Salvage chemotherapy with irinotecan and cisplatin in patients with metastatic gastric cancer failing both 5-fluorouracil and taxanes

We conducted a phase II study to assess the efficacy and tolerability of irinotecan and cisplatin as salvage chemotherapy in patients with advanced gastric adenocarcinoma, progressing after both 5-fluorouracil (5-FU)- and taxane-containing regimen. Patients with measurable metastatic gastric cancer, progressive after previous chemotherapy that consisted either of a 5-FU-based regimen followed by second-line chemotherapy containing taxanes or a 5-FU and taxane combination were treated with irinotecan and cisplatin. Irinotecan 70 mg/m(2) was administered on day 1 and day 15; cisplatin 70 mg/m(2) was administered on day 1. Treatment was repeated every 4 weeks. For 28 patients registered, a total of 94 chemotherapy cycles were administered. The patients' median age was 51 years and 27 (96%) had an ECOG performance status of 1 or below. In an intent-to-treat analysis, seven patients (25%) achieved a partial response, which maintained for 6.3 months (95% confidence interval 6.2-6.4 months). The median progression-free and overall survival were 3.5 and 5.6 months, respectively. Major toxic effects included nausea, diarrhea and neurotoxicity. Although there was one possible treatment-related death, toxicity profiles were generally predictable and manageable. We conclude that irinotecan and cisplatin is an active combination for patients with metastatic gastric cancer in whom previous chemotherapy with 5-FU and taxanes has failed.     

An open-labeled phase II trial of docetaxel in combination with cisplatin as first-line cytotoxic therapy for anthracycline-naive patients with metastatic breast cancer

The combination of docetaxel and cisplatin has shown promising results in anthracycline-pretreated patients with advanced breast cancer, but with substantial toxicity. The efficacy and safety in anthracycline-naive patients has not been evaluated. Between October 2003 and January 2006, we enrolled 39 patients. None had undergone chemotherapy for metastatic disease or been exposure to adjuvant anthracycline-based regimens earlier. Eligibility criteria included: histologically proven metastatic cancer; WHO performance status (PS) 0-2; and adequate hematological, hepatic and renal function. Docetaxel (70 mg/m) and cisplatin (50 mg/m) were administered every 3 weeks until the patient either refused to continue, or progression, or even unacceptable toxicity occurred. Tumor response was assessed every three cycles. One patient was withdrawn from response analysis because of toxicity. Thirty-eight patients had a complete tumor assessment. Median age was 50 years (range, 28-63); 5.1% had a WHO of PS of 0; 87% a PS of 1; 7.7% a PS of 2; in 69%, two or more organs were involved. A total of 291 cycles (range, 1-9) were administered. Three complete responses and 27 partial responses (intent-to-treat response rate 30/39=76.9%) resulted; disease remained stable in six patients and two had disease progression. Grade III/IV toxicities included diarrhea in 10.2%, asthenia/fatigue in 2.5%, mucositis in 5.1% and neutropenia in 87.3% of patients. Seven patients developed febrile neutropenia (17.9%). The median time to progression was 11.2 months; the timespan was not sufficient to track the median survival. Docetaxel/cisplatin is an active regimen with acceptable toxicity in the first-line treatment of metastatic breast cancer, but it is not sufficiently promising as a standard. Further randomized study is warranted.     

Induction chemotherapy with docetaxel, cisplatin, fluorouracil and l-leucovorin for locally advanced head and neck cancers: a modified regimen for Japanese patients

