奥沙利铂联合亚叶酸钙与5-氟脲嘧啶治疗老年晚期结直肠癌的临床研究

目的评价国产奥沙利铂（L-OHP）联合亚叶酸钙（CF）、5-氟脲嘧啶（5-Fu）治疗局部晚期或转移性老年结直肠癌患者（≥70岁）的临床疗效及毒副反应。方法入组30例患者，方案L-OHP130mg／m^2静脉滴注2h，第1天；CF200mg／m^2静脉滴注2h，第1～5天；5一Fu425mg／m^2静脉滴注6h，第1-5天。每3周重复，两周期后评价疗效。结果30例患者均可评价疗效，无CR病例，PR15例，SD8例，PD7例，有效率为50％，中位生存期18个月，中位无进展生存9．5个月，1年生存率为66.7％。主要毒副反应为神经毒性，中性粒细胞减少，消化道反应及腹泻。结论L-OHP联合5-Fu／FA方案治疗局部晚期或转移性老年结直肠癌患者疗效较高，耐受性较好，值得进一步研究。     

羟基喜树碱冻干粉针联合用药肝动脉化疗栓塞治疗原发性肝癌120例

 目的 探讨拓僖联合用药肝动脉化疗栓塞治疗原发性肝癌的临床疗效。方法 120例原发性肝癌患者采用肝动脉灌注化疗加栓塞，共接受肝动脉化疗栓塞术（TACE）治疗1 ~ 4次。灌注药物：拓僖10 ~ 30 mg、吡喃阿霉素（THP）30 ~ 40 mg、卡铂100 ~ 200 mg，与超液化碘油5 ~ 18 ml混合交替注入，最后明胶海绵颗粒栓塞。近期疗效及毒副反应按WHO标准评价。结果 CR 6.7 %，PR 52.5 %，NC 31.7 %，PD 9.2 %，近期有效率（CR+PR）为59.2 %；AFP下降50 %以上占63.6 %，其中12例AFP一度降至正常；有轻中度毒副反应。结论 拓僖联合用药肝动脉化疗栓塞治疗原发性肝癌疗效确切、安全，毒副反应轻。     

艾素联合奥沙利铂治疗晚期结直肠癌的临床研究

为了观察艾素（多西他赛,DOC）联合奥沙利铂（L-OHP）治疗晚期结直肠癌的疗效和毒副反应,对34例晚期结直肠癌患者采用DOC联合L-OHP方案化疗,DOC75mg/m^2,静脉滴入,d1;L-OHP130mg/m^2,静脉滴入,d2;28d为1个周期,至少2个周期后评定疗效。结果示34例可评价疗效,其中完全缓解（CR）1例,部分缓解（PR）12例,总有效率（CR＋PR）为38.2%。中位生存期12个月。毒副反应主要为骨髓抑制、周围神经炎和脱发。初步研究结果提示,DOC联合L-OHP方案治疗晚期结直肠癌,缓解率高,毒副反应可以耐受。     

奥沙利铂联合希罗达治疗晚期胃癌近期疗效观察

目的：观察奥沙利铂（L-OHP）联合希罗达（Xeloda）在治疗晚期胃癌中的作用。方法：L-OHP 130mg／m^2，静脉滴入，d1，Xeloda 2500mg／m^2，早晚各服1次，连服14d，21d重复。结果：21例患者中。CR1例，PR12例，NC5例，PD3例，RR61．9％。毒副反应主要为外周神经损害、手足综合征、恶心和呕吐，患者均可耐受。结论：L-OHP联合希罗达方案治疗晚期胃癌具有较好的疗效，能显著提高患者的生存质量。     

