吉非替尼与厄洛替尼治疗非小细胞肺癌临床疗效比较及药物经济学评价

目的比较吉非替尼与厄洛替尼治疗非小细胞肺癌的临床疗效和药物经济学评价。方法比较实验组(服用吉非替尼)38例和对照组(服用厄洛替尼)34例NSCLC患者分别给予吉非替尼和厄洛替尼治疗的临床疗效、不良反应发生情况及药物经济学评价结果。结果两组患者有效率及临床控制率比较,差异无统计学意义(P0.05);两组肿瘤进展时间及1年生存率比较,差异无统计学意义(P0.05);两组患者不良反应发生率及严重程度比较,差异无统计学意义(P0.05);实验组患者治疗费用及费用疗效比均显著低于对照组,差异具有统计学意义(P0.05)。结论吉非替尼与厄洛替尼治疗NSCLC疗效相当,但吉非替尼更加经济适用。     

盐酸埃克替尼与吉非替尼治疗化疗失败的非小细胞肺癌28例

目的:探讨盐酸埃克替尼和吉非替尼治疗化疗失败的非小细胞肺癌(NSCLC)的疗效和不良反应。方法:28例NSCLC患者,随机分为试验组和对照组,分别予以盐酸埃克替尼(125 mg,po,tid)和吉非替尼(250 mg,po,qd),观察两组患者的近期疗效和不良反应。结果:试验组14例患者无完全缓解(CR),部分缓解(PR)率21.4%,病情稳定(SD)率35.7%、疾病进展(PD)率28.6%,1例患者因瘫痪退出,1例患者死亡,近期有效率为21.4%,疾病控制率为57.1%。对照组14例患者无CR,PR 7.1%,SD 50%,PD 14.3%,死亡4例,近期有效率为7.1%,疾病控制率为57.1%。两组的近期有效率和疾病控制率、无疾病进展期(PFS)和总生存期(OS)无明显差异。主要不良反应为皮疹,两组比较无显著差异。结论:盐酸埃克替尼与吉非替尼疗效相似,但安全性高,能有效治疗化疗失败的NSCLC。     

厄洛替尼治疗晚期非小细胞肺癌的疗效及安全性研究

目的厄洛替尼是治疗非小细胞肺癌的靶向药物,多项国内外研究已证明该药可延长非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的生存。本研究回顾性总结了厄洛替尼在非选择NSCLC人群中的应用,旨在探讨厄洛替尼治疗晚期非小细胞肺癌的远期疗效及安全性。方法回顾分析本院2006年3月至2009年7月之间接受化疗后应用厄洛替尼治疗化疗失败的晚期NSCLC患者,口服150 mg/d厄洛替尼直至疾病进展,观察疗效、生存时间和副反应。结果共有36例患者入组。36例患者中PR 22.2%(8/36),SD 50.0%(18/36),PD 27.8%(10/36),CR=O,DCR(CR+PR+SD)72.2%;PFS为5.8个月。其中腺癌与非腺癌、无吸烟者与吸烟者的疗效差异无统计学意义,但是生存曲线提示腺癌比非腺癌患者(7.6个月vs 1.0个月,P=0.037)、无吸烟比吸烟患者(11.1个月vs 4.6个月,P=0.025)具有更长的PFS,差异有统计学意义;性别因素未能影响疗效或PFS。毒副作用主要为为轻度皮疹、腹泻、转氨酶升高。结论厄洛替尼治疗晚期非小细胞肺癌有效,对腺癌和非吸烟人群有一定优势,且耐受性良好,是治疗晚期非小细胞肺癌患者的一个新的选择。     

吉非替尼治疗肺腺癌脑转移的临床观察

目的本研究拟分层探讨吉非替尼治疗肺腺癌脑转移的疗效及不良反应。方法回顾分析60例肺腺癌脑转移患者的临床资料,所有患者均口服吉非替尼250 mg/d,直到疾病进展、死亡或发生不可耐受的不良反应,分析其临床疗效及不良反应。结果全组60例患者的中位生存时间(median overall survival,m OS)和中位无进展生存时间(median progression-free survival,m PFS)分别为23.7个月和10.8个月,有效率(response rate,RR)和疾病控制率(disease control rate,DCR)分别为61.5%和91.8%。吉非替尼用于初治患者的m OS和m PFS分别为33.6个月和11个月,RR和DCR分别为74.0%和100.0%。吉非替尼用于复治患者的m OS和m PFS分别为17.2个月和5.8个月,RR和DCR分别为49.0%和81.3%。EGFR敏感性突变患者的m OS和m PFS分别为23.8个月和10.0个月,RR和DCR分别为74.0%和100.0%。EGFR突变状态不明患者的m OS和m PFS分别为34.6个月和11.3个月,RR和DCR分别为52.3%和85.7%。全组患者均耐受性良好,未发生严重不良反应。常见的不良反应包括:皮疹28例(46.7%)、肝功能不全4例(6.7%)、腹泻12例(20.0%)、口腔溃疡2例(3.3%)。结论吉非替尼治疗肺腺癌脑转移有效率较高,耐受性良好,尤其对初治、EGFR敏感突变的肺腺癌脑转移患者是一种更佳的治疗选择。     