Combination chemotherapy with docetaxel (T), cisplatin (P), fluorouracil (5-FU) and leucovorin has been reported to have major activity against squamous cell carcinoma of the head and neck (SCCHN) administered as a 4-day (TPFL4) or 5-day (TPFL5) regimen. The purpose of this study was to evaluate the efficacy and toxicity of a modified TPFL regimen (m-TPFL) for locally advanced SCCHN, consisting of a modified dosage with docetaxel, cisplatin, 5-FU and l-leucovorin (l-LV) designed for Japanese patients. Organ preservation of the primary tumor site was also assessed. Thirty-four Japanese patients with locally advanced SCCHN were eligible. Docetaxel was administered as a 1-h i.v. infusion at 48 mg/m2 on day 1; cisplatin, 24 mg/m2/day; 5-FU, 560 mg/m2/day and l-LV, 125 mg/body/day were delivered on days 1-4 by continuous i.v. infusion. This regimen was administered every 28 days. Patients who achieved a complete response (CR) after induction chemotherapy underwent radiation therapy alone. Ninety-one cycles were administered. The main hematological toxicity was neutropenia, classified as grade III or IV in 18.7% of cycles. The most common non-hematologic toxicities included anorexia, stomatitis and alopecia. The clinical overall response rate to m-TPFL was 88.2%, with 58.8% CRs and 29.4% partial responses. After definitive locoregional therapy, 25 of 34 patients were disease-free with preserved primary tumor site anatomy. Overall and progression-free survival rates at the 2-year follow-up are 92.8 and 75.3%, respectively. Our m-TPFL regimen designed for Japanese patients yielded excellent response rates with an acceptable toxicity profile in good-performance-status patients.     

吉西他滨及长春瑞滨联合顺铂对晚期耐药乳腺癌的治疗观察

目的：观察吉西他滨及长春瑞滨分别联合顺铂的化疗方案治疗对蒽环类和紫杉类耐药的复发转移性晚期乳腺癌的疗效及不良反应。方法：将56例乳腺癌患者随机分为A、B两组各28例,A组应用吉西他滨1000mg/m2进行静脉滴注30min,第1、8天;顺铂25mg/m2静脉滴注,第1～3天。B组应用长春瑞滨25mg/m2静脉滴注,第1、8天;顺铂用法同A组。每21天为1个周期,至少化疗2个周期后评价疗效。结果：A组总有效率为57.1%,B组总有效率为53.6%,两组疗效差异无统计学意义。结论：吉西他滨及长春瑞滨联合顺铂方案治疗对蒽环类和紫杉类耐药的晚期乳腺癌疗效较好,不良反应可以耐受。     

A phase II study of epirubicin, vinorelbine and cisplatin in advanced breast cancer

Our objective was to evaluate the activity and safety of the combination of cisplatin, epirubicin and vinorelbine (CEV) in advanced breast cancer patients. Patients with advanced breast cancer, locally advanced or metastatic, received epirubicin 75 mg/m2 and cisplatin 50 mg/m2 on day 1, and vinorelbine 25 mg/m2 on day 8. Cycles were repeated every 3 weeks. A total of 35 patients were treated. Thirty-one patients were evaluated for response. One hundred and fifty-five cycles of chemotherapy were administered overall. The objective response rate (ORR) was 84%, including complete response in 13% of patients. All stage III patients achieved a downstaging, with a pathological complete response in two out of 10 patients. Patients with stage IV disease obtained objective response in 67% of cases. Toxicity was mild to moderate. The most common grade 3-4 adverse event was febrile neutropenia, which occurred in 17% of patients. We conclude that CEV combination represents an effective treatment for patients with previously untreated advanced breast cancer, allowing an important ORR. Moreover this regimen appears to be well tolerated.     

重组人血管内皮抑制素联合GP方案治疗晚期非小细胞肺癌37例临床观察

目的 观察重组人血管内皮抑制素(恩度)联合GP方案治疗晚期非小细胞肺癌(NSCLC)的疗效和毒副反应.方法 经病理学或细胞学检查证实的37例晚期NSCLC患者,包括鳞癌21例,腺癌16例.吉西他滨1 000 mg/m2,静脉滴注,第1、8天;顺铂80 mg/m2,静脉滴注,分3 d给予;恩度15 mg/d,静脉滴注,第1～14天,21 d为1个周期.每例患者至少完成2个周期.根据WHO疗效评定及毒副反应分级标准,观察其近期疗效、疾病进展时间及毒副反应.结果 37例晚期NSCLC患者中,CR 1例,PR 15例,SD 14例,PD 7例,总有效率(CR+PR)43.2%.中位疾病进展时间为5.2个月.毒副反应主要为血液学、消化道毒性,Ⅲ～Ⅳ度中性粒细胞减少占32.4%,Ⅲ～Ⅳ度血小板减少占20.5%,未见与化疗相关的死亡.结论 恩度联合GP方案治疗晚期NSCLC近期客观疗效较高,安全性好.     