奥沙利铂联合卡培他滨治疗晚期大肠癌的临床观察

目的：观察奥沙利铂联合卡培他滨治疗晚期大肠癌的疗效和毒副反应。方法：38例均为术后有残留病灶或复发转移有可测量病灶的晚期大肠癌患者,静脉滴注奥沙利铂130mg／m^2,d1;卡培他滨2500mg／m^2,分早晚2次口服,d1～d14每3周为Ⅰ周期。结果：38例患者中,CR2例,PR16例,SD10例,PD10例,近期有效率（CR＋PR）为47．3％,中位生存期（MST）13个月,中位疾病进展时间（TTP）7．9个月。毒副反应主要为手足综合征、神经毒性,多为Ⅰ～Ⅱ度。结论：奥沙利铂联合卡培他滨的方案疗效高,毒副反应小,患者易耐受,生活质量提高。     

奥沙利铂联合5-FU／CF方案治疗肝癌复发转移的临床观察

目的 探讨奥沙利铂联合5-Fu（5-氟脲嘧啶）／CF（醛氢叶酸钙）方案治疗肝癌复发转移的疗效及安全性。方法26例为全身多发转移的原发性肝癌病人，给予奥沙利铂130mg／m^2，iv，d1；CF100mg，iv，5-FU450mg／m^2，iv，d1-5。4wk重复，2周期后复查，进展者停止化疗，余继续化疗4个周期。结果26例病人都可以作出评价：其中CR1例、PR8例、SD8例和PD9例，总有效率（CR＋PR）34．62％：AFP情况与疗效无关（P〉0．05）。随访截止，17例病人死亡，中位生存时间（MST）8．5mo，1a生存率76.7％。有效病人的MST为13．6mo，TTP为3．8mo，无效的MST为6．5mo。未发生Ⅲ-Ⅳ度毒性反应。结论奥沙利铂联合5-FU／CF方案治疗肝癌多发转移安全有效.     

国产吉西他滨联合奥沙利铂治疗晚期乳腺癌30例

[目的]观察国产吉西他滨（GEM）联合奥沙利铂（L-OHP）治疗晚期乳腺癌的疗效及毒副作用。[方法]采用GEM联合L-OHP治疗复发性乳腺癌患者30例。GEM 1000mg／m^2,d。静滴;L-OHP 130mg／m^2,d1静滴：21d为1个周期,至少治疗2个周期。[结果]CR1例．PR7例．SD10例,PD12例,总有效率（CR＋PR）26．66％。毒副反应主要为骨髓抑制、恶心／呕吐、手足综合征等。白细胞及血小板减少发生率分别为70．00％和63.33％、恶心,呕吐发生率为60．00％,手足综合征发生率为56．67％。[结论]GEM联合L-OHP治疗晚期乳腺癌疗效好．毒副作用可耐受．有较好的临床应用价值。     

奥沙利铂联合醛氢叶酸和氟尿嘧啶治疗晚期胃癌28例

[目的]研究奥沙利铂（L-OHP）联合醛氢叶酸和氟尿嘧啶治疗晚期胃癌的疗效和毒副反应。[方法]L-OHP 130mg/m^2，静脉滴注2h，CF 150mg/m^2，静滴d1，5-Fu 400mg/m^2，静推d1＋5-Fu 2.5g静脉输注70h，每21～28d为一个周期，两周期后评定疗效。[结果]全组28例可评价病例，CR 1例，PR 8例，SD 10例，PD 7例，总有效率为22.2%。初治病例中有效率为35.3%，而复治病例中为27.3%。中位疾病无进展时间为5.1个月（28天～13个月）。常见毒副反应为消化道、血液学毒性及外周感觉神经毒性。[结论]奥沙利铂联合醛氢叶酸和氟尿嘧啶治疗晚期胃癌疗效肯定，毒副反应能耐受，值得进一步使用。     

