周剂量紫杉醇联合低剂量FP方案治疗晚期食管癌46例临床观察

目的　研究周剂量紫杉醇联合低剂量氟脲嘧啶持续滴注及低剂量顺铂治疗晚期食管癌的近期疗效和毒副反应。方法　晚期食管癌 46例 ,紫杉醇 60mg/(m2 ·week) ,静滴 3小时 ,连用 3周 ;5 -FU 2 0 0mg/(m2 ·d) ,持续滴注 ,连用 2 1天 ;PDD 6mg/(m2 ·d) ,静滴 2小时 ,每周 5天连用 3周 ;以上化疗方案每 4周重复。结果　总有效率 67% ,其中CR 0例 ,PR 31例 ,化疗中主要毒性反应表现为骨髓抑制、消化道反应、脱发等 ,神经毒性、过敏反应少 ,患者耐受性好。结论　紫杉醇作为一种新型抗肿瘤药 ,周剂量使用与低剂量 5-FU持续滴注及低剂量PDD联合 ,对晚期食管癌近期效果显著 ,毒性反应小 ,值得推广     

周剂量多西紫杉醇、奥沙利铂联合低剂量氟尿嘧啶方案治疗晚期胃癌的临床观察

目的：研究周剂量多西紫杉醇、奥沙利铂联合低剂量氟尿嘧啶（5-FU）持续滴注治疗晚期胃癌的近期疗效和毒副作用。方法：晚期胃癌31例，应用多西紫杉醇40mg／m^2，静滴1小时，每周1次，连用2周；奥沙利铂70mg／m^2，静滴2小时，每周1次，连用2周；5-FU200mg／m^2，连用14天。以上化疗方案每4周重复，2周期后评定疗效。结果：31例晚期胃癌总有效率67．7％，其中CR2例，PR19例。主要毒性反应为骨髓抑制、消化道反应、脱发等。结论：多西紫杉醇、奥沙利铂作为新的抗胃癌药物，联合低剂量5-FU持续滴注对晚期胃癌近期效果显著，毒副反应较小，可以作为晚期胃癌的一种选择方案。     

周剂量多西紫杉醇联合小剂量顺铂、5-氟脲嘧啶持续静脉滴注治疗晚期胃癌的疗效观察

目的 评价周剂量多西紫杉醇联合小剂量顺铂、5-氟脲嘧啶(5-Fu)持续静脉滴注治疗晚期胃癌的临床疗效和毒副反应.方法 48例晚期胃癌随机分为两组,试验组:多西紫杉醇35 mg/(m2·d)静滴,d1,8,15;顺铂 mg/(m2·d),d1～5,d8～12;5-Fu250mg/(m2·d)微量输液泵维持持续静滴,d1～14,3周为1周期.对照组:顺铂75mg/(m2·),d1静滴;5-Fu 1000mg/(m2@d),d1～5>3周为1周期.治疗3～4个周期后评价疗效和毒副反应.结果 试验组总有效率为45.8%;对照组总有效率为37.5%.两组有效率比较差异无统汁学意义(P>0.05).试验组较对照组白细胞下降(79.2%vs 45.8%);试验组腹泻(41.6%vs 20.8%)较对照组明显升高(P<0.05);试验组恶心、呕吐的发生率(33.3%vs 12.5%)低于埘照组,蒡异均有统计学意义(P<0.05).结论 多西紫杉醇联合小剂量顺铂、5-Fu持续静脉滴注治疗晚期胃癌具有较好的疗效,毒剐反应可耐受,是晚期胃癌化疗的有效方案.     