重组人血管内皮抑制素联合GP方案治疗晚期非小细胞肺癌37例临床观察

目的观察重组人血管内皮抑制素（恩度）联合GP方案治疗晚期非小细胞肺癌（NSCLC）的疗效和毒副反应。方法经病理学或细胞学检查证实的37例晚期NSCLC患者,包括鳞癌21例,腺癌16例。吉西他滨1000mg／m^2,静脉滴注,第1、8天;顺铂80mg／m^2,静脉滴注,分3d给予;恩度15mg／d,静脉滴注,第1～14天,21d为1个周期。每例患者至少完成2个周期。根据WHO疗效评定及毒副反应分级标准,观察其近期疗效、疾病进展时间及毒副反应。结果37例晚期NSCLC患者中,CR1例,PR15例,SD14例,PD7例,总有效率（CR＋PR）43．2％。中位疾病进展时间为5．2个月。毒副反应主要为血液学、消化道毒性,Ⅲ-Ⅳ度中性粒细胞减少占32．4％,Ⅲ-Ⅳ度血小板减少占20．5％,未见与化疗相关的死亡。结论恩度联合GP方案治疗晚期NSCLC近期客观疗效较高,安全性好。     

长春瑞滨联合顺铂治疗蒽环及紫杉类耐药的晚期转移性乳腺癌

目的观察长春瑞滨联合顺铂方案（NP方案）治疗蒽环和紫杉类耐药的晚期转移性乳腺癌的疗效和安全性。方法20例蒽环类和紫杉类方案治疗失败的晚期转移性乳腺癌患者接受：长春瑞滨25mg／m2,静脉滴注,第1天和第8天;顺铂75mg／m2,静脉滴注,第1天,或25mg／m2,静脉滴注,第l一3天;每3周重复。每例患者至少化疗2个周期,每2个疗程评价1次。结果总有效率（CR＋PR）50％,其中CR2例（10％）,PR8例（40％）,SD4例（20％）,PD6例（30％）。中位随访时间6个月（4-18个月）,16例存活,4例死亡。中位疾病进展时间5个月（3～15个月）;中位总生存期8个月（4-18个月）,1年生存率为60％。主要不良反应为骨髓抑制和消化道反应,Ⅲ-Ⅳ度消化道反应、白细胞下降和血小板下降分别为25％、65％和10％。结论NP方案治疗蒽环类和紫杉类治疗失败的晚期转移性乳腺癌患者疗效可靠且可耐受,可以考虑作为难治性乳腺癌的解救方案。     

Phase II study of weekly paclitaxel plus 24-h continuous infusion 5-fluorouracil,folinic acid and 3-weekly cisplatin for the treatment of patients with advanced gastric cancer

