重组人血管内皮抑素联合顺铂治疗恶性胸腔积液的Meta分析

目的 系统评价重组人血管内皮抑素(Endostar)联合顺铂与单药顺铂胸腔内注射治疗恶性胸腔积液(MPE)的疗效及安全性.方法 搜索Pubmed、Embase、CBM、CNKI、万方及维普数据库系统,检索关于重组人血管内皮抑素联合顺铂与单药顺铂治疗MPE的随机对照试验(RCT).应用STATA 12.0软件对数据进行Meta分析.结果 总共纳入17篇RCT,总计1105例患者.Meta分析结果显示:重组人血管内皮抑素联合顺铂(联合组)的胸腔积液缓解率高于单药顺铂(观察组)(RR=1.623,95%CI=1.472~1.789;Z=9.71,P=0.000),联合组的KPS评分改善率高于观察组(RR=1.592,95%CI=1.422~1.782;Z=8.09,P=0.000).在消化道不良反应方面,联合组发生率高于观察组(RR=1.204,95%CI=1.003~1.447;Z=1.99,P=0.047).而肝肾毒性、骨髓抑制、发热、疲乏等不良反应的发生率两组比较差异无统计学意义(P>0.05).结论 现阶段研究结果证明,重组人血管内皮抑素联合顺铂治疗MPE的疗效优于单药顺铂,不良反应较轻,安全性好,期待纳入更多高质量研究进一步分析.     

复方苦参注射液联合顺铂治疗恶性胸腔积液的Meta分析

目的:评价复方苦参注射液联合顺铂治疗恶性胸腔积液的近期疗效、生活质量的改善和毒副反应。方法:计算机检索The Cochrane Library、PubMed、Embase、中国生物医学文献数据库（CBM）、中国期刊全文数据库(CNKI)、维普中文科技期刊全文数据库(VIP)和万方数据库,对符合纳入标准的随机对照试验进行方法学质量评价,采用RevMan 5.3进行Meta分析。结果:共纳入18 个研究1 382名患者。结果显示,与单用顺铂相比,复方苦参注射液联合顺铂在胸腔积液的完全缓解率［OR=2.41,95%CI:1.89~3.06,P<0.000 01］、部分缓解率［OR=1.45,95%CI:1.17~1.81,P=0.000 9］、有效率［OR=3.69,95%CI:2.88~4.72,P<0.000 01］、生活质量改善率［OR=4.09,95%CI:3.07~5.45,P<0.000 01］优于顺铂单药;在毒副反应方面,复方苦参注射液联合顺铂能降低胃肠道反应、骨髓抑制、肝功能损害、肾功能损害的发生率。结论:对恶性胸腔积液的治疗,与单用顺铂相比,复方苦参注射液联合顺铂能提高恶性胸腔积液患者的疗效,改善患者的生活质量,降低毒副反应,但受纳入研究的数量及质量的影响,上述结论尚需更多高质量的临床试验来进一步证实。     

金葡素联合顺铂与顺铂单药控制恶性胸腹水疗效的Meta分析

目的:评价金葡素联合顺铂与顺铂单药治疗恶性胸腹水的有效性与安全性。方法:检索中国生物医学文献数据库（1990-2014）、中国期刊全文数据库（1990-2014）、维普数据库（1990-2014.12）、万方数据库（1990-2014.12）、PubMed （1990-2014.12）、Cochrane Library（1990-2014.12）纳入金葡素联合顺铂（试验组）与顺铂单药（对照组）治疗恶性胸腹水的随机对照试验（RCT）,采用Jadad改良法制定的量表评价纳入研究的质量,RevMan 5.2进行Meta分析。结果:共检索到文献100篇,按照纳入与排除标准共纳入文献16篇。Meta分析结果:金葡素联合顺铂用药治疗恶性胸腹水有效率上明显优于顺铂单药［OR=2.12,95%CI（1.64,2.74）,P<0.000 01］,金葡素联合顺铂较顺铂单药组易引起发热［OR=2.26,95%CI(1.36,3.75),P=0.002］,但两组在胸闷胸痛［OR=1.09,95%CI(0.55,2.17),P=0.81］发生率上无明显差异,在胃肠道反应［OR=0.34,95%CI(0.18,0.64),P=0.000 7］、白细胞下降［OR=0.27,95%CI(0.16,0.46),P<0.000 01］发生率上金葡素联合顺铂组明显低于顺铂单药组,且在改善患者生活质量上优于顺铂单药［OR=4.83,95%CI(2.96,7.87),P<0.000 01］。结论:金葡素联合顺铂较顺铂单药组在治疗恶性胸腹水上更为有效,并且毒副反应轻,安全性高。     

