NP、MVP与CAP方案治疗晚期非小细胞肺癌的对照研究

目的　比较 3组不同联合化疗方案对晚期非小细胞肺癌的疗效和毒性。方法　统计分析用NP(长春瑞宾、顺铂 )方案、MVP(丝裂霉素、长春地辛、顺铂 )方案及CAP(环磷酰胺、阿霉素、顺铂 )方案治疗的 89例晚期非小细胞肺癌的临床资料。　结果　有效率为 46 .4%( 13/2 8)。MVP组有效率为 40 %( 12 /30 ) ,CAP组有效率为 2 9%( 9/31) ,毒副反应主要为可耐受的骨髓抑制。结论　NP方案及MVP方案均为治疗晚期非小细胞肺癌较为安全有效的化疗方案。     

MNP方案治疗晚期非小细胞肺癌临床研究

目的：研究MNP方案（丝裂霉素、异长春花碱、顺铂）治疗晚期非小细胞肺癌的疗效。方法：91例晚期非小细胞肺癌患者接受MNP方案化疗，MMC 6mg/m^2静脉推注，d1,NVB 25 mg/m^2-30mg/m^2静脉推注d1,d8,DDP 40mg-50mg静脉点滴d1-3。结果：所有患者完全缓解（CR）3例，部分缓解（PR）41例，无变化（NC）43例，进展（PD）4例，总有效率48．4％，中位缓解期8．5月，中位生存期10．8月，1a生存期43．3％，其副反应主要为骨髓抑制、胃肠道反应。结论：用MNP方案治疗晚期非小细胞肺癌效率较高，值得临床推广。     

不同方案治疗晚期非小细胞肺癌疗效比较

1997年 5月～ 2 0 0 1年 11月我们应用由丝裂霉素 (MMC)、去甲长春新碱 (NVB)和顺铂 (cDDP)组成的MNP方案治疗晚期NSCLC ,与同期MVP方案治疗的患者比较 ,观察两方案的疗效、耐受性和生存期[1] 。1　材料与方法1 1　一般资料 :确诊为晚期非小细胞肺癌的Ⅲ、Ⅳ期患者79例 ,其中男     

NP方案和TP方案治疗晚期非小细胞肺癌的临床研究

虽然现在肺癌的治疗效果有所改善,但晚期NSCLC经支持治疗后中位生存时间只有4～5个月。近年来随着紫杉醇、吉西他滨、长春瑞滨等药物在临床的推广应用,NSCLC的疗效得到了较好的提高。本科2003年6月-2010年6月应用NP方案和TP方案治疗晚期NSCLC 62例,现对其近期疗效和不良反应报告如下。     

NP方案和TP方案治疗晚期非小细胞肺癌的临床研究

虽然现在肺癌的治疗效果有所改善,但晚期NSCLC经支持治疗后中位生存时间只有4～5个月[1].近年来随着紫杉醇、吉西他滨、长春瑞滨等药物在临床的推广应用,NSCLC的疗效得到了较好的提高.本科2003年6月～2010年6月应用NP方案和TP方案治疗晚期NSCLC 62例,现对其近期疗效和不良反应报告如下.     

MVP方案治疗晚期非小细胞肺癌的疗效评价

于 1997年 5月～ 2 0 0 1年 6月 ,我们对已确诊的Ⅲ～Ⅳ期非小细胞肺癌 48例病人 ,采用ＭＶＰ方案化疗 ,观察近期疗效报道如下。1　资料与方法1 1　临床资料　 48例经病理学和细胞学确诊的晚期非小细胞肺癌患者 ,男 2 9例 ,女 19例 ,年龄 3 8～ 72岁 ,中位年龄 5 6岁。其中腺癌 2 5例 ,鳞癌 2 0例 ,未分型癌 3例。初治者 3 3例 ,复治者 15例。有肺内转移者 18例 ,合并胸水者 6例 ,淋巴结转移者 2 2例 ,肝转移者 3例 ,骨转移者 3例。所有病人化疗前均常规检查血常规、尿常规、肝肾功能、心电图、腹部Ｂ超、胸片或胸部ＣＴ。1 2　用药方法　静…     