The aim of this study was to evaluate the toxicity and efficacy of combination chemotherapy with weekly 24-h continuous infusion of 5-fluorouracil (5-FU)/folinic acid, weekly paclitaxel and 3-weekly cisplatin in patients with unresectable, locally advanced or metastatic gastric adenocarcinoma. Between November 1999 and November 2001, 29 chemotherapy-naive patients (13 male and 16 female) with a median age of 56 years (range 22-72) were consecutively enrolled at three centers. 5-FU 2 g/m2 was given weekly over 24 h i.v. preceded by folinic acid 500 mg/m2 as a 2-h infusion. Paclitaxel 80 mg/m2 was administered as a 1-h infusion weekly and cisplatin 50 mg/m2 as 1-h infusion on days 8 and 29. Six weeks of therapy (days 1, 8, 15, 22, 29 and 36) followed by 1 week of rest was considered one cycle. A median of 3 cycles (range 1-5) was administered to 29 patients with a total of 73 cycles applied. All patients were assessable for toxicity and survival, 28 patients were assessable for response (one patient received less than one complete cycle and could not be evaluated for response). Four patients (14%) obtained a complete response and 10 patients (34%) a partial response (overall response rate 48%, 95% CI 29-68%). Seven patients (24%) had stable disease. Seven patients (24%) had progressive disease during or within 4 weeks after treatment. The median progression-free and overall survival times were 8 months (range 1-23) and 11 months (range 1-23), respectively. Overall toxicity was acceptable. Hematological toxicity was favorable with only one patient (3%) experiencing WHO grade 3/4 leukocytopenia and one patient (3%) WHO grade 3/4 anemia. Non-hematologic WHO grade 3/4 toxicities included alopecia in 19 (66%), nausea/vomiting in six (21%), diarrhea in six (21%), neurotoxicity grade 3 in three (10%) and infection in three (10%) patients. A total of 42 applications (10%) (range 0-5) had to be postponed and dose reductions of at least one drug was necessary in 37% of applications. In three patients (10%) treatment was stopped because of toxicity. All patients were treated on an outpatient basis. Thus, the combination of weekly paclitaxel, cisplatin and continuously infused 5-FU/folinic acid appears to be a highly active regimen for the treatment of patients with advanced gastric cancer. Compared with our previous experience with the same combination of drugs but using paclitaxel at 175 mg/m2 given every 3 weeks, the protocol with weekly application of paclitaxel 80 mg/m2 shows a reduced incidence of hematologic toxicity, particularly leukopenia. Other organ toxicities apart from a slightly higher incidence of peripheral neuropathy were comparable between the two treatment protocols. Efficacy with a response rate of 50% was well preserved by this weekly regimen.     

Phase II study of gemcitabine in combination with cisplatin in patients with locally advanced and/or metastatic pancreatic cancer

The present phase II trial was performed to assess the efficacy and toxicity of polychemotherapy with gemcitabine and cisplatin in patients with locally advanced or metastatic carcinoma of the pancreas. Sixteen patients received six courses of an i.v. cytotoxic regimen consisting of gemcitabine (1000 mg/m2, days 1, 8 and 15) and cisplatin (35 mg/m2, days 1, 8 and 15) administered in 28-day intervals. Complete remission (CR) occurred in one patient (6%), partial remission (PR) in four patients (25%) and stable disease in seven patients (44%), whereas four patients (25%) developed progressive disease resulting in an overall response rate of 31%. Mean duration of responses (CR+PR) was 3.6 (range 0.7-8.5) months and mean time to progression was 7.4 (range 3.8-12.6) months. After a mean observation period of 11.5 months the overall survival was 9.6 months with 12 patients (75%) still being alive, which compares favorably with historical data of the administration of gemcitabine alone. The performance status improved in three (19%) and stabilized in eight (50%) out of 16 patients for 4 weeks or longer. Treatment-associated toxicity included alopecia of WHO grade III in all cases, leukopenia of WHO grades I and II in 10 patients (63%), grade III in five patients (31%), and thrombocytopenia grades I and II in four patients (25%), and grades III and IV in 10 patients (63%). We conclude that the administered dosage and schedule of gemcitabine and cisplatin in patients with locally advanced or metastatic cancer of the pancreas constitutes an active cytotoxic regimen associated with moderate toxicity.     

Multicenter phase II study of chemoimmunotherapy in the treatment of metastatic melanoma

