多西他赛、卡铂联合吉非替尼治疗非小细胞肺癌疗效观察

目的：分析多西他赛、卡铂联合吉非替尼治疗非小细胞肺癌的临床治疗效果。方法选取本院在2013年2月-2014年2月期间确诊的80例非小细胞肺癌患者,以随机方式分为两组。观察组患者使用多西他赛、卡铂联合吉非替尼进行治疗,对照组患者仅使用吉非替尼进行治疗。3周为一周期,两周期后观察并分析比较两组患者治疗效果及各项不良反应发生情况。结果观察组治疗总有效率为67.0%,对照组为23.0%;观察组患者疾病控制率为75.0%,对照组为50.0%, P〈0.05;观察组患者各项不良反应发生率显著低于对照组。结论多西他赛、卡铂联合吉非替尼治疗非小细胞肺癌疾病控制率较高,治疗效果较为满意,且不良反应较轻,患者耐受性较好,值得广泛使用。     

紫杉醇联合卡铂化疗治疗卵巢癌的临床观察

目的观察紫杉醇联合卡铂化疗方案治疗卵巢癌的疗效和毒副反应。方法40例卵巢癌患者用“紫杉醇＋卡铂”全身化疗或“紫杉醇＋卡铂”腹腔化疗,观察其疗效及不良反应。结果40例中,CR12例,PR18例,SD6例,PD4例,总有效率75％,主要不良反应为骨髓抑制、脱发、恶心、呕吐,但均可耐受。结论紫杉醇联合卡铂化疗方案治疗卵巢癌有较好疗效,不良反应可耐受。     

吉西他滨联合伯尔定治疗晚期非小细胞肺癌60例临床观察

目的观察吉西他滨联合伯尔定治疗晚期非小细胞肺癌的疗效及毒副作用。方法吉西他滨1000mg／m^2，第1天及第8天静脉滴注。伯尔定AUC=5，第1天静脉滴注。21d为一周期，连续二周期。结果完全缓解（CR）：0例；部分缓解（PR）：28例；无变化（NC）：26例；进展（PD）：6例。有效率46．7％。主要毒副作用为粒细胞减少，血小板减少，皮疹，恶心呕吐等，经对症处理能缓解，不影响治疗。结论吉西他滨联合伯尔定治疗晚期非小细胞肺癌能取得较好的疗效。患者对毒副作用能耐受。     

阿瑞匹坦用于肺腺癌紫杉醇联合顺铂化疗引起恶心呕吐的临床研究

目的观察阿瑞匹坦在肺腺癌紫杉醇联合顺铂方案化疗中的急性期及延迟期止吐疗效和安全性。方法 50例肺腺癌患者,均接受紫杉醇联合顺铂的TP方案化疗,随机分为实验组及对照组,每组25例。对照组患者接受5-HT3受体拮抗剂托烷司琼、地塞米松预防止吐,实验组在对照组基础上联合应用阿瑞匹坦预防止吐。完成1个周期化疗后,评估两组患者在化疗后急性期及延迟期恶心呕吐情况及不良反应。结果 50例患者均按期完成1个周期的TP方案化疗,实验组和对照组急性恶心、呕吐完全缓解率(CR)分别为44%和32%(χ~2=0.764,P>0.05),有效率(RR)分别为80%和72%(χ~2=0.439,P>0.05),差异无统计学意义。实验组和对照组延迟性恶心呕吐CR分别为52%和24%(χ~2=4.160,P<0.05),RR分别为76%和44%(χ~2=5.333,P<0.05),差异有统计学意义。两组患者不良反应主要包括头晕、乏力、呃逆、腹胀、便秘,均为轻度,差异无统计学意义。结论阿瑞匹坦联合托烷司琼、地塞米松方案预防肺腺癌紫杉醇联合顺铂化疗引起的急性期及延迟期恶心呕吐疗效确切,安全性高,值得临床进一步应用推广。     

Prodrug-based nano-drug delivery system for co-encapsulate paclitaxel and carboplatin for lung cancer treatment

Context: Paclitaxel (PTX) and carboplatin (CBP) are widely used for the combined chemotherapy of non-small cell lung cancer (NSCLC). However, the development of multidrug resistance of cancer cells, as well as systemic toxic side effects resulting from nonspecific localization of anticancer drugs to non-tumor areas are major obstacles to the success of chemotherapy in treating cancers.