经纤维支气管镜行非小细胞肺癌局部化疗临床研究

目的　观察经纤维支气管镜 (纤支镜 )行瘤体内局部注射抗癌化疗药物结合全身化疗 ,与单纯全身化疗治疗中晚期非小细胞肺癌的疗效。方法　选择 6 6例中晚期非小细胞肺癌 ,随机分为观察组 34例 ;经纤支镜直视下对支气管腔内瘤体局部注射化疗药物 ,同期全身化疗 ;对照组 32例 ;单用全身化疗 (方案同观察组 )。一疗程结束后评价两组疗效 ,化疗期间记录毒副反应。结果　以X线标准评价 :观察组有效率 (CR +PR)为 36 .36 % ,对照组有效率 (CR +PR)为 31.2 5 %。两组间疗效未见差异性 (P >0 .0 5 ) ;以纤支镜标准评价 :观察组有效率 (CR +PR)为 71.88% ,对照组有效率 (CR +PR)为 4 3.33%。组间疗效比较有统计学意义(P <0 .0 5 )。观察组支气管腔内瘤体缩小较对照组明显。结论　经纤支镜行肿瘤局部注射抗癌药物加全身化疗在解除支气管阻塞方面效果明显 ,毒副反应未见明显增加 ,是治疗晚期肺癌有效的姑息方法之一。     

Chemotherapy for advanced non-small-cell lung cancer

The management of patients with advanced non-small-cell lung cancer has changed considerably in the last decade. Chemotherapy prolongs survival and improves quality of life in patients with a good performance status and appears to improve disease-related symptoms in patients with a lower performance status. Platinum-based doublets remain the standard regimen, but nonplatinum combinations are reasonable alternatives. Newer agents with novel mechanisms of action have opened new areas of clinical research and are likely to further improve the outcome of patients with advanced non-small-cell lung cancer.     

Gefitinib therapy for advanced non-small-cell lung cancer

OBJECTIVE: To review the pharmacology, pharmacokinetics, clinical efficacy, and toxicity of gefitinib in non-small-cell lung cancer (NSCLC). DATA SOURCES: Primary literature search through MEDLINE and CANCERLIT, and abstract presentations (1966-May 2003). STUDY SELECTION AND DATA EXTRACTION: All published trials and abstracts citing gefitinib were evaluated, and all information deemed relevant was included in this article. DATA SYNTHESIS: NSCLC is known to overexpress epidermal growth factor receptor (EGFR). Gefitinib is a selective EGFR tyrosine kinase inhibitor. Based on the Phase I/II trial results, the optimal dose is 250 mg/d orally. It is well tolerated, with minimal and reversible toxicity. Skin rash and diarrhea are the most common adverse effects. Recent trials have shown that gefitinib provided a 10% tumor response rate and improved disease-related symptoms in patients with refractory, advanced NSCLC. CONCLUSIONS: Gefitinib, with a unique mechanism of action and favorable toxicity profile, has demonstrated clinical activity in NSCLC patients with chemotherapy-refractory disease. It provides a valuable addition to the treatment options as monotherapy in patients with advanced NSCLC after failure of both platinum-based and docetaxel chemotherapies. Further research is required to evaluate the use of gefitinib in different clinical settings.     