Combining chemotherapy and immunotherapeutic agents such as interleukin-2 and interferon alpha-2b might improve treatment results in metastatic melanoma (MM) patients compared with chemotherapy alone. This prospective study evaluated the potential efficacy of a biochemotherapy regimen followed by maintenance biotherapy for the treatment of MM. Twenty-two patients with stage IV melanoma were treated for 5 consecutive days with cisplatin at 20 mg/m, vinblastine at 1.6 mg/m, and dacarbazine at 160 mg/m. Pegylated interferon alpha-2b at a dose of 50 microg every week, subcutaneous interleukin-2, 1.8 MIU, and oral 13-cis-retinoic acid (13-cis-RA) at 0.5 mg/kg were given 5 days/week for 3 weeks each month during the period of chemotherapy administration. Maintenance biotherapy was continued in patients who had a complete or partial response or disease stability (clinical benefit) after six courses of biochemotherapy. The primary endpoint was response; secondary endpoints were the evaluation of the immunologic parameters, toxicity, progression-free survival, and overall survival. Twelve patients (54.5%) achieved a response, and seven (31.8%) maintained stable disease for at least 6 months with maintenance biotherapy. The median progression-free survival and overall survival were 23.3 and 45.7 months, respectively. The most important toxicities from chemotherapy were grades 3 and 4 neutropenia and thrombocytopenia in 41 and 18% of patients, respectively, whereas grade 2 autoimmune reactions were observed in 21% of patients after maintenance biotherapy. A prolonged enhancement of immunologic function was observed in the 19 patients treated with maintenance therapy. A regimen of six cycles of biochemotherapy followed by maintenance immunotherapy is well tolerated, and shows significant activity in patients with MM.     

Phase II trial of cisplatin and etoposide in patients with metastatic melanoma

Summary Fourteen patients with metastatic melanoma were treated with cisplatin and etoposide by bolus intravenous infusion daily for 5 consecutive days each month. All patients were evaluable for toxicity and twelve for response. Eight patients were treated with cisplatin 20 mg/m² and etoposide 100 mg/m² daily. Because of excessive myelosuppression, the daily dose of etoposide was reduced to 75 mg/m² in the remaining six patients. There were no major responses among 12 evaluable patients (major response rate 24% with 95% confidence). The median time to progression was one month. One patient with a liver metastasis had a minor response lasting 6 + months. The combination of cisplatin and etoposide in these doses and schedule lacked sufficient clinical efficacy in the treatment of metastatic melanoma.     

长春瑞滨联合顺铂治疗蒽环类耐药的晚期乳腺癌患者疗效分析

目的观察长春瑞滨联合顺铂对复发、转移性乳腺癌患者的治疗作用。方法复发、转移性乳腺癌患者57例,所有患者均接受长春瑞滨25mg/m2加入0.9%的氯化钠注射液50mL静脉推注,第1、8天应用;顺铂75mg/m2加入0.9%的氯化钠注射液250mL静脉滴注,分两天即第1、2应用,应用顺铂前后适当水化,21天1周期,化疗2～6个周期。结果 57例均可评价疗效,全组患者CR5例(8.8%),PR23例(40.4%),RR28例(49.1%)。结论对已用过蒽环类药物的晚期复发、转移性乳腺癌患者应用长春瑞滨联合顺铂方案化疗疗效较好,不良反应轻,可在临床上作为二线解救方案推广应用。     

吉西他滨联合氟尿嘧啶治疗紫杉醇类及顺铂耐药的晚期卵巢癌

目的观察吉西他滨联合氟尿嘧啶(5-FU)治疗对紫杉醇类、顺铂耐药的晚期卵巢癌的疗效和不良反应。方法 2005-02～2011-12用吉西他滨1000 mg/m2,第1、8天;5-FU 300 mg/m2,第1～3天;5-FU 1500 mg/m2微量泵持续72 h静脉滴注,亚叶酸钙(CF)200 mg第1～3天;治疗对紫杉醇类、顺铂耐药的晚期卵巢癌患者36例。结果 36例患者中,CR为19.4%(7例),PR为33.3%(12例),SD为19.4%(7例),PD 27.8%(10例),RR为52.8%,DCR为72.2%。在累计136个疗程中,Ⅲ～Ⅳ度血液学不良反应的发生率为27.2%(37/136)。其中Ⅲ～Ⅳ度中性粒细胞减少症的发生率为21.3%(29/136),Ⅲ～Ⅳ度血小板减少症的发生率为12.5%(17/136),Ⅲ～Ⅳ度贫血的发生率为10.3%(14/136);非血液学不良反应36例的136疗程中,Ⅲ～Ⅳ度消化道反应发生率为30.9%(42/136),口腔溃疡发生率为27.2%(37/136),化疗性肠炎发生率为16.9%(23/136)。结论吉西他滨联合氟尿嘧啶治疗对紫杉醇类、顺铂耐药的晚期卵巢癌有较好的疗效,且不良反应可以耐受。     

