小剂量CHG预激方案治疗老年人急性髓系白血病的临床研究

Objective To explore the efficacy and side effect of inductive chemotherapy with lowdose,cytarabine,homoharringtonine and granulocyte colony-stimulating factor(CHG) in elderly acute myeloid leukemia(AML). Methods Thirty-five elderly patients (age＞60 years) with AML were enrolled for the initial treatment with CHG regimen,The CHG regimen consisted of cytarabine 10 mg/m2 per 12 h by subcutaneous injection,days 1-14,homoharringtonine 1 mg/m2 per day by intravenous continuous infusion,days 1-14,and G-CSF 200 μg/m2 per day by subcutaneous injection 12 h before chemotherapy,days 0-14. G-CSF only was used when white blood cell count(WBC) was less than 20×109/L during the whole course. Results After the first course,12 patients achieved complete response (CR),15 patients achieved partial response(PR),and 8 patients had no response(NR). After the second course,5 of 15 PR patients achieved CR,2 of 8 NR patients achieved PR. The total effective rate was 82 % (29/35). Of those 17 CR patients,eleven patients continued maintenance therapy and remained in remission for 12-34 months with a median CR duration of 18 months,the other 6 patients relapsed and were treated with original regimen,including one achieved CR again,4 achieved PR,and 1 achieved NR. The CHG regimen had mild hematologic toxicities and no severe nonhematologic toxicities. Conclusion CHG regimen is effective and well tolerated in remission for elderly AML.     

小剂量CHG预激方案治疗老年人急性髓系白血病的临床研究

Objective To explore the efficacy and side effect of inductive chemotherapy with lowdose,cytarabine,homoharringtonine and granulocyte colony-stimulating factor(CHG) in elderly acute myeloid leukemia(AML). Methods Thirty-five elderly patients (age＞60 years) with AML were enrolled for the initial treatment with CHG regimen,The CHG regimen consisted of cytarabine 10 mg/m2 per 12 h by subcutaneous injection,days 1-14,homoharringtonine 1 mg/m2 per day by intravenous continuous infusion,days 1-14,and G-CSF 200 μg/m2 per day by subcutaneous injection 12 h before chemotherapy,days 0-14. G-CSF only was used when white blood cell count(WBC) was less than 20×109/L during the whole course. Results After the first course,12 patients achieved complete response (CR),15 patients achieved partial response(PR),and 8 patients had no response(NR). After the second course,5 of 15 PR patients achieved CR,2 of 8 NR patients achieved PR. The total effective rate was 82 % (29/35). Of those 17 CR patients,eleven patients continued maintenance therapy and remained in remission for 12-34 months with a median CR duration of 18 months,the other 6 patients relapsed and were treated with original regimen,including one achieved CR again,4 achieved PR,and 1 achieved NR. The CHG regimen had mild hematologic toxicities and no severe nonhematologic toxicities. Conclusion CHG regimen is effective and well tolerated in remission for elderly AML.     

EPOCH方案治疗老年人外周T细胞淋巴瘤的临床研究

Objective To evaluate the clinical efficacy and toxicity of EPOCH regimen in the treatment of elderly patients with peripheral T-cell lymphoma. Methods Twenty-eight elderly patients with pathologically diagnosed peripheral T-cell lymphoma were treated with EPOCH regimen, including 96-hour continuous infusion of etoposide 50 mg/m2, epirubincin 12 mg/m2 and vincristin 0.4 mg/m2 on daysl through 4,cyclophosphamide 750 mg/m2 given as intravenous bolus on day 5 and prednisone 60 mg/m2 administered orally on daysl through 5. The EPOCH regimen was repeated very 21 days. Clinical efficacy and safety profiles of EPOCH regimen was systemically reviewed and analysed. Results All the 28 patients received a total of 85 cycles of EPOCH regimen. The median cycles was two courses. Fifteen patients achieved complete response, while five cases obtaining partial response. The overall response rate was 71.4 %. The median survival time was 20 months. In newly diagnosed patients, complete response rate (CR) as well as partial response (PR) and overall response rate (OR) reached 64.7 %, 23.5 % and 88.2 %, respectively, which was significantly higher than that in refractory cases, whose CR, PR and OR were 36.4 %, 9.1% and 45.5 %(λ 2 = 5.99, P ＜0.05). In addition, the median survivalduration of newly diagnosed patients was longer than that of refractory cases, whose median survival time was 24 and 13 months, respectively. The major adverse events was myelosuppression with grade 3-4 neutropenia and thrombocytopenia in 53.6 % and 50.0 % cases.Non-hematologic toxicities were moderate and uncommon. The frequency of adverse effects in de novo patients showed little difference in comparison with that in refractory ones (P＞0.05). Conclusion EPOCH regimen was an effective and well tolerated therapeutic schedule for elderly patients with peripheral T-cell lymphoma.     

