多西他赛每周方案联合顺铂二线治疗治疗非小细胞肺癌

目的 研究多西他赛每周方案联合顺铂二线治疗非小细胞肺癌(NSCLC)的疗效和毒性反应.方法 48例晚期非小细胞肺癌患者,既往曾接受1个含铂方案治疗,采用多西他赛30 mg/m2,静脉滴注60 min,第1、8、15 d给药,顺铂40 mg静脉滴注60 min,第1～3 d,每28 d为1周期.患者的行为状态评分(PS)均为ECOG≤2.结果 48例患者均可评价,总共化疗周期数为189周期.1例完全缓解(CR)占2.1%,14例部分缓解(PR)占29.2%,有效率(ORR)为31.3%,中位生存时间为37周,1年生存率为33%,粒细胞减少与乏力为主要的毒性反应,其他的毒性反应为脱发和体液潴留.结论 多西他赛30 mg/m2每周给药联合顺铂二线治疗NSCLC有确切的疗效且耐受性好.     

多西紫杉醇联合顺铂治疗晚期非小细胞肺癌

目的：探讨多西紫杉醇联合顺铂治疗晚期非小细胞肺癌（Non-Small Cell Lung Cancer,NSCLC）的临床疗效和不良反应。方法：42例晚期NSCLC患者,采用多西紫杉醇75 mg/m^2加入5%葡萄糖注射液500 mL中静脉滴注1 h,第1天;顺铂25 mg/m^2加入0.9%氯化钠注射液500 mL中静脉滴注,第1-3天。21 d为一个周期,至少二个周期评价疗效。结果：42例患者中,完全缓解（CR）2例,部分缓解（PR）19例,无变化（NC）13例,进展（PD）8例;初治组有效率为54.5%,复治组有效率为45.0%,两组比较,差异无统计学意义（P〉0.05）。中位生存期为10.9个月,中位疾病进展时间为4.8个月,1年生存率为40.5%。Ⅲ-Ⅳ度不良反应：白细胞减少为33.3%,脱发为19.0%,口腔黏膜炎为11.9%。结论：多西紫杉醇联合顺铂治疗晚期非小细胞肺癌有较好的疗效,不良反应轻,耐受性好,值得进一步研究。     

图像引导放疗同步NP方案化疗治疗局部晚期非小细胞肺癌的近期疗效观察

目的评价局部晚期非小细胞肺癌（NSCLC）接受放化疗综合治疗的结果。方法 50例局部晚期非小细胞肺癌患者接受图像引导放疗联合NP方案化疗模式治疗。化学治疗方案采用NP方案（N：国产长春瑞滨,25 mg/m2,第1、8天使用;P：顺铂,25 mg/m2,第2～4天使用;28 d为1个周期）,化疗从放疗开始第1天起同期应用,分别于第1、5周给予,放疗结束后巩固1个周期,共3个周期。图像引导放疗方法应用医科达Synergy医用直线加速器行图像引导放疗。中位放疗剂量62 Gy（55～69 Gy）。结果 50例患者完全缓解6例,部分缓解34例,稳定6例,进展4例,总有效率为80%。1年生存率为74%,4例（8%）患者出现NC I CTC≥3级放射性肺炎,16例（32%）患者出现放射性食管炎（Ⅰ～Ⅱ级）。结论图像引导放疗联合NP方案可获得较好的临床治疗效果,不良反应可以耐受。     

多西他赛单药一线治疗晚期非小细胞肺癌临床研究

目的探讨多西他赛单药一线治疗晚期非小细胞肺癌临床疗效及不良反应。方法48例晚期非小细胞肺癌患者,多西他赛75m4g／lm2静脉滴注,第1天。21d为1个周期,治疗2～4个周期后评价临床疗效及不良反应。结果48例患者共化疗140个周期,中位化疗2．9个周期。RR为25．O％,DCR为56．3％,中位无进展生存期5．3个月,中位生存期8．6个月,1年生存率35．4％。不良反应以粒细胞减少、贫血、腹泻、脱发为主。结论多西他赛单药一线治疗晚期非小细胞肺癌临床疗效良好,患者耐受性较好。     

