紫杉醇联合卡铂治疗复发性上皮性卵巢癌48例临床观察

目的:评价紫杉醇联合卡铂治疗复发性上皮性卵巢癌的近期疗效及不良反应。方法:复发性上皮性卵巢癌48例,采用紫杉醇联合卡铂治疗(TP)26例,随机对采用顺铂+阿霉素+环磷酰胺(CAP)治疗22例作为对照组。紫杉醇135 mg/m2,静脉滴注;卡铂300~400 mg/m2,静脉滴注,3~4周重复。顺铂70~80 mg/m2,分3天静脉滴注;阿霉素50 mg/m2,分2天静脉推注;环磷酰胺500 mg/m2,静脉推注。结果:48例均可评价疗效,TP组治疗有效率69.2%,CAP组治疗有效率40.9%,两组间疗效比较有统计学意义(P<0.05)。TP组主要不良反应为骨髓抑制、胃肠道反应、肌肉关节疼痛和周围神经毒性,Ⅳ度不良反应主要为白细胞减少和胃肠道反应。结论:紫杉醇联合卡铂方案可作为复发性上皮性卵巢癌的首选药物,治疗有效率优于传统的顺铂+阿霉素+环磷酰胺方案,值得推广应用。     

复发性卵巢癌患者临床特征及生存时间的影响因素

目的 探讨复发性卵巢癌患者临床特征及生存时间的影响因素。方法 选取2016年10月至2018年12月本院收治的卵巢癌患者58例,分为对照组(初次诊断的卵巢癌)45例、复发性卵巢癌13例。两组均根据患者情况进行手术治疗、单药铂类化疗、联合铂类化疗;收集两组患者的年龄、临床分期、体力状况评分。对复发性卵巢癌患者进行为期3年的随访,记录无进展生存时间、总生存时间,分析影响因素。结果 复发性卵巢癌组患者年龄(65.38±5.52)岁,明显高于对照组(58.52±6.16)岁;无进展生存时间明显短于对照组,手术治疗比例和单药铂类化疗比例明显低于对照组;上述差异均有统计学意义(均P<0.05)。不同年龄、临床分期、体力状况评分、无进展生存时间、手术治疗、化疗方案的复发性卵巢癌患者总生存时间比较差异均有统计学意义(均P<0.05)。多因素Cox模型分析显示,临床分期、体力状况评分、无进展生存时间、手术治疗、化疗方案是复发性卵巢癌患者总生存时间的独立影响因素(均P<0.05)。结论 复发性卵巢癌患者年龄偏大,无进展生存时间较短;临床分期、体力状况评分、治疗方案均会显著影响患者生存时间...     

卡铂联合多西他赛及吉西他滨治疗复发性卵巢癌的临床分析

目的探讨卡铂、多西他赛及吉西他滨联合疗法治疗复发性卵巢癌的疗效及不良反应。方法将笔者所在医院随访发现卵巢癌复发的45例患者随机分为试验组和对照组,试验组采用卡铂、多西他赛及吉西他滨联合治疗,对照组采用顺铂联合吉西他滨治疗。观察比较两组患者治疗后近期总有效率、中位生存期及不良反应。结果试验组近期总有效率、中位生存期、骨髓抑制率均显著高于对照组（P〈0．05）,对照组消化道不良反应发生率显著高于试验组（P〈0．05）。结论卡铂、多西他赛及吉西他滨联合疗法对于复发性卵巢癌的治疗具有更好的疗效,与传统疗法相比,并未增加安全风险。     

奈达铂与顺铂治疗晚期卵巢癌的临床疗效比较

目的比较奈达铂与顺铂治疗晚期卵巢癌的临床疗效和不良反应。方法 42例晚期卵巢癌患者随机分为奈达铂联合环磷酰胺组(A组,22例)和顺铂联合环磷酰胺组(B组,20例),比较2组的近期临床疗效及毒副作用。结果 A组治疗总有效率为59.1%,完全缓解率为27.3%;B组治疗总有效率为45.0%,完全缓解率为15.0%,2组差异有统计学意义(P<0.05);2组毒副作用无明显差异性(P>0.05)。结论奈达铂+环磷酰胺为晚期卵巢癌的有效化疗方案,值得临床推广应用。     