EPOCH方案治疗老年人外周T细胞淋巴瘤的临床研究

Objective To evaluate the clinical efficacy and toxicity of EPOCH regimen in the treatment of elderly patients with peripheral T-cell lymphoma. Methods Twenty-eight elderly patients with pathologically diagnosed peripheral T-cell lymphoma were treated with EPOCH regimen, including 96-hour continuous infusion of etoposide 50 mg/m2, epirubincin 12 mg/m2 and vincristin 0.4 mg/m2 on daysl through 4,cyclophosphamide 750 mg/m2 given as intravenous bolus on day 5 and prednisone 60 mg/m2 administered orally on daysl through 5. The EPOCH regimen was repeated very 21 days. Clinical efficacy and safety profiles of EPOCH regimen was systemically reviewed and analysed. Results All the 28 patients received a total of 85 cycles of EPOCH regimen. The median cycles was two courses. Fifteen patients achieved complete response, while five cases obtaining partial response. The overall response rate was 71.4 %. The median survival time was 20 months. In newly diagnosed patients, complete response rate (CR) as well as partial response (PR) and overall response rate (OR) reached 64.7 %, 23.5 % and 88.2 %, respectively, which was significantly higher than that in refractory cases, whose CR, PR and OR were 36.4 %, 9.1% and 45.5 %(λ 2 = 5.99, P ＜0.05). In addition, the median survivalduration of newly diagnosed patients was longer than that of refractory cases, whose median survival time was 24 and 13 months, respectively. The major adverse events was myelosuppression with grade 3-4 neutropenia and thrombocytopenia in 53.6 % and 50.0 % cases.Non-hematologic toxicities were moderate and uncommon. The frequency of adverse effects in de novo patients showed little difference in comparison with that in refractory ones (P＞0.05). Conclusion EPOCH regimen was an effective and well tolerated therapeutic schedule for elderly patients with peripheral T-cell lymphoma.     

COMBINATION CHEMOTHERAPY WITH COBDP IN MALIGNANT LYMPHOMA: AN ANALYSIS OF 64 CASES

From February 1986 to February 1989, 64 patients with malignant lymphoma were treated with COBDP regimen. Of these patients, there were 7 cases with Hodgkin's disease and 57 cases with non Hodgkin's lymphoma. Clinical staging showed 7 stage Ⅰ , 5 stage Ⅱ, 22 stage Ⅲ and 30 stage Ⅳ . The COBDP regimen was carried out as : Cyclophosphamide 600 mg iv on days 1,8; vincristine 2 mg iv on days 1,8; Pingyanymycin long im on days 1, 4, 8, 11; cis-dichlorodiamineplatinum 20 mg iv drip on day 1 - 5 and prednisone 10 mg po tid on day 1 -14. Treatment results showed 39% (25 cases) achieving complete remission (CR) , 52% (33 cases) partial remission (PR) , giving an over-all response rate of 91 % (CR PR). There was a significant difference in the CR of the untreated patients (56%) and that of the treated ones (28%) (P< 0.05) .However, between two groups of patients, no statistical significance was observed in the median CR duration (> 12 months, vs >9 months) and the median surrivals of the CR patients (> 16. 5     

周剂量紫杉醇联合替吉奥治疗晚期胃癌(英文)