长春瑞滨联合铂类治疗中晚期子宫内膜癌

目的：比较长春瑞滨和紫杉醇分别与铂类联合治疗中晚期子宫内膜癌的近期疗效及毒副反应。方法：33例晚期子宫内膜癌，治疗组（NP方案组）21例，长春瑞滨＋顺铂或卡铂化疗，长春瑞滨25mg／m^2，静注d1、8；顺铂25mg／m^2，静注d1～3，或卡铂（300mg／m^2或者AUC4～5）静脉滴注d1。对照组（TP方案组）12例：紫杉醇135～150mg／m^2，静注d1；顺铂或卡铂用法同前。结果：全组均完成2周期以上化疗，其中CR4例．PR14例，NC10例，PD5例。有效率（CR＋PR）54．54％。NP方案组，CR2例，PR9例，有效率（CR＋PR）52．38％；TP方案组，CR2例，PR5例，有效率（CR＋PR）58．33％，两组间无统计学差异（P〉0．05）。副反应主要为骨髓抑制、白细胞、血小板减少，Ⅲ～Ⅳ度发生率，NP组为71．43％，TP组为75．0％（P〉0．05）。结论：长春瑞滨＋铂类联合与紫杉醇＋铂类联合化疗治疗中晚期子宫内膜癌有相同的疗效且毒副反应可以耐受。     

FOLFOX方案治疗晚期原发性肝癌临床观察

目的探讨奥沙利铂（L-OHP）联合亚叶酸钙（CF）／5-氟脲嘧啶（5-Fu）组成的FOLFOX4方案治疗晚期原发性肝癌病人的疗效与安全性。方法12例晚期原发性肝癌病人，采用FOLFOX4方案进行治疗，FOLFOX4方案：L-OHP85mg／m^2静脉滴入2h，d1、d15；CF200mg，静脉滴入，持续2h，d1、d2和d15、d16；5-FU400mg／m^2，静脉推注d1、d2、d15、d16，600mg／m^2，静脉滴入持续22h，d1、d2、d15、d16；每28d为1周期。2周期评价疗效和毒性。治疗前后查肝肾功能，血常规，AFP，ECG，CT或MRI、B超等。疗效和不良反应按WHO疗效及不良反应评价标准评价。结果11例病人，均可以评价客观疗效，其中CR无病例，PR2例，SD4例，PD5例：总有效率为18．18％，稳定率54．54％，10例AFP增高的病人中4例AFP下降，下降率为40％。生存期最短的为3mo，最长的8mo；中位生存期为5．8mo。FOLFOX最少为2周期，最多4周期，共30周期。常见的毒副反应为轻、中度白细胞减少72．72％（8／11）和轻度周围神经毒性（2／11）。结论经过初步应用，以FOLFOX4方案静脉化疗对于晚期原发性肝癌的疗效较好，安全性高，且不良反应较轻，病人易于耐受，值得进一步研究应用。     

Hepatic arterial infusion chemotherapy for cancer of the liver

Hepatic artery infusion chemotherapy (HAIC) provides objective palliation for unresectable primary and secondary liver neoplasms. By utilizing HAIC rather than systemic chemotherapy, a greater concentration of the chemotherapeutic agent(s) within the liver is achieved with a comparative decrease in toxic side effects. A review of pertinent literature disclosed response rates of 50-71% associated with the administration of 5-fluorouracil (5-FU) and 5-fluoro-2-deoxyuridine (5-FUDR) via the hepatic artery, whereas response rates of 0-25% have been tabulated for systemic chemotherapy.     

电化学治疗联合肝动脉插管置泵化疗治疗中晚期肝癌75例疗效观察

目的探讨电化学治疗(electrochemicaltherapy,ECHT)联合肝动脉化疗治疗中晚期肝癌的疗效。方法经开腹在直视下将特制的正负电极插入瘤体,通过电化学治疗仪将直流电施加于肿瘤,利用其产生的电离、电渗析作用,改变肿瘤组织生存的内环境,使肿瘤细胞代谢紊乱,发生变性、坏死,而达到治疗目的。治疗中局部可注入带正电荷的平阳霉素与高渗氯化钠溶液,以加速电化学反应,提高治疗效果。结果全组75例均为Ⅲ期,术后恢复良好,随访6个月~5年,1,2,3年生存率分别为85%,76.6%,73.5%,4例生存期已超过5年。结论电化学治疗肝癌疗效确切;创伤小、方法简便、安全性高、痛苦小、出血少,可避免肝叶切除术后所致的切面渗血,瘤体破裂及胆瘘等问题;不需阻断肝血流,可减少术后肝功能不全的发生。采用多电极合理设置的电化学治疗,并辅以肝动脉插管留置药泵周期性化疗,可提高疗效。     

