卡培他滨联合沙利度胺化疗对结直肠癌组织胸苷磷酸化酶表达的影响

目的:探讨卡培他滨联合沙利度胺治疗晚期结直肠癌的近期疗效及癌组织胸苷磷酸化酶的表达。方法:比较卡培他滨联合沙利度胺和5-氟尿嘧啶 亚叶酸 奥沙利铂(FOLFOX4)方案治疗晚期结直肠癌的疗效、不良反应,并采用ELISA方法测定两组患者癌组织中TP含量。结果:卡培他滨联合沙利度胺组疗效优于FOLFOX4组,总有效率分别为50.0%和36.3%(P<0.05);卡培他滨联合沙利度胺组TP浓度均数(211.2±30.5μg/L)显著低于FOLFOX4组(323.4±28.3μg/L)(P<0.005)。结论:卡培他滨联合沙利度胺治疗晚期结直肠癌疗效肯定,安全性较好。     

沙利度胺联合方案治疗晚期结直肠癌临床观察

目的探讨沙利度胺联合方案治疗晚期结直肠癌的疗效及安全性。方法45例经病理证实的晚期结直肠癌患者随机分为治疗组和对照组。治疗组22例接受沙利度胺联合卡培他滨和奥沙利铂治疗,对照组23例仅接受卡培他滨联合奥沙利铂治疗。3周为1周期,至少2周期化疗,评价疗效。研究无进展生存期(PFS)、客观有效率（ORR）、疾病控制率（DCR）,并观察安全性及不良反应。结果治疗组DCR为68.2%,而对照组为43.5%,差异有统计学意义（P＜0.05）, PFS 、ORR及患者生活质量两组间差异无统计学意义(P＞0.05)。结论沙利度胺联合方案治疗晚期结直肠癌可显著提高疾病控制率且耐受性良好,值得临床进一步研究。     

FOLFIRI方案联合沙利度胺治疗晚期结直肠癌的临床观察

目的:评价FOLFIRI方案联合沙利度胺对晚期结直肠癌的疗效和耐受性.方法:选择21例患者行FOLFIRI方案化疗,均联合沙利度胺口服,40d后观察疗效,并评价副作用,肿瘤标记物CA72-4,CEA变化.结果:疗效为CR O,PR 6例(28.6%),SD13例(61.9%),PD 2例(9.5%),副作用主要为延迟性腹泻,腹痛,Ⅲ-Ⅳ分别为2例(9.5%),1例(4.8%).化疗后CEA,CA72-4下降(P＜0.05).结论:FOLHRI方案联合沙利度胺对晚期结直肠癌的疗效较满意,耐受性好.     

FOLFIRI方案联合沙利度胺治疗晚期结直肠癌的临床观察

目的：评价FOLFIRI方案联合沙利度胺对晚期结直肠癌的疗效和耐受性。方法：选择21例患者行FOLFIRI方案化疗，均联合沙利度胺口服，40d后观察疗效，并评价副作用，肿瘤标记物CA72—4，CEA变化。结果：疗效为CR0，PR6例（28．6％），SD13例（61．9％），PD2例（9，5％），副作用主要为延迟性腹泻，腹痛，Ⅲ-Ⅳ分别为2例（9．5％），1例（4．8％）。化疗后CEA，CA72—4下降（P〈0．05）。结论：FOLFIRI方案联合沙利度胺对晚期结直肠癌的疗效较满意，耐受性好。     

贝伐珠单抗联合奥沙利铂+卡培他滨化疗治疗转移性结直肠癌的疗效及安全性

目的 探讨贝伐珠单抗联合奥沙利铂+卡培他滨化疗治疗转移性结直肠癌的疗效及安全性.方法 采用随机数字表法将78例转移性结直肠癌患者分为对照组和研究组,每组39例,对照组患者给予奥沙利铂+卡培他滨化疗,研究组患者给予贝伐珠单抗联合奥沙利铂+卡培他滨治疗.治疗2个疗程后,比较两组患者的临床疗效、肿瘤标志物[癌胚抗原(CEA)...     

卡培他滨联合沙利度胺治疗晚期结直肠癌39例

[目的]观察卡培他滨(希罗达)联合沙利度胺对晚期结直肠癌的作用.[方法]对我院39例晚期结直肠癌采用希罗达联合沙利度胺应用治疗.希罗达1250mg/m2,每天2次,口服1～14天;沙利度胺100mg,口服1～21天.28天为一个化疗周期,4个周期为一个疗程,完成一个疗程后30天评价疗效,按照WHO实体瘤近期客观疗效评定标准进行评价.[结果]39例病例中3例因药物不良反应未服完1个疗程即中断治疗.36例可评价病例中,CR 3例(8.33%),PR 14例(38.88%),NC¨例(30.56%),PD8例(22.22%),总有效率47.22%.毒性反应主要为神经毒性、便秘和手足综合征.[结论]希罗达联合沙利度胺治疗晚期结直肠癌疗效肯定,安全性较好.     

