平消胶囊联合三苯氧胺治疗乳腺增生

目的:观察平消胶囊与三苯氧胺合用治疗乳腺增生的临床疗效.方法:将520 例乳腺增生患者随机分为治疗组和对照组各260例,对照组单用三苯氧胺治疗,治疗组在对照组相同治疗的基础上加用平消胶囊治疗.结果:治疗组总有效率为90.4%,对照组总有效率为67.7%,两组有显著性差异(P＜0.01).结论:平消胶囊与三苯氧胺合用治疗乳腺增生疗效满意,优于单用三苯氧胺.     

治疗乳腺增生常用药物疗效比较

目的:比较乳腺增生治疗药物的疗效。方法:选择临床诊断为乳腺增生症的患者随机分成四组,分别给予乳癖消、乳康片、平消胶囊、三苯氧胺治疗各100例,对比观察疗效及不良反应。结果:总有效率分别为33%、40%、89%、85%。前三种中药制剂未见明显不良反应,三苯氧胺有不良反应。结果:对于保守治疗的乳腺增生症应根据具体情况,主要选择中药制剂,慎用三苯氧胺。     

平消胶囊治疗乳腺病351例临床疗效评价

目的：治疗乳腺腺病的有效药物的临床疗效评价。方法：选择467例乳腺腺病患者，随机分为两组，进行前瞻性治疗，治疗组351例，单用平消胶囊治疗，对照级116例，使用乳康片，乳癖消，消遥丸等药物，结果：治疗组有效率93．44％，对照组有效率49．13％，两组显著性差异（P＜0．05）。结论：平消胶囊为目前治疗乳腺腺病最有效的药物之一。     

平消胶囊治疗乳腺增生性改变60例临床观察

目的 探讨平消胶囊治疗乳腺增生性改变的疗效。方法 全部病例治疗前均经临床检查及近红外线乳腺透照检查或B超、X线钼钯检查，诊断为乳腺增生性改变，其中治疗组60例，采用西安正大制药有限公司的平消胶囊，口服治疗，每日3次，每次4—6粒，服药一个月。对照组60例，采用乳癖消口服，每日3次，每次5粒，服药一个月。治疗后仍采用临床检查，近红外线乳腺透照，B超或X线钼钯检查，并观察疗效。结果 平消胶囊治疗乳腺增生性改变的总有效率为95％，而对照组为41％。结论 平消胶囊治疗乳腺增生性改变疗效好，治愈率高，毒副作用少，可作为治疗乳腺增生性改变的首选药物。     

平消胶囊联合三苯氧胺在乳腺癌后期治疗中的作用

目的：探讨平消胶囊在乳腺癌后期治疗中的价值和作用。方法：对108例患者采用随机对照方法，单纯三苯氧胺组（对照组54例），平消胶囊＋三苯氧胺组（试验组54例），比较两组不良反应，生活质量及并发症。结果：试验组生活质量提高，并发症减少，不良反应减少。结论：平消胶囊使乳腺癌后期治疗中患者的生活质量提高，减少不良反应及并发症的发生，可延长生存时间，有价值，可推广。     

平消胶囊治疗乳腺病351例临床疗效评价

目的治疗乳腺腺病的有效药物的临床疗效评价。方法选择４６７例乳腺腺病患者,随机分为两组,进行前瞻性治疗。治疗组３５１例,单用平消胶囊治疗,对照组１１６例,使用乳康片,乳癖消,消遥丸等药物。结果治疗组有效率９３．４４％,对照组有效率４９．１３％,两组显著性差异Ｐ＜０．０５。结论平消胶囊为目前治疗乳腺腺病最有效的药物之一。     

平消胶囊治疗乳腺良性疾病的疗效观察

我院对经穿刺细胞学诊断的乳腺良性疾病1760例，其中乳腺腺病1125例，乳腺腺瘤635例，行口服平消胶囊治疗。服药时间分别为1月、3月、6月。经随访观察平消胶囊对乳腺腺病及腺瘤具有显著的治疗作用，且无毒副作用，总有效率达93.43%，值得临床推广应用。     