Objective: This study aimed to engineer a prodrug-based nano-drug delivery system for co-encapsulate hydrophilic (CBP) and hydrophobic anti-tumor drugs (PTX). This system was expected to resolve the multidrug resistance cause by single drug, and the dual-drug-loaded liposome was also planned to specifically target the cancer cells without obvious influence on normal cells and tissues.

Methods: In this paper, PLGA-PEG-CBP was synthesized by the conjugation between the carboxylic group of PLGA-PEG-COOH and the amino group of CBP. Then, self-assembled nanoparticles for combination delivery of PTX and PLGA-PEG-CBP (PTX/CBP NPs) were prepared by solvent displacement technique. The in vitro and in vivo anti-tumor efficacy was assessed in NCL-H460 human non-small cell lung carcinoma cell line.

Results: PTX/CBP NPs achieved the highest cytotoxic effect among all formulations in vitro, as compared with single drug delivery NPs. In vivo investigation on NSCLC animal models showed that co-delivery of PTX and CBP possessed high tumor-targeting capacity and strong anti-tumor activity.

Conclusions: The PTX/CBP NPs constructed in this research offers an effective strategy for targeted combinational lung cancer therapy.     

多西他赛、顺铂联合同期放疗治疗中晚期宫颈癌的疗效观察

目的 观察多西他赛、顺铂联合同期放疗对中晚期宫颈癌的临床疗效.方法 将64例中晚期宫颈癌患者随机分为两组,对照组32例采用放射治疗,观察组32例在对照组基础上采用多西他赛与顺铂同期化疗.比较两组的临床疗效和不良反应发生情况.结果 观察组总有效率为84.4％,明显高于对照组的59.4％(x2=4.07,P＜0.05).观察组骨髓抑制、恶心呕吐发生率分别为43.8％(14/32)、21.9％(7/32),略高于对照组的31.3％(10/32)、12.5％ (4/32),但差异均无统计学意义(x2=1.09,1.17,均P＞0.05).结论 中晚期宫颈癌采用多西他赛与顺铂同期放化治疗,能够明显提高疗效,并且不会增加不良反应的发生率,值得临床推广应用.     

紫杉醇联合顺铂化疗治疗卵巢癌82例临床观察及护理

目的探讨紫杉醇联合顺铂化疗治疗卵巢癌的临床效果及护理方法。方法将120例卵巢癌患者随机分为试验组82例和对照组38例。2组均予紫杉醇联合顺铂法化疗及常规日常护理,试验组另采取有针对性的个体化护理措施。比较2组生活质量情况、住院时间及患者满意度情况。结果试验组有效率为97.6%高于对照组的84.2%,差异有统计学意义(P<0.05)。试验组住院天数短于对照组,患者满意度高于对照组,差异均有统计学意义(P<0.05)。结论紫杉醇联合顺铂化疗治疗卵巢癌疗效较好;针对性护理有利于建立患者信心,有效提高患者生活质量,值得临床推广应用。     

吉西他滨与多西紫杉醇联合顺铂在治疗非小细胞肺癌中的价值

目的探讨吉西他滨与多西紫杉醇联合顺铂在治疗非小细胞肺癌中的临床价值。方法选择35例患者使用吉西他滨联合顺铂治疗,并与35例使用多西紫杉醇联合顺铂的患者比较,连续2个治疗周期后观察患者的不良反应,并对所有患者电话随访1年,比较两组的临床疗效。结果吉西他滨组有效率为31．4％,多西紫杉醇组有效率为34-3％,两组有效率差异无统计学意义（P〉0．05）。吉西他滨组恶心呕吐的发生率显著高于多西紫杉醇组（P〈0．05）：多西紫杉醇组发生白细胞减少的概率显著高于吉西他滨组（P〈0．05）;两组发生血小板减少的概率均较高．但发生率之间差异无统计学意义（P〉0．05）;两组发生血红蛋白减少和肝肾功能受损的概率差异亦无统计学意义（P〉0．05）。结论吉西他滨与多西紫杉醇联合顺铂治疗非小细胞肺癌均有一定的临床效果,在使用吉西他滨治疗时主要注意患者的血小板调控以及预防恶心呕吐,使用多西紫杉醇治疗时则要注意患者的白细胞和血小板的数目。     