泰素帝联合卡铂治疗卵巢癌患者生存质量分析

目的:探讨泰素帝联合卡铂治疗卵巢癌的临床效果,为临床治疗提供客观依据。方法:将64例卵巢癌患者随机分为对照组(31例)和观察组(31例),应用卡铂联合环磷酰胺(PC方案)治疗;观察组应用泰素帝联合卡铂(TP方案)进行治疗。治疗后应用KPS、PS和QOL对患者进行功能和生活质量评估,并观察化疗后不良反应。结果:观察组RR(66.67%)高于对照组(54.84%),两组比较,差异有统计学意义(P<0.05);观察组CA125〔(49.35±3.72)U/ml〕,低于对照组〔(57.93±4.08)U/ml〕,两组比较,差异有统计学意义(P<0.05);观察组KPS和QOL分别为86.22±4.021和51.73±1.04,均高于对照组(79.38±3.19和46.08±1.26),两组比较,差异有统计学意义(P<0.05)。两组不良反应情况比较,差异无统计学意义(P>0.05)。结论:泰素帝联合卡铂治疗卵巢癌可以有效提高临床治疗效果,且能够提高患者生存质量。     

健择联合草酸铂治疗晚期复发性卵巢癌的临床观察

目的探讨健择联合草酸铂治疗晚期复发性卵巢癌的临床效果。方法采用健择（GEM）和草酸铂（L—OHP）化疗方案对25例复发性晚期卵巢癌患者化疗并与25例使用其他化疗方案的患者进行对比分析。结果健择联合草酸铂治疗晚期复发性卵巢癌疗效确切,患者耐受性好,患者的生存质量明显改善。结论健择联合草酸铂治疗晚期复发性卵巢癌与其他化疗方案相比具有优势,值得推广。     

静脉用盐酸托烷司琼及联合沙利度胺治疗卵巢癌化疗所致恶心呕吐疗效及安全性研究

目的探讨静脉用盐酸托烷司琼及联合沙利度胺治疗卵巢癌化疗所致恶心呕吐的疗效及安全性。方法回顾性分析2015年1月至2017年7月中国医科大学附属盛京医院收治的94例卵巢癌患者,根据治疗方法将其分为两组,各47例。两组均采用紫杉醇联合卡铂(TC)方案化疗,对照组使用盐酸托烷司琼静脉滴注治疗,研究组在对照组的基础上加用沙利度胺口服治疗。分别评价两组急性期和延迟期止恶心、止呕吐的疗效,统计两组欧洲肿瘤研究与治疗中心生存质量核心问卷评分,比较两组不良反应情况。结果研究组急性期和延迟期止恶心、止呕吐总有效率高于对照组(P 0. 05);两组化疗后15 d欧洲肿瘤研究与治疗中心生存质量核心问卷评分均升高(P 0. 05),且研究组高于对照组(P 0. 05);两组不良反应发生率比较差异无统计学意义(P 0. 05)。结论与静脉用盐酸托烷司琼相比,盐酸托烷司琼联合口服沙利度胺治疗卵巢癌化疗所致恶心呕吐疗效更好,且安全性高。     

含铂的3种化疗方案对非小细胞肺癌的疗效比较

目的：分析比较含铂的3种化疗方案对非小细胞肺癌的临床疗效。方法：将102例晚期非小细胞肺癌患者随机分为A、B、c组。分别接受GP方案（吉西他滨＋顺铂）、TP方案（紫杉醇＋顺铂）、NP方案（长春瑞滨＋顺铂）化疗,观察疗效及不良反应情况。结果：A组总有效率为35．3％,B组为38．2％,C组为44．1％。不良反应主要有骨髓抑制、脱发、胃肠道反应、恶心呕吐,经对症处理后均得到明显好转。其中C组骨髓抑制发生率明显高于A、B组（P〈0．05）。结论：3种化疗方案对非小细胞肺癌的疗效相近,不良反应可逆,均为有效治疗方案。     

异环磷酰胺联合足叶乙甙治疗铂类耐药的卵巢癌的临床研究

目的 评价异环磷酰胺联合足叶乙甙治疗铂类耐药的卵巢癌的疗效及安全性.方法 对26例铂类耐药的复发性卵巢癌患者应用异环磷酰胺1.5 g/m2,第1～3天静滴;依托泊苷75 mg/m2,第1～5天静滴,21 d为1个疗程,至少2疗程,最多6疗程.结果 共入组患者26例,可评价临床疗效20例,可评价血清CA125疗效24例,可评价毒性26例.临床和CA125总有效率分别为65.0%的79.2%,中位无疾病进展生存时间和总生存时间分别为10个月和16个月.主要毒副作用为白细胞减少,Ⅲ/Ⅳ度毒性为49.2%.结论 异环磷酰胺联合足叶乙甙可以对铂类耐药的复发性卵巢癌患者进行挽救治疗,且耐受性良好,有一定疗效.     