重组人血管内皮抑制素联合顺铂胸腔灌注化疗治疗恶性胸腔积液的Meta分析

目的 系统评价重组人血管内皮抑制素（恩度）联合顺铂胸腔灌注化疗与顺铂单药胸腔灌注化疗治疗恶性胸腔积液的有效性与安全性。方法 计算机检索PubMed、The Cochrane Library、Web of Science、万方数据库、中国期刊全文数据库（CNKI）、中国科技期刊数据库（VIP）,同时辅以手工检索,收集2005年至2015年比较恩度联合顺铂胸腔灌注化疗与顺铂单药胸腔灌注化疗治疗恶性胸腔积液的随机对照研究（RCT）。使用Cochrane系统评价指导手册50评价纳入的RCT质量,采用RevMan 5.2软件进行Meta分析,以胸腔积液控制有效率、生活质量改善率、不良反应发生率为结局指标。结果 本研究共纳入15项RCT,共936例患者。Meta分析结果显示,恩度联合顺铂组治疗的胸腔积液控制有效率（RR=1.54,95％CI：1.38～1.71,P＜0.000 01）、生活质量改善率（RR=1.61,95％CI：1.41～1.84,P＜0.000 01）均优于顺铂单药组,差异有统计学意义。两组在胃肠道反应、胸痛、发热、骨髓抑制、肝肾功能异常、乏力、心电图异常等不良反应的发生率方面,差异无统计学意义（P＞0.05）。结论 恩度联合顺铂胸腔灌注化疗较顺铂单药能够明显提高恶性胸腔积液患者治疗的有效率和生活质量,且不增加毒副反应。     

非小细胞肺癌紫杉醇类联合顺铂同步或序贯放化疗对比的Meta分析

目的:探讨紫杉醇类联合顺铂同步放化疗对比序贯放化疗的临床疗效和安全性。方法:通过Cochrane Library、PubMed、EMbase、中国生物医学文献数据库、中国学术期刊全文数据库、中国科技期刊数据库和数字化期刊全文数据库,检索时限为自各数据库建库起至2012-03-28,全面检索多西紫杉醇或紫杉醇联合顺铂同步放化疗对比序贯放化疗治疗非小细胞肺癌的随机对照试验(RCT),按纳入排除标准筛选文献、提取资料和质量评价后,采用Rev Man 5.1软件进行Meta分析。结果:纳入18个RCT,共1 385例患者。Meta分析结果显示,在近期疗效方面,多西紫杉醇(OR合并=2.99,95%CI为2.15～4.16,P<0.01)或紫杉醇(OR合并=2.79,95%CI为2.02～3.85,P<0.01)联合顺铂同步放化疗疗法对比序贯放化疗疗法,差异有统计学意义。在1(OR合并=2.07,95%CI为1.45～2.94,P=0.000 1)、2(OR合并=2.00,95%CI为1.31～3.04,P=0.001 0)和3年(OR合并=3.25,95%CI为1.87～5.68,P=0.000 1)生存率方面,紫杉醇联合顺铂同步放化疗疗法对比序贯放化疗疗法,差异有统计学意义。多西紫杉醇联合顺铂同步放化疗疗法能提高1年生存率,OR合并=1.85,95%CI为1.32～2.60,P=0.000 4。在安全性方面,紫杉醇联合顺铂同步放化疗疗法增加放射性肺炎、骨髓抑制和脱发不良反应,P<0.05;多西紫杉醇联合顺铂同步放化疗疗法增加放射性肺炎、放射性食管炎和白细胞降低不良反应,P<0.05。结论:多西紫杉醇或紫杉醇联合顺铂同步放化疗疗法治疗非小细胞肺癌,近期疗效优于序贯放化疗疗法,并能提高患者的生存率,但有增加不良反应的趋势,在选择治疗方案时需要权衡利弊综合考虑。     