中西医结合治疗乳腺囊性增生的疗效观察

本院乳腺疾病普查乳腺小叶增生发病率为20％，而囊性增生的占25％，有1－3％的癌变率，我院于1997年1月至1998年12月应用平消胶囊加工三苯氧胺治疗乳腺囊性增生66例，总有效率达97％，取得良好的治疗效果。     

平消胶囊治疗乳腺良性疾病的疗效观察

我院对经穿刺细胞学诊断的乳腺良性疾病1760例，其中乳腺腺病1125例，乳腺腺瘤635例。行口服平消胶囊治疗，服药时间分别为1月、3月、6月，经随访观察；平消胶囊对乳腺腺病及腺瘤具有显的治疗作用。且无毒副作用。总有效率达93.43%，值得临床推广应用。     

女性乳腺囊性增生病103例临床分析

目的 分析和探讨女性乳腺囊性增生病的病因及癌变率。方法 对103例女性乳腺囊性增生病患者，行口服平消胶囊及三苯氧胺治疗后门诊复查，如肿块明显缩小变软,可继续服药观察；如肿块缩小不明显，行针吸细胞学检查或手术切除活检，同时查雌激素和孕激素受体。结果 103例中67例肿块明显变软缩小，36例无明显变化。36例中的29例进行了针吸细胞学检查, 7例手术切除肿块并活检。14例发现为乳腺单侧囊性增生癌变，癌变患者中11例雌激素受体阳性，3例孕激素阳性。结论 乳腺囊性增生患者，经服药治疗后如无明显变化需尽快行针吸细胞学检查或手术切除活检。     

平消胶囊治疗单纯性甲状腺肿药效的实验研究

目的:通过丙硫氧嘧啶诱导的大鼠甲状腺肿模型,评价平消胶囊治疗单纯性甲状腺肿的药效作用。方法:将实验大鼠随机分为对照组、模型组、平消胶囊低、中、高剂量组和阳性药左旋甲状腺素钠(10μg/kg)组。对照组大鼠每日灌胃给予双蒸水,模型组及给药组每日灌胃给予1%丙基硫氧嘧啶混悬液,共21天,于第14天起,给药组给予平消胶囊低、中、高剂量和阳性药,持续至第49天。观察监测大鼠体重、甲状腺湿重、血清甲状腺功能五项、桥本氏甲状腺炎指标等,评估平消胶囊对单纯性甲状腺肿的治疗效果。结果:平消胶囊给药期间,大鼠甲状腺在外观形态方面有一定的减小,结合各组大鼠甲状腺湿重情况,结果表明平消胶囊可抑制甲状腺肿大。给药组大鼠FT4、TSH、T3明显下降,TGAb明显回升,表明平消胶囊可显著改善单纯性甲状腺肿大鼠的FT4、TSH、T3和TGAb指标。结论:平消胶囊可通过调控FT4、TSH、T3和TGAb进而改善大鼠甲状腺肿大。     

平消胶囊配合化疗治疗中晚期肺癌疗效观察

目的:探讨平消胶囊配合化疗治疗中晚期肺癌的效果。方法:选择106例肺癌患者,随机分为两组,进行临床疗效观察,治疗组54例,用平消胶囊配合化疗,患者在化疗前3天开始口服平消胶囊,每次6～8粒,每天3次,连服8周以上。对照组52例单用化疗。结果:治疗组有效率(CR PR)57.4%,对照组有效率36.5%,两组有效率有显著性差异(P<0.05)。治疗组症状改善率81.5%,对照组症状改善率53.9%,两组有显著性差异(P<0.05)。毒副反应治疗组较对照组明显少而轻。结论:平消胶囊配合化疗治疗中晚期肺癌,对治疗有明显的增效作用,并能减轻毒副作用,提高生存质量,具有临床应用的价值。     