紫杉醇联合小剂量顺铂和持续静滴低剂量氟尿嘧啶治疗晚期胃癌35例

目的观察紫杉醇(PTX)联合小剂量顺铂(PDD)和持续静滴低剂量氟尿嘧啶(5-FU)治疗晚期胃癌的疗效和毒副反应。方法全组35例患者中,贲门癌14例,胃体癌21例,应用PTX90mg/m2,第1、8天;5-FU250mg/m2持续24小时静滴,连用12天;PDD6mg/(m2.d)静滴,连用5天,间隔2天,再用5天,21天为1周期,平均用药3.06个周期。结果全组35例均可评价,获得CR3例,PR17例,SD10例,PD5例,有效率(CR PR)为57.1%,肿瘤控制率(CR PR SD)为85.7%,中位TTP为9个月(1~32个月),中位生存时间13个月(2~35个月)。主要不良反应为骨髓抑制、恶心呕吐和粘膜炎。结论紫杉醇联合小剂量顺铂和持续静滴低剂量氟尿嘧啶治疗晚期胃癌患者疗效较好,不良反应可以耐受,值得深入研究。     

多西紫杉醇联合低剂量氟尿嘧啶持续静脉输注治疗中晚期食管癌的近期疗效观察

目的 观察国产多西紫杉醇联合低剂量氟尿嘧啶(5-Fu)持续静脉输注治疗中晚期食管癌的近期疗效和毒副反应.方法 20例中晚期食管癌患者行此方案化疗,多西紫杉醇40 mg/(m2·d),静脉滴注1 h,第1,8天;5-Fu 250 mg/(m2·d),低剂量持续泵静脉输注24 h,连用14 d.以上方案每4周为1周期,2周期观察近期疗效和毒副反应.结果 20例患者均可评价疗效,其中CR 1例,PR 10例,SD 5例,PD 4例,总有效率55.0%(11 / 20).主要毒副反应为骨髓抑制,非血液学毒性轻微.结论 多西紫杉醇联合5-Fu低剂量持续泵静脉输注治疗中晚期食管癌具有较好疗效,副反应轻,耐受性好.     

薏苡仁注射液联合低剂量顺铂和5-氟尿嘧啶治疗晚期胰腺癌的临床观察

目的本文观察了薏苡仁注射液(康莱特、KLT)联合低剂量顺铂(DDP)和5-氟尿嘧啶(5-FU)联合方案治疗晚期胰腺癌的疗效及毒副作用.方法化疗方案康莱特100 ml静滴,d1～d20,间隔8天,5-FU 320 mg/(m2·d),持续8 h,连用2周,DDP 5 mg/(m2·d)每周5天连用2周,其后休息2周,连用两个周期后进行疗效评价.结果12例晚期胰腺癌中PR 2例,SD 7例,PD 3例,总有效率16.67%.7例疼痛减轻、行为状况评分提高或体重增加,临床受益反应率为58.33%.治疗后NK、CD 3、CD 4和CD 4/CD 8值较治疗前有明显提高.主要毒副作用为轻度的血液和消化道副反应.结论康莱特联合低剂量DP和5-FU联合化疗方案对晚期胰腺癌能够提高缓解率和临床受益反应率,毒副反应能耐受.     

5氟尿嘧啶持续静脉滴注与小剂量顺铂联用治疗晚期胃癌53例

[目的]观察持续静脉滴注5氟尿嘧啶 (5 Fu)与小剂量顺铂 (DDP)联合应用治疗晚期胃癌的近期疗效及毒性。[方法]治疗组53例患者接受5 Fu350mg/m2·d ,持续滴注28～30天 ,DDP5mg/m2·d ,每周应用5天 ,连续应用4周的联合化疗方案化疗2个周期 ,对照组53例采用FAM/FMP(5 Fu+MMC +ADM/DDP)方案 ,治疗两个周期 ,常规剂量给药。[结果]治疗组完全缓解 (CR)0例 ,部分缓解 (PR)32例 ,近期总有效率 (CR +PR)60.37 % ,对照组CR0例 ,PR21例 ,总有效率39.62% ,两组差异具有显著性 ,常见毒副反应如骨髓抑制及恶心、呕吐的发生率对照组明显高于治疗组。[结论]FP方案治疗晚期胃癌 ,近期疗效肯定 ,毒副反应低     

