长春瑞滨联合顺铂、亚叶酸钙/5-氟脲嘧啶治疗晚期食管癌21例

目的探讨长春瑞滨(NVB)联合顺铂(DDP)、亚叶酸钙(CF)、5-氟尿嘧啶(5-Fu)的NFP方案治疗晚期食管癌的近期疗效与不良反应。方法NVB 25 mg.m-2,静脉注入,d1,8;DDP 30 mg.m-2,静滴,d1~3;CF 200 mg,静滴,d1~5;5-Fu 500 mg.m-2,静滴8 h;28 d为一周期,两周期后评价疗效。结果可评价疗效的21例中完全缓解(CR)1例(4.8%),部分缓解(PR)7例(33.3%),总有效率(CR PR)38.1%(8/21)。主要不良反应静脉炎、骨髓抑制和胃肠道反应,经对症处理患者均能忍受。结论长春瑞滨联合顺铂、亚叶酸钙/5-氟脲嘧啶治疗晚期食管癌疗效较好,毒副反应可以耐受,值得进一步扩大临床研究及应用。     

盖诺联合顺铂治疗初治非小细胞肺癌的疗效观察

目的评价盖诺（长春瑞滨,NVB）联合顺铂（顺氯氨铂,DDP）治疗初治非小细胞肺癌（NSCLC）近期疗效和毒副作用。方法对北京市平谷区医院近4年来84例初治晚期（Ⅲb-Ⅳ）非小细胞肺癌采用盖诺联合顺铂化疗（NP方案）,盖诺25mg/m2·d,d1.8;顺铂25mg/m2·d,d3～5,每3周重复一次,完成3周期或以上评价疗效。结果总有效率34.5%,主要毒副作用是骨髓抑制和消化道反应。结论盖诺联合顺铂治疗晚期非小细胞肺癌疗效确切,毒副反应可耐受,骨髓抑制为其剂量限制性毒性。     

周剂量紫杉醇联合顺铂治疗晚期食管癌临床观察

目的 观察周剂量紫杉醇(PTX)加顺铂(DDP)联合化疗治疗晚期食管癌的近期疗效和毒副反应.方法 晚期食管癌患者48例分为两组,PTX DDP组:PTX 80mg/m2静滴第1,8天;顺铂20mg/d静滴第1～5天.5-Fu DDP CF组:5-Fu 500mg/m2静滴,第1～5天;DDP 20mg/d静滴第1～5天,CF 100mg/次静滴,在5-Fu前2h内给药第1～5天,21天为1周期,2周期后按UICC标准评价近期疗效和毒副反应.结果 PTX DDP方案治疗20例食管癌患者有效率为70%;5-Fu DDP CF方案治疗28例的有效率为50%.前一联合方案总有效率高于后者,有显著性差异(P＜0.05),不良反应也较后者重,但大多数患者能耐受,主要为剂量限制性毒性.表现为Ⅱ～Ⅲ度为主的骨髓抑制.结论 周剂量紫杉醇联合顺铂治疗晚期食管癌近期疗效显著,毒副反应小.     

适形放射治疗联合FP方案同步放化疗治疗食管癌70例的临床观察

目的观察三维适形放射治疗联合5-氟尿嘧啶(5-FU)加顺铂(DDP)同步化疗治疗食管癌的疗效及耐受性。方法 70例食管癌患者采用三维适形放疗1.8～2gY/f,1f/d,至60～66gY,同步化疗FP方案:顺铂25mg/m2,d1-d3,5-FU600mg/m2,d1-d3,28天为1周期,共4个周期。结果食管癌同步放化疗的有效率77%,1、3、5年生存率分别为64%、42%,38%。主要毒副反应表现为骨髓抑制和消化道反应。结论三维适形放射治疗联合化疗治疗食管癌近期疗效好,且毒副反应可以耐受。     