以铂类为主化疗方案联合调强放射治疗复发性晚期卵巢癌临床观察

目的卵巢癌是导致女性死亡的重要恶性肿瘤,多数患者就诊时已处于晚期,丧失手术治疗时机,故临床寻求一种高效的治疗方式对改善患者生存质量具有重要意义。本研究探讨以铂类为主化疗方案联合调强放射治疗(intensity modulated radiation therapy,IMRT)复发性晚期卵巢癌的疗效。方法选取河南科技大学第一附属医院2015-01-05-2015-12-10收治的80例复发性晚期卵巢癌患者为研究对象,按照年龄、病理类型和临床分期组间匹配的原则分为两组,各40例。对照组采用铂类为主化疗方案治疗,观察组采用铂类为主化疗方案联合IMRT治疗,比较两组患者临床疗效、生活质量、随访生存率和毒副作用。结果观察组总控制率为95.00%,高于对照组的80.00%,χ~2=4.114,P=0.043;治疗后,观察组KPS评分为(82.47±6.22)分,高于对照组的(62.89±5.11)分,t=8.852,P0.001;观察组随访1年生存率为75.00%,高于对照组的52.50%,χ~2=4.381,P=0.036;观察组随访3年生存率为57.50%,高于对照组的35.00%,χ~2=4.073,P=0.044;观察组肝功能损伤率为10.00%,与对照组15.00%比较,差异无统计学意义,χ~2=0.457,P=0.499;观察组骨髓抑制率为55.00%,与对照组47.50%比较,差异无统计学意义,χ~2=0.450,P=0.502;观察组脱发率为40.00%,与对照组37.50%比较,差异无统计学意义,χ~2=0.053,P=0.819;观察组消化道反应率为40.00%,与对照组35.00%比较,差异无统计学意义,χ~2=0.213,P=0.644。结论以铂类为主化疗方案联合IMRT治疗复发性晚期卵巢癌效果确切,可提升患者生存率及生活质量,且耐受性较好。     

Urinary excretion of platinum from platinum industry workers

OBJECTIVES: Assessment of level of exposure to platinum and platinum concentration in urine from platinum industry workers to evaluate internal exposures and excretion kinetics. METHODS: Platinum concentrations in urine samples from 34 workers were measured by adsorptive voltammetry after UV-photolysis. Morning and evening samples were taken two to six times during six months. Individual exposures were assessed by personal air sampling. Also, two male volunteers were exposed to platinum dust for four hours at a typical platinum refinery workplace. RESULTS: Urinary platinum excretion after a shift in platinum industry workers was found to be up to 6270 ng/g creatinine-- that is, 1000 times above the median value of unexposed people. Urinary excretion reached the maximum nearly 10 hours after inhalative exposure to dust containing platinum. Elimination corresponded to a first half life of about 50 (95% confidence interval (95% CI) 36 to 66) hours, but there were indications that a part of the incorporated platinum is stored longer. The amount of urinary platinum excretion showed a close correlation with the exposure level monitored by personal air sampling. CONCLUSIONS: A newly developed analytical method enabled the detection of even natural background concentrations of platinum. Thus, increased urinary platinum concentrations could be detected early, which is important to avoid damaging health of exposed workers.

 

     

伊立替康联合顺铂与紫杉醇联合顺铂治疗宫颈癌的临床疗效分析

目的 比较伊立替康联合顺铂与紫杉醇联合顺铂治疗宫颈癌患者的临床疗效.方法 选择2012年1月至2015年12月在江汉大学附属医院进行中晚期宫颈癌治疗的患者76例,随机分为观察组和对照组,各38例.对照组使用紫杉醇联合顺铂(TP)方案进行治疗,观察组使用伊立替康联合顺铂(IP)方案进行治疗.观察两组患者临床疗效、治疗前后血清SCC-Ag、CD133水平变化以及不良反应发生情况.结果 观察组患者总有效率为89.47％,对照组为68.42％,观察组患者治疗后总有效率明显高于对照组,且具有统计学差异(x2=3.879,P＜0.05).肿瘤直径治疗前两组无明显差异(t=0.420,P＞0.05),治疗后均有所减小,而观察组减少的更为明显(t=3.442,P＜0.05).两组患者治疗前血清SCC-Ag、CD133水平无明显差异,治疗后观察组患者血清SCC-Ag水平(t=10.690,P＜0.05)和CD133阳性率明显低于对照组(x2=4.375,P＜0.05).观察组患者骨髓抑制、消化道反应、脱发、肝肾功能损害以及外周神经毒性等不良反应发生率均低于对照组,具有统计学差异(x2值分别为6.480、5.330、5.510、5.050、5.680,均P＜0.05).结论 伊立替康联合顺铂化疗对中晚期宫颈癌患者具有良好的临床疗效,能够显著降低患者血清SCC-Ag、CD133水平,且不良反应小,安全可靠.     

