吉西他滨联合长春瑞滨治疗晚期非小细胞肺癌的临床研究

目的:观察吉西他滨联合长春瑞滨治疗晚期非小细胞肺癌(NSCLC)的临床疗效及毒副反应。方法:38例初治NSCLC给予吉西他滨1000mg/m2,d1、d8,静脉滴注30分钟,长春瑞滨25mg/m2,d1、d8,静脉推注,21d为1个周期,至少治疗2个周期。结果:全组38例均可评价,无CR,PR13例,总有效率(CR PR)34·2%(13/38),SD31·6%(12/38),PD21·1%(8/38),中位生存期为11个月,疾病进展时间为5·9个月;1年生存率及2年生存率分别为44·7%(17/38)和23·7%(9/38)。血液学毒性反应主要是Ⅰ~Ⅱ度白细胞下降占73·7%(28/38),Ⅲ~Ⅳ度白细胞下降占10·5%(4/38),Ⅰ~Ⅱ度血红蛋白及血小板下降分别占26·3%(10/38)和31·6%(12/38),非血液毒性包括食欲减退、Ⅰ~Ⅱ度恶心及呕吐、局部静脉炎等,所有不良反应经对症处理及支持治疗后均恢复正常。结论:吉西他滨联合长春瑞滨组成GN方案对于晚期NSCLC疗效较好,毒副反应可耐受,值得临床推广。     

长春瑞滨与紫杉醇联合铂类治疗老年晚期非小细胞肺癌临床对照研究

目的观察比较长春瑞滨与紫杉醇加顺铂及卡铂联合方案治疗老年晚期非小细胞肺癌(NSCLC)的临床疗效和毒副反应.方法 76例年龄≥70岁的老年晚期NSCLC患者分别应用NP(长春瑞滨 顺铂)、NC(长春瑞滨 卡铂)及TC(紫杉醇 卡铂)方案化疗.每例患者至少完成2周期后评价疗效及毒副反应.3组患者一般特征具有可比性(P＞0.05).结果 3组患者有效率分别为NP组32.4%、NC组33.3%、TC组37.5%,3组间有效率比较差异无显著性(χ2=0.177,P＞0.05).NP组中位生存期10个月,1年生存率38.7%;NC组中位生存期10.25个月,1年生存率41.7%;TC组中位生存期12.5个月,1年生存率57.7%,3组间比较差异有显著性(χ2=12.66,P=0.0018).3组主要毒副反应为骨髓抑制及消化道反应,NP、NC、TC组Ⅲ～Ⅳ度白细胞减少发生率分别为46.4%、33.3%和58.3%(χ2=4.180,P＞0.05);NP组Ⅲ～Ⅳ度消化道反应较NC组及TC组明显,分别为14.3%、8.3%和4.2%(χ2=0.831,P＞0.05).3组病例均无化疗相关死亡发生.结论 NP、NC、TC联合方案是治疗老年晚期NSCLC有效且耐受性较好的方案.     

吉西他滨联合长春瑞滨治疗转移性乳腺癌34例的疗效和毒副作用

背景与目的:化疗是治疗转移性乳腺癌的主要方法之一,蒽环类和紫杉类药物是乳腺癌化疗最有效的药物.但是很多患者在辅助治疗或者一线救援方案中已经用过这两类药物.长春瑞滨和吉西他滨也是乳腺癌化疗的有效药物之一.本研究目的是观察吉西他滨联合长春瑞滨治疗转移性乳腺癌的疗效与毒副作用.方法:34例接受过蒽环和/或紫杉类治疗的转移性乳腺癌患者,接受吉西他滨联合长春瑞滨方案治疗,吉西他滨1000 mg/m2静脉滴注30 min,d1、d8,长春瑞滨25 mg/m2静脉推注,d1、d8,每21天重复一次.结果:全组34例共完成109个周期的治疗,中位数3周期,范围1～6周期;均可评价疗效.没有完全缓解的病例,部分缓解9例,病情稳定19例,病情进展6例,客观有效率(完全缓解 部分缓解)26.47%;中位疾病进展时间5.4个月,中位生存期17.8个月;1年生存率68%(95%可信区间为50%～86%),2年生存率46%(95%可信区间为26%～66%).不良反应主要为Ⅰ～Ⅱ度骨髓抑制、末梢神经毒性及胃肠道反应,部分患者出现轻度的皮疹及肝功能损害.结论:吉西他滨联合长春瑞滨方案治疗转移性乳腺癌患者,初步观察有一定的疗效,其毒副作用患者可以耐受.     