长春瑞滨联合顺铂治疗148例晚期非小细胞肺癌疗效观察

目的:观察国产长春瑞滨(NVB)联合顺铂(DDP)治疗晚期非小细胞肺癌(NSCLC)的疗效.方法:盖诺25 mg/m2,d1.8;DDP40 mg/m2,d1,2,21～28天为1周期,至少治疗2周期.结果:CR 15例,PR 56例,SD 46例,PD 31例,有效率为44%.不良反应主要为骨髓抑制和消化道反应.结论:NVB加DDP联合化疗治疗晚期NSCLC疗效较高,不良反应可耐受,可作为晚期NSCLC一线治疗方案.     

国产长春瑞滨联合顺铂治疗晚期非小细胞肺癌的临床观察

目的观察国产长春瑞滨(盖诺,NVB)联合顺铂(DDP)治疗晚期非小细胞肺癌(N SCLC)化疗方案的疗效。方法有明确的病理和/或细胞学诊断的34例晚期N SCLC患者,运用NVB 25m g/m2,静滴d1,d8;DDP 25m g/m2,静滴d1,d2,d3,每21天为1周期。结果CR 0例,PR 14例(41.2%),SD 16例(47.1%),PD 4例(11.8%),有效率为41.2%(14/34)。不良反应主要为骨髓抑制和消化道反应。结论国产长春瑞滨和顺铂联合方案治疗晚期N SCLC,疗效较高且毒副反应可以耐受。     

紫杉醇联合顺铂治疗晚期食管癌疗效分析

目的:观察紫杉醇联合顺铂治疗晚期食管癌的疗效和毒副反应。方法:治疗组采用紫杉醇140mg/m2d1+顺铂30mg/m2d1~d3静脉滴注。对照组顺铂30mg/m2d1~d3+氟尿嘧啶0.5g/m2d1~d5静脉滴注。每3周重复1次,至少连用4周期评定结果。结果:治疗组与对照组有效率分别为59.5%和38.5%,两组比较有统计学意义(P<0.05);中位生存期分别为9.8个月和6.7个月;主要毒副反应为骨髓抑制及消化道反应。结论:以紫杉醇联合顺铂的联合化疗方案治疗晚期食管癌,疗效好、毒性小,值得进一步推广。     

盖诺联合顺铂及5-氟脲嘧啶治疗食管癌术后患者的疗效观察

目的观察以盖诺（长春瑞滨）为主的联合化疗方案治疗术后食管癌的疗效及安全性。方法选择食管癌术后患者联合化疗,盖诺25 mg/m^2静脉滴注d1及d5,顺铂30 mg/m^2静脉滴注d2至d4,5氟-脲嘧啶500 mg/m^2静脉滴注4 h d1至d5,3-4周重复。结果治疗后近期疗效有效率84.4%。主要副反应为恶心、呕吐及白细胞减少,但多为Ⅰ-Ⅱ级。结论盖诺毒副作用可以耐受,盖诺联合顺铂及5氟-脲嘧啶联合化疗方案疗效显著,毒性反应能耐受,且费用低,值得推广。     

奈达铂联合5-氟脲嘧啶治疗顺铂耐药的晚期食管癌临床疗效观察

目的考察奈达铂联合5-氟脲嘧啶（5-Fu）对顺铂耐药的晚期食管癌的临床疗效及毒副反应。方法奈达铂80 mg.m-2静滴2 h,d1;亚叶酸钙（CF）75 mg·m-2静滴2 h后,5-FU 500 mg·m-2持续静滴6 h以上,d1～5,28 d为一周期。完成2～3个周期后,根据WHO标准评价疗效和毒副反应。结果总有效率（CR＋PR）42.4%,1年生存率29.1%;主要毒副作用为骨髓抑制。结论对顺铂耐药的晚期食管癌患者,奈达铂联合5-Fu治疗是安全有效的方案,值得临床推广。     