Objective:There remains no standard first-line chemotherapeutic regimen for advanced gastric cancer (AGC).The aim of this study was to evaluate the efficacy and safety of combination regimen with weekly paclitaxel and S-1 as a first-line chemotherapy for AGC. Methods:Forty-six patients with AGC were included in this study. Paclitaxel was administered weekly at a dose of 60 mg/m2 on days 1, 8 and 15, S-1 was administered orally twice daily at 80 mg/m2/day for 2 weeks. The regimen was repeated every four weeks. Results:The results showed that the overall response rate was 45.7%, with 3 patients achieved complete response and 18 patients had a partial response, the disease control rate was 76.1%. The median progress free survival was 7.2 months 95% confidence interval (CI):6.3-8.1 months and the median overall survival was 11.6 months (95% CI:10.6-12.6 months) after treatment with paclitaxel and S-1. Neutropenia occurred in 25 patients (54.3%) and grade 3/4 neutropenia was observed in 8 patients (17.4%), gastrointestinal reactions were the most common non-hematologic toxicities, while severe gastrointestinal toxicities were uncommon. Conclusion:The regimen of weekly paclitaxel and S-1 demonstrated activity and acceptable toxicity for AGC as a first-line chemotherapy.     

Combination chemotherapy with paclitaxel, cisplatin and fluorouracil for patients with advanced and metastatic gastric or esophagogastric junction adenocarcinoma: a multicenter prospective study

Objective:To evaluate the efficacy and toxicity of the combination regimen of paclitaxel,cisplatin and 5-FU(PCF) as first-line or second-line therapy in patients with advanced gastric and esophagogastric junction(EGJ) adenocarcinoma in China.Methods:The patients were treated with paclitaxel 150mg/m2 on d1;fractionated cisplatin 15mg/m 2 and continuous infusion 5-FU 600mg/(m2·d) intravenously on d1-d5 of a 21-d cycle until disease progression or unacceptable toxicities.Results:Seventy-five patients have been enrolled,among which,41 received PCF regimen as the first-line therapy(group A) and 34 received the regimen as the second-line therapy(group B) with the median age of 59 years old and Karnofsky performance status(KPS) score ≥80.Toxicities were analyzed in all 75 patients.Seventy-one patients were evaluable for efficacy.The median overall survival(mOS) was 12.0 months(95% CI:7.9-16.2 months) in group A and 7.3 months(95% CI:4.3-10.3 months) in group B,respectively.The median progression-free survival(mPFS) was 5.7 months(95% CI:4.1-7.2 months) and 5.0 months(95% CI:3.1-6.9 months),respectively.The response rate(CR+PR) was 40%(16/40;95% CI:24.9-56.7%) in group A and 22.6%(7/31;95% CI:9.6-41.1%) in group B.Major grade 3 or 4 adverse events include neutropenia(41.3%),febrile neutropenia(9.3%),nausea/anorexia(10.7%),and vomiting(5.3%).There was no treatment-related death.Conclusions:The combination chemotherapy with PCF is active and tolerable as first-line and secondline therapy in Chinese patients with advanced gastric and EGJ adenocarcinoma.The response and survival of PCF are same as those of DCF,but the tolerance is much better.     

紫杉醇联合顺铂治疗复发性宫颈癌的临床观察

Objective： To observe the efficacy and toxicities of paclitaxel plus cisplatin in the treatment of recurrent cervical cancer. Methods： Twenty-three patients with a diagnosis of recurrent cervical cancer were eligible. Three-weekly chemotherapy regimen consisted of paclitaxel 135-150 mg/m^2 infusion for 3 h on day 1, cisplatin 25 mg/m^2 infusion on day 1 to 3. All patients received at least two cycles treatment. Results： The response rates was 47.8%, including CR 2 cases （8.7%）, PR 9 cases （39.1%）. The major toxicity included neutropenia, nausea vomiting, arthralgia, myalgia and alopecia. Conclusion： Paclitaxel combined with cisplatin is an effective therapy with acceptable adverse reactions for recurrent cervical cancer.     