多西他赛单药每周方案与GP方案治疗老年晚期非小细胞肺癌的疗效比较

【目的】对比分析以铂类为基础的GP（吉西他滨＋顺铂）联合化疗和多西他赛单药每周方案一线治疗老年Ⅲb～Ⅳ期非小细胞肺癌的近期疗效和毒副作用。【方法】58例Ⅲb～Ⅳ期从未接受过化疗的老年非小细胞肺癌患者,多西他赛组（n=31）给予多西他赛35mg／m^2,d1、d8、d15,28d为一疗程,GP组（n=27）给予吉西他滨1g／m^2,d1、d8,顺铂25mg／m^2,d1～3,21d为1疗程,两疗程后评价客观疗效及不良反应。【结果】两纽有效率：多西他赛纽25．8％,GP组25．9％（P〉0．05）;多西他赛组粒细胞减少、肝毒性及胃肠道反应显著低于GP组（P〈0．05）。【结论】多西他赛单药每周方案治疗非小细胞肺癌,疗效与GP方案相似,但毒副反应较GP方案显著减少,可作为拒绝接受标准化疗的老年晚期非小细胞肺癌患者的一线治疗。     

A study of weekly paclitaxel plus 5-fluorouracil and cisplatin for patients with advanced or recurrent inoperable gastric cancer

Purpose

To investigate the efficacy and safety of weekly paclitaxel plus 5-fluorouracil and cisplatin for patients with advanced or recurrent inoperable gastric cancer.

Patients and methods

The eligibility criteria included histologically confirmed advanced gastric cancer or recurrent inoperable gastric cancer. Patients were treated with weekly paclitaxel 60 mg/m² on the 1st, 8th and 15th days combined with 5-fluorouracil 500 mg/m² by a continuous intravenous infusion from the 1st to the 5th day, and a cisplatin 75 mg/m² intravenous infusion for 3 days. The cycles were repeated every 4 weeks.

Results

Forty-six patients were assessed for response and toxicity. Three patients achieved complete responses, and 20 patients achieved partial responses; the overall response rate was 50.0% (95% confidence interval [CI], 34.9–65.1%). With a median follow-up of 20 months, the median progression-free and overall survivals were 24 and 46 weeks, respectively, with a 1-year survival rate of 41.3% (95% CI, 27.0–56.8%). The most common hematological toxicity was myelosuppression, which included neutropenia, anemia, thrombocytopenia; the grade 3 toxicity rate was 26.1% (12/46), and only 1 patient was observed with a grade 4 neutropenia. The nonhematological toxicities included anorexia, diarrhea, nausea/vomiting, stomatitis/mucositis, alopecia, dizziness, skin rash, neurotoxicity, and infection; the grade 3 toxicity rate was 34.8% (16/46), but no grade 4 nonhematologic toxicity was observed.

Conclusions

The combination chemotherapy consisting of weekly paclitaxel plus 5-fluorouracil and cisplatin was effective and well tolerated in patients with advanced and recurrent inoperable gastric cancers.     

Efficacy and safety of dose-modified docetaxel plus cisplatin-based induction chemotherapy in Asian patients with locally advanced head and neck cancer

What is known and Objective: The beneficial effects of docetaxel plus cisplatin‐based induction chemotherapy for patients with unresectable, advanced head and neck cancer (HNC) have been documented in Western countries. However, the efficacy of such treatment has not been confirmed in Asian patients. We aimed to determine whether incorporation of dose‐modified docetaxel into a cisplatin‐based induction regimen would be both effective and tolerable in our Asian population of patients. Methods: Thirty‐six patients with stage III or IV HNC who had undergone cisplatin‐based induction chemotherapy were included in the current analysis. Fifty‐three percentage of the patients had received induction chemotherapy with bolus cisplatin and continuous 5‐fluorouracil (PF group), while the remaining 47% had additionally received dose‐modified docetaxel (TPF group). We assessed the relative impact of the two treatments on clinical outcomes and treatment‐related toxicities. Results and Discussion: The disease control rate was higher in the TPF group (92·9% vs. 76·5%), although the difference did not reach statistical significance (P = 0·217). Addition of docetaxel increased the median progression‐free survival to 435 days, which was 2·3 times longer than that (188 days) of patients not receiving docetaxel (P = 0·019). Non‐haematological toxicity profile was similar and acceptable in both treatment groups. Higher incidence of grade 3/4 neutropenia and more episodes of neutropenic fever‐related hospitalization occurred in the docetaxel‐treated patients, but most of them were managed uneventfully. What is new and conclusion: Addition of dose‐modified docetaxel to cisplatin‐based induction chemotherapy was both efficacious and generally safe. Docetaxel addition significantly prolonged progression‐free survival and had an acceptable safety profile in our Asian population of patients with locoregionally advanced HNC.     