吉西他滨联合顺铂治疗耐药转移性乳腺癌的临床观察

观察吉西他滨联合顺铂(DDP)方案治疗蒽环类和(或)紫杉类耐药转移性乳腺癌的疗效和不良反应.采用吉西他滨联合DDP方案治疗蒽环类和(或)紫杉类均耐药转移性乳腺癌患者52例.吉西他滨1 000 mg/m2,静脉滴入,d1,d8;DDP 25 mg/m2,静脉滴入,d1～d3.21 d为1个周期,至少用2个周期.本组患者治疗有效率为44.2%(23/52),中位生存时间11.0个月,中位疾病进展时间为5.3个月,1年生存率为42.3%.主要不良反应为胃肠道反应和骨髓抑制.Ⅲ～Ⅳ度呕吐发生率为28.9%(15/52).Ⅲ～Ⅳ度中性粒细胞减少发生率为15.4%(8/52),Ⅲ～Ⅳ度血小板减少发生率为17.3%(9/52).初步研究结果显示,吉西他滨联合DDP方案治疗蒽环类和(或)紫杉类均耐药的转移性乳腺癌疗效较好,毒副反应可耐受,是蒽环类及紫杉类耐药的转移性乳腺癌的有效选择.     

吉西他滨/长春瑞滨对Ⅲ～Ⅳ期非小细胞肺癌的放射增敏作用

目的探讨放疗联合吉西他滨/长春瑞滨治疗晚期非小细胞肺癌的近期疗效及不良反应。方法 27例Ⅲ～Ⅳ期非小细胞肺癌(non-small cell lung cancer,NSCLC),分为2组,其中吉西他滨组12例和长春瑞滨组15例。放疗前均先给予2个周期"紫杉醇+顺铂"方案诱导化疗,紫杉醇135 mg/m2静脉滴注第1天,顺铂30 mg/m2静脉滴注第1～3天,21天为1个周期。放疗同期予吉西他滨300 mg/m2,第1、8、15、22天,或长春瑞滨20 mg/m2,第1、8、15、22天。放疗均采用三维适形方式。结果完全缓解率(CRR)、部分缓解率(PRR)及总有效率(ORR)分别为3.7%(1/27)、55.6%(15/27)和59.3%(16/27)。其中长春瑞滨组和吉西他滨组CRR、PRR及ORR分别为6.7%(1/15)和0、60.0%(9/15)和50.0%(6/12)、66.7%(10/15)和50.0%(6/12)。肺、食管及血液毒性均未出现严重损伤,27例患者均顺利完成放疗。结论放疗联合吉西他滨/长春瑞滨治疗Ⅲ～Ⅳ期非小细胞肺癌近期疗效较好,不良反应均能耐受。远期疗效有待进一步随访。     

吉西他滨联合奥沙利铂治疗老年晚期非小细胞肺癌观察

观察吉西他滨联合奥沙利铂治疗老年晚期非小细胞肺癌（non-small cell lung cancer,NSCLC）的近期疗效及毒副反应.初治的Ⅲ～Ⅳ期老年NSCLC 22例,以21 d为1个周期,吉西他滨1000 mg/m^2,静脉滴入,d1、d8;奥沙利铂100mg/m^2,静脉滴入,d1.连用2个周期后评价疗效.全组22例均可评价,有效率为40.9%（9/22）,毒副反应主要为骨髓抑制及外周神经感觉异常.初步研究结果提示,吉西他滨联合奥沙利铂治疗老年晚期NSCLC有一定的疗效,毒性较小可以耐受.     

吉西他滨联合奥沙利铂治疗老年晚期非小细胞肺癌观察

观察吉西他滨联合奥沙利铂治疗老年晚期非小细胞肺癌(non-smallcelllungcancer,NSCLC)的近期疗效及毒副反应。初治的Ⅲ~Ⅳ期老年NSCLC22例,以21d为1个周期,吉西他滨1000mg/m2,静脉滴入,d1、d8;奥沙利铂100mg/m2,静脉滴入,d1。连用2个周期后评价疗效。全组22例均可评价,有效率为40·9%(9/22),毒副反应主要为骨髓抑制及外周神经感觉异常。初步研究结果提示,吉西他滨联合奥沙利铂治疗老年晚期NSCLC有一定的疗效,毒性较小可以耐受。     

