拓扑替康联合顺铂治疗晚期非小细胞肺癌近期疗效观察

目的观察拓扑替康联合顺铂治疗晚期非小细胞肺癌近期疗效及毒性。方法拓扑替康1.2mg/(m2.d),d1~5,顺铂20 mg/(m2.d),d1~5,3周为1周期。结果有效率为51.35%,其中CR 2例,PR 17例;毒副反应主要为骨髓抑制,Ⅲ~Ⅳ度白细胞下降率为40.54%,Ⅲ~Ⅳ度消化道反应为8.11%。结论拓扑替康联合顺铂治疗晚期非小细胞肺癌有效率高,主要毒副反应是骨髓抑制,可以作为治疗晚期非小细胞肺癌常规方案推广。     

伊立替康联合顺铂治疗复发转移性卵巢癌

目的:观察伊立替康联合顺铂治疗复发转移性卵巢癌的疗效与安全性。方法:对11例复发性卵巢癌应用伊立替康200mg/m2,静滴,第1天;顺铂25 mg/m2,静滴,第1-3天,21天为1个周期,2个周期后进行一次疗效评价。结果:11例患者中完全缓解1例,部分缓解6例,总有效率为63.6%;主要不良反应为血液毒性,Ⅲ-Ⅳ度中性粒细胞下降36.3%(4/11),其次为恶心、呕吐,Ⅲ-Ⅳ度恶心、呕吐为27.3%(3/11),仅1例出现Ⅲ度腹泻。结论:伊立替康联合顺铂治疗复发转移性卵巢癌是可行、安全、有效的。     

拓扑替康治疗小细胞肺癌Ⅱ期临床研究

目的：观察围产拓扑替康单药二线治疗复发性小细胞肺癌（small cell lung cancer,SCLC)和与顺铂联合方案治疗初治SCLC的疗效及毒性。方法：采用多中心开放式研究方法,在100例病例中有97例符合人组条件,其中采用拓扑替康单药治疗的复发SCLC38例,用药方法为拓扑替康1．25mg/(m^2.d)连用5天,每3周一疗程;拓扑替康与顺铂联合用于初治SCLC病例59例,顺铂80mg/(m^2.d)d1,拓扑替康1mg/(m^2.d),连用5天,每3周一疗程。结果：拓扑替康单药用于复发SCLC有效率为37．5％,其中CR3．1％,34．4％,与顺铂联合用于初治SCLC细胞缺乏,Ⅲ-Ⅳ度血小板下降31．6％,而联用药组Ⅲ-Ⅳ度中性粒细胞缺乏61．0％,Ⅲ-Ⅳ度血小板下降39．0％,非血液学毒性较轻,结论：拓扑替康是治疗SCLC的有效药物之一,联合顺铂后可提高疗效,拓扑替康的主要毒副反应为血液学毒性。     

拓扑替康作为二线化疗药物在卵巢癌化疗中的药物敏感性实验

背景与目的：晚期卵巢癌的治疗通常采用肿瘤细胞减灭术辅以化学治疗,常用的一线化疗方案为含顺铂的联合化疗,但绝大多数晚期卵巢癌容易复发,并产生耐药,本研究通过药物敏感性实验评价拓扑替康在复发性和对顺铂耐药的卵巢癌患者中应用的临床价值。方法：采用三磷酸腺苷生物发光法对41例新鲜卵巢癌组织标本(其中9例为复发癌组织标本)进行药敏实验,药物采用顺铂和拓扑替康,分别配制成1倍血浆峰值浓度。结果：41例卵巢癌组织标本中,对拓扑替康敏感的比率(80．5％)高于顺铂(51．2％),在21例对顺铂耐药的卵巢癌组织标本中有18例对拓扑替康敏感。结论：拓扑替康可以作为一种较好的二线化疗药物用于卵巢癌患者的化疗,特别是在对顺铂耐药的情况下。     

盐酸拓扑替康联合顺铂治疗复发性小细胞肺癌21例

[目的]观察盐酸拓扑替康联合顺铂治疗复发性小细胞肺癌的疗效。[方法]采用盐酸拓扑替康1．2mg／m^2日静滴第1—5天，顺铂30mg／m^2日静滴第1—3天，28天为1个周期．至少治疗2个周期。[结果]CRl例，PR6例，SDll例，PD3例，总有效率33．3％。主要毒副反应以血液学毒性为主，白细胞下降Ⅲ—Ⅳ度23．8％，粒细胞下降Ⅲ—Ⅳ度26．2％。[结论]盐酸拓扑替康联合顺铂治疗复发性小细胞肺癌疗效确切，但骨髓抑制较重，应在密切监测下使用。     