低剂量长疗程氟尿嘧啶持续滴注治疗老年晚期胃癌

目的：评价低剂量长疗程氟尿嘧啶（5-Fu）静脉泵持续滴注治疗老年晚期胃癌的客观疗效及毒副反应。方法：117例老年晚期胃癌，采用低剂量5-FU 375mg／d静脉泵持续24小时滴注，连用21天，联用低剂量亚叶酸钙（CF）25mg／m^2、羟基喜树碱（HCPT）10mg和／或顺铂（PDD）10mg，每周各连用5天，共用3周。4周为1个周期，化疗2个周期。结果：117例患者均可评价疗效，获得cR9例（7．7％），PR58例（49．6％），RR67例（57．3％）。毒副反应主要为口腔炎（63．2％）、口腔溃疡（38．5％）、恶心呕吐（36．8％）、腹泻（30．8％）、粒细胞下降（25．6％）、便秘（17．9％）和静脉炎（6．0％），主要为I～Ⅱ级毒副反应，对症处理后均能缓解。结论：低剂量长疗程5-Fu持续滴注治疗老年晚期胃癌患者疗效好，毒副反应不严重，一般均能耐受，值得进一步研究。     

周剂量紫杉醇联合顺铂、氟尿嘧啶治疗晚期胃癌临床观察

目的观察周剂量紫杉醇(PTX)联合顺铂(PDD)、氟尿嘧啶(5-Fu)治疗晚期胃癌的疗效及安全性。方法 46例晚期胃癌患者应用周剂量PTX+5-Fu+PDD联合化疗,至少2周期后评价疗效及毒副反应。结果 46例患者中,CR 6例(13.0%),PR 26例(56.5%),SD 12例(26.1%),PD 2例(4.3%),有效率为69.5%,临床获益率为89.1%。毒副反应主要为白细胞减少、脱发和胃肠道反应。结论周剂量PTX联合PDD、5-Fu方案是一种治疗晚期胃癌疗效高、安全性好的方案。     

低剂量5-氟尿嘧啶持续静注联合顺铂、周剂量多西紫杉醇治疗晚期胃癌

目的:观察低剂量5-氟尿嘧啶(5-Fu)持续静注联合顺铂(DDP),周剂量多西紫杉醇(DOC)即FPD方案治疗晚期胃癌的疗效和毒性。方法:60例晚期胃癌患者随机分成两组,A组30例用FPD方案:5-Fu 200mg.m-2.d-1,经静脉微量泵持续24h注射,DDP 6mg.m-2.d-1,静滴1h,每周5d,DOC 25 mg.m-2.w-1静滴,均连用3周。B组30例应用低剂量5-Fu持续静注联合DDP(FP)方案,具体用法同A组。两组均以21d为1个疗程,间隔1周重复,2个周期后评定疗效。结果:A、B两组近期有效率分别为73.3%(22/30)及63.3%(19/30);中位无进展时间分别为4.8个月及2.6个月;中位生存期分别为9个月及5个月。两组无与化疗药物毒性有关死亡,毒副作用较轻。A组主要剂量限制性不良反应为骨髓抑制,Ⅲ/Ⅳ度白细胞减少占13.3%(4/30),无Ⅲ/IV度血小板及血红蛋白下降。非血液毒性主要是消化道反应和脱发。而对照组B组有轻度骨髓抑制及消化道副反应,无Ⅲ/IV度血液毒性及其他严重副反应。结论:FPD方案治疗晚期胃癌近期疗效较好,毒副反应较小,是较为理想的方案。     

低剂量5—氟脲嘧啶持续输注治疗晚期肿瘤

目的:观察低剂量5-氟脲嘧啶(5-FU)持续输注联合低剂量顺铂(PDD)方案治疗晚期恶性肿瘤的疗效.方法:采用5-FU250mg/m~2·d~(-1),使用便携式微量输液泵持续深静脉输注3～4周;PDD6mg/m~2·d~(-1),静脉输注1/小时,每周用5天,连续3～4周.以上方案连用二周期为一疗程.结果:全组共28例,CR1例,PR13例,总有效率为53.6%,其中对肝转移灶的有效率较高为75.0%.中位缓解期4.5个月(2～8~ 月).未见Ⅲ度～Ⅳ度的毒副反应.结论:低剂量5-FU持续输注联合低剂量PDD方案治疗晚期恶肿瘤是一个有效低毒的化疗方案.     