多西紫杉醇联合顺铂2周方案治疗晚期非小细胞肺癌临床观察

目的探讨多西紫杉醇联合顺铂2周给药一线治疗晚期非小细胞肺癌(NSCLC)的疗效及毒副作用。方法多西紫杉醇75mg/m2静脉滴注,顺铂25mg/m2×3d静脉滴注联合化疗,每2周重复疗程。化疗期间用粒细胞-集落刺激因子预防性支持治疗。结果共39例晚期NSCLC患者完成化疗,36例可评价疗效,其中完全缓解1例(2.8%),部分缓解13例(36.1%),稳定21例(58.3%),进展1例(2.8%);总有效率38.9%。本方案化疗所致毒性反应主要为骨髓抑制,恶心、呕吐,肌肉、关节痛,脱发和疲劳。结论多西紫杉醇联合顺铂2周给药是治疗晚期NSCLC的有效可行方案,其毒副作用患者可耐受,值得进一步研究。     

紫杉醇联合顺铂、5-氟尿嘧啶治疗晚期食管癌近期疗效观察

目的 观察紫杉醇联合顺铂(DDP)加亚叶酸钙(CF)和5-氟尿嘧啶(5-FU)方案治疗晚期食管癌的近期疗效及安全性.方法 观察55例晚期食管癌患者,PTX 135～175 mg·m-2,静脉滴注3 h,d1,DDP 20 mg·m-2 d1～d4、CF 0.2g·m-2 d2～d3、5-FU 2.0g·m-2持续静滴4...     

Escalating doses of paclitaxel and epirubicin in combination with cisplatin in advanced ovarian epithelial carcinoma: a phase I-II study

Our objective was to identify a new active three-drug combination regimen consisting of paclitaxel (PTX), epirubicin (EPI) and cisplatin as first-line line chemotherapy for advanced ovarian carcinoma. A phase I study was carried out to evaluate the dose-limiting toxicity (DLT) and the maximally tolerated dose (MTD) of PXT and EPI in combination with a fixed dose of cisplatin every 4 weeks. Side-effects were recorded according to the NCI Common Toxicity Criteria. Patients were treated in cohorts of three with fixed-dose cisplatin 80 mg/m2 and EPI 80-->100 mg/m2 and PXT 100-->160 mg/m2 until DLT was reached. Once MTD was identified, a single-step phase II study was therefore carried out to test the clinical activity and panel of toxicity of such regimen. Objective responses were recorded according to the WHO criteria. Time to progression and overall survival (OS) were secondary endpoints. The DLT was myelosuppression and, in more detail, febrile neutropenia, which occurred at the fifth dose level (PTX 140 mg/m2, EPI 100 mg/m2 and cisplatin 80 mg/m2) in two out of three patients. Other side-effects were grade 3 mucositis in two out of three patients and grade 3 anemia in one case. The combination of cisplatin 80 mg/m2 plus EPI 80 mg/m2 and PCT 140 mg/m2 every 4 weeks was considered as the MTD. In the phase II study a complete response was observed in six patients (33%) and a partial response in nine cases (50%) for an overall response rate of 83% [95% confidence limits (CL) 59-96%]. Median time to progression of patients with measurable disease was 16.4 months. Median OS was not reached after a follow-up of 42 months. This study demonstrated that PTX and EPI can be safely administered in combination with cisplatin to fit patients with advanced epithelial ovarian carcinoma. The three-drug regimen of cisplatin 80 mg/m2, EPI 80 mg/m2 and PTX 140 mg/m2 every 4 weeks is very active, at least in terms of objective response rate. This level of activity overlaps with the 95% CL of the activity of cisplatin alone; however, it does encourage future trials of the combination.     