曲妥珠单抗加顺铂联合卡培他滨化疗对人表皮生长因子受体阳性晚期胃癌患者肿瘤标志物的影响

目的 探讨曲妥珠单抗加顺铂联合卡培他滨化疗对人表皮生长因子受体(HER)阳性晚期胃癌患者肿瘤标志物的影响.方法 59例HER阳性晚期胃癌患者随机分为2组,对照组29例,观察组30例,对照组予以顺铂联合卡培他滨化疗,观察组在对照组治疗基础上加用曲妥珠单抗治疗,比较2组治疗效果及血清糖类抗原199(CA199)、癌胚抗原(CEA)、CA724水平,并评估比较生活质量.结果 观察组治疗后总有效率为56.67%、疾病控制率为80.00%,均高于对照组的31.03%、55.17%,差异均有统计学意义(P均<0.05);治疗后观察组CA199、CEA及CA724水平均低于对照组,差异均有统计学意义(P均<0.05);治疗后观察组生活质量评分高于对照组,差异有统计学意义(P<0.05).结论 对HER阳性晚期胃癌患者给予曲妥珠单抗加顺铂联合卡培他滨化疗,效果显著,可有效改善患者生活质量及肿瘤标志物水平.     

卡培他滨联合胸腺肽α1治疗高龄晚期结直肠癌临床观察

目的 研究卡培他滨联合胸腺肽α1治疗高龄晚期结直肠癌患者的疗效.方法 将60例高龄晚期结直肠癌患者随机分2组,治疗组30例,对照组30例.治疗组:卡培他滨2000 mg·m-2·d-1分两次口服,第1天至第14天,每3周1个周期,化疗4个周期;胸腺肽α1:每次1.6mg,皮下注射,隔日一次,治疗12周.对照组:仅用卡培他滨,用法用量同治疗组.两组均观察3～12个月,观察两组有效率、稳定率、生存时间、Karnofsky评分及体重变化、CEA水平变化及不良反应.结果 治疗组有效率26.7%、稳定率76.7%、中位生存时间为8.4个月,对照组有效率13.3%,稳定率46.7%,中位生存时间5.8个月.治疗组Karnofsky评分、体重变化及CEA下降均明显优于对照组(P<0.05);两组不良反应比较差异无统计学意义(P>0.05).结论 卡培他滨联合胸腺肽α1能提高高龄晚期结直肠癌患者治疗效果,改善其生活质量,延长生存期,不增加卡培他滨的副作用.     

卡培他滨联合奥沙利铂治疗晚期结直肠癌的近远期疗效及对血清癌胚抗原、糖类抗原19-9表达水平的影响

目的 探讨卡培他滨联合奥沙利铂治疗晚期结直肠癌(CRC)的近远期疗效及对血清癌胚抗原(CEA)、糖类抗原19-9(CA19-9)表达水平的影响.方法 采用随机数字表法将68例晚期CRC患者分为观察组与对照组,每组34例.对照组患者给予卡培他滨治疗,观察组患者给予卡培他滨联合奥沙利铂治疗.比较两组患者的近期疗效、不良反应、血清CEA和CA19-9水平及3年生存情况.结果 观察组患者的客观有效率(ORR)和疾病控制率(DCR)分别为58.82％和82.35％,分别高于对照组的32.35％和58.82％,差异均有统计学意义(P﹤0.05).化疗期间,两组患者腹泻、恶心呕吐、血小板减少、白细胞减少、手足综合征、口腔黏膜炎、周围神经毒性的严重程度比较,差异均无统计学意义(P﹥0.05).治疗后,两组患者的血清CEA、CA19-9水平均低于本组治疗前,且观察组患者的血清CEA、CA19-9水平均低于对照组,差异均有统计学意义(P﹤0.05).观察组患者的3年总生存率高于对照组,平均生存时间长于对照组,差异均有统计学意义(P﹤0.05).结论 与单药卡培他滨治疗相比,卡培他滨联合奥沙利铂治疗晚期CRC可进一步提高近远期疗效,降低血清CEA、CA19-9水平,减少肿瘤负荷,延长总生存期.     