伊立替康联合顺铂治疗复发转移性卵巢癌

目的：观察伊立替康联合顺铂治疗复发转移性卵巢癌的疗效与安全性。方法：对11例复发性卵巢癌应用伊立替康200mg／m^2,静滴,第1天;顺铂25mg／m^2,静滴,第1—3天,21天为1个周期,2个周期后进行一次疗效评价。结果：11例患者中完全缓解1例,部分缓解6例,总有效率为63．6％;主要不良反应为血液毒性,Ⅲ-Ⅳ度中性粒细胞下降36．3％（4／11）,其次为恶心、呕吐,Ⅲ-Ⅳ度恶心、呕吐为27．3％（3／11）,仅1例出现Ⅲ度腹泻。结论：伊立替康联合顺铂治疗复发转移性卵巢癌是可行、安全、有效的。     

伊立替康联合顺铂在局部晚期宫颈癌同步放化疗中的近期疗效观察

目的:评价伊立替康联合顺铂在局部晚期宫颈癌同步放化疗中的近期疗效及毒副作用。方法:2011年5月-2011年12月收治的Ⅱb-Ⅳa期宫颈癌患者21例,在行三维适型放疗过程中予以伊立替康联合顺铂同步放化疗。结果:治疗结束后4周总的有效率为90.5%(19/21)。其中CR 15例、PR 4例、SD 2例、PD 0例。毒性反应以骨髓抑制为主,Ⅲ-Ⅳ级白细胞下降为57.1%(12/21)。Ⅲ-Ⅳ度血小板下降为33%(7/21)。Ⅲ-Ⅳ级腹泻19%(4/21)无致死性并发症发生。结论:在局部晚期宫颈癌同步放化疗过程中应用伊立替康近期疗效满意,但应特别注意骨髓抑制及腹泻等并发症,应积极给予对症处理。     

拓扑替康联合顺铂治疗晚期卵巢癌的近期疗效观察

目的:观察拓扑替康(TPT)联合顺铂(PDD)治疗晚期卵巢癌的疗效、毒副反应。方法:对45例临床确诊的晚期卵巢癌病人进行化疗,TPT0.75mg/m2,PDD20mg/m2,连用5天为1个疗程,21天为1周期,2个周期结束后评价疗效。结果:45例病人化疗后,总有效率44.44%(20/45),其中初治病人有效率68.75%(11/16),复治病人有效率31.03%(9/29)。化疗后毒副作用主要表现为骨髓抑制,白细胞下降75.56%(34/45),Ⅲ度以上46.67%(21/45);血小板下降44.44%(20/45),Ⅲ度以上24.44%(11/45)。结论:TPT联合PDD治疗晚期卵巢癌,疗效肯定;尤其是对复发病人仍有效,可做为复发卵巢癌的二线或三线化疗。     

盐酸拓扑替康与顺铂联合治疗24例晚期肺癌

盐酸拓扑替康(金喜素)每日0.75mg/m2,加入NS150ml中静滴30分钟,每周期1～5天;顺铂每日30mg/m2,第1～3天用于金喜素之后,21天为1个周期,3个周期评价疗效.治疗24例晚期肺癌,CR2例(8.3%),PR9例(37.5%),NC10例(41.7%),PD3例(12.5%),总有效率(CR PR)为45.8%(11/24).主要毒副反应为骨髓抑制,Ⅲ～Ⅳ度白细胞减少4例(16.7%).     

拓扑替康联合顺铂治疗小细胞肺癌疗效观察

目的:探讨拓扑替康(topotecan,TPT)联合顺铂(DDP)治疗小细胞肺癌(smallcelllungcancer,SCLC)的疗效。方法:35例初治SCLC患者应用TPT1mg/(m2·d),静脉滴入30min;联合DDP20mg/(m2·d),静脉滴入,连用5d,每3周为1个周期,2～3个周期后评价疗效和不良反应。结果:TPT与DDP联合用于初治SCLC有效率为74.3%(26/35),其中CR20.0%(7/35),PR54.3%(19/35)。主要不良反应为骨髓抑制,其中Ⅲ～Ⅳ度中性粒细胞缺乏为54.3%(19/35),Ⅲ～Ⅳ度血小板下降为34.3%(12/35),Ⅲ～Ⅳ度血红蛋白下降为20.0%(7/35),非血液学毒性较轻。结论:TPT联合DDP是治疗SCLC疗效较好方案,主要不良反应为血液学毒性。     

Compliance with guidelines and correlation with outcome in patients with advanced germ-cell tumours

PurposeTo evaluate prior compliance with guidelines in patients treated with salvage chemotherapy for advanced germ-cell tumours (GCT).Patients and methodsData concerning the initial management of patients requiring salvage chemotherapy for GCT at Institut Gustave Roussy between 2000 and 2010 were obtained and correlated with recommendations for treatment. Criteria of non-compliance were defined based on guidelines. Compliance with guidelines, predictive factors for non-compliance and the impact on outcome were analysed.ResultsAmong 82 patients treated in the salvage setting, guidelines to initial treatment were followed in only 41 cases (50%). The most common non-compliance criteria were non-adherence to the planned dose (16%), an inappropriate interval between first-line chemotherapy cycles (16%), the lack of post-chemotherapy surgery (16%) and a long interval to post-chemotherapy surgery (48%). Compliance with standard care was better in cancer centres than in other hospitals (private or public) (Odd Ratio (OR): 6.9, P = 0.001). A poor-risk status according to the International Germ Cell Cancer Collaborative Group (IGCCCG) was also predictive of compliance in univariate but not in multivariate analysis. No significant difference in outcome after salvage chemotherapy was observed. Patients relapsing after non-compliant first-line therapy tended to be more easily salvaged, which is consistent with the fact that their initial treatment was inadequate. Some of these relapses were therefore probably not due to true biologically refractory disease.ConclusionGuidelines for first-line treatment are adhered to in only half the patients requiring salvage chemotherapy. As the only predictive factor for non-compliance was the treating centre, centralisation of patients with GCT in well-trained hospitals should be recommended.     