香菇多糖联合吉西他滨＋顺铂方案一线治疗晚期非小细胞肺癌近期疗效与不良反应观察

目的 观察香菇多糖（LNT）注射液联合吉西他滨（GEM）＋顺铂（DDP）方案（GP方案）一线治疗晚期非小细胞肺癌（NSCLC）的近期疗效和不良反应。方法 经组织学和/或细胞学确诊的初治晚期NSCLC患者71例,随机分为对照组（GP方案）和观察组（LNT联合GP方案）。对照组应用GEM 1 000 mg/㎡,d1、d8;DDP 25 mg/㎡,d1～d3;观察组在此基础上加用香菇多糖注射剂1mg,每周2次静脉滴注。21天为1周期。完成2～4周期后进行疗效评定。结果 观察组35例患者中,获PR 13例,SD 19例,PD 3例,RR为37.1%（13/35）,DCR为 91.4%（32/35）, 中位治疗至疾病进展生存时间（TTP）为6.8个月,中位生存时间（MST）为12.3个月,1年生存率为45.7%（16/35）;对照组36例患者中,获PR 13例,SD 18例,PD 5例;RR为36.1%（13/36）,DCR为86.1%（31/36）,TTP为6.5个月,MST为11.6个月,1年生存率为41.7%（15/36）。两组比较差异无统计学意义（P＞0.05）。KPS改善率：观察组为77.1%（27/35）,对照组为38.9%（14/36）,差异有统计学意义（P＜0.05）。两组主要不良反应为血液学毒性、消化道反应和脱发。其中观察组与对照组相比,Ⅲ～Ⅳ度粒细胞减少发生率（14.3%/36.1%）显著降低,差异有统计学意义（P＜0.05）,Ⅲ～Ⅳ度恶心呕吐发生率（11.4%/19.4%）亦有一定程度降低（P＞0.05）。结论 香菇多糖注射剂联合GP方案一线治疗晚期非小细胞肺癌具有改善患者生活质量和增效减毒作用,可作为化疗的重要辅助用药。     

Favorable survival observed after carboplatin, paclitaxel, and concurrent accelerated hyperfractionated radiotherapy for treatment of locally advanced head and neck carcinoma

Purpose: Several trials have demonstrated the superiority of simultaneous chemoradiotherapy compared with radiation alone for patients with locally advanced head and neck cancers. However, the optimal regimen remains to be defined. This study assessed the safety and activity of combined carboplatin (C), paclitaxel (P), and twice-daily radiotherapy (RT) in a community based, multicenter, phase II trial. Materials and Methods: Eligible patients (N = 52) had ECOG PS 0-2 and previously untreated, stage III or IV (M0), unresectable, squamous cell cancers of the head and neck. Treatment consisted of 6 weekly courses of C (AUC = 1), P (40 mg/m(2)/1-h) and twice-daily radiation (120 cGy BID; total dose of 6,960 cGy). Subsequently, patients with N2/N3 disease were permitted neck dissection. Results: Median follow-up was 61 months. Sixty-seven percent (67%) of patients had stage IV (M0) disease at baseline. Fifty-five percent (55%) of treated patients experienced NCI Grade 3-4 dysphagia, stomatitis, or mucositis; 80% had >/=Grade 3 toxicity of any organ system. Median weight loss was 7.1 lbs; 35% of patients experienced 10% or more weight loss. Of 43 patients evaluable for response, responses were: 29 CR (67%), 7 PR (16%), 1 MR (2%), 4 SD (9%), and 2 PD (5%); the overall response rate (CR+PR) was 84%. For the entire cohort of 52 patients, the estimated overall survival at 36 months was 60%; progression-free survival was 50%. Conclusions: We conclude that weekly C + P and concurrent twice-daily hyperfractionated radiotherapy is tolerated and highly active in patients with unresectable, locally advanced squamous cell carcinoma of the head and neck.     

A randomized,double-blind,placebo-controlled,dose ranging study to assess the efficacy and safety of eltrombopag in patients receiving carboplatin/paclitaxel for advanced solid tumors

Abstract

Objectives:

Eltrombopag, an oral, nonpeptide thrombopoietin receptor agonist, has been shown to increase platelet counts in adults with chronic immune thrombocytopenia and chronic hepatitis C. This multicenter phase 2 study assessed the efficacy and safety of eltrombopag in patients receiving first-line carboplatin/paclitaxel for the treatment of advanced solid tumors.     