Phase I evaluation of continuous 5-fluorouracil infusion followed by weekly paclitaxel in patients with advanced or recurrent gastric cancer

OBJECTIVE: We conducted a phase I trial of escalating doses of weekly paclitaxel (Taxol) in combination with a fixed systemic administration of 5-fluorouracil (5-FU) in patients with advanced or metastatic gastric cancer. METHODS: Patients with advanced or recurrent gastric cancer were treated with escalating doses of weekly paclitaxel as a 60 min intravenous (i.v.) infusion, along with a fixed dose of continuous 5-FU infused over 5 days. Plasma sampling was performed to characterize the pharmacokinetics and pharmacodynamics of paclitaxel. RESULTS: Eighteen patients received combination therapy at four dose levels of weekly Taxol, ranging from 60 to 90 mg/m2/week. Dose-limiting toxicities > grade 3 were observed at the 90 mg/m2/week dose level. Toxicities included anemia, neutropenia, thrombocytopenia, nausea and alopecia. Two episodes of grade 4 neutropenia occurred in two of the three patients receiving this dose. At each dose level, pharmacological studies documented the persistence of significant serum paclitaxel levels over 24 h after drug administration. The maximum tolerated dose (MTD) for this regimen was 90 mg/m2/week of paclitaxel for 3 weeks plus 600 mg/m2/day of continuous 5-FU for 5 days. CONCLUSIONS: The combination of weekly paclitaxel and 5-FU demonstrated an acceptable toxicity profile and feasible pharmacokinetic results suggesting its practical applicability. Based on these findings, the recommended dose and schedule for phase II study of combination chemotherapy is paclitaxel 80 mg/m2/week x 3 over 4 weeks, and continuous 5-FU 600 mg/m2/day x 5 days every 4 weeks.     

大剂量醛氢叶酸加5-氟尿嘧啶持续48小时滴注联合顺铂治疗晚期食管与贲门癌初步观察

目的：观察大剂量醛氢叶酸（Leucovorin,LV)加5-氟尿嘧啶（5-Fluorouracil,5-Fu）持续48小时滴注联合顺铂Cisplantin,DDP)治疗晚期食管，贲门癌患的疗效及其不良反应。方法：病理确诊的食管，贲门癌38例，食管鳞癌24例，贲门腺癌14例。采用DDP25mg/m^2静脉滴注30分钟，d1-3天，LV200mg/m^2静脉滴注2小时，5-Fu0.5静脉推注10分钟，然后5-Fu3.0/m^2，用输液泵连续输注48小时，每21天重复，2个周期以上评定疗效。结果：完全缓解（CR）2例（5.26%)，部分缓解（PR）17例（44.74%)。稳定（NC）18例（47.37%)，进展（PD）1例（2.63%)，总有效率50%，食管癌有效率54.17%，贲门癌有效率42.86%。恶心，呕吐，口腔粘膜炎，骨髓抑制，腹泻及脱发为主要不良反应。结论；大剂量LV 5-Fu48小时滴注联合顺铂治疗晚期食管，贲门癌疗效较好，不良反应较小，值得进一步扩大观察。     

A case responding to weekly paclitaxel therapy as second-line chemotherapy for gastric cancer previously treated with TS-1

A 58-year-old male patient with the recurrence of para-aortic lymphnodes after TS-1 treatment was treated by a weekly infusion of paclitaxel as second-line chemotherapy. Paclitaxel was administered at a weekly dose of 70 mg/m2/day for three weeks followed by a one week interval. After 2 courses, the tumor was reduced, and the reduction was judged as PR. Moreover, after 5 courses, the tumor was more remarkably reduced and the reduction was judged as CR. The grade 2 leukopenia, neutropenia, and grade 1 alopecia were observed as adverse events. Recently, we treated 11 patients of advanced or recurrent gastric cancers with measurable lesions, using the weekly paclitaxel therapy after TS-1 treatment. The response rate was 36.4%. The median duration of PR was 130 days. Therefore, a weekly paclitaxel regimen was considered to be one of the promising regimens for advanced or recurrent gastric cancer as the second-line chemotherapy after TS-1 treatment.     