Living with secondary breast cancer: coping with an uncertain future with unmet needs

JOHNSTON S.R.D. (2010) European Journal of Cancer Care 19 , 561–563 Living with secondary breast cancer: coping with an uncertain future with unmet needs     

Costs associated with complications are lower with capecitabine than with 5‐fluorouracil in patients with colorectal cancer

BACKGROUND:

Capecitabine, an oral alternative to 5‐fluorouracil (5‐FU) in patients with colorectal cancer (CRC), has equal clinical efficacy and a favorable safety profile; however, its use may be limited because of unit cost concerns. In this study, the authors measured the cost of chemotherapy‐related complications during treatment with capecitabine‐ and 5‐FU–based regimens.

METHODS:

Patients with CRC who received at least 1 administration of capecitabine or 5‐FU during 2004 and 2005 were identified from the Thomson MarketScan research databases. Monthly frequency and cost for 23 complications were recorded. Logistic regression was used to predict complication probability. General linear models were used to predict monthly complication cost and total monthly expenditure.

RESULTS:

In total, 4973 patients with CRC met the inclusion criteria for this analysis. Although the most frequently observed complications were the same between capecitabine and 5‐FU (nausea and vomiting, infection, anemia, neutropenia, diarrhea), each was observed with greater frequency in 5‐FU–based regimens. The mean predicted monthly complication cost was significantly higher (by 136%) with 5‐FU monotherapy than with capecitabine monotherapy (difference, $601; 95% confidence interval [95% CI], $469‐$737). In addition, the mean predicted monthly complication cost for 5‐FU+oxaliplatin was higher than the cost with capecitabine plus oxaliplatin (difference, $1165; 95% CI, $892‐$1595). When acquisition, administration, and complication costs were taken into consideration, there were no significant differences in the total cost between capecitabine regimens and 5‐FU regimens.

CONCLUSIONS:

Capecitabine compared well with 5‐FU–based therapy in patients with CRC and was associated with lower complication rates and associated costs. Cancer 2009. © 2009 American Cancer Society.     

Experience with Impedance Phlebography Compared with Venography

Venography is a particularly reliable method for the diagnosis of deep venous thrombosis but is not suitable as a screening test. Impedance phlebography represents another attempt to discover a simple, non-invasive and reliable method of detecting deep venous thrombosis. It does not, however, meet these criteria.     

再放疗并同步使用Docetaxel在鼻咽癌放疗后复发病人中的应用

目的:不能手术切除的鼻咽癌放疗后再复发的病人,其治疗困难,化疗疗效差,而单独再放疗只能挽救一小部分病人,本文探讨再放疗并同步使用多西紫彬醇(Docetaxel)在鼻咽癌首次放疗后复发病人中可行性及毒副反应,并评价其疗效。方法:对11例鼻咽癌足量放疗后经组织病理学证实复发、而无法行手术及腔内放疗的患者进行了同步放化疗。放疗采用三维适形放疗,外照射鼻咽部,分次量为1.8Gy,总剂量为36Gy-39.6Gy。化疗采用Docetaxel,15mg/m2,每周一次,静脉滴注。结果:10%、33%的患者分别出现Ⅲ度、Ⅳ度皮肤反应,18%、10%的病人分别出现Ⅲ度、Ⅳ度黏膜反应,18%患者出现Ⅲ度恶心呕吐,27%的患者出现Ⅲ度-Ⅳ度白细胞下降,10%患者出现Ⅲ度血小板下降。1例患者因严重的黏膜反应致使治疗延迟2周。治疗结束后,9例(82%)患者达到CR,2例(18%)达到PR,反应率为100%。结论:对于放疗后局部复发的鼻咽癌患者,采用同步放化疗,3D-CRT同时每周使用Docetaxel是可行的,其毒性反应在可以接受的范围内,短期疗效显著。     

Protothecosis successfully treated with amikacin combined with tetracyclines

Summary We report a case of protothecosis in an 18-year-old female student caused by Prototheca zopfii successfully treated with amikacin combined with tetracyclines. Zusammenfassung Es wird über eine Protothecose, verursacht durch Prototheca zopfii, bei einer 18-j?hrigen Studentin berichtet, die erfolgreich mit Amikacin in Kombination mit Tetracyclinen behandelt wurde.