Hepatic arterial infusion of chemotherapy for advanced hepatocellular carcinoma

Treatment of advanced hepatocellular carcinoma (HCC) remains a significant problem for clinicians. Sorafenib, the only approved agent, improves survival rate, but is associated with a low tumor response rate. Alternative approaches for the treatment of advanced HCC are urgently needed. Hepatic arterial infusion of chemotherapy (HAIC) is a promising modality for the treatment of advanced HCC. Since its introduction, there have been improvements in implantable pumps, in catheter implantation and in the convenience and safety of HAIC in general. Numerous clinical studies have shown that HAIC provides moderate therapeutic efficacy with substantially favorable toxicity profiles in selected patient groups with advanced HCC. However, the lack of large randomized studies means that HAIC is not yet a well‐established treatment for advanced HCC. We believe there is an urgent need for the further investigation of HAIC for the treatment of advanced HCC.     

动脉介入联合腹腔化疗治疗中晚期肝癌56例

目的为了探讨中、晚期肝癌行动脉介入联合腹腔化疗的疗效.方法56例(A组)行动脉介入联合腹腔化疗,58例(B组)行动脉介入治疗.结果A、B两组有效率分别为64.3%、39.7%有显著差异(P<0.05),A组中位生存期明显延长,有38例患者AFP下降明显(P<0.01).结论采用动脉介入联合腹腔化疗是治疗中、晚期肝癌有效方法之一,值得推广应用.     

Hepatic artery infusion chemotherapy for colorectal metastases: a personal experience

A personal experience is reported with hepatic artery infusion (HAI) chemotherapy of 57 patients with metastatic colorectal carcinoma confined to the liver. Fifty-seven percent of the 54 patients who received more than 2 weeks of infusion had objective regressions documented on hepatic scans. The response rate with fluorouracil and mitomycin C (75%) was higher than for fluorouracil alone (52.5%). The median survival of treated patients was 15 months with the longest survivor living 3 years 8 months, and responders had a median survival 3 months longer than nonresponders. Complications included one case of hemolytic uremic syndrome after HAI with mitomycin C. Survival after HAI was 9 months longer than that of comparable historical controls who received no treatment, but survival after HAI with fluorouracil alone was not superior to that of comparable patients treated with intravenous fluorouracil. HAI produces a high frequency of tumor regression, but superior survival has yet to be demonstrated.     

Isolated hepatic perfusion chemotherapy for unresectable malignant hepatic tumors

Treatment failure with conventional approaches, including systemic and regional chemotherapy, for refractory advanced primary or metastatic hepatic cancers has evoked periodic waves of enthusiasm for isolated hepatic perfusion (IHP) over the past 50 years. With technical refinements of the procedure and the introduction of a novel biochemical regimen combining tumor necrosis factor and melphalan, several hepatobiliary-oncological centers initiated clinical trials of IHP in the 1990s. In parallel, a percutaneous technique of IHP has been developed in this era as a minimally invasive, simple form of IHP, and phase I and II studies have been done in some specialized centers. This study attempts to review past and current techniques of IHP, and to outline their possible role in the treatment of unresectable hepatic tumors, with special reference to hepatocellular carcinoma and colorectal hepatic metastases. Received: January 10, 2002     

复方斑蝥注射液在原发性肝癌化疗中的作用

目的：评价复方斑螫注射液在原发性肝癌化疗中的临床疗效。方法：选择原发性肝癌患者142例，随机分为观察组72例，对照组70例，观察近期疗效、生存质量（卡式评分）、CP分级、AFP定量及毒副作用。结果：治疗组AFP定量下降率、卡式评分改善率高于对照组，近期进展率、白细胞下降率、胃肠道反应率低于对照组，差异均具有显著统计学意义。观察组近期有效率高于对照组，CP分级上升率低于对照组，但差异无显著统计学意义。结论：复方斑蝥注射液在原发性肝癌化疗中有减轻化疗反应、提高生存质量的作用。     