含美罗华联合方案治疗复发耐药B细胞性非霍奇金淋巴瘤

Objective： The prognosis of relapsed or refractory B-cell lymphoma is poor, with a short-term survival after conventional second-line chemotherapy, Rituximab, a chimeric anti-CD20 antigen, in combination with CHOP or CHOP-like chemotherapy may improve both disease free survival （DFS） and overall survival （OS） of naive patients, but its role in the second-line therapy for relapsed non-Hodgkin＇s Lymphoma （NHL） remains to be defined, This study aimed to evaluate the efficacy of rituximab-containing salvage regimens for relapsed or refractory NHL, and observe the toxicities. Methods： The clinical data of 54 patients, who were with relapsed or refractory NHL and treated in the Cancer Center of Sun Yat-sen University, were analyzed retrospectively, Of the 54 patients, 29 were man, 25 were women, with a median age of 52.5 years old （range 18 to 75）; 50 patients （92.6%） scored 0-1 for the ECOG performance status; for second-line international prognostic index （slPI）, 21 （38.9%） scored 0-1,30 （55.6%） scored 2 to 3, and 3 （5.6%） scored 4-5; 40 cases were diffuse large B-cell lymphoma （DLBCL）, accounting for 74.1% of all subtypes, Rituximab was administered intravenously at a dose of 375 mg/m^2 at the day before each chemotherapy cycle, The second or third-line salvage regimens included EPOCH, CHOP, DHAP, DICE, IVAC, IMVP-16 and FND, Results： Of the 54 patients, 49 received retuximab-containing salvage regimens, The objective response rate of the 45 evaluable cases was 68,8%, with a complete remission （CR） rate of 37.7%; 3 patients achieved CR after radiotherapy following rituximab-based regimens and 3 achieved CR after autologous hematopoietic stem cell transplantation, The most frequent adverse events were leucopenia, nausea and alopecia. The addition of rituximab to chemotherapy only elevated the occurrence of mild infusion-related reactions, such as chills, fever and pruritus. The median follow-up time was 18 months （range 2-86 months）; 5 patients were lost, 24 were dead （23 died of lymphoma, and 1 died of severe hepatitis）, the other patients remained alive. The median survival time was 32 months （range 2-86 months, 95% confidential interval 16-48 months）. The 1-, 2- and 3-year OS rates were 70.6%, 53,6% and 41,5%, respectively, The median TTP was 6 months （range 0-52 months）, The median PFS was 10 months （range 0-47 months, 95% CI 0-26 months）, The 1- and 2-year PFS were 49,3% and 41,3%. Conclusion： Rituximab-containing salvage regimens are effective and well tolerated therapy for patients with relapsed or refractory B-cell NHL, even those were extensively treated.     

Safety of in vitro amplified HLA-haploidentical donor immune cell infusions for childhood malignancies

In vitro amplified human leukocyte antigen （HLA）-haploidentical donor immune cell infusion （HDICI） is not commonly used in children. Therefore, our study sought to evaluate its safety for treating childhood malignancies. Between September 2011 and September 2012, 12 patients with childhood malignancies underwent HDICI in Sun Yat-sen University Cancer Center. The median patient age was 5.1 years （range, 1.7-8.4 years）. Of the 12 patients, 9 had high-risk neuroblastoma （NB） [7 showed complete response （CR）, 1 showed partial response （PR）, and 1 had progressive disease （PD） after multi-modal therapies], and 3 had Epstein-Barr virus （EBV）-positive lymphoproliferative disease （EBV-LPD）. The 12 patients underwent a total of 92 HDICIs at a mean dose of 1.6 x 108 immune cells/kg body weight： 71 infusions with natural killer （NK） cells, 8 with cytokine-induced killer （CIK） cells, and 13 with cascade primed immune cells （CAPRIs）; 83 infusions with immune cells from the mothers, whereas 9 with cells from the fathers. Twenty cases （21.7%） of fever, including 6 cases （6.5%） accompanied with chills and 1 （1.1%） with febrile convulsion, occurred during infusions and were alleviated after symptomatic treatments. Five cases （5.4%） of mild emotion changes were reported. No other adverse events occurred during and after the completion of HDIDIs. Neither acute nor chronic graft versus host disease （GVHD） was observed following HDICIs. After a median of 5.0 months （range, 1.0-11.5 months） of follow-up, the 2 NB patients with PR and PD developed PD during HDICIs. Of the other 7 NB patients in CR, 2 relapsed in the sixth month of HDICIs, and 5 maintained CR with disease-free survival （DFS） ranging from 4.5 to 11.5 months （median, 7.2 months）. One EBV-LPD patient achieved PR, whereas 2 had stable disease （SD）. Our results show that HDICI is a safe immunotherapy for childhood malignancies, thus warranting further studies.     