紫杉醇联合顺铂治疗对5-氟尿嘧啶耐药的食管癌的疗效分析与评价

目的 观察紫杉醇联合顺铂治疗耐5-氟尿嘧啶(5-FU)食管癌的疗效及毒性反应.方法 48例对5-FU耐药的食管癌患者,接受紫杉醇135mg/m2,静脉滴注,第1、8天;顺铂20mg/m2,静脉滴注,第1~5天;21d为1个周期.结果 共完成192个周期,6例完全缓解,28例部分缓解,10例病灶稳定,4例病灶进展,总有效率为68%.中位疾病进展时间为8个月,中位生存期为19个月;主要毒副反应为骨髓抑制及胃肠道反应.结论 紫杉醇联合顺铂治疗耐5-FU食管癌疗效较好,毒副反应较轻,可作为5-FU治疗失败的食管癌的解救方案.     

奥沙利铂联合氟尿嘧啶和亚叶酸钙治疗晚期结直肠癌的疗效观察

目的探讨奥沙利铂、5-氟脲嘧啶和亚叶酸钙联合治疗晚期结直肠癌的疗效及不良反应。方法 40例晚期结直肠癌患者均采用奥沙利铂联合5-氟尿嘧啶和亚叶酸钙治疗,治疗方案为:奥沙利铂130mg/m2静脉滴注4h,第1天;亚叶酸钙200mg/m2静脉滴注2h,第1～5天(在静脉滴注5-氟尿嘧啶之前),5-氟尿嘧啶400mg/m2静脉滴注4～6 h,平均用药4周期,2周期后进行疗效评价。结果 40例晚期结直肠癌患者中,完全缓解(CR)4例(10%),部分缓解(PR)18例(45%),稳定(SD)10例(25%),进展(PD)8例(20%),总有效率(ORR)为55%。不良反应为厌食疲乏、皮肤色素沉着、神经毒性、手足综合症、腹泻、恶心呕吐、肝功损害、白细胞下降,多数患者能耐受。结论奥沙利铂联合5-氟尿嘧啶和亚叶酸钙治疗晚期结直肠癌的疗效肯定,毒副反应小,患者能耐受,值得推广。     

多西紫杉醇联合奥沙利铂治疗进展期胃癌87例临床分析

目的评估多西紫杉醇联合奥沙利铂治疗进展期胃癌的效果和安全性。方法130例进展期胃癌患者随机分为实验组87例,对照组43例,实验组给予多西紫杉醇50mg／m^2静脉滴注,第1—3天;奥沙利铂65mg／m^2静脉滴注,第1天;氟脲嘧啶（5-Fu）500mg／m^2静脉滴注,第1～5天;亚叶酸钙（CF）300mg,第1～5天,在5-Fu之前2h静脉滴注。对照组用奥沙利铂130mg／m^2静脉滴注,第1天;5-Fu与CF的给药方法同实验组。3周为1个周期,治疗2个周期后评价疗效。结果实验组近期疗效、组织学变化、影像学变化等与对照组比较,差异均有统计学意义（均P〈0．05）。两组在白细胞减少、血小板减少、消化道反应、肝肾功能损害等不良反应方面比较,差异无统计学意义（均P〉0．05）。结论多西紫杉醇联合奥沙利铂化疗方案治疗进展期胃癌安全、有效。     

An NCIC CTG phase I/pharmacokinetic study of the matrix metalloproteinase and angiogenesis inhibitor BAY 12-9566 in combination with 5-fluorouracil/leucovorin