SOX 方案与 FOLFOXs 方案治疗晚期胃癌疗效的荟萃分析

目的：替吉奥作为氟尿嘧啶的口服前体药物联合奥沙利铂已广泛应用于临床治疗晚期胃癌,本研究拟评价替吉奥+奥沙利铂(SOX)方案与5-氟尿嘧啶+亚叶酸钙+奥沙利铂(FOLFOXs)方案治疗晚期胃癌的疗效比较,并对其安全性做出评价。方法计算机检索 Cochrane-Library、Pubmed、EMBASE、Web of science、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊全文数据库,同时辅以其他检索,检索时间从各数据库建库至2014年10月,收集所有比较 SOX 与 FOLFOXs 方案治疗晚期胃癌的随机对照试验(RCTs)。按照 Jadad 质量评分量表对纳入研究进行方法学质量评价,对符合要求的文献应用 RevMan 5.0软件进行 Meta 分析。结果共纳入14篇符合标准的 RCT,患者共867例,其中 SOX 方案化疗患者433例,FOLFOXs 方案化疗患者434例,其有效率分别为45.26%和34.10%,两组间差异有统计学意义(OR =1.60,95% CI =1.22~2.11,P =0.0008),疾病控制率(DCR)分别为82.21%和71.88%,差异有统计学意义(OR =1.84,95% CI =1.32~2.56,P =0.0003);在化疗不良反应方面,SOX方案较 FOLFOXs 方案在白细胞下降、恶心和呕吐、贫血、腹泻、肝功能损伤、口腔炎的发生率明显减低(P <0.05),而血小板下降和周围神经综合征的发生率差异无统计学意义(P =0.16,P =0.59)。结论在晚期胃癌的临床治疗中,SOX 方案在总有效率和疾病控制率方面优于 FOLFOXs 方案,而且其不良反应明显低于 FOLFOXs 方案,可作为化疗的优先选择方案。     

Genomic signatures individualize therapeutic decisions in non-small-cell lung cancer

Gene expression signatures have been developed in an effort to dissect the biologic phenotypes of malignancies. These signatures have tremendous power to identify new cancer subtypes and to predict clinical outcomes based on patterns of gene expression. Expression profiles specific to a phenotype can be derived from in vitro data, as well as from patient cohorts with clinically relevant outcomes. In addition to predicting outcomes in non-small-cell lung cancer (NSCLC), similar techniques have been used to develop gene expression signatures that predict sensitivity or resistance to specific chemotherapeutic agents. Additionally, expression data have been used to identify oncogenic pathway deregulation to help direct the use of targeted agents. Used in combination, it is likely that gene expression signatures will help assess prognosis and may also be of value in guiding the use of cytotoxic and targeted therapy in NSCLC. Clinical trials are ongoing to validate these predictive gene expression signatures in a prospective manner.     

Duration of therapy in advanced, metastatic non-small-cell lung cancer

Advanced, metastatic non-small-cell lung cancer (NSCLC) remains a challenge to oncologists. There is little doubt that platinum-based combination chemotherapy improves survival and has a palliative effect by improved patients' symptoms and quality of life. Yet chemotherapy is not curative, is associated with toxicity, and can be costly. In most recent phase III trials, the median survival time is 8 to 10 months. Therefore, the optimal duration of therapy-one that balances survival and palliative effects against toxicity, cost, and intrusiveness on patients' lives-remains an important issue. Three recent randomized trials that addressed this in stage IIIB/IV NSCLC are reviewed. Two evaluated brief durations of first-line therapy (3 cycles in one, 4 in the other) versus longer-duration therapy (6 cycles and continuous therapy, respectively). No benefit in response rate, symptom relief, quality of life, or survival was noted for the longer-duration therapy. In addition, cumulative toxicities occurred more frequently in patients who received longer treatment durations. The third trial administered 4 cycles of first-line platinum-based therapy and then randomized responding patients to observation or 6 months of further therapy with vinorelbine. No survival benefit was noted for vinorelbine. There trials suggest that duration of first-line therapy in advanced, metastatic NSCLC should be brief (3 to 4 cycles). Prolonged therapy does not appear to improve survival and carries the risk of cumulative toxicity. Second-line therapy considered in those patients fit enough to receive it at the time of disease progression.     

中药血管抑制剂人参皂甙Rg3联合GP方案治疗非小细胞肺癌的临床观察

目的观察人参皂苷Rg3联合化疗治疗非小细胞肺癌的疗效。方法将符合入组条件的70例非小细胞肺癌患者随机分成两组,对照组仅采用常规化疗,试验组在化疗基础上加用人参皂苷Rg3,疗程为3个月。治疗后观察瘤体体积及生活质量评分。结果对照组和试验组患者瘤体大小变化有效率分别为59%和80%,治疗后生活质量评分显效率分别为51%和78%,两组比较差异有统计学意义(P<0.05)。结论人参皂苷Rg3联合化疗治疗非小细胞肺癌疗效确切,不良反应较少。     