DG及DP方案治疗晚期非小细胞肺癌的临床研究

目的 探讨多西紫杉醇＋吉西他滨（DG方案）和多西紫杉醇＋顺铂(DP方案)治疗晚期非小细胞肺癌的临床疗效和毒性反应。方法 经病理学或细胞学确诊不可手术的Ⅲb／Ⅳ期NSCLC患者125例,DG组65例,DP组60例。DG组：多西紫杉醇100㎎/㎡,d1;吉西他滨1 100㎎/㎡,d1、8。DP组:多西紫杉醇100㎎/㎡,d1; 顺铂80㎎/㎡,d2。对临床疗效和毒副反应进行对比观察。结果 有效率DG组为46.2%,DP组为45%,两组差异无统计学意义（P﹥0.05）。DG组和DP组中位生存期分别为12.4月和11.7月,一年生存率为50.8%和46.7%,均无统计学差异（P >0.05）。毒副反应均以骨髓抑制、胃肠反应为主,可耐受。DP组Ⅲ~Ⅳ度白细胞下降、恶心/呕吐、腹泻较DG组严重（P﹤0.05）。其他毒副反应相似。结论 DG方案和DP方案治疗晚期NSCLC均具有较好的耐受性和疗效,毒副反应可以耐受。DG方案毒副反应较DP方案更少、更轻,可作为晚期NSCLC较理想的化疗方法之一。     

紫杉醇联合顺铂及卡培他滨治疗晚期胃癌

目的探讨紫杉醇联合顺铂及卡培他滨一线治疗晚期胃癌的疗效和安全性。方法回顾性分析2004年6月-2008年6月收治的使用PCX方案化疗的32例晚期胃癌患者的临床资料。化疗方案：紫杉醇（PTX）150mg／m^2,静脉滴注2h,第1天;顺铂（DDP）25mg／m^2,静脉滴注,第1—3天;卡培他滨1250mg／m^2,口服,第1—14天。21d为1周期,用药至少2个周期后进行疗效评价。结果32例患者均可评价疗效,完全缓解1例,部分缓解12例,稳定13例,进展6例,总有效率40．6％;中位疾病进展时间（TTP）6．1个月（2～14个月）,中位生存时问（MST）11个月（2-31个月）。主要不良反应为胃肠道反应和骨髓抑制,多为Ⅰ或Ⅱ度。Ⅲ／Ⅳ度不良反应主要有恶心、呕吐（21．9％,7／32）、中性粒细胞减少（15．6％,5／32）和乏力（9．4％,3／32）。12．5％（4／32）的患者出现中性粒细胞减少性发热。所有患者均无化疗相关性死亡。结论紫杉醇联合顺铂及卡培他滨一线治疗晚期胃癌有较好的疗效,不良反应可以耐受。     

多西他赛联合卡铂一线治疗老年晚期非选择性非小细胞肺癌临床观察

目的观察多西他赛联合卡铂一线治疗老年晚期表皮生长因子受体（EGFR）突变状况不明（非选择性）非小细胞肺癌（NSCLC）的疗效和毒性反应。方法老年晚期非选择性NSCLC患者共46例,多西他赛用量60 mg/m2,第1天静脉滴注,卡铂AUC=4,第2天静脉滴注。21~28 d为1个周期,每例患者至少接受2个周期治疗。结果 46例患者均可评价疗效,完全缓解（CR）1例,部分缓解（PR）21例,稳定（SD）19例,进展（PD）5例,总有效率为47.87%（22/46）,其中位疾病进展时间为（TTP）5.61个月,中位生存时间（MST）13.21个月（3~20个月）,1年生存率为49.21%。主要毒副反应为白细胞下降、骨关节痛、指端麻木、脱发等,积极治疗能控制。结论多西他赛联合卡铂一线治疗老年晚期非选择性NSCLC安全、有效。     