卡培他滨节拍化疗在晚期结直肠癌维持治疗中的疗效观察

摘 要：［目的］ 探讨卡培他滨节拍化疗维持治疗晚期结直肠癌的疗效及安全性。［方法］ 入组69例复发转移性结直肠癌患者,完成联合化疗后疗效评价无疾病进展,根据治疗方法不同分为节拍化疗组、常规化疗组。节拍化疗组32例给予小剂量卡培他滨节拍化疗500mg,2次/d,持续口服,28d为1个周期;常规化疗组37例每次给予卡培他滨 1250mg/m2,2次/d,连续14d,休7d,21d为1个周期;4个周期后观察毒副反应及近期疗效,Kaplan-Meier法绘制中位无进展生存期（PFS）生存曲线图。［结果］ 节拍化疗组与常规化疗组有效率分别为15.63%和16.22%（χ2=0.004,P=0.947）,疾病控制率分别为71.88%和70.27%（χ2=0.021,P=0.884）,差异均无统计学意义。节拍化疗组中位PFS为8.6个月,常规化疗组为7.9个月,差异无统计学意义(χ2=0.367,P=0.554)。节拍化疗组不良反应发生率均低于常规化疗组,且骨髓抑制及手足综合征发生率两组比较差异有统计学意义(P<0.05)。［结论］卡培他滨节拍化疗较常规化疗在结直肠癌晚期维持治疗中显示出等效低毒的特点,值得临床进一步推广。     

卡培他滨节拍化疗在晚期三阴性乳腺癌维持治疗中的疗效观察北大核心

目的:探讨卡培他滨节拍化疗在晚期三阴性乳腺癌患者维持治疗中的近远期疗效、生活质量以及不良反应。方法:将经联合化疗有效的58例晚期三阴性乳腺癌患者随机分为卡培他滨节拍化疗组和卡培他滨常规剂量组两组,每组患者各29例。节拍化疗组患者给予卡培他滨节拍化疗,常规剂量组患者给予常规剂量卡培他滨化疗。治疗2个月后评价近期疗效,每个月评价不良反应,并统计两组患者的中位疾病进展时间、中位生存时间、1年生存率、2年生存率和生活质量的变化。结果:58例患者均可评价疗效。节拍化疗组患者中CR 0例,PR 5例,SD 22例,PD 2例,客观缓解率(ORR)和疾病控制率(DCR)分别为17.2%和93.1%;常规剂量组患者中CR 0例,PR 6例,SD 20例,PD 3例,客观缓解率(ORR)和疾病控制率(DCR)分别为20.7%和89.7%。两组患者的ORR和DCR相比差异无统计学意义(P>0.05)。节拍化疗组患者的中位肿瘤无进展生存时间(PFS)为7.1个月,与常规剂量组患者(6.9个月)比较,差异无统计学意义(P>0.05);节拍化疗组患者的1年、2年生存率分别为72.4%、58.6%,与常规剂量组患者(69.0%、55.2%)比较,差异无统计学意义(P>0.05)。生活质量改善方面,节拍化疗组患者显著优于常规剂量组患者(P<0.05);节拍化疗组患者的主要不良反应为骨髓抑制、消化道反应和手足综合征等,均以Ⅰ-Ⅱ度为主,均可耐受,常规剂量组患者的消化道反应、骨髓抑制、手足综合征等不良反应的发生率和严重程度均显著高于节拍化疗组(P<0.05)。结论:卡培他滨节拍化疗作为晚期三阴性乳腺癌患者的维持治疗,其近远期疗效与常规剂量维持化疗相当,同时可提高患者生活质量,不良反应轻且发生率低,值得临床推广应用。     

A successfully resected case of colorectal cancer with multiple liver metastases treated with FOLFIRI after failure of mFOLFOX6

A sixty-year-old man was admitted with anorexia and abdominal mass. Colonoscopy revealed type 2 tumor at sigmoid colon. Computed tomography (CT) demonstrated multiple liver metastases. The patient was diagnosed as sigmoid colon cancer with multiple liver metastases. The patient was treated with mFOLFOX6 as neoadjuvant chemotherapy because the liver metastases were unresectable. However, after 2 cycles of mFOLFOX6, the level of CEA and CA19-9 much increased. The regimen was replaced by FOLFIRI. The level of CEA and CA19-9 decreased after 2 cycles of FOLFIRI. CEA and CA19-9 further decreased and colonoscopy and CT revealed a partial response after 5 cycles of FOLFIRI. The patient was subjected to curative resection. Sigmoidectomy and liver resection were performed. Histological response was Grade 1b at liver metastasis. The patient was discharged and had an uneventful recovery. Six months after surgery, CEA and CA19-9 decreased to normal level, and the patient is free of recurrence. Neoadjuvant chemotherapy for metastatic colorectal cancer may render some unresectable patients resectable, affording these patients the possibility of prolonged survival. However, the optimal approach is unknown.     