BACKGROUND: This phase I study was performed to evaluate the safety, tolerability, and efficacy of the oral matrix metalloproteinase inhibitor BAY 12-9566 in combination with 5-fluorouracil/leucovorin in patients with advanced solid tumours, and to identify the maximum tolerated dose and the dose for use in future studies. PATIENTS AND METHODS: BAY 12-9566 and 5-fluorouracil/leucovorin were administered to 17 patients in 3 cohorts. Each patient served as his/her own control, with 5-fluorouracil being given alone on days 1-5 of cycle 1. In cohort 1, BAY 12-9566 at 800 mg p.o. b.i.d. was given with 350 mg/m2 5-fluorouracil/20 mg/m2 leucovorin x 5 days q28 days. In cohort 2, the BAY 12-9566 dose was reduced to 400 mg p.o. b.i.d., with the 5-fluorouracil/leucovorin doses remaining unchanged. Finally, in cohort 3, BAY 12-9566 400 mg bid was given with 5-fluorouracil 400 mg/m2/day. Patients were continued on therapy until unacceptable toxicity or tumour progression occurred. Pharmacokinetic analyses for both BAY 12-9566 and 5-fluorouracil were performed. RESULTS: The maximum tolerated dose was 400 mg p.o. b.i.d. BAY 12-9566 plus 5-fluorouracil/leucovorin at 400 mg/m2/day and 20 mg/m2/day, respectively. Thrombocytopenia necessitated a decrease of the dose of BAY 12-9566 by 50% from cohort 1 to cohort 2. Two dose-limiting toxicities occurred in cohort 3 consisting of neutropenic fever, and ileitis, causing severe diarrhea. Of 17 patients treated on study, 7 of 14 patients evaluable for response achieved stable disease. Pharmacokinetic analysis suggested there was no interaction between BAY 12-9566 and 5-fluorouracil. CONCLUSIONS: BAY 12-9566 400 mg bid and 5-fluorouracil 350 mg/m2 plus leucovorin 20 mg/m2 can be co-administered. Although there is some evidence of a clinical interaction, there is no apparent pharmacokinetic interaction. Future studies with these 2 types of agents administered in combination are warranted.     

草酸铂联合亚叶酸钙和5-氟脲嘧啶治疗晚期胃癌临床观察

目的 探讨草酸铂(L-OHP)联合亚叶酸钙(CF) 5-氟脲嘧啶(5-FU)方案治疗晚期胃癌近期疗效及其不良反应.方法 L-OHP 130mg/m2,静脉滴注3h,第d1;CF 100mg/m2,静脉滴注,第d1～5;5-FU150mg/m2,用CF之后静脉推注,同时5-FU 345mg/m2,静脉滴注,6～8 h,第d1-5,21d重复.结果 48例晚期胃癌患者,获CR 5例(10.4%),PR 24例(50%),SD 11例(22.9%),PD 8例(16.7%),总有效率(CR PR)达60.4%,主要不良反应为恶心、呕吐、白细胞和血小板降低及轻度周围神经毒性.结论 L-OHP联合CF 5-FU方案一线治疗晚期胃癌具有较好的疗效和安全性.     

伊立替康联合5-FU/CF治疗转移性结直肠癌46例

目的：评价伊立替康（CPT—11）联合5-FU／CF方案治疗FOLFOX4或LV5FU2方案失败的结直肠癌的客观疗效，临床受益和不良反应。方法：用CPT—11联合5-FU／CF方案治疗晚期结直肠癌患者46例，采用2周方案，即CPT—11 180mg／m^2 iv d1，CF200mg／m^2 iv d1-2，5-FU400mg iv bolusd1，5-FU600mg／m^2 iv，22hd1—2，每2周重复。观察期3—6个月。结果：完全缓解0例，部分缓解18例（有效率39．13％），稳定20例（43．47％），进展8例（17．39％）。临床受益率82．6％（19／23）。临床反应评价有效者36例（78．86％），生活质量显著提高。结论：CPT-11联合5-Fu／CF方案可作为转移性结直肠癌的二线治疗。     

A phase II study of an oxaliplatin/vinorelbine/5-fluorouracil combination in patients with anthracycline-pretreated and taxane-pretreated metastatic breast cancer