A Phase I/II study of docetaxel, etoposide, and carboplatin before concurrent chemoradiotherapy with cisplatin and etoposide in limited-stage small cell lung cancer

Summary Limited stage small cell lung cancer (LS-SCLC) is an infrequent but aggressive tumor. No major advances in the treatment of this disease have been achieved in recent years. This study was conducted to determine the maximum-tolerated dose (MTD) and efficacy of docetaxel, etoposide, and carboplatin (DEC) given before definitive chest radiotherapy with concurrent cisplatin and etoposide. Seventeen untreated LS-SCLC patients received docetaxel 50 mg/m², etoposide 50–80 mg/m², and carboplatin AUC = 5–6, intravenously on day 1 followed by etoposide 100–160 mg/m² orally on days 2 and 3 every 21 days for two cycles followed by once daily radiotherapy to a total dose of 50 Gy given concurrently with cisplatin (60 mg/m², d1) and etoposide (120 mg/m², d1 and 240 mg/m² day 2–3) for 2 cycles. All patients were assessable for toxicity and 15 for response. The most frequent toxicity was grade 3 and 4 neutropenia in 41% of patients during DEC and in 57% with chemoradiation. The MTD for DEC was docetaxel 50 mg/m² plus carboplatin AUC = 5 and etoposide 50/100 mg/m² with growth factor support. Significant nonhematologic toxicities were primarily radiation-related esophagitis (43%). One patient (6%) died from toxicity. The overall response rate was 82% with 10 patients (59%) achieving a complete response. The median survival was 12.1 months (95% CI, 6.4–17.8 months) and the 1-year survival rate was 47%. This novel approach produced similar efficacy results to current two drug regimens but was associated with significant neutropenia. Alternative strategies to increase complete response rates and survival are needed.     

顺铂联合吉西他滨或多西他赛对晚期非小细胞肺癌的近期疗效和不良反应的观察

目的 比较顺铂联合吉西他滨或多西他赛治疗晚期非小细胞肺癌的近期疗效和不良反应.方法 选取浙江省舟山医院2009年1月至2012年3月晚期非小细胞肺癌化疗初治患者120例,完全随机分为GP组（吉西他滨±顺铂）和DP组（多西他赛±顺铂）,每组60例.2组均给予顺铂30 mg/m^2,静脉滴注,第1～3天;GP组给予吉西他滨1 000 mg/m^2,静脉滴注30 min,第1、8天;DP组给予多西他赛75 mg/m^2,静脉滴注60 min,第1天.21 d为1个周期,共化疗2个周期.评价近期疗效和不良反应.结果 2组均无完全缓解病例.GP组和NP组的总缓解率分别为41.7％ （25/60）和43.3％（26/60）,差异无统计学意义（P＞0.05）.GP组白细胞下降、肌肉酸痛的发生率明显低于DP组,差异有统计学意义[白细胞下降：63.3％ （38/60）比81.7％（49/60）,肌肉酸痛：0比31.7％ （19/60）,P＜0.05];血小板减少、皮疹的发生率明显高于DP组,差异有统计学意义[血小板减少：73.3％ （44/60）比33.3％（20/60）,皮疹：36.7％（22/60）比0,P＜0.05].结论 以顺铂为基础联合吉西他滨或多西他赛的双药化疗方案的近期疗效相当,不良反应各有侧重点,化疗过程中对不良反应应针对性地观察、预防和治疗.     

胃癌术后同步放化疗64例临床分析

目的评价胃癌术后放疗同步紫杉醇顺铂方案治疗的临床疗效和毒性反应,比较适形放疗与常规放疗在放疗毒性反应方面的差异。方法采用常规4野或三维适形放疗技术DT60Gy和紫杉醇135mg／m^2第1天,顺铂20mg／m^2第1～3天同步化疗,4周1次共2周期。结果3年总生存率、3年无复发生存期分别为78．2％、70．9％,28．1％患者出现治疗失败。3级及以上毒性反应发生率为70．3％．主要毒性反应为消化道（28．1％）、血液学毒性（21．8％）和脱发（18．7％）,1洌患者发生治疗相关死亡。结论胃癌术后的同步化疗方案效果较好,安全可行;适形放疗技术可以进一步减轻放疗相关毒性反应尤其是胃肠道反应。     