Prognostic study of preoperative serum levels of CEA and CA 19-9 in colorectal cancer

PURPOSE: Carcinoembrionic Antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9) are the most frequently used tumor markers in the clinical setting of colorectal cancer. The aim of this study is to evaluate the prognostic value of preoperative serum levels of CEA and CA 19-9 in colorectal cancer patients. METHODS: Serum levels of CEA and CA 19-9 were examined in 586 patients with colorectal cancer. Cut-off levels were calculated at reference value:<2.5 ng/mL (group A) versus >2.5 ng/mL (group B) for CEA and, <37 U/mL (group A) versus >37 U/mL (group B) for CA 19-9. RESULTS: According to tumor progression, each marker tended to show a higher level. Group A showed a significantly better prognosis than group B in both CEA and CA 19-9. In Dukes classification A, B and C, only CEA showed a better prognosis in group A than group B. At the time of recurrence compared to the pre-operative point, the CEA and CA 19-9 levels were significantly higher in both group A and B, however. In relation to the necessity of adjuvant chemotherapy (5-FU containing regimen) in Dukes A, the cases without adjuvant chemotherapy in group B of CEA showed a poor prognosis. CONCLUSION: The measurement of preoperative serum CEA and CA 19-9 is useful for prognostic prediction in colorectal cancer. Cut-off levels calculated at the reference value reflect the prognosis in this study. Especially, preoperative CEA reveals a potential high risk group in Dukes A which should be carefully treated by adjuvant chemotherapy to avoid recurrence.     

CEA and CA 19-9 are Still Valuable Markers for the Prognosis of Colorectal and Gastric Cancer Patients

Background: The purpose of this study was to assess the predictive effect of preoperative CEA and CA 19-9levels on the prognosis of colorectal and gastric cancer patients. Materials and Methods: CEA and CA 19-9 wereevaluated preoperatively in patients undergoing surgery for colorectal cancer (n=116) and gastric cancer (n=49).Patients with CEA levels <5 ng/mL were classified as CEA Group 1, 5-30 ng/mL as CEA Group 2 and >30 ng/mL were classified as CEA Group 3. Similarly the patients with a CA 19-9 level <35 U/mL were classified as CA19-9 Group 1, with 35-100 U/mL as Group 2 and with >100 U/mL as Group and 3. TNM stages and histologicgrades were noted according to histopathological reports. Patients with a TNM grade 0 or 1 were classified asGroup A, TNM grade 2 patients constituted Group B and TNM grade 3 and 4 patients constituted Group C.Demographic characteristics, tumor locations and blood types of the patients were all recorded and these datawere compared with the preoperative CEA and CA19-9 values. Results: A significant correlation between CA19-9 levels (>100 U/mL) and TNM stage (in advanced stages) was determined. We also determined a significantcorrelation between TNM stages and positive vlaues for both CEA and CA 19-9 in colorectal and gastric cancerpatients. In comparison between CEA and CA 19-9 levels and age, gender, tumor location, ABO blood group,and tumor histologic grade, no significant correlation was found. Conclusions: Positive levels of both CEA andCA 19-9 can be considered to indicate an advanced stage in colorectal and gastric cancer patients.     

To widen the setting of cancer patients who could benefit from metronomic capecitabine

Purpose  We investigated the efficacy and toxicity of metronomic capecitabine administered at a fixed dose of 1,000 mg daily in three elderly or poor performance status patients with advanced colorectal cancer (CRC) and gastric cancer. Methods  In this study a pretreated advanced CRC patient (patient 1), a not previously treated advanced gastric cancer patient (patient 2), and a not previously treated advanced rectal cancer patient (patient 3) were given metronomic capecitabine administered at a fixed dose of 1,000 mg daily (day 1–28 continuously). The efficacy was evaluated every 3 months by instrumental evaluation and the treatment was continued until progression of disease or toxicity. Results  A stable disease was observed in all three patients. The duration of treatment was above 3 months and no major toxicities occurred. Conclusions  Our results indicate that metronomic capecitabine may be considered a safe and valid treatment option for advanced CRC and gastric cancer patients, both after failure of previous lines of chemotherapy or in front-line when standard chemotherapy is contraindicated, especially when the aim of medical treatment is to achieve disease control and to arrest tumour growth without affecting the patient’s quality of life. Nevertheless, further clinical studies, as well as a greater clinical experience are required in order to better define the role of this strategy in medical oncology.     