The aim of this phase II study was to evaluate safety and efficacy of an oxaliplatin/vinorelbine/5-fluorouracil (FON) combination in anthracycline and taxane-pretreated metastatic breast cancer patients. The following treatment was given: on day 1 of a 21-day cycle, oxaliplatin 130 mg/m (2-h intravenous infusion); on days 1 and 5, vinorelbine [dose level (DL) 1: 17.5 mg/m; DL2: 22 mg/m]; on days 1-5, continuous infusion 5-fluorouracil (DL1: 600 mg/m/day; DL2: 750 mg/m/day). Forty-seven patients were treated (DL1: 43; DL2: 4). Median age was 54 years; 68% had liver metastases, 53% were taxane refractory/resistant and 38% were anthracycline refractory/resistant. Patients received a median of six treatment cycles. Of 46 eligible patients, 16 had partial response; the overall response rate was 34.8% (95% confidence interval 21.3-50.3%), 11 had stable disease lasting more than 4 months. Median follow-up was 13.0 months, median time to progression 5.7 months and estimated overall survival 18.8 months. DL2 was too toxic with three patients having grade 3-4 toxicity, including one death. At DL1, 26 patients (60%) experienced grade 3-4 neutropenia (six febrile neutropenia) and eight had grade 3 oxaliplatin-specific peripheral neuropathy after a median of 646.4 mg/m oxaliplatin (range 124-1619 mg/m). Oxaliplatin (130 mg/m, day 1)/vinorelbine (17.5 mg/m, days 1,5)/5-fluorouracil (600 mg/m/day, days 1-5) demonstrate encouraging activity and a manageable safety profile in anthracycline- and taxane-pretreated metastatic breast cancer patients.     

奥沙利铂联合氟尿嘧啶、亚叶酸钙治疗晚期胃癌的临床观察

目的：观察奥沙利铂（oxaliplatin,L—OHP）联合氟尿嘧啶（fluorouracil,Fu）、亚叶酸钙（calcium folimate,CF）治疗晚期胃癌的近期疗效和毒副反应。方法：48例晚期胃癌患者均经病理学证实。化疗方案为L—OHP100mg／m。静脉滴注2h第1天,CF200mg／m^2静脉滴注2h,第1～2天,FU2400mg／m。持续静脉泵入46h。每3～4周重复,2个周期后评效。结果：48例患者均可评效。完全缓解（CR）2例,部分缓解（PR）16例,稳定20例,进展10例,有效率（CR＋PR）37．5％,临床受益率79．17％,中位疾病进展时间（TFP）5．8个月,中位生存期9．1个月。1年生存率54．17％。主要毒副反应为恶心呕吐、骨髓抑制及轻度的外周神经系统病变。结论：L—OHP联合FU、CF方案治疗晚期胃癌疗效较好,毒副反应轻,值得临床推广。     

A phase II trial of modified FOLFOX as first-line chemotherapy in advanced colorectal cancer

The objective was to evaluate the efficacy and toxicity of leucovorin plus 5-fluorouracil combined with oxaliplatin (modified FOLFOX regimen) every 2 weeks on previously untreated advanced colorectal cancer patients in the Chinese population. Fifty-one inpatients were enrolled to receive 85 mg/m oxaliplatin intravenously over a 2- h period on day 1, together with 400 mg/m2 leucovorin over 2- h, followed by a 46-h infusion of 5-fluorouracil at 2600 mg/m2 every 2 weeks. Treatment was given until progression or unmanageable toxicity ensued. In all, 51 patients received three or more oxaliplatin doses and a median of nine treatment cycles (range 3-16 cycles). Of the 51 eligible patients, two complete responses and 22 partial responses were observed for an overall response rate of 47.0% (95% confidence interval 35-64%). Median progression-free survival was 7.7 months (95% confidence interval 6.8-8.6) and median overall survival was 15.0 months (95% confidence interval 13.1-16.9). Toxicities were mild: five patients (9.8%) reported grade 3-4 neutropenia, 33 patients (64.8%) experienced grade 1-3 neurotoxicity and only six patients (11.8%) experienced grade 3 neurotoxicity. The leucovorin plus 5-fluorouracil combined with oxaliplatin (modified FOLFOX) regimen is active and well tolerated in patients with previously untreated advanced colorectal cancer in the Chinese population.     