吉非替尼治疗非小细胞肺癌脑转移的临床研究

目的探讨吉非替尼治疗非小细胞肺癌（NSCLC）脑转移的疗效及安全性。方法回顾性分析11例采用吉非替尼治疗的NSCLC脑转移患者的临床资料。所有患者均口服吉非替尼250mg,1次／d,直至疾病进展或出现不可耐受的不良反应。结果11例患者颅内病灶的有效率（RR）和疾病控制率（DCR）分别为27．3％和81．8％。全身病灶的RR和DCR分别为36．4％和81．8％。接受吉非替尼联合脑部放疗的患者RR上优于接受埃克替尼单药治疗者,但差异无统计学意义（P〉0．05）。RR和DCR与年龄、性别、病理类型、ECOG评分、脑转移种目、吉非替尼治疗情况、脑部放疗及表皮生长因子受体（EGFR）突变状况均无关。全组中位无进展生存时间（PFS）为6．1个月,其中EGFR突变型为10．1个月。PFS与EG．FR基因突变状况有关,而与其他临床病理特征无关。主要不良反应为皮肤干燥、皮疹和腹泻,以1～2级为主。结论吉非替尼对NSCLC脑转移有一定疗效,且不良反应可耐受,值得临床进一步研究验证。     

吉非替尼治疗83例老年晚期非小细胞肺癌的疗效分析

目的:探讨影响吉非替尼治疗晚期非小细胞肺癌(NSCLC)老年患者的疗效及其生存情况的临床因素。方法:对2007年1月-2009年6月在中国医学科学院肿瘤医院接受吉非替尼治疗的83例晚期NSCLC老年患者的临床资料进行回顾性分析。结果:全组患者中位年龄为70岁,客观有效率为32.5%,疾病控制率(DCR)为85.5%。吸烟状态对DCR方面的影响具有统计学意义(P=0.049)。中位无进展生存期(PFS)为11.6个月,不同性别、是否有吸烟史、病理类型是否为腺癌以及吉非替尼的疗效对PFS有显著影响(P<0.05)。中位总生存期(OS)为24.0个月,病理类型为腺癌(P<0.001)、吉非替尼治疗是否有效(P=0.029)以及吉非替尼治疗进展后可以继续接受其他抗肿瘤治疗(P=0.006)是明显改善总生存期的独立预后因素。结论:吉非替尼治疗老年晚期NSCLC有较好疗效。     

吉非替尼治疗晚期复发非小细胞肺癌

目的 评价吉非替尼治疗晚期复发非小细胞肺癌的临床价值.方法 48例经病理确诊既往化疗失败的NSCLC患者,吉非替尼250mg口服,每日1次,连续用药至肿瘤进展或发生不可耐受的毒副作用.结果 48例均可评价疗效,总RR为22.9%,腺癌患者的有效率显著高于非腺癌患者(P=0.024),不吸烟者的有效率显著高于吸烟者(P=0.011),疾病控制率77.1%,中位PFS为4个月,中位生存期为8.9个月,常见的毒副作用是皮疹和腹泻.结论 吉非替尼治疗既往化疗失败的晚期非小细胞肺癌,具有较好的疗效和安全性.     

厄洛替尼联合吉西他滨治疗晚期胰腺癌疗效观察

目的观察厄洛替尼联合吉西他滨治疗晚期胰腺癌的疗效及安全性。方法将晚期胰腺癌患者42例随机分为观察组20例和对照组22例。观察组给予厄洛替尼联合吉西他滨治疗;对照组给予吉西他滨治疗,2组均以21d为1个疗程。比较2组临床疗效及不良反应。结果观察组有效率(RR)、疾病控制率(DCR)分别为10.0%、65.0%,高于对照组的4.5%、50.0%;观察组PFS、OS分别为3.6、6.1个月,长于对照组的3.1、5.2个月,差异均有统计学意义(P<0.05)。2组不良反应主要为皮疹、腹泻、骨髓抑制、恶心、呕吐、乏力等。结论厄洛替尼联合吉西他滨治疗晚期胰腺癌有一定疗效,耐受性好,值得进一步扩大样本研究。     

吉非替尼与厄洛替尼治疗非小细胞肺癌的疗效对比

目的探究吉非替尼与厄洛替尼治疗非小细胞肺癌的疗效。方法收集2013年3月至2016年3月我院收治的90例非小细胞肺癌患者进行研究,将上述患者随机分为两组,观察组接受吉非替尼治疗,对照组接受厄洛替尼治疗,比较两组患者临床治疗效果与不良反应情况。结果观察组治疗有效率(73.3%)、疾病控制率(93.3%)与对照组相比,组间差异无统计学意义(P>0.05)。观察组13例患者出现不良反应,概率为28.9%;对照组23例患者出现不良反应,概率为51.1%,组间差异具统计学意义(P<0.05)。结论吉非替尼与厄洛替尼治疗非小细胞肺癌的疗效相当,但前者不良反应较小,值得临床推广。     