紫杉醇加氟尿嘧啶持续静脉滴注治疗晚期胃癌

目的观察紫杉醇联合醛氢叶酸和氟尿嘧啶持续静脉滴注治疗晚期胃癌的疗效和毒副反应。方法经病理组织学诊断的晚期胃癌26例，紫杉醇(paclitaxel，PTX，商品名为泰素Taxol)135mg／m^2，静脉滴注3h，第1天；醛氢叶酸(leucovorin，LV)200mg／m^2，静脉滴注2h，随后5-氟尿嘧啶(5-Fluorouracil，5-Fu)375mg／m^2，静脉推注10min，再接5-Fu3．0g／m^2用输液泵连续滴注120h，21d为1周期。所有患者至少接受2个周期治疗。结果26例均可评价疗效，总有效率为46．2％，其中CR2例，占7．7％。主要毒副反应为骨髓抑制、恶心呕吐、腹泻、黏膜炎、脱发、关节肌肉痛和心脏毒性反应，但均可耐受。结论PTX联合LV和5-Fu持续静脉滴注治疗晚期胃癌疗效较好，毒性可以耐受。     

PPF方案治疗晚期食管癌30例疗效观察

目的：探讨晚期食管癌应用ＰＰＦ方案治疗的疗效与毒副作用，方法：平阳霉素（ＰＹＭ）６０ｍｇ／ｍ＾２肌注第１、４、８、１１天，顺铂（ＰＤＤ）４０ｍｇ静滴第１～３天，５－氟脲嘧啶（５－Ｆｕ）５００ｍｇ／ｍ＾２静滴第１～５天，３周重复，结果：治疗组有效率６３．３％，对照组有效率３６．７％，疗效有显差异（ｘ＾２＝４．２７，Ｐ〈０．０５），主要毒副反应无显性差异。结论：ＰＰＦ方案对晚期食管癌有较好的疗效，毒副反应能耐受，可作为晚期食管癌的有效治疗方案，     

Paclitaxel by 72-hour continuous infusion followed by bolus intravenous ifosfamide or epirubicin: results of two phase I studies

STUDY PURPOSES: To determine the maximum-tolerated dose (MTD) of paclitaxel administered by 72-hour continuous infusion followed by bolus intravenous ifosfamide on days 4 and 5 or epirubicin on day 4, every 21 days. To assess the toxicity and preliminary activity in patients with advanced refractory solid tumors. PATIENTS AND METHODS: Sixteen patients with progressive disease after standard chemotherapy for advanced disease were treated with the combination paclitaxel-ifosfamide and 10 patients with the combination paclitaxel-epirubicin. RESULTS: In the first phase I study the MTDs were: paclitaxel 135 mg/m2 and ifosfamide 2.5 mg/m2/day; hematologic toxicity was the dose-limiting toxicity (DLT) during the first cycle of therapy at dose level 4. Paclitaxel administered at 135 mg/m2 and epirubicin 50 mg/m2 were the MTDs in the second phase I study; grade 4 stomatitis was the DLT of this combination. CONCLUSIONS: Paclitaxel by 72-hour continuous infusion followed by bolus ifosfamide was a manageable regimen with an acceptable hematologic toxicity in the absence of neurotoxicity. Preliminary activity of this combination was encouraging in a group of patients with ovarian cancer. The optimal way to combine paclitaxel and epirubicin and the best schedule relative to such a long paclitaxel infusion time in this combination regimen remain to be determined.