重组人 p53腺病毒注射液联合顺铂治疗恶性胸腔积液疗效及安全性的 Meta 分析

目的：运用 Meta 分析的方法评价重组人 p53腺病毒（rAd-p53）注射液联合顺铂治疗恶性胸腔积液的疗效及安全性。方法应用 Cochrane Library、Pubmed、Embase、中国生物医学文献数据库、中国期刊全文数据库、万方医药期刊全文数据库及维普中文科技期刊全文数据库,全面收集有关 rAd-p53联合顺铂与单药顺铂治疗恶性胸腔积液的随机对照研究（RCT）。用 RevMan5.2软件对数据进行 Meta分析。结果本研究共纳入10篇 RCT,总计538例患者。Meta 分析结果显示,rAd-p53联合顺铂组与单药顺铂组相比,胸腔积液总缓解率前者高于后者（ RR =1.67,95% CI 为0.90~2.01;Z =5.51,P =0.00001）;Kamofsky 评分改善率前者高于后者（ RR =1.76,95% CI 为1.45~2.14;Z =5.69,P <0.00001）;发热发生率前者高于后者（RR =3.10,95% CI 为2.25~4.27;Z =6.94,P <0.00001）;两组胸痛发生率比较差异无统计学意义（RR =0.99,95% CI =0.5~1.96,Z =0.04,P =0.97）;消化道反应发生率比较差异无统计学意义（RR =1.16,95% CI =0.90~1.50;Z =1.13,P =0.26）,骨髓抑制反应发生率比较差异无统计学意义（RR =1.09,95% CI =0.81~1.47;Z =0.59,P =0.55）。结论现有研究表明,rAd-p53联合顺铂治疗恶性胸腔积液的疗效优于单药顺铂,发热均为自限性,安全性好,值得晚期恶性肿瘤伴胸腔积液患者治疗的临床推广。     

甘露聚糖肽联合顺铂治疗恶性胸腔积液疗效观察

目的观察甘露聚糖肽联合顺铂治疗恶性胸腔积液的临床疗效和毒副反应。方法 48例恶性胸腔积液患者随机分为治疗组和对照组,每组24例。胸腔闭式引流胸腔积液后,治疗组胸腔注射甘露聚糖肽20 mg和顺铂60 mg,对照组单药顺铂60 mg胸腔注射。2组均每周1次,连续3周。1个月后观察2组疗效及毒副反应。结果治疗组缓解率83.3%,对照组缓解率62.5%(P<0.05);治疗组KPS评分改善率明显高于对照组(P<0.05);治疗组毒副反应明显低于对照组(P<0.05)。结论甘露聚糖肽联合顺铂治疗恶性胸腔积液疗效满意。     

高聚金葡素与顺铂联合治疗恶性胸腔积液临床疗效观察

目的:观察高聚金葡素联合应用顺铂治疗恶性胸腔积液的有效性和安全性。方法:选取我院2009年1月至2012年10月患有恶性胸腔积液的住院患者30例,分成2组,其中单药顺铂(A组)15例,高聚金葡素联合顺铂(B组)15例。结果:A组有效率为53.33%,B组为80.00%。B组的临床疗效及生活质量明显优于A组(P<0.05),不良反应轻微、可控。B组发热及胸痛发生率显著高于A组(P<0.05),其它不良反应相近。结论:高聚金葡素联合应用顺铂治疗晚期肿瘤并发恶性胸腔积液的疗效优于单药顺铂治疗,不良反应轻微。     