培美曲塞单药或联合顺铂二线治疗晚期非小细胞肺癌52例临床观察

目的回顾分析培美曲塞单药或联合顺铂二线治疗晚期复发或进展的非小细胞肺癌的临床疗效及不良反应。方法经病理学或细胞学确诊,一线化疗后出现复发或进展的晚期非小细胞肺癌患者52例。所有患者分为单药治疗组24例和联合治疗组28例。单药治疗组给予培美曲塞单药治疗（培美曲塞500mg/m2,第1天,21d为1个周期）,联合治疗组给予美曲塞联合顺铂治疗：（培美曲塞500mg/m2＋顺铂75mg/m2,第1天,21d为1个周期）。完成2个周期以上化疗评价疗效和不良反应。结果52例患者中,完全缓解（CR）0例,部分缓解（PR）2例,稳定（SD）34例,进展（PD）16例,有效率（RR）为3.85%（2/52）,疾病控制率（DCR）为69.23%（36/52）。2组疗效比较,差异无统计学意义（P〉0.05）。主要不良反应为Ⅰ/Ⅱ度骨髓抑制、胃肠道反应,经对症处理后不影响化疗进行。单药治疗组好于联合用药组（P〈0.05）。结论培美曲塞单药或联合顺铂二线治疗晚期非小细胞肺癌疗效较好,不良反应较轻,耐受性较好。     

FOLFOX方案治疗局部进展期或转移性胃癌的疗效分析

目的:观察FOLFOX方案治疗局部进展期或转移性胃癌的疗效、不良反应及安全性。方法:37例局部进展期或转移性胃癌患者均行锁骨下深静脉穿刺或外周肘正中静脉穿刺,置入单腔输液导管,经电脑输液泵控制氟尿嘧啶的输液速度,接受FOLFOX方案化疗(奥沙利铂85 mg/m2,静脉滴注2 h,第1天;亚叶酸钙200 mg/m2,静脉滴注2 h,第1天～第2天;氟尿嘧啶400 mg/m2,静脉滴注,第1天～第2天;氟尿嘧啶600 mg/m2,持续静脉滴注44 h;14 d为1个周期),中位化疗6个周期,4个周期后评价疗效。结果:全组37例均可评价疗效,总有效率为67.6%,其中完全缓解率为27.0%,部分缓解率为40.5%,肿瘤进展时间为9.2个月,中位生存期为13.7个月。在初次化疗的11例患者中,有效率为81.8%;在既往接受过化疗的26例患者中,有效率为61.5%。FOLFOX方案化疗的主要不良反应为血液学毒性、恶心、呕吐和末梢神经感觉异常,多为～度,度不良反应主要包括恶心、呕吐和末梢神经感觉异常。结论:奥沙利铂联合氟尿嘧啶、亚叶酸钙的化疗方案作为辅助性化疗或姑息性化疗用于局部进展期或转移性胃癌均有较好疗效,且毒副反应轻,患者耐受性好。     

晚期限局性非小细胞肺癌替吉奥顺铂同步调强放疗的效果观察

目的观察以替吉奥联合顺铂(SP)方案化疗,并行同步调强放疗治疗晚期限局性非小细胞肺癌的疗效及安全性。方法初治晚期限局性非小细胞肺癌42例,行替吉奥40～60 mg/m2,2次/d,口服d1～14联合顺铂25 mg/m2,1次/d,静脉滴注d1～3化疗,每3周为1周期,并于第1周期开始同步行调强放疗DT 58～66 Gy/29～33 F。其后再行2周期SP方案巩固化疗。结果 42例中有39例完成观察,总有效率(RR)为69.2%,疾病控制率(DCR)为87.2%。中位无进展生存期(PFS)为11.2个月,1年生存率为84.6%。鳞癌和非鳞癌患者疗效相当。常见的3～4级毒性反应为白细胞下降、粒细胞下降、贫血等。结论替吉奥联合顺铂同步调强放疗治疗晚期限局性非小细胞肺癌安全有效,且对于各种组织学类型均有效,为晚期限局性非小细胞肺癌的治疗提供了一种新的选择。