学意义。结论 治疗组的Karnofsky评分、疗效稳定以上率、一年生存率均优于对照组，且未见明显骨髓抑制。提示SMI联合化疗治疗晚期NSCLC有增效减毒作用。