A pilot trial of combination cisplatin, 5-fluorouracil and interferon-alpha in the treatment of advanced esophageal carcinoma

BACKGROUND/OBJECTIVES: Based on the synergistic effect between cisplatin and 5-fluorouracil (5-FU), and between 5-FU and interferon-alpha, we conducted a trial to assess the response rate and toxicity of the combination of cisplatin, 5-FU and interferon-alpha in patients with advanced esophageal cancer. METHODS: Patients with locally advanced or metastatic squamous cell or adenocarcinoma of the esophagus were eligible. No prior chemotherapy or interferon were allowed. Patients received cisplatin 80 mg/m(2) on day 1, 5-FU 750 mg/m(2)/day by continuous intravenous infusion for 5 days, and interferon-alpha 5 x 10(6) units/m(2)/day by subcutaneous injection on days 1-5 of each cycle. Cycles were repeated every 21 days for a total of 6 cycles. RESULTS: Forty patients were enrolled. Median age was 57.5 years (range 30-70). 33 had squamous carcinoma and 7 adenocarcinoma; 15 were male; the locoregional metastatic ratio was 1:39; median ECOG performance status was 2 (range 1-3). Grade 3-4 toxicities were: leukopenia (9 cases), thrombocytopenia (4), electrolyte imbalance (11), febrile neutropenia (11), vomiting (5), diarrhea (4), and mucositis (11). There were 3 early deaths, most probably related to therapy. Five patients (13%) achieved a complete response and 17 (42%) achieved a partial response, yielding an overall response rate of 55%. Response rates for squamous and adeno histology were 61% and 29%, respectively. Median survival was 6.4 months. CONCLUSION: The combination of cisplatin, 5-FU and interferon-alpha produces a high response rate in advanced squamous cell esophageal carcinoma, but with considerable toxicity. A modified combination of the above agents is presently being evaluated at our institution.     

多西他赛联合奈达铂方案治疗晚期食管癌的临床观察

目的观察多西他赛联合奈达铂方案治疗晚期食管癌的近期疗效和毒副反应。方法 69例晚期食管鳞状细胞癌患者随机分为2组:观察组35例,多西他赛75 mg/m2静脉滴注,第1天,奈达铂100 mg/m2静脉滴注,第1天;对照组34例,多西他赛75 mg/m2静脉滴注,第1天,顺铂75 mg/m2静脉滴注,第1天;每3周1个周期,至少完成2个周期。结果 2组的总有效率相比,差异不具有统计学意义。治疗组Ⅲ~Ⅳ度毒性反应主要是白细胞及血小板减少,对照组Ⅲ~Ⅳ度毒性反应主要是恶心呕吐、食欲不振。结论在晚期食管癌中,多西他赛联合奈达铂方案与多西他赛联合顺铂方案疗效相近,但在毒副反应方面,多西他赛联合奈达铂方案耐受性良好,更具有优势。     

Weekly paclitaxel in the treatment of advanced or metastatic breast cancer previously treated or not treated with docetaxel: a phase II study

BACKGROUND: Paclitaxel has been approved for 3-weekly administration in Japan. Recent reports suggest that weekly paclitaxel can achieve a higher tumor response and lower toxicity. METHODS: This study was designed to investigate the usefulness and tolerability of weekly paclitaxel by 1-hour infusion in patients with metastatic breast cancer who were previously treated with docetaxel or other anticancer agents. RESULTS: Thirty-five patients were enrolled. The overall response rate was 41.2% (14/34, 95% confidence interval: 24.6-59.3%). The median time to progression and the median survival time were 218.5 and 624 days, respectively. One patient developed dyspnea, probably induced by a hypersensitivity reaction. The most common hematological toxicities were leukopenia and neutropenia, although no patients developed grade 4 leukopenia or neutropenia and G-CSF support was not required. CONCLUSIONS: Weekly paclitaxel could be safely administered and achieved a relatively high response rate. Weekly paclitaxel would be a good candidate second-line therapy for recurrent or advanced breast cancer.     