Tamoxifen in disseminated breast cancer

86 postmenopausal women with disseminated breast cancer have been treated orally with 30 mg of Tamoxifen per day (ICI 46474, Nolvadex) for periods of 2 months or more. The overall responders were 28/86 (32.5%) with a median remission duration of 9 months. In 30 patients already shown to be resistant to cytotoxic chemotherapy. Tamoxifen was used as first hormonal agent; the remission rate in this group was 12/30 (40%), while it was 28.5% (16/56) in the others who had already received different hormonal treatments. In 6 early menopausal cases, the treatment had to be stopped for a dangerous "worsening syndrome". Other side effects were trivial. In 28/35 cases (80%), we have found the reappearance of a pattern of estrogenic activity in vaginal smears during treatment. Hence a "simil-estrogen", more than an "anti-estrogen" mechanism of action is postulated and a selection of patients for treatment in the "mid postmenopausal age" is recommended.     

Postoperative chemotherapy with a novel oral anticancer drug composed of tegafur, gimeracil and oteracil potassium to curability C scirrhus type gastric cancer

We report the a case of 60-year-old male whose final finding was curability C and stage IV scirrhus type gastric cancer because of N3, CY1 and DM (+) treated with a novel oral anticancer drug composed of tegafur (FT), Gimeracil (CDHP) and Oteracil Potassium (Oxo) in a molar ratio of 1:04:1 after operation. This drug was administered orally twice daily after meals at a dose of 80 mg/body/day. One cycle consisted of consecutive administration for 28 days and 14 days rest, and this treatment cycle was repeated twice. Postoperative abdominal CT showed swollen paraaortic lymph nodes regarded as metastasis. However, they were reduced after 1 cycle and remained so. The serum carcinoembryonic antigen (CEA) level had decreased after 1 cycle. The patient's performance status (PS) had also recovered without severe side effects. It was considered that this anticancer drug composed of FT, CDHP and Oxo was effective to scirrhus type gastric cancer and useful as an adjuvant chemotherapy in view of the patient's living quality.     

High-dose oral tamoxifen, a potential multidrug-resistance-reversal agent: phase I trial in combination with vinblastine.

BACKGROUND: P-glycoprotein mediates resistance to natural-product anti-neoplastic agents like vinblastine through an active transport process resulting in reduced intracellular concentration of these agents. The triphenylethylene antiestrogen tamoxifen and its major metabolite N-desmethyltamoxifen at concentrations of 4-6 microM enhance the intracellular concentration of natural-product antineoplastics and augment the cytotoxicity of such drugs three-fold to 10-fold in a variety of human and murine cell lines. PURPOSE: On the basis of these preclinical findings, we conducted a phase I clinical trial of high-dose, oral tamoxifen administered in conjunction with a 5-day continuous infusion of vinblastine. METHODS: We studied 53 patients with advanced epithelial tumors. Tamoxifen was given orally as a loading dose on day 1, followed by two doses a day on days 2-13. Vinblastine was given as a 120-hour continuous infusion (1.5 mg/m2 per day) on days 9-13 of each tamoxifen course. The starting dose of tamoxifen was 40 mg/m2 administered twice a day following a loading dose of 150 mg/m2. The maximum dose was 260 mg/m2 twice a day following a loading dose of 680 mg/m2. Treatment cycles were repeated every 28 days. RESULTS: The dose-limiting toxic effects of tamoxifen were neurologic and began within 3-5 days after the start of treatment. They consisted of tremor, hyperreflexia, dysmetria, unsteady gait, and dizziness. One patient experienced a grand mal seizure 24 hours after the last tamoxifen dose. Toxic effects were rapidly reversible. Asymptomatic prolongation of the QT interval on electrocardiogram occurred at doses of tamoxifen of 80 mg/m2 or higher given twice a day. No coagulation or ophthalmologic abnormalities occurred. Tamoxifen did not enhance the toxicity of vinblastine. Mean plasma concentrations of tamoxifen or N-desmethyltamoxifen at 260 mg/m2 tamoxifen given twice a day for 13 days were 6.04 and 6.56 microM, respectively. There was no relationship between plasma antiestrogen content and the development of neurotoxic effects. CONCLUSIONS: Tamoxifen at 150 mg/m2 given twice a day following a loading dose of 400 mg/m2 results in plasma levels of tamoxifen and N-desmethyltamoxifen of 4 and 6 microM, respectively, without dose-limiting toxicity. We recommend this dose for phase II trials of tamoxifen to modulate P-glycoprotein-mediated drug resistance. IMPLICATIONS: Our study demonstrates that high-dose tamoxifen can be safely administered and that plasma concentrations that may inhibit P-glycoprotein function can be achieved.     