培美曲塞与多西他赛联合铂类治疗晚期非小细胞肺癌临床观察

目的 比较培美曲塞与多西他赛联合铂类一线治疗晚期非小细胞肺癌(NSCLC)的效果及毒副反应.方法 102例晚期NSCLC患者随机分为培美曲塞+顺铂(PC)组52例和多西他赛+顺铂(TP)组50例.PC组:培美曲塞500 mg/m2静脉滴注,第1天;顺铂75 mg/m2静脉滴注,第1～3天.TP组:多西他赛75 mg/m2静脉滴注,第1天;顺铂75 mg/m2静脉滴注,第1～3天.两组均21 d为1周期.比较两组疾病控制率、无进展生存期、中位生存期和1年生存率.结果 102例患者均可评价疗效及毒副反应,无完全缓解病例,部分缓解43例,稳定38例,进展21例.PC组与TP组的疾病控制率[80.8％(42/52)与78.0％ (39/50)]、无进展生存期(5.69个月与4.71个月,P=0.334)、中位生存期(10.49个月与10.48个月,P=0.851)和1年生存率(32.0％与24.0％,x2=1.59,P=0.210)差异均无统计学意义.两组的不良反应主要为骨髓抑制和消化道反应,培美曲塞可致白细胞数下降(P =0.010)、脱发(P=0.004)、发热(P =0.024)、皮疹(P =0.048),两组比较差异均有统计学意义;而两组在贫血(P =0.873)、血小板减少(P=0.541)、恶心/呕吐(P=0.114)、肝毒性(P=0.403)、肾毒性(P=0.541),两组差异无统计学意义.结论 培美曲塞与多西他赛联合顺铂治疗晚期肺腺癌的临床疗效相当,但可降低毒副反应发生率.     

Trastuzumab for the treatment of non-small-cell lung cancer

OBJECTIVE: To evaluate trastuzumab for the treatment of advanced non-small-cell lung cancer (NSCLC).DATA SOURCES: Clinical literature was accessed through MEDLINE (1966-January 2003), EMBASE (1974-January 2003), International Pharmaceutical Abstracts (1970-January 2003), Proceedings of the American Society of Clinical Oncology (1995-January 2003), and Genentech. Key search terms included trastuzumab, lung cancer, Herceptin, and NSCLC.DATA SYNTHESIS: Research has revealed that NSCLC specimens may express the protein HER-2/neu. The monoclonal antibody against HER-2/neu, trastuzumab, could prove valuable for patients. An evaluation of the studies exploring trastuzumab for management of NSCLC was conducted. Phase II clinical trials reveal variable response rates from no improvement to a partial response rate of 42%. Due to a lack of clinical trials and deficiencies in the literature, the ultimate benefit of this agent remains to be proven.CONCLUSIONS: Clinical data from ongoing trials indicate potential synergy when trastuzumab is added to standard chemotherapy. The ultimate benefit in NSCLC remains to be proven.     

A phase II study of docetaxel and infusional cisplatin in advanced non-small-cell lung cancer

BACKGROUND: To evaluate the efficacy and safety of combination chemotherapy of cisplatin (5-day continuous infusion) and docetaxel for the treatment of previously untreated patients with advanced non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS: Eligible patients had an ECOG performance status of 0-2 with measurable NSCLC. Patients received continuous infusion cisplatin 20 mg/m2/day on 5 days and bolus docetaxel 60 mg/m2/day (day 1; PiD therapy) at a 4-week interval. RESULTS: Forty-three patients were enrolled. The mean number of cycles administered per patient was 2, and ranged from 1 to 4. The response rate was 49% (95% confidence interval, 33.9-63.8%). The median survival time was 47 weeks and the 1-year survival rate was 47%. The major toxic effects were grade 3 or 4, neutropenia (88%), leukopenia (81%), thrombocytopenia (14%) and anemia (42%). There were no treatment-related deaths. CONCLUSION: PiD therapy was a well-tolerated and active regimen for patients with advanced NSCLC. The major toxicity was neutropenia.