大剂量顺铂分次给药治疗非小细胞肺癌的近期疗效及安全性的Meta分析

目的:采用Meta分析方法对顺铂分次给药治疗非小细胞肺癌的近期疗效及不良反应进行评价。方法:检索Pubmed、EMbase、Cochrane Library、中国知网CNKI全文数据库、维普数据库、万方数据库和中国生物医学文献数据库,查找建库初始至2016年4月公开发表的研究顺铂分次给药治疗非小细胞肺癌的临床随机对照试验。按照纳入与排除标准选择文献,质量评估,资料提取,采用RevMan 5.2软件进行Meta分析。结果:共纳入6篇中文RCT文献。Meta分析结果显示,顺铂分次给药组与单次给药组在近期疗效上无明显差异［OR=0.81,95%CI（0.57,1.15）,P=0.24］;顺铂分次给药组发生恶心与呕吐少于单次给药组［OR=0.45,95%CI（0.30,0.69）,P=0.000 3］;而发生骨髓抑制［OR=0.64,95%CI（0.40,1.01）,P=0.06］、肾功能下降［OR=0.74,95%CI（0.30,1.82）,P=0.51］和神经毒性［OR=0.38,95%CI（0.13,1.12）,P=0.08］,与单次给药组无明显差异。结论:大剂量顺铂分次给药,在不降低近期疗效的情况下,减轻了化疗相关性恶心和呕吐,值得广泛应用。     

含铂双药与非铂类单药一线治疗老年晚期NSCLC对比研究的Meta分析

目的:对联合铂类的双药方案和非铂类单药方案一线治疗老年晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的有效性及安全性进行Meta分析。方法:计算机检索PubMed、EMbase、Cochrane Library、中国期刊全文数据库(CNKI)和中国生物医学文献数据库(CBMdice),收集以含铂双药方案对比非铂单药方案治疗老年晚期NSCLC的随机对照试验,用RevMan5.2软件对数据进行Meta分析。结果:共纳入12项随机对照试验(753例病例),Meta分析结果显示,与非铂单药方案相比,含铂双药方案化疗可提高老年晚期NSCLC患者的化疗客观有效率1.37倍,两者差异有统计学意义(RR=1.37,95%CI:1.12～1.69,P=0.002),但两组1年生存率差异无统计学意义,RR=1.07,95%CI:0.91～1.27,P=0.41;并且含铂双药组更易发生3～4级白细胞减少(RR=2.33,95%CI:1.62～3.35,P<0.01)、3～4级中性粒细胞减少(RR=3.09,95%CI:1.72～5.53,P=0.000 1)、3～4级血小板减少(RR=2.96,95%CI:1.58～5.54,P=0.000 07)和3～4级恶心呕吐(RR=4.89,95%CI:2.46～9.72,P<0.01)等不良反应,差异均有统计学意义。结论:与非铂单药方案相比,含铂双药方案可提高化疗有效率,但不能改善1年生存率,且含铂双药组发生3～4级不良反应的可能性更大,故不适合作为老年晚期NSCLC一线化疗方案,但这一结论仍需开展针对老年晚期NSCLC患者的大样本随机对照试验加以验证。     

Randomised phase III study of S-1 alone versus S-1 plus lentinan for unresectable or recurrent gastric cancer (JFMC36-0701)

BackgroundLentinan (LNT) is a purified β-1, 3-glucan that augments immune responses. The present study was conducted to assess the efficacy of LNT in combination with S-1 as a first-line treatment for unresectable or recurrent gastric cancer.Patients and methodsEligible patients were randomly assigned to receive S-1 alone or S-1 plus LNT. The primary end-point was overall survival (OS). Secondary end-points were time-to-treatment failure (TTF), overall response rate (ORR), safety, quality of life (QOL), and biomarker. The percentages of LNT-binding monocytes in peripheral blood prior to treatment were analysed for the biomarker assessment.ResultsOne hundred and fifty-four and 155 patients were randomly assigned to receive S-1 alone or S-1 plus LNT, respectively. The median OS was 13.8 and 9.9 months (P = 0.208), the median TTF was 4.3 and 2.6 months (P < 0.001), the ORR was 22.3% and 18.7% for the S-1 and S-1 plus LNT groups, respectively. The incidences of haematologic and non-haematologic adverse events were similar, and no significant changes in QOL scores were observed during the treatment in both groups. In a subpopulation of patients with LNT-binding monocytes ≥2%, patients who received more than two cycles of chemotherapy showed a longer survival time in the S-1 plus LNT group.ConclusionsOS did not improve and TTF was significantly worse in the S-1 plus LNT group as compared with the S-1-only group. This study showed no efficacy of LNT when combined with S-1 treatment in patients with unresectable or recurrent gastric cancer.Clinical trial registration ID numberUMIN 000000574.     