吉西他滨联合顺铂与联合多西紫杉醇治疗非小细胞肺癌的随机对照研究

目的含铂类方案目前是治疗晚期非小细胞肺癌（NSCLC）的标准方案,但其严重的毒副反应促使人们寻找新的替代方案,本研究探讨用吉西他滨联合多西紫杉醇与吉西他滨联合顺铂方案治疗晚期NSCLC的疗效、生存率及毒副反应。方法对62例经病理或细胞学证实的晚期NSCLC的初治患者给予联合化疗,随机分为GT（吉西他滨联合多西紫杉醇）组与GP（吉西他滨联合顺铂）组,两组病例具有可比性,GT组31例,吉西他滨1000mg／m^2,静脉滴注,d1,8,多西紫杉醇（艾素）75mg／m^2加入生理盐水200mL中静脉滴注1h,d1;GP组31例,吉西他滨1000mg／m^2,静脉滴注,d1,8,顺铂25mg/m^2,静脉滴注,d1-3,21d为1个周期,每例治疗不超过6个周期。结果GT组患者总有效率为35．4％,1年生存率为76．2％,中位生存期18．6个月,中位TTP4．9个月,中位PFS3．0个月;GP组患者总有效率为32．2％,1年生存率为67．8％,中位生存期为14．6个月,中位4．4个月,中位PFS3．0个月。两组间有效率、1年生存率、中位生存期差异无统计学意义。最常见的毒副反应为恶心呕吐,GT和GP组的Ⅲ＋Ⅳ度反应发生率分别为3．2％和54．8％,差异有统计学意义（P〈0．05）,其余毒副反应轻微,可耐受。结论吉西他滨联合多西紫杉醇与吉西他滨联合顺铂相比疗效相似,但毒副反应轻,安全可行,耐受性好,中位生存期、1年生存率及生活质量以吉西他滨联合多西紫杉醇的非铂方案较好,值得临床推荐应用。     

吉西他滨联合长春瑞滨治疗蒽环类／紫杉类耐药晚期乳腺癌24例

[目的]观察国产吉西他滨联合长春瑞滨方案治疗蒽环类和／或紫杉类治疗失败的晚期乳腺癌的近期疗效与毒副反应。[方法]对接受蒽环类和,或紫杉类药物治疗病情进展的24例乳腺癌患者,采用国产吉西他滨联合长春瑞滨方案治疗：吉西他滨1000mg／m^2,静脉滴注30min,d1、d8;长春瑞滨25mg／m^2,静脉推注,d1、d8;每21d重复一次．至少2个周期评价疗效。[结果]全组24例患者均可评价疗效,其中CR2例（8.33％）,PR9例（37.50％）,SD8例（33．33％）。PD5例（20．83％）;客观有效率（CR＋PR）45．83％,临床受益率（CR＋PR＋SD）79．16％;中位疾病进展时间（TTP）6．8个月;中位生存期（MST）17．1个月。主要毒副反应为骨髓抑制和胃肠道反应,但均可耐受。[结论]吉西他滨联合长春瑞滨方案治疗蒽环类和／或紫杉类药物治疗失败的晚期乳腺癌患者,疗效确切,其毒副作用患者可以耐受．值得临床进一步研究.     

含长春瑞滨与含吉西他滨两方案治疗老年非小细胞肺癌对比研究

目的对比观察长春瑞滨(NVB)联合顺铂(DDP)方案及吉西他滨(Gemcitabine, GEM)联合DDP方案在晚期老年非小细胞肺癌临床疗效及毒性反应.方法51例晚期老年肺小细胞肺癌随机分为两组,长春瑞滨组25例,吉西他滨组26例.结果所有被研究对象的症状均有不同程度的改善.长春瑞滨组完全缓解(CR)1例,部分缓解(PR)9例,有效率为40.0%,吉西他滨组CR 2例,PR 9例,有效率为42.3%,两组间差异无显著性(P＞0.05),中位生存期(MST)长春瑞滨组为9.2个月,吉西他滨组为9.6个月,中位缓解时间两组分别为4.0个月及4.3个月.毒性反应长春瑞滨组白细胞Ⅲ/Ⅳ度下降发生率为28%,吉西他滨组白细胞Ⅲ/Ⅳ度下降占23%,但吉西他滨组血小板Ⅲ/Ⅳ度下降有5例,占19%,明显高于长春瑞滨组(P＜0.05).长春瑞滨组发生静脉炎5例,占20%,明显高于吉西他滨组(P＜0.05).结论吉西他滨联合顺铂与长春瑞滨联合顺铂对晚期老年非小细胞肺癌的近期临床疗效相近,中位生存期及中位缓解期均相似,毒性反应总的较轻,NP及GP方案均可作为治疗晚期老年非小细胞肺癌的一种安全、有效的化疗方案.     