Urinary platinum levels associated with dental gold alloys

Platinum concentrations were determined in 50 urine and 20 saliva samples obtained from 50 subjects who had gold dental restorations. In addition, 42 urine and 35 saliva samples were collected from subjects who did not have gold dental restorations. Subjects with gold alloys had significantly (p < .001) higher urinary platinum excretion (mean = 11.9 +/- 8.5 ng/gm creatinine, range = 1.9-45.8 ng/gm creatinine) than controls (mean = 6.2 +/- 3.2 ng/gm, range = 1.9-14.4 ng/gm creatinine). Mean saliva concentrations were significantly higher in subjects with dental gold alloys (526 pg/gm vs. 8.5 pg/gm; p < .001). A laboratory test with 5 commercially available dental gold/platinum alloys showed that 0.1% sodium chloride mobilized platinum within 1 hr (i.e., 1-18 pg/ml) of its introduction. In conclusion, dental gold/platinum alloys appear to be the main source for urinary platinum excretion from the occupationally unexposed population.     

Measurement of short-term exposure to airborne soluble platinum in the platinum industry

A number of cases of respiratory sensitization to soluble platinum have arisen in the U.K. over the last few years, despite measured 8 h TWA exposure levels below the current long-term exposure limit in most cases. One possible cause of sensitization may be as a result of high exposures over short periods. Short-term sampling has been hampered by inadequate sampling and analysis techniques. This investigation has used two types of personal inhalable sampler, with ICP-MS analysis, to take 15 min TWA soluble platinum exposure measurements at three sites. The lower detection limit for soluble platinum salts was approximately 0.01 μg m⁻³ for 15 min samples, allowing exposures two orders of magnitude below the exposure limit to be measured. It was found that the majority of short-term exposure levels were significantly below 0.006 mg m⁻³. No evidence was found for altered work practices during sampling, indicating that either sensitization is occurring at airborne exposure levels below the exposure limit, or there is an alternate route of exposure.     

晚期非小细胞肺癌两种含铂新方案的临床近期疗效比较

目的　观察NP(长春瑞宾加顺铂 )方案和GP(吉西他宾加顺铂 )方案两种含铂方案治疗晚期非小细胞肺癌 (non -smallcelllungcancer,NSCLC)的近期疗效和毒副反应。方法　采用NP方案治疗晚期NSCLC2 5例 ,GP方案治疗 2 3例。结果　临床疗效 :GP组完全缓解 0例 ,部分缓解 8例 ,稳定 12例 ,进展 3例 ,有效率为 3 4 8% ;NP组完全缓解 0例 ,部分缓解 8例 ,稳定 13例 ,进展 4例 ,有效率为 3 2 0 %。两组有效率差异无统计学意义 (P =0 776 )。毒副反应 :GP组血小板减少明显 (P =0 0 0 9) ,NP组白细胞减少明显 (P =0 0 0 6 )。结论　NP方案和GP两种方案治疗晚期NSCLC均有效 ,两种方案疗效相似。两组均有血液毒性 ,GP方案以血小板减少为主 ,且有过敏现象 ;NP方案以白细胞减少为主 ,并有静脉炎和周围神经毒性。     

Ambisome plus miltefosine for Indian patients with kala-azar

The combination of one intravenous administration of 5 mg/kg Ambisome and oral administration of miltefosine, 2.5 mg/kg/day for 14 days, was evaluated in 135 Indian patients with kala-azar. The Intent-to-Treat cure rate at 6 months was 124 of the 135 enrolled patients (91.9%: 95% CI = 86-96%), and the per protocol cure rate was 124 of 127 evaluable patients (97.6%: 95% CI = 93-100%). Side effects could be attributed to each drug separately: fevers, rigors and back pain due to Ambisome; gastrointestinal side effects due to miltefosine. This combination is attractive for reasons of efficacy, tolerance, and feasibility of administration, although the gastrointestinal side effects of miltefosine require medical vigilance. Clinical Trials.gov identification number: NCT00371995.