调强放疗联合多西他赛和顺铂化疗并卡培他滨维持治疗中晚期食管癌的临床观察

目的 评价调强放疗联合多西他赛和顺铂同期化疗并卡培他滨维持治疗中晚期食管癌的临床疗效和安全性.方法 46例Ⅲ/Ⅳ期的中晚期食管癌患者根据入选标准随机分成调强放疗联合多西他赛和顺铂化疗并卡培他滨维持治疗（治疗组）和调强放疗联合多西他赛和顺铂化疗（对照组）,每组23例,治疗组在放疗第1天同时给予多西他赛75 mg/m2,第1天静脉滴注,顺铂25 mg/m2,第1～3天静脉滴注,21 d为1个周期,直至放疗结束后行卡培他滨维持治疗;对照组在放疗的同时联合多西他赛和顺铂化疗.两组放疗方法相同,采用X线和CT检查比较两组疗效,并且比较两组间毒副反应的差别.结果 治疗组与对照组完全缓解率（CR）分别为56.5％和47.8％,有效率（CR＋ PR）分别为91.30％和82.61％,差异无统计学意义.中位生存时间（OS）分别为22.9个月和18.2个月,中位无进展生存期（PFS）分别为11.7个月和9.5个月,两组有统计学差异（P≤0.001）.治疗组1、2、3年生存率分别为82.6％、47.8％和21.7％,对照组1、2、3年生存率分别为60.9％、30.4％和13.0％,两组有统计学差异（P≤0.001）.毒性反应方面,对照组Ⅱ～Ⅲ度的放射性食管炎、胃肠道反应较治疗组严重（P＜0.05）.结论 调强放疗联合多西他赛和顺铂同期化疗并卡培他滨维持治疗较单纯调强放疗联合多西他赛和顺铂化疗疗效好,可提高中晚期食管癌的有效率、局部控制率,延长生存期,提高生活质量,且毒副反应患者均能耐受.     

吉西他滨联合顺铂与长春瑞滨联合顺铂治疗晚期非小细胞肺癌的临床疗效观察

目的 观察吉西他滨联合顺铂与长春瑞滨联合顺铂治疗晚期非小细胞肺癌的(NSCLC)的临床疗效及毒副作用.方法 78例Ⅲ～Ⅳ期NSCLC患者,随机分为GP组和NP组,GP组:国产吉西他滨(泽菲)1 000 mg/m2,静滴,d 1、d 8;顺铂80 mg/m2,静滴,d 1,联合化疗.NP组:国产长春瑞滨(盖诺)25 mg/m2,静滴,d 1、d 8;顺铂80 mg/m2,静滴,d 1,联合化疗.两个方案均为每3周一个周期.结果 78例NSCLC均可评价疗效,GP组40例,完全缓解(CR) 部分缓解(PR)16例,有效率40.0%,NP组38例,CR PR 15例,有效率39.5%,两组有效率相当(P=0.985).主要不良反应均为骨髓抑制.其中NP组的Ⅲ～Ⅳ度白细胞减少和静脉炎的发生率明显高于GP组(P＜0.05),GP组的Ⅲ～Ⅳ度血小板减少高于NP组(P＜0.05),两组的其他不良反应相近(P＞0.05).而住院费GP组高于NP组.结论 吉西他滨联合顺铂与长春瑞宾联合顺铂治疗晚期NSCLC两者疗效相当,而前者不良反应发生率要低于后者,更适合老年体弱者,但费用稍贵,临床可根据不同病人选择不同方案.     