吉非替尼治疗晚期非小细胞肺癌的临床疗效及安全性

目的 探讨吉非替尼治疗晚期非小细胞肺癌的效果和安全性。方法 54例晚期非小细胞肺癌患者,以随机方法分为观察组与对照组,各27例。对照组采用厄洛替尼治疗,观察组采用吉非替尼治疗。比较两组病情控制率、不良反应发生情况。结果 治疗后,观察组病情控制率92.59%高于对照组的62.96%,差异有统计学意义(P<0.05)。观察组不良反应发生率18.52%与对照组的14.81%比较,差异无统计学意义(P>0.05)。结论 在对晚期非小细胞肺癌患者进行治疗时,吉非替尼的效果相对于厄洛替尼而言更好,而且具有较好的安全性,因此值得推荐。     

Novel non-operative treatment and treatment strategies in pancreatic cancer

Patients with advanced pancreatic cancer have traditionally been treated with palliative care only. The last decade has seen significant improvements in the surgical treatment of this disease but until the late 1990s there was no effective non-surgical treatment for these tumours. The introduction of gemcitabine has given clinicians treating patients with pancreatic cancer a new option. The published randomised data of gemcitabine in patients with pancreatic cancer has shown both a small survival advantage and significant improvements in quality of life indicators in these patients. These data have stimulated a resurgence of interest in pancreatic tumours and several studies have been or are currently investigating novel treatments or treatment strategies. The explosion in the molecular knowledge of cancer has led to the development of several ‘molecular designer drugs’ that have been tested in pancreatic cancer. The furthest advanced of these is a matrix metalloproteinase (MMP) inhibitor called marimastat. The first randomised data using this new class of agents is increasing and suggests that marimastat may have a role in the future treatment of patients with pancreatic cancer. Other agents such as gastrimmune, are about to enter Phase III studies and several other molecular treatment strategies are progressing from the in vitro stage towards the clinical arena. Each of these treatments and treatment regimens are discussed along with their current progress.     

Domestic violence treatment referrals for men seeking alcohol treatment

The annual prevalence of intimate partner violence (IPV) in samples of men seeking alcohol treatment has been estimated at 50% or higher. One proposed approach to these co-occurring problems is the provision of IPV screening and treatment referrals within alcohol treatment programs. The current study found that alcohol treatment providers infrequently referred men with a pretreatment year history of IPV to domestic violence treatment programs, and that men receiving such referrals rarely followed the recommendation and sought additional treatment. These findings suggest future research is necessary to identify factors that may act as barriers to IPV assessment or referral in alcohol treatment settings, factors that may limit client follow-through on such referrals, and new strategies for addressing IPV in substance abusing populations.     

Buprenorphine treatment of opium-dependent outpatients seeking treatment in Iran

The goal of this study was to evaluate the efficacy of 1-, 3-, and 8-mg per day doses of buprenorphine in the maintenance treatment of opium-dependent patients over a 6-month treatment period. Participants were 513 opium-dependent individuals who were seeking treatment in an urban outpatient clinic, offering a 1-hr weekly individual counseling session. Overall, 305 patients (59.5%) completed the 6-month study. Completion rates by dosage group were 33.9% for the 1-mg dose group, 64.3% for the 3-mg dose group, and 80.1% for the 8-mg dose group—each significantly different from the other two groups. The results support the efficacy and safety of buprenorphine for outpatient treatment of opium dependence and seem to indicate that the highest dose (8 mg) of buprenorphine was the best of the three doses for Iranian opium-dependent patients to increase their retention in treatment.     

Interpreting treatment effects when cases are institutionalized after treatment

Drug treatment clients are at high risk for institutionalization, i.e., spending a day or more in a controlled environment where their freedom to use drugs, commit crimes, or engage in risky behavior may be circumscribed. For example, in recent large studies of drug treatment outcomes, more than 40% of participants were institutionalized for a portion of the follow-up period. When longitudinal studies ignore institutionalization at follow-up, outcome measures and treatment effect estimates conflate treatment effects on institutionalization with effects on many of the outcomes of interest. In this paper, we develop a causal modeling framework for evaluating the four standard approaches for addressing this institutionalization confound, and illustrate the effects of each approach using a case study comparing drug use outcomes of youths who enter either residential or outpatient treatment modalities. Common methods provide biased estimates of the treatment effect except under improbable assumptions. In the case study, the effect of residential care ranged from beneficial and significant to detrimental and significant depending on the approach used to account for institutionalization. We discuss the implications of our analysis for longitudinal studies of all populations at high risk for institutionalization.