紫杉醇联合顺铂治疗晚期食管鳞癌临床观察

目的 观察紫杉醇联合顺铂治疗晚期食管鳞癌的疗效及不良反应.方法 用紫杉醇注射液175mg/m2静脉滴注3h,第1天;顺铂25mg/m2,静脉滴注,第1-3天.该方案治疗25例晚期食管鳞癌,3周为1个周期.结果 25例患者共完成化疗周期数为104个,其中完全缓解1例(4.1％),部分缓解10例(41.7％),稳定9例(37.5％),进展4例(16.7％),总有效率为45.8％(11/24).至末次随访,死亡20例,全组中位生存期11.0个月(95％CI:8.35～13.65个月),1年生存率37.3％.12例治疗有效病例的中位生存期为12.5个月(95％CI:9.11～ 15.90个月),治疗无效病例的中位生存期为8.0个月(95％CI:5.50～9.50个月),获治疗有效病例的中位生存期显著好于无效病例(P =0.022).主要毒副反应有:白细胞减少(Ⅲ度7例,Ⅳ度1例)、中性粒细胞减少(Ⅲ度5例,Ⅳ度1例)、血小板下降(Ⅲ度1例)和脱发(Ⅱ度19例).结论 紫杉醇联合顺铂方案治疗晚期食管癌有效安全,可作为晚期食管鳞癌首选化疗方案.     

An indirect comparison of the efficacy of bevacizumab plus carboplatin and paclitaxel versus pemetrexed with cisplatin in patients with advanced or recurrent non-squamous adenocarcinoma non-small cell lung cancer

Abstract

Objective:

There are two new treatment options available for the treatment of adenocarcinoma histology non-small cell lung cancer (NSCLC) which offer improved benefit in terms of progression-free (PFS) and overall survival (OS) over chemotherapy. Both bevacizumab and pemetrexed when combined with chemotherapy significantly increase PFS and OS in patients with advanced NSCLC versus chemotherapy alone. The aim of this analysis was to compare the efficacy for patients with non-squamous adenocarcinoma NSCLC treated with bevacizumab, carboplatin and paclitaxel (BCP) to pemetrexed and cisplatin (PC) by using indirect comparison (ITC) methodology.     

紫杉醇、顺铂方案联合腹腔热灌注化疗对晚期卵巢癌病人免疫功能及生存质量的影响

目的 探讨紫杉醇、顺铂方案(TP方案)联合腹腔热灌注化疗对晚期卵巢癌病人免疫功能及生存质量的影响.方法 选取2016年1月至2019年1月南阳市中心医院72例晚期卵巢癌病人,随机数字表法分为观察组和对照组,各36例.对照组给予单纯紫杉醇、顺铂方案静脉化疗,观察组在静脉化疗的基础上,在末次化疗后第8天进行腹腔热灌注化疗,...     

埃克替尼联合化疗治疗肺癌EGFR基因L833V和H835L罕见复合突变1例

非小细胞肺癌发生发展最常见的驱动因素是表皮生长因子受体（EGFR）突变,主要为19外显子缺失和第21外显子L858R突变,其他罕见基因突变发生率低,临床治疗方案尚未明确。本文报道1例携带EGFR基因H835L和L833V罕见突变的非小细胞肺癌患者,给予埃克替尼单药治疗3个月,疾病稳定（SD）,再予以埃克替尼联合化疗后病灶缩小,并维持SD近5个月。     

叶酸靶向聚合物纳米粒共传输紫杉醇和吉西他滨用于乳腺癌的治疗（英文）

针对肿瘤细胞不同信号通路的多药递药系统具有协同治疗的作用。本文中,我们开发了一种由聚-L-赖氨酸(PLL)和负载有紫杉醇/吉西他滨的聚谷氨酸(PGA-PTX和PGA-GEM)组装的叶酸(FA)修饰的聚合物多药纳米粒(FA-PMDNPs),用于FA受体靶向的乳腺癌协同治疗。PGA富含大量的羧基,为药物负载提供了充足的反应位点和负电荷。透射电子显微镜(TEM)结果表明制备的FA-PMDNPs粒径均一,为球形。溶血实验表明FA-PMDNP具有良好的生物相容性。由于乳腺癌细胞(4T1)的FA受体(FR)高表达,体外细胞活性和体内疗效结果表明FA-PMDNP比单药能够更有效地抑制乳腺癌细胞(4T1)的增殖。与单药相比,FA-PMDNPs可以有效地靶向癌细胞。因此,FA受体靶向双重载药递药系统是一种具有潜力的肿瘤纳米治疗平台。