紫杉醇脂质体联合5-FU/DDP治疗晚期食管癌49例临床观察

目的观察紫杉醇脂质体联合5-FU/DDP治疗晚期食管癌的疗效及不良反应。方法 49例患者使用紫杉醇脂质体135 mg/m2,5-FU 500 mg/m2静脉滴注,第1-5天;顺铂25 mg/m2静脉滴注,第1-3天。21天为1周期,连用2周期后按照实体瘤疗效评价标准(RECIST 1.0)评价疗效。结果 49例患者共完成212周期化疗,平均完成4.3周期,CR 4例(8.2%),PR 19例(38.8%),SD 12例(24.4%),PD 14例(28.6%),总有效率(CR+PR)47.0%,临床受益率(CR+PR+SD)74.4%。中位疾病进展时间6月(95%CI:5.09～6.91)。49例患者1年生存率为79.6%(39/49),2年生存率为46.9%(23/49)。不良反应主要为血液学毒性及消化道反应。结论紫杉醇脂质体联合5-FU/DDP治疗晚期食管癌具有较好的有效性及安全性。     

紫杉醇联合氟脲嘧啶和亚叶酸钙方案治疗晚期胃癌的临床观察

 目的观察含紫杉醇联合氟脲嘧啶/亚叶酸钙方案治疗晚期胃癌的近期疗效及毒副反应。方法晚期胃癌43例患者均给予紫杉醇(PTX)135mg/m2,静滴3h,第一天给药;亚叶酸钙(CF)200mg/m2静脉滴注2h,给予氟脲嘧啶(5-Fu)500mg/m2静脉推注,后续5-Fu3000mg/m2,持续静脉输注泵泵注48h,21天为1周期,至少应用3周期后按WHO标准评价疗效和毒副反应。结果全组43例可评价疗效41例,完全缓解(CR)4例,部分缓解(PR)21例,稳定(SD)12例,进展(PD)4例,近期客观有效率60.98%,中位TTP为8.3个月。可评价毒性患者41例,主要毒副反应为骨髓抑制、胃肠道反应和脱发。结论PTX联合5-Fu/CF治疗晚期胃癌有较好的疗效,毒性反应轻可耐受,值得在临床上推广。     

放化疗联合与单独化疗对晚期食管癌生存期影响的比较

目的探讨放化疗联合与单独化疗对晚期食管癌生存期和疾病进展时间的影响,观察紫杉醇联合顺铂治疗晚期食管癌的近期疗效和不良反应。方法47例晚期和术后转移复发的食管鳞癌患者,应用紫杉醇175 mg/m2静脉点滴,d1;DDP 75 mg/m2静脉点滴,d1;21 d为1个周期。每2个周期评价疗效,将获得CR、PR和SD的患者非随机的分成可测量病灶的放射治疗组(A组)和继续化疗或观察组(B组)。结果入组的47例患者均可评价疗效,其中CR 1例,PR 19例,SD 24例, PD 3例,总有效率(CR PR)为42.6%(95%CI为0.28～0.58)。A组21例行放疗,中位疾病进展时间(TTP)为10个月,中位生存期为13个月;B组23例行化疗或未再治疗,其中位TTP为5个月,中位生存期11个月,两组差异均有统计学意义(P<0.015,P<0.024)。化疗最常见的不良反应为脱发和骨髓抑制,无Ⅲ度以上不良反应和化疗相关死亡。放疗的不良反应主要为轻度骨髓抑制和乏力,但无中途停止和放疗相关死亡。结论紫杉醇联合DDP化疗后再放疗较单独化疗可延长晚期食管癌患者的生存时间,耐受性好,值得临床深入探讨。     