外泌体在肿瘤发展中的研究进展

外泌体是细胞经过"内吞-融合-外排"等一系列调控过程而形成的细胞外纳米级小囊泡。外泌体可以携带蛋白,运送RNA,在细胞间物质和信息转导中起重要作用。外泌体可能通过调控免疫功能,促进肿瘤血管新生和肿瘤转移,以及直接作用于肿瘤细胞等途径,影响肿瘤的进展。外泌体可应用于肿瘤的诊断。本文总结了近年来有关外泌体在肿瘤发展中作用的研究进展。     

Inhibitory effect of suramin in rat models of angiogenesis in vitro and in vivo

The aim of the present study was to test the ability of the chemotherapeutic agent suramin to inhibit angiogenesis in experimental models in vitro and in vivo. In the culture of rat aortic rings on fibronectin, suramin dose-dependently inhibited vascular cell growth, achieving the maximal effect (mean − 88% versus controls, P < 0.05) at 400 μg/ml. Image analysis showed that suramin could inhibit microvessel sprouting in fibrin from rat aortic rings as evaluated by the ratio between the cellular area and the mean gray value of the sample (sprouting index); suramin at 50 μg/ml significantly reduced the sprouting index from the control value of 0.35 ± 0.04 to 0.14 ± 0.02 mm²/gray level (P < 0.05). Likewise, the area occupied by cells was 19.2 ± 1.8 mm² as compared with 41.8 ± 4.2 mm² in controls (P < 0.05). In the rat model of neovascularization induced in the cornea by chemical injury, suramin at 1.6 mg/eye per day reduced the length of blood vessels (0.7 ± 0.1 mm as compared with 1.5 ± 0.1 mm in controls, P < 0.05). In the same model the ratio between the area of blood vessels and the total area of the cornea (area fraction score) was decreased by suramin from 0.19 ± 0.02 in controls to 0.03 ± 0.003 (P < 0.05). Suramin given i.p. at 30 mg/kg per day markedly inhibited the neovascularization induced in the rat mesentery by compound 48/80 or conditioned medium from cells secreting the angiogenic protein fibroblast growth factor-3 (FGF-3). The area fraction score in control rats treated with compound 48/80 was 0.31 ± 0.03, and this was reduced to 0.07 ± 0.01 by suramin (P < 0.05). After i.p. administration of FGF-3 the area fraction score was reduced by suramin from 0.29 ± 0.03 to 0.05 ± 0.01 (P < 0.05). These results provide evidence that suramin exerts inhibitory effects on angiogenesis in both in vitro and in vivo models. Received: 9 January 1998 / Accepted: 29 June 1998     

重组人血管内皮抑制素治疗恶性肿瘤的研究进展

重组人血管内皮抑制素(恩度)是一种广谱的抗血管生成分子靶向药物,主要循证证据为联合化疗治疗晚期非小细胞肺癌(NSCLC).近年来,重组人血管内皮抑制素用于治疗多种恶性肿瘤的研究逐渐增多,并取得了较好的疗效.此外,有关重组人血管内皮抑制素联合治疗手段、给药途径、给药方法的研究逐渐开展,有利于其合理应用.     

Effect of trauma of implantation of metastatic tumor in bone in mice

We studied the influence of surgical trauma to the iliac bone on the implantation of I. V. injected tumor cells, which formed tumor in the surgical wounds of 27/84 mice (32%). None of these mice or nonsurgical mice developed tumor in the opposite or uninjured pelvic bone (P < 0.0001). When different numbers (10⁵, 5 × 10⁵, and 10 × 10⁵) of TA3Ha cells were injected I. V. immediately after surgery, the frequency of tumor formation showed an increase (respectively, 32%, 63%, 71%). As the interval between induction of trauma and tumor cell injection was increased from 0 to 15 days, the frequency of tumor formation declined from 32% to 0%. These results suggest that the healing wound is a privileged site for experimental metastasis, particularly in the early stages. It is likely that the proteins in the blood clotting cascade are involved in local tumor implantation. © 1994 Wiley-Liss, Inc.     

胶质瘤中微RNA研究进展

微RNA(microRNA,miR)可在转录后水平负调控靶基因表达,miR异常表达与肿瘤生成密切相关.对胶质瘤中多个miR异常表达及其机制的研究将对进一步探讨胶质瘤的分子病理及其诊治开拓新途径.     