Pemetrexed: a multitargeted antifolate

BACKGROUND: The US Food and Drug Administration approved pemetrexed in February 2004 for the treatment of malignant pleural mesothelioma (MPM) in combination with cisplatin in patients with unresectable disease or for whom curative surgery is not an option. Pemetrexed is the first agent approved for the treatment of MPM. In August 2004, pemetrexed was approved as a second-line, single-agent treatment of locally advanced or metastatic non-small cell lung cancer (NSCLC). OBJECTIVES: The goals of this article were to summarize the pharmacology, pharmacokinetics, efficacy, and safety of pemetrexed, and to review its current and potential roles in therapy for MPM, NSCLC, and other oncologic conditions. METHODS: Relevant English-language literature was identified through searches of PubMed (1966-December 2004), International Pharmaceutical Abstracts, and the Proceedings of the American Society of Clinical Oncology (January 1995-December 2004). Search terms included pemetrexed, Alimta, MTA, multitargeted antifolate, LY231514, mesothelioma, MPM, non-small cell lung cancer, NSCLC, breast cancer, and pancreatic cancer. In addition to published literature, abstracts and posters presented at national and international scientific meetings were reviewed. RESULTS: Myelosuppression was the predominant dose-limiting toxicity of pemetrexed reported in Phase I studies. Identification of the correlation between poor folate status and increased pemetrexed toxicity in a multivariate analysis led to the requirement of folic acid and vitamin B12 supplementation for patients in all pemetrexed studies, with a resulting noted decrease in pemetrexed toxicity. A single, multicenter, randomized Phase III trial compared the efficacy of pemetrexed in combination with cisplatin versus cisplatin alone in the treatment of MPM. Response rates were 41.3% in the pemetrexed/cisplatin combination and 16.7% with single-agent cisplatin (P < 0.001). The median survival time for the pemetrexed/cisplatin combination was significantly longer at 12.1 months versus 9.3 months for cisplatin alone (P = 0.02). One international, multicenter, randomized Phase III trial in patients with NSCLC compared single-agent pemetrexed versus docetaxel in patients previously treated with chemotherapy. Overall response rates (9.1% and 8.8%) and median survival (8.3 months and 7.9 months) did not differ between pemetrexed and docetaxel (P = 0.105 and P = 0.226, respectively). Hematologic adverse effects-grade 3/4 neutropenia (40.2% vs 5.3%; P < 0.001), febrile neutropenia (12.7% vs 1.9%; P < 0.001), and neutropenic infections (3.3% vs 0%; P = 0.004)-were significantly greater in the docetaxel-treated patients than in the pemetrexed-treated patients, as was alopecia (37.7% vs 6.4%; P < 0.001). Results of an international, multicenter Phase III trial of pemetrexed in combination with gemcitabine conducted in patients with pancreatic cancer indicate that the combination is no more efficacious than single-agent gemcitabine. Results in other disease states are still preliminary. CONCLUSIONS: Pemetrexed is a multitargeted antifolate that has demonstrated antitumor activity in various tumor types as a single agent and in combination with other chemotherapeutic agents. Efficacy for the treatment of MPM in combination with cisplatin has been demonstrated, and approval as a second-line agent in NSCLC was based on response rate as a surrogate end point for survival. The addition of folic acid and vitamin B12 supplementation markedly reduced.     

奈达铂联合多西他赛治疗晚期非小细胞肺癌的临床疗效观察

【目的】观察比较奈达铂联合多西他赛化疗方案与顺铂联合多西他赛化疗方案治疗晚期非小细胞肺癌（NSCLC ）的近期疗效及不良反应。【方法】本院70例晚期NSCLC患者根据使用化疗药物不同分为两组,分别为奈达铂联合多西他赛治疗36例,顺铂联合多西他赛治疗34例。具体用药方案为奈达铂组：采用奈达铂25 mg/（m^2· d）,d1～3给予,多西他赛75 mg/m^2,d1。顺铂组：采用顺铂25 mg/（m^2· d）,d1～3给予,21 d为1个周期,化疗2个周期后按WHO标准评价疗效及不良反应。【结果】奈达铂组：完全缓解（CR）1例,部分缓解（PR）14例,稳定（SD）18例,进展（PD）3例,有效率（RR）为41．7％（15/36）;顺铂组：CR 1例,PR 13例,SD 18例,PD 2例,有效率（RR）41．2％（14/34）,两组有效率比较差异无显著性（ P ＞0．05）。消化道反应：奈达铂组和顺铂组分别为5．6％（2/36）和29．4％（10/34）,两组相比较差异有显著性（ P ＜0．01）;肾毒性分别为0（0/36）和5．9％（2/34）（ P ＜0．05）;骨髓抑制：白细胞减少奈达铂组为72．2％（26/36）,顺铂组为70．6％（24/34）,两组相比较差异无显著性（ P＞0．05）。【结论】奈达铂联合多西他赛方案治疗晚期NSCLC的有效率不低于顺铂联合多西他赛方案,胃肠道毒性较顺铂联合多西他赛组轻,不良反应主要为骨髓抑制,两组白细胞下降无差异,但血小板下降较顺铂联合多西他赛组明显。     