不同化疗方案同期联合放疗治疗中晚期宫颈癌的临床观察

目的 探讨紫杉醇脂质体（力扑素）对比顺铂同期联合放疗治疗中晚期宫颈癌的疗效及不良反应。方法 选取45例ⅠB2期以上的局部中晚期宫颈癌患者分为力扑素组（n=26）和顺铂组（n=19）,分别给予力扑素55mg／m2或顺铂30mg/m2每周静滴1次,共5次,两组均同时给予盆腔三维适形放疗（全盆腔总剂量45Gy／25次）或后装治疗（A点剂量30～36Gy／5～6次）,比较两组的疗效及不良反应。结果 45例患者均顺利完成同期放化疗。力扑素组获CR 13例,PR 10例,SD 3例,无PD,有效率（RR）为88.5％;顺铂组获CR 12例,PR 3例,SD 3例,PD 1例,RR为84.2％,两组RR差异无统计学意义（P＞0.05）。力扑素组和顺铂组的1年生存率分别为96.2％和89.5％,1年无进展生存率分别为92.3％和73.7％,两组比较差异无统计学意义（P＞0.05）。不良反应均以1～2级为主,力扑素组的血液学毒性及消化道不良反应均低于顺铂组。结论 对局部中晚期宫颈癌患者采用力扑素或顺铂周化疗方案同期放疗的疗效相当,但力扑素周方案化疗同期联合放疗的不良反应较轻,值得临床推广应用。     

吉西他滨联合氟尿嘧啶、亚叶酸钙治疗老年晚期食管癌的临床观察

目的：探讨吉西他滨（GEM）联合氟尿嘧啶（5-FU）、亚叶酸钙（LV）组成的GLF方案治疗老年晚期食管癌的客观疗效和安全性。方法：32例老年晚期食管癌患者,采用GLF方案化疗,GEM800mg/m^2,第1、8天,静脉滴注30分钟,CF200mg,第1～5天,5-FU350mg/m^2,第1～5天,21天为1周期。2周期后评价疗效。结果：29例患者可评价疗效,共完成周期数92个,其中完全缓解1例,部分缓解12例,稳定8例,进展8例,总有效率（CR＋PR）44.8%,疾病控制率（CR＋PR＋SD）72.4%,中位疾病进展时间5.2个月,中位生存期9.5个月（2.0～14.6个月）。主要毒性反应为Ⅰ～Ⅱ度血液性毒性,包括白细胞下降（41.4%）、贫血（51.7%）、血小板下降（58.6%）,Ⅲ～Ⅳ度非血液毒性,包括乏力（24.1%）以及腹泻（10.3%）,均可耐受。结论：吉西他滨联合氟尿嘧啶、亚叶酸钙治疗老年晚期食管癌疗效肯定,安全性较好,患者可耐受。     

脂质体紫杉醇联合顺铂及氟尿嘧啶一线治疗43例晚期胃癌的临床研究

[目的]评价脂质体紫杉醇（力扑素）联合顺铂、氟尿嘧啶（5-Fu）组成的PCF方案一线治疗43例晚期胃癌的临床疗效和毒副反应。[方法]脂质体紫杉醇135～175mg/m2,静滴3h,d1;顺铂20mg/m2,静滴2h,d1～5;5-Fu750mg/m2持续静脉滴注d1～5。21d为1个周期。按RECIST标准评定疗效,按WHO标准评价毒副反应,Kaplan-Meier法绘制生存曲线。[结果]全组共完成化疗167个周期,中位治疗3个周期。39例患者完成2个周期以上化疗并可评价疗效,其中CR1例,PR19例,SD11例,PD8例,总有效率51.3%。中位无进展生存时间6.0个月,中位总生存时间11.5个月,1年生存率41.0%。主要的Ⅲ~Ⅳ级血液学毒性为白细胞减少及中性粒细胞减少,发生率分别为16.2%和25.6%。全组仅1例发生过敏反应。无患者因毒性反应而停药,无治疗相关性死亡发生。[结论]脂质体紫杉醇联合顺铂及氟尿嘧啶一线治疗晚期胃癌疗效肯定,毒副反应轻,对患者生活质量改善明显。     

紫杉醇持续滴注联合方案二线治疗难治性晚期食管鳞癌

[目的]研究含紫杉醇（PTX）持续静脉滴注方案二线治疗晚期食管癌的疗效和毒性。[方法]26例晚期食管鳞癌患者应用含低剂量PTX持续静脉输注联合方案化疗：PTX20mg/m2,civ,16h,d1～3,d8～9;DDP3.75mg/m2,iv,d1～4,d8～11;5-Fu375mg/m2,civ,24h,d1～5,d8～12;叶酸60mg,po,d1～5,d8～12;21d为1个周期,至少应用2个周期。[结果]23例完成2个周期治疗者可评价疗效,CR1例,PR9例,SD10例,PD3例,有效率为43.5%,中位疾病进展时间（TTP）5.1个月。主要毒副反应为骨髓抑制和脱发,其他毒副反应较轻。[结论]低剂量PTX持续静脉输注联合方案治疗晚期食管鳞癌安全有效。     