Evaluation of the antitumoral effect of dihydrocucurbitacin-B in both in vitro and in vivo models

Aims  We evaluated both in vitro and in vivo antitumoral properties of an isolated compound from Wilbrandia ebracteata, dihydrocucurbitacin-B (DHCB), using B16F10 cells (murine melanoma). Materials and methods  We made use of MTT and ³H-Thymidine assays to investigate the cell viability and cell proliferation, flow cytometry analysis to monitor cell cycle and apoptosis, western blot analysis to evaluate the expression of cell cycle proteins, imunofluorescence analysis and in vivo tumor growth and metastasis. Results  Dihydrocucurbitacin-B significantly reduced cell proliferation without important effects on cells viability. DHCB lead cells to accumulate in G2/M phases accompanied by the appearance of polyploid cells, confirmed by fluorescence assays that demonstrated a remarkable alteration in the cell cytoskeleton and formation of binuclear cells. Annexin-V-FITC incorporation demonstrated that DHCB did not induce apoptosis. About 10 μg/mL DHCB was found to decrease cyclin-A, and especially in cyclin-B1. The in vivo experiments showed that DHCB treatment (once a day up to 12 days; p.o.) was able to reduce the tumor growth and lung metastasis up to 83.5 and 50.3%, respectively. Conclusions  Dihydrocucurbitacin-B reduces cell proliferation due to a decrease in the expression of cyclins, mainly cyclin-B1 and disruption of the actin cytoskeleton, arresting B16F10 cells in G2/M phase. Taken together, the in vitro and in vivo experiments suggest that DHCB was effective against cancer, however, it remains to be proved if DHCB will be a good candidate for drug development.     

中国乳腺癌患者生活质量研究进展

生活质量（qualityoflife,QOL）又译作生命质量、生存质量,它是在世界卫生组织提倡的健康新概念“人们在躯体上、精神上及社会生活中处于一种完好的状态,而不仅仅是没有患病和衰弱”的基础上构建的,是医学模式由生物医学模式向生物一心理一社会医学模式转变的体现。西方发达国家已将此概念广泛应用于临床试验、卫生政策制定和卫生资源效益评价等众多领域。生存质量已作为评价肿瘤患者术后状况的首选指标。     

Survey of changes in dietary preferences in cancer patients in China

Objective The aim of this study was to investigate the changes in dietary preferences in cancer patients in China and to determine the need for encouraging the adherence to a sensible diet among such patients.Methods A total of 468 cancer patients were interviewed using a self-designed questionnaire focusing on changes in the intake of specific foods. Data were analyzed using SPSS 16.0. Results Most patients completely avoided roosters and carp(73.1%), condiments(51.9%), and meat of aquatic species(40.4%). All other types of the specific foods were completely avoided by different subpopulations of the patients.Conclusion In addition to focusing on disease treatment, medical professionals need to help cancer patients overcome barriers associated with the customs of avoiding specific foods encompassed by the term ”fawu” and provide them with dietary guidance in order to prevent negative nutritional effects.     

新疆维吾尔族妇女宫颈病变中DAPK表达的研究

[目的]探讨DAPK基因与新疆维吾尔族妇女宫颈病变的相关关系。[方法]选取维吾尔族妇女正常或炎症的宫颈组织30例、CINⅠ30例、CINⅡ/Ⅲ30例、宫颈鳞癌组织30例采用免疫组化SP法检测DAPK蛋白表达;为了进一步验证DAPK蛋白表达水平,采用逆转录聚合酶链反应（RT-PCR）法检测正常或炎症的宫颈组织10例、CINⅠ10例、CINⅡ/Ⅲ15例、宫颈鳞癌组织20例中mRNA的表达。[结果]DAPK的蛋白表达率在正常或炎症的宫颈组织、CINⅠ、CINⅡ/Ⅲ、宫颈鳞癌组织中分别为93.3%、83.3%、60.0%、33.3%,SCC组阳性表达率明显减少（P〈0.05）;四组mRNA的表达率分别为90.0%、90.0%、46.7%、10.0%,SCC组阳性表达率明显减少（P〈0.05）。宫颈组织中DAPK在蛋白水平和mRNA水平的表达均和宫颈病变程度成负关（P〈0.05）。[结论]新疆维吾尔族妇女宫颈病变组织中DAPK蛋白和mRNA水平均随病变程度加深而减少;DAPK蛋白检测可能为宫颈癌的早期诊断提供依据。