Clinical evaluation of the combination treatment of intrapleural or intraperitoneal administration of lentinan and OK-432 for malignant effusion

The combination treatment of non-specific immunomodulator Lentinan (LNT) and OK-432 is effective for controlling Th1/Th2 balance and inducing Th1 dominant status in cancer patients. According to this rationale, we tried an administration of LNT and OK-432 in the pleural or peritoneal cavity for patients with malignant effusion. In all 21 lesions of the 20 cases, 10 revealed a complete disappearance and 7 revealed diminution of the effusion. The efficacy of this treatment is 81%. All patients developed a clinical efficacy in 1 to 3 courses of this treatment, and 9 lesions developed clinical efficacy in only 1 course. None of patients developed toxic symptoms LNT, and 10 developed a low grade fever by OK-432. The combination of LNT and OK-432 is effective and for QOL conserving loco-regional treatment.     

Management of Lung Cancer-Associated Malignant Pericardial Effusion with Intrapericardial Administration of Carboplatin: A Retrospective Study

It has been reported that 5.1–7.0% of acute pericarditis are carcinomatous pericarditis. Malignant pericardial effusion (MPE) can progress to cardiac tamponade, which is a life-threatening condition. The effectiveness and feasibility of intrapericardial instillation of carboplatin (CBDCA; 150 mg/body) have never been evaluated in patients with lung cancer, which is the most common cause of MPE. Therefore, we evaluated the effectiveness and feasibility of intrapericardial administration of CBDCA following catheter drainage in patients with lung cancer-associated MPE. In this retrospective study, 21 patients with symptomatic lung cancer-associated MPE, who were administered intrapericardial CBDCA (150 mg/body) at Gunma Prefectural Cancer Center between January 2005 and March 2018, were included. The patients’ characteristics, response to treatment, and toxicity incidence were evaluated. Thirty days after the intrapericardial administration of CBDCA, MPE was controlled in 66.7% of the cases. The median survival period from the day of administration until death or last follow-up was 71 days (range: 10–2435 days). Grade 1–2 pain, nausea, fever, and neutropenia were noted after intrapericardial CBDCA administration. No treatment-related deaths were noted in the current study. Intrapericardial administration of CBDCA (150 mg/body) did not cause serious toxicity, and patients exhibited promising responses to lung cancer-associated MPE. Prospective studies using larger sample sizes are needed to explore the efficacy and safety of this treatment for managing lung cancer-associated MPE.     

Synergistic action of lentinan (LNT) with endocrine therapy of breast cancer in rats and humans

With the aim of clarifying the nature of the synergistic action of LNT with endocrine therapy for mammary tumor, the effect of LNT post-treatment was investigated in rats with DMBA-induced mammary tumors and also in patients with recurrent breast cancer. LNT injection following surgical therapy (Ax + Ox) resulted in a much greater regression of tumor growth than that obtained by surgery alone, but not after medical therapy (Tamoxifen). Image analysis using an immunohistochemical technique revealed that LNT-surgical therapy resulted in marked atrophy of tumors and as well as intense infiltration of T cells, B cells and macrophages into the stroma around the tumor. Blood prolactin level was greatly reduced by LNT injection. A clinical randomized controlled study demonstrated the efficacy and safety of LNT post-treatment with surgical therapy in 33 patients with recurrent breast cancer. The mode of the synergistic action of LNT in combination with endocrine therapy on hormone-dependent tumors was discussed.     