泰索帝联合顺铂治疗26例蒽环类耐药性晚期乳腺癌临床观察

目的:观察泰索帝联合顺铂方案治疗蒽环类耐药性晚期乳腺癌的疗效与副反应。方法:运用泰索帝联合顺铂方案治疗蒽环类耐药性晚期乳腺癌26例,观察其疗效与副反应。结果:本文运用泰索帝联合顺铂化疗方案治疗26例蒽环类耐药的晚期乳腺癌患者,完全缓解(CR)7.7%,部分缓解(PR)42.3%,疾病稳定(SD)30.8%,疾病进展(PD)19.2%,RR50.0%,CBR80.8%,中位肿瘤进展时间(TTP)5.6个月(2～24个月),1年生存率为61.5%。主要副反应为胃肠道反应和骨髓抑制,胃肠道反应以恶心、呕吐常见,3级副反应发生率分别为3.8%、3.8%,无4/5级副反应发生,骨髓抑制以粒细胞减少最为常见,其中3/4级发生率分别为34.6%,无5级副反应,仅出现1/2级厌食、腹胀、乏力、外周神经炎、心电图异常、肝、肾功能异常等副反应,均能较好地耐受。结论:泰索帝联合顺铂方案治疗蒽环类耐药性晚期乳腺癌疗效较好,副反应较小,是治疗蒽环类耐药性晚期乳腺癌的有效化疗方案。     

国产奈达铂联合吉西他滨治疗晚期非小细胞肺癌临床研究

目的：观察国产奈达铂联合吉西他滨治疗中晚期非小细胞肺癌的疗效和毒副反应。方法：27例不能手术的Ⅲ～Ⅳ期非小细胞肺癌患者，应用奈达铂80～100mg/m2，静脉滴注，d1，吉西他滨1000mg/m2，静脉滴注，d1、d8、d15，28天为1个周期，用药3个周期后进行评价，并观察同期采用顺铂联合吉西他滨化疗的Ⅲ～Ⅳ期非小细胞肺癌患者35例作为对照。结果：奈达铂组27例，CR1例，PR10例，NC11例，PD5例，总有效率（CR+PR）为40.7％（11/27），顺铂组总有效率42.9%（15/35）；中位生存时间奈达铂组6.6个月，顺铂组6.7个月，无明显差异（P〉0.05）；奈达铂主要毒副反应的为骨髓抑制，白细胞下降74.1%，但Ⅲ～Ⅳ度下降为29.6%，其次是消化道反应，未发现明显的肝肾毒性、周围神经毒性等。结论：奈达铂联合国产吉西他滨治疗中晚期非小细胞肺癌疗效与顺铂联合吉西他滨疗效相当，但毒副反应减轻，耐受性好。     

周剂量多西紫杉醇联合顺铂二线治疗进展期胃癌的临床研究

目的 研究多西紫杉醇(TXT)联合顺铂(DDP)方案二线治疗进展期胃癌的疗效和毒副作用.方法 既往应用FOLFOX4或XELOX方案化疗进展的晚期胃癌患者36例,采用多西紫杉醇(艾素)35 mg/m2,第1、8天,静滴;顺铂20 mg/m2,第1～5天,静滴,21 d为1个周期.结果 36例患者中,CR 0例,PR 10例,SD 12例,PD 14例,客观有效率(CR+PR)27.8%,中位生存期6.5个月,中位肿瘤进展时间4.4个月.毒副作用主要为中性粒细胞减少.结论 多西紫杉醇联合顺铂方案二线治疗进展期胃癌有效率较高,有生存优势,毒副作用可耐受.