125I放射性粒子植入术后卡培他滨单药化疗联合二陈汤治疗晚期结直肠癌疗效分析

目的探讨二陈汤联合¹²⁵I粒子植入、卡培他滨单药化疗对晚期结直肠癌患者预后及生活质量的影响。方法选取2019年9月至2020年9月间广州市中西医结合医院收治的60例晚期痰湿内停证型结直肠癌患者,分为试验组和对照组,每组30例。所有患者行肿瘤¹²⁵I粒子植入、术后卡培他滨单药化疗,治疗组加用中医二陈汤治疗。比较两组患者治疗前后的疗效和生活质量。结果实验组治疗后肿瘤缩小百分率、癌胚抗原(CEA)下降程度、部分缓解率和客观缓解率均优于对照组,差异均有统计学意义(均P<0.05);对照组的疾病稳定率优于试验组,差异有统计学意义(P<0.05)。两组患者的完全有效率和疾病进展率比较,差异无统计学意义(P>0.05)。试验组治疗后癌痛缓解和生活质量评分改善程度均好于对照组,差异均有统计学意义(均P<0.05)。结论125 I粒子植入术后卡培他滨单药化疗联合二陈汤治疗晚期痰湿内停型结直肠癌患者,治疗效果优于单纯西医治疗,且能更好改善患者生活质量。     

联合检测凝血4项和肿瘤标志物在结直肠癌中的临床意义和诊断价值

目的:探讨联合检测凝血4项和肿瘤标志物在结直肠癌中的临床意义和诊断价值。方法:检测84例结直肠癌患者和80例结直肠良性疾病患者外周血中纤维蛋白原(FIB)、糖类抗原19-9(CA19-9)、癌胚抗原（CEA）水平;应用ROC曲线分析各指标的诊断价值。结果:结直肠癌患者术前FIB、CA19-9、CEA水平均明显高于结直肠良性疾病患者,差异有统计学意义(P＜0.05);Ⅲ-Ⅳ期结直肠癌患者FIB、CA19-9、CEA水平均明显高于Ⅰ-Ⅱ期患者,差异有统计学意义(P＜0.05);结直肠癌患者FIB水平和CEA、CA19-9水平存在着相关性。联合检测FIB、CA19-9、CEA水平可提高结直肠癌的诊断率。结论:术前肿瘤标志物及凝血4项的检测有助于鉴别结直肠良性、恶性肿瘤及监测血栓的形成,提高诊断效能,有利于早期发现与治疗。     

Changing patterns of Serum CEA and CA199 for Evaluating the Response to First-line Chemotherapy in Patients with Advanced Gastric Adenocarcinoma

Background: This study was designed to investigate the value of CEA and CA199 in predicting the treatmentresponse to palliative chemotherapy for advanced gastric cancer. Materials and Methods: We studied 189 patientswith advanced gastric cancer who received first-line chemotherapy, measured the serum CEA and CA199 levels,used RECIST1.1 as the gold standard and analyzed the value of CEA and CA199 levels changes in predictingthe treatment efficacy of chemotherapy. Results: Among the 189 patients, 80 and 94 cases had increases ofbaseline CEA (≥5 ng/ml) and CA199 levels (≥ 27U/ml), respectively. After two cycles of chemotherapy, 42.9%patients showed partial remission, 33.3% stable disease, and 23.8% progressive disease. The area under theROC curve (AUC) for CEA and CA199 reduction in predicting effective chemotherapy were 0.828 (95%CI0.740-0.916) and 0.897 (95%CI 0.832-0.961). The AUCs for CEA and CA199 increase in predicting progressionafter chemotherapy were 0.923 (95%CI 0.865-0.980) and 0.896 (95%CI 0.834-0.959), respectively. Patients whoexhibited a CEA decline ≥24% and a CA199 decline ≥29% had significantly longer PFS (log rank p=0.001,p<0.001). With the exception of patients who presented with abnormal levels after chemotherapy, changes of CEAand CA199 levels had limited value for evaluating the chemotherapy efficacy in patients with normal baselinetumor markers. Conclusions: Changes in serum CEA and CA199 levels can accurately predict the efficacy offirst-line chemotherapy in advanced gastric cancer. Patients with levels decreasing beyond the optimal criticalvalues after chemotherapy have longer PFS.