榄香烯乳联合顺铂胸腔灌注治疗恶性胸腔积液疗效及安全性的Meta分析

目的:系统评价榄香烯乳联合顺铂胸腔灌注治疗恶性胸腔积液的临床疗效和安全性。方法:以“榄香烯乳、顺铂、恶性胸腔积液”等为关键词,计算机检索如下数据库:Pubmed、CNKI、万方医学网、FMRS等,纳入榄香烯乳联合顺铂胸腔灌注治疗恶性胸腔积液的随机对照试验（RCT）,并用RevMan 5.3软件进行Meta分析。结果:本文纳入6个研究,包括463例恶性胸腔积液患者,所有研究均采用随机对照方法。Meta分析结果显示,榄香烯乳联合顺铂胸腔灌注治疗恶性胸腔积液有效率优于单纯用顺铂胸腔灌注,差异具有统计学意义（P＜0.000 1）,且并不增加药物不良反应。结论:榄香烯乳联合顺铂胸腔灌注治疗恶性胸腔积液疗效优于单用顺铂,且不良反应发生率低。     

阿帕替尼联合静脉化疗治疗晚期肺癌相关恶性胸腔积液的疗效观察

目的:探索阿帕替尼联合静脉化疗治疗晚期肺癌相关恶性胸腔积液的有效性和安全性。方法:回顾性纳入62例本中心符合纳入标准的非鳞、非小细胞肺癌患者,阿帕替尼联合静脉化疗组（研究组）及单独静脉化疗组（对照组）分别为31例,分析其疗效及不良反应发生情况。结果:本研究主要为一线治疗非鳞、非小细胞肺癌患者,研究组对恶性胸腔积液的疾病控制率为90.3%,明显高于对照组的77.4%。主要不良反应未见明显升高。结论:阿帕替尼联合静脉化疗可显著提高晚期非鳞、非小细胞肺癌患者恶性胸腔积液治疗有效率。     

重组人血管内皮抑素联合顺铂胸腔循环热灌注治疗肺癌合并恶性胸腔积液的疗效观察

目的：观察重组人血管内皮抑素联合顺铂胸腔热灌注治疗恶性胸腔积液的临床疗效和不良反应.方法：将90例合并恶性胸腔积液患者随机分为2组,每组45例.A组重组人血管内皮抑素＋顺铂联合组：胸腔热灌注术循环时胸腔内注入顺铂40mg,术毕胸腔内注入重组人血管内皮抑制素30mg,2次/周,连续3周;B组顺铂组：胸腔热灌注术循环时胸腔内注入顺铂40mg,2次/周,连续3周.评价近期疗效、生活质量及不良反应.结果：A组RR 86.67％,B组53.33％ （P ＜0.01）.A组生活质量改善者32例（71.11％）,B组19例（42.22％）（P＜0.01）.结论：重组人血管内皮抑素联合顺铂胸腔热灌注治疗恶性胸腔积液疗效显著,可明显改善患者的生活质量,不良反应小.     

Bevacizumab plus chemotherapy for advanced non-squamous non-small-cell lung cancer with malignant pleural effusion

Purpose

The presence of malignant pleural effusion (MPE) indicates a poorer prognosis for patients with non-small-cell lung cancer (NSCLC) and impairs their quality of life. Because vascular endothelial growth factor (VEGF) is the key mediator MPE production, we evaluated the efficacy and safety of chemotherapy plus bevacizumab, an anti-VEGF antibody, in non-squamous NSCLC patients with MPE, especially regarding the control of pleural effusions.

Methods

From November 1, 2009 to September 30, 2011, medical charts of 13 consecutive patients with MPE who received bevacizumab plus chemotherapy as the initial or secondary treatment were retrospectively analyzed.