复方斑蝥注射液在原发性肝癌化疗中的作用

目的:评价复方斑蝥注射液在原发性肝癌化疗中的临床疗效。方法:选择原发性肝癌患者142例,随机分为观察组72例,对照组70例,观察近期疗效、生存质量(卡式评分)、CP分级、AFP定量及毒副作用。结果:治疗组AFP定量下降率、卡式评分改善率高于对照组,近期进展率、白细胞下降率、胃肠道反应率低于对照组,差异均具有显著统计学意义。观察组近期有效率高于对照组,CP分级上升率低于对照组,但差异无显著统计学意义。结论:复方斑蝥注射液在原发性肝癌化疗中有减轻化疗反应、提高生存质量的作用。     

Hepatic arterial infusion chemotherapy with 5-fluorouracil-based regimens in the management of liver metastases of colorectal carcinoma

Background We assessed the efficacy and safety of hepatic arterial infusion chemotherapy, using 5-fluorouracil-based regimens, in the treatment of unresectable liver metastases of colorectal carcinoma. Patients and Methods Thirty patients with liver metastases of colorectal carcinoma were given hepatic arterial infusion chemotherapy using 5-fluorouracil-based regimens, through an implantable port system, inserted into the hepatic artety by percutaneous procedures. Weekly 5-fluorouracil infusions were given to 17 patients, daily 5-fluorouracil infusions were given to 2, the MF (5-fluorouracil-mitomycin) regimen was given to 8, and the FEM (5-fluorouracil-epirubicin-mitomycin) regimen was given to 3. Results The median survival time was 11.6 months, with an overall response rate of 64%. These results were similar to those in previous reports on hepatic arterial infusion chemotherapy using floxuridine. Hematologic and hepatic toxicity was minimal Grade 3 thrombocytopenia occurred in 2 patients (7%), and a grade 2 elevation of alkaline phosphatase, in 1 (4%). Biliary sclerosis was not observed. The major toxicity was nausea and vomiting, grade 2 or 3, most of which was controllable, in 5 patients (18%). The occurrence of hepatic failure resulting in death was significantly (P=0.0015) lower in responsive cases than in nonresponsive cases. Conclusion We consider that 5-fluorouracil-based regimens can be used safely for hepatic arterial infusion chemotherapy with minimal toxicity, and that they are useful in preventing hepatic failure, because of their high response rate.     

Response to chemotherapy improves hepatic reserve for patients with hepatocellular carcinoma and Child–Pugh B cirrhosis

There is no established treatment for patients with advanced hepatocellular carcinoma (HCC) with Child–Pugh class B cirrhosis. The aim of the present study was to assess the efficacy of hepatic arterial infusion chemotherapy (HAIC) according to Child–Pugh score (CPS) and to evaluate the correlation of a patient's response to HAIC with hepatic reserve and outcome. We retrospectively reviewed the medical records of 377 patients treated with HAIC between March 2003 and February 2015. Subjects included 179 with Child–Pugh class B. Median overall survival was 12.1 months for patients with CPS = 7 (n = 75) and 11.9 months for patients with CPS = 8 (n = 58), which were significantly longer compared with those of patients with CPS = 9 (n = 46, 6.3 months). The objective response rates of patients with CPS = 7, 8 and 9 were 26.7%, 27.6% and 6.5%, respectively. The CPS of responders improved significantly after HAIC, whereas those of nonresponders did not. A multivariate analysis demonstrated that improved CPS, responses to HAIC and absence of extrahepatic lesions were independent favorable prognostic factors. Patients with CPS = 7 or 8 tolerated HAIC, but nine (19.6%) of patients with CPS = 9 were unable to complete one course. HAIC is effective and safe for patients with a CPS = 7 or 8 and improved hepatic reserve of responders significantly.