紫杉醇脂质体联合顺铂、氟尿嘧啶一线治疗晚期胃癌的临床观察

目的：评价紫杉醇脂质体联合顺铂、氟尿嘧啶（ＰＣＦ方案）一线治疗晚期胃癌的临床疗效和毒副反应。方法：ＰＣＦ方案一线治疗４２例晚期胃癌的具体用法：紫杉醇脂质体１７５ｍｇ／ｍ^２,第１天静滴９０ｍｉｎ;顺铂７５ｍｇ／ｍ^２,第１天静滴;亚叶酸钙４００ｍｇ／ｍ^２,第１天滴注２ｈ;氟尿嘧啶２６ｇ／ｍ^２,亚叶酸钙滴注结束后立即持续泵入４６ｈ。２１天为１周期,每２周期按ＲＥ ＳＩＳＴ标准评价疗效,所有患者至少接受２周期化疗。结果：４２例患者共接受１９２个周期的化疗,所有患者均可评价疗效。完全缓解３例（７.１％）,部分缓解２０例（４７.６％）,稳定１２例（２８.６％）,进展７例,总有效率为５４.８％,中位进展时间（ＴＴＰ）６.５个月,中位生存时间（ＭＳＴ）１３.９个月。常见的不良反应为血液学毒性,胃肠反应、肌肉酸痛、外周神经毒性较轻,以Ⅰ、Ⅱ级为主。１０例（２３.８％）发生Ⅲ ～Ⅳ级粒细胞减少,伴发热１例（２.４％）;Ⅲ级恶心呕吐反应４例（９.５％）,Ⅲ级肌肉酸痛３例（７.１％）,Ⅲ级外周神经毒性２例（４.７％）,无化疗相关性死亡病例。结论：紫杉醇脂质体联合顺铂、氟尿嘧啶（ＰＣＦ方案）一线治疗晚期胃癌疗效确切,不良反应轻,值得临床推广应用。     

PFC方案治疗晚期食管贲门癌的临床观察

目的：观察PFC方案（紫杉醇联合氟尿嘧啶和顺铂）治疗晚期不能手术或手术未能完全切除及术后复发的食管癌和贲门癌患者的疗效和毒性。方法：41例患者分别接受PFC方案化疗2～6周期,按WHO标准评价疗效及毒副反应。结果：41例均可评价,其中完全缓解（CR）3例7．3％,部分缓解（PR）18例43．9％,稳定（SD）15例36．6％,进展（PD）5例12.2％。中位疾病进展时间为7．9个月,中位生存时间为11．3个月。结论：PFC方案治疗晚期食管贲门癌患者安全有效,毒副反应较轻。     

GP与NP方案治疗对蒽环类及紫杉类均耐药的转移性乳腺癌的疗效观察

目的比较GP（吉西他滨/顺铂）和NP（长春瑞滨/顺铂）方案治疗对蒽环类及紫杉类均耐药转移性乳腺癌（MBC）的疗效及不良反应。方法采用GP和NP方案治疗对蒽环类及紫杉类均耐药MBC58例,比较患者的总有效率（ORR）、总生存时间（OS）、肿瘤进展时间（TTP）及1年生存率。结果GP组ORR为33.3%（10/30）,CR6.7%（2/30）,PR26.7%（8/30）;NP组ORR为32.1%（9/28）,CR7.1%（2/28）,PR25.0%（7/28）。两组ORR差异无统计学意义（P=0.923）。GP组中位OS为19.9（95%CI11.8～28.0）个月,中位TTP为9.2（95%CI7.0～11.4）个月,1年生存率为69.0%;NP组中位OS为19.1（95%CI14.4～23.8）个月,中位TTP为（95%CI2.5～6.7）4.6个月,1年生存率为67.9%,两组中位OS（P=0.888）和1年生存率（P=0.924）差异无统计学意义,GP方案中位TTP优于NP方案（P=0.024）。两组均无化疗相关死亡病例,主要不良反应为骨髓抑制及胃肠道反应。结论NP与GP方案对蒽环类及紫杉类均耐药MBC均有较好的近期疗效,不良反应均可耐受,同为有效解救方案。