Results

Of the 13 patients, 6 did not undergo pleurodesis, 3 were unsuccessfully treated by pleurodesis, 2 had encapsulated pleural effusion, and 2 had no re-expansion of the lung. Twelve patients (92.3 %) achieved MPE control lasting >8 weeks following bevacizumab plus chemotherapy. Five of 10 patients with measurable lesions had confirmed partial responses. Of 3 patients without measurable lesions, one had confirmed CR. Median progression-free survival time without re-accumulation of MPE was 312 days. Grade 3 or 4 neutropenia, thrombocytopenia, hypertension, or proteinuria was observed in 2, 2, 1, or 1 patient, respectively.

Conclusions

This is the first study to report that bevacizumab plus chemotherapy is highly effective for the management of MPE in non-squamous NSCLC patients. Prospective clinical trials are warranted to investigate the efficacy of bevacizumab for MPE.     

香菇多糖与环磷酰胺联合治疗前列腺癌荷瘤小鼠的实验研究

目的 前列腺癌具有较高的死亡率,探求其有效治疗方式已成为学者的研究重点.本研究探讨香菇多糖联合环磷酰胺治疗前列腺癌荷瘤小鼠效果及联合治疗机制,为该联合治疗方案临床应用提供依据.方法 利用RM-1细胞建立前列腺癌皮下移植小鼠模型,将60只Balb/c荷瘤小鼠随机平分为4组,即对照组(Control组,生理盐水治疗)、LNT组(香菇多糖治疗)、CTX组(环磷酰胺治疗)和LNT+CTX组(香菇多糖和环磷酰胺治疗);观察治疗后荷瘤小鼠肿瘤体积比与平均存活时间,苏木精-伊红(HE)染色观察治疗后肿瘤组织病理学改变,检测荷瘤小鼠脾质量、脾指数和淋巴细胞水平确定荷瘤小鼠免疫功能情况.结果 联合治疗后LNT+CTX组荷瘤小鼠肿瘤体积比达到3.51±0.80,显著低于Control组(t=3.174)、LNT组(t=2.730)和CTX组(t=3.086),P<0.05;且治疗16 d后,LNT+CTX组肿瘤体积比出现下降趋势.HE染色结果进一步表明,LNT组、CTX组和LNT+CTX组肿瘤组织出现明显病理学改变,且LNT+CTX组病理学改变最明显.LNT+CTX组荷瘤小鼠平均存活时间达到60 d,显著长于Control组(χ2=7.747)、LNT组(χ2=3.653)和CTX组(χ2=2.784),差异有统计学意义,P<0.05.香菇多糖和环磷酰胺联合治疗后,LNT+CTX组荷瘤小鼠脾质量〔(0.28±0.08)g〕、脾指数〔(16.96±2.48)mg/g〕及淋巴细胞〔CD3+为40.67±3.13,CD4+为25.76±1.90,CD4+/CD8+为1.62±0.24〕显著低于LNT组,但高于CTX组和Control组,均P<0.05.治疗后各组荷瘤小鼠CD8+水平差异无统计学意义,P>0.05.结论 香菇多糖与环磷酰胺联合作用共同减缓了肿瘤生长,提高了荷瘤小鼠存活时间,其可能机制是香菇多糖提高了环磷酰胺治疗小鼠的免疫功能,促进了对肿瘤杀伤.     

抗血管生成治疗在恶性胸腔积液中的应用进展CSCD

恶性胸腔积液(malignant pleural effusions,MPE)是晚期肿瘤的常见并发症,肺癌和恶性胸膜间皮瘤(malignant pleural mesothelioma,MPM)是MPE最常见的病因。MPE的治疗原则是在针对病因的全身治疗的基础上对胸腔进行局部治疗。血管内皮生长因子(vascular endothelial growth factor,VEGF)在MPE形成中的多个环节起着关键作用。贝伐珠单抗能抑制VEGF的活性,减少MPE的形成,改善患者预后。本综述系统回顾了贝伐珠单抗及其他抗血管生成药物在非小细胞肺癌(non-small cell lung cancer,NSCLC)和MPM相关MPE中的研究进展,阐述了不同抗血管生成药物对MPE的临床疗效和安全性。