Metastatic breast cancer: controlled trial of chemotherapy with and without hormones

Two hundred and twenty-three patients with disseminated breast cancer entered in a randomized trial: Group I: 130 patients were given a monthly 5 day- course of a cytotoxic chemotherapy protocol including Adriamycine, Vincristine, Cyclophosphamide, 5 Fluoro-uracile (A.V.L.F.); Group II: 93 patients were given alternatively the same program and a non cross resistant program including: VM 26, Mitomycine C, Methotrexate (V.M.M.). The patients of these groups were randomized into three subgroups: Subgroup O: chemotherapy alone; Subgroup N: chemotherapy + Tamoxifen (20 mg/m2/day); Subgroup NN: chemotherapy + Tamoxifen + Norethisterone (40 mg/m2/day). Objective response rates to cytotoxic chemotherapy were respectively of 65 per cent and 68 per cent in groups I and II of chemotherapy. Further more mean-duration of response and survival were not different. Objective response rates were comparable in the three subgroups of chemo-hormonotherapy. However, the survival was significantly better in the subgroup N (with Tamoxifen) when compared with the subgroup O (without hormonotherapy), and marginally better (p = 0,09) when compared with the NN subgroup (with Tamoxifen + Norethisterone).     

The combination of radiotherapy, adjuvant chemotherapy (cyclophosphamide-doxorubicin-ftorafur) and tamoxifen in stage II breast cancer. Long-term follow-up results of a randomised trial.

Two hundred patients with node positive stage II breast cancer were randomised to four groups after radical mastectomy and axillary evacuation: (1) Postoperative radiotherapy, (2) Adjuvant chemotherapy with eight courses of CAFt (cyclophosphamide 500 mg m-2 + doxorubicin 40 mg/m-2 + ftorafur 20 mg kg-1 orally day 1-14) every fourth week, (3) Postoperative radiotherapy and adjuvant chemotherapy and (4) postoperative radiation, adjuvant chemotherapy and tamoxifen 40 mg daily for 2 years. Thirty-two per cent of the patients discontinued treatment due to GI-toxicity, while 26% required dose reductions due to leukopenia. Radiation pneumonitis was more frequent after the combination of postoperative radiotherapy with chemotherapy. There was a better relapse-free survival in the groups receiving chemotherapy compared to radiotherapy alone (P = 0.05), which was highly significant in a multivariate Cox analysis (P = 0.004). No significant survival differences were seen. Tamoxifen had no clear overall effect but there were better relapse-free (P = 0.04) and overall (P = 0.004) survival with tamoxifen in estrogen receptor positive patients, while estrogen receptor negative patients had a somewhat poorer survival (P = 0.07) after tamoxifen. Local control was better (NS) after the combination (93%) radiotherapy and chemotherapy compared to either treatment alone (76% with radiotherapy and 74% with chemotherapy at 5 years).     

Chinese Medicine in Cancer Treatment – How is it Practised in the East and the West?