多西他赛联合顺铂方案新辅助治疗局部晚期食管鳞癌的临床研究

目的分析比较多西他赛联合顺铂方案(TP)与氟尿嘧啶联合顺铂方案(PF)新辅助治疗局部晚期食管鳞癌的有效性及安全性。方法收集自2010年6月至2013年3月在我院肿瘤内科和胸心外科住院新辅助化疗的局部晚期食管鳞癌患者94例,其中TP方案组42例(DTX 75 mg/m2,静滴d1,DDP 20 mg/m2,静滴d1^d3)和PF组52例(5-FU 1000 mg/m2,静滴d1d3)和PF组52例(5-FU 1000 mg/m2,静滴d1^d5;DDP 20 mg/m2,静滴d1d5;DDP 20 mg/m2,静滴d1^d3,q4周)组。化疗3周期后评价疗效及毒副反应。结果全部入组病例均可评价近期疗效和毒副反应。TP组患者的近期有效率明显高于PF组(P<0.05);然而疾病控制率相似,无统计学意义(P=0.344);两组化疗方案的3d3,q4周)组。化疗3周期后评价疗效及毒副反应。结果全部入组病例均可评价近期疗效和毒副反应。TP组患者的近期有效率明显高于PF组(P<0.05);然而疾病控制率相似,无统计学意义(P=0.344);两组化疗方案的3⁴级毒副反应方面比较,毒副作用均可耐受,恶心呕吐、过敏、乏力、腹泻的34级毒副反应方面比较,毒副作用均可耐受,恶心呕吐、过敏、乏力、腹泻的3⁴级不良反应发生率两组比较差异无统计学意义(P>0.05)。骨髓抑制、神经毒性及肌痛差异具有显著性(P<0.05)。结论在局部晚期食管鳞癌新辅助化疗中,TF方案与PF方案比较,具有更好的近期有效率,但有更高的毒副反应,经过及时处理后PF方案可具有较好的耐受性。     

Chemoimmunotherapy in the treatment of metastatic gastric cancer

Docetaxel, capecitabine and 5-fluorouracil have been shown to be active in the treatment of metastatic gastric adenocarcinoma. Consistent with this finding, the aim of this study was to test this combination in a clinical trial. Forty-one patients with metastatic gastric adenocarcinoma and a median age of 64 years were recruited for the study. The treatment was based on the administration of docetaxel 60 mg/m2 every 4 weeks, leucovorin 200 mg/m2, 5-fluorouracil 400 mg/m2 bolus, and capecitabine 1000 mg/m2 twice daily on days 1 and 2 every 2 weeks. Patients achieving a clinical benefit were treated, as maintenance immunotherapy, with low-dose interleukin-2 and 13-cis-retinoic acid. The primary end point of this phase II study was the response rate. The secondary end points relied on the evaluation of the immunological parameters, toxicity, and progression-free survival and overall survival. The overall response rate in the 41 evaluable patients was estimated to be 49%. Median progression-free and overall survival was 9.5 and 21.1 months, respectively. Grade 3 and 4 hematological toxicities were neutropenia and thrombocytopenia in 44 and 5% of patients, respectively. A sustained improvement of evaluated immunological parameters with a negligible toxicity profile was observed in the 27 patients treated with interleukin 1-2/13-cis-retinoic acid. Docetaxel in combination with leucovorin, 5-fluorouracil and capecitabine followed by low-dose interleukin 1-2 and 13-cis-retinoic acid is well tolerated, and shows a significant activity in patients with metastatic gastric adenocarcinoma.