Chinese medicine therapies in cancer treatment are very common in the East. Although it is usually classified as a form of complementary and alternative therapy in the West, Chinese medicine is an independent medical profession in Hong Kong and mainland China. It has a different perspective in understanding health and diseases compared with Western medicine. In oncology practice, whereas Western medicine focuses on direct tumour eradication by surgery, radiation therapy and systemic therapies, Chinese medicine focuses on restoring body balance and enhancing the body's defences (immunity), in addition to some cytotoxic herbal therapies. Most often patients, especially those in the East, receive both treatments. Chinese medicine is also commonly used to reduce side-effects from chemotherapy or radiation therapy, to aid recovery after an operation, to palliate symptoms and to address survivorship issues. However, this raises concerns of drug–herb interactions and toxicity in combination therapies. Commonly used Chinese medicine treatment modalities include acupuncture, moxibustion, diet therapy, prescribed Chinese medicine herbal decoction, single Chinese medicine herbs or supplements and tai chi. Although there is an increasing trend of Chinese medicine use in cancer patients in both the East and the West, the scientific evidence of safety and efficacy is often questioned by oncologists. This article reviews the current evidence in different Chinese medicine therapies in cancer management in both the East and the West.     

中医药联合甲磺酸阿帕替尼治疗Ⅳ期恶性肿瘤的单臂单中心临床研究

背景与目的：目前,甲磺酸阿帕替尼在中国仅被批准用于晚期胃癌三线治疗,而近年来研究表明,抗血管生成药物在多种晚期实体瘤中疗效显著。以中西医结合为主的综合治疗模式在抗肿瘤治疗中存在优势。该研究旨在观察中医药联合甲磺酸阿帕替尼干预二线治疗失败后Ⅳ期恶性肿瘤患者的短期临床疗效及安全性。方法：选择2016年1月—2017年7月上海中医药大学附属龙华医院肿瘤科收治的21例二线治疗失败后的晚期恶性肿瘤患者为研究对象,治疗方案为甲磺酸阿帕替尼500 mg,口服,每天1次,28 d为1个疗程（可根据患者不良反应分级进行剂量调整）,同时联合中药静脉制剂+口服辨证中药汤剂治疗,评价短期临床疗效和安全性。结果：21例患者经中医辨证联合甲磺酸阿帕替尼靶向治疗1个疗程后,部分缓解（partial response,PR）6例,疾病稳定（stable disease,SD）15例,总有效率（overall response rate,ORR）为27.27%,疾病控制率（disease control rate,DCR）为95.45%;治疗后肿瘤标志物CEA、CA125、CYFRA211及神经元特异性烯醇化酶（neuron-specific enolase,NSE）明显下降,与治疗前相比差异有统计学意义（P＜0.05）,所有患者均未见4级不良反应。结论：对于二线治疗失败后的晚期恶性肿瘤患者,中医联合血管生成靶向药物甲磺酸阿帕替尼疗效明确,不良反应可耐受。本研究为进一步开展中医药联合甲磺酸阿帕替尼治疗的大样本、随机、对照研究提供了前期临床数据支持。     

放射联合活血化瘀中药治疗鼻咽癌疗效观察

（目的）观察活血化瘀中药配合放射疗法治疗鼻咽癌的疗效。（方法）自1995年6月至1997年12月将初治鼻咽癌患者135例先行血液流变学检测共11项,其中3项以上异常者随机分为两组：常规放疗组（对照组）46例,放疗加中药组（试验组）60例。两组放疗方法及剂量相同。试验组在放疗同时口服中药活化生津液6ml/日。疗前、疗后观察口腔粘膜反应,肿瘤消退情况,血液流变学变化及免疫功能改变,近期生存率。（结果）试验组治疗后血液流变学有5项指标明显改善（P＜0．05）。试验组远处转移率3．31,对照组15．21（P＜0.05）。试验组和对照组1年生存率分别98.3％及97．8%,2年生存率分别为95.4％及94．34％（P值均＞0．05）。[结论]活血化瘀中药配合放射治疗鼻咽癌可以改善其血液高粘状态,改善微循环,减少远处转移。能否提高长期生存率尚待临床长期观察。