恒速持续与间歇静脉滴注脱氧氟脲苷毒副作用比较

目的比较胃肠癌术后恒速持续静脉滴注与间歇静脉滴注脱氧氟脲苷对病人的毒副作用。方法选择2002年1月至2005年12月间的80例胃肠癌手术后病人,随机分为两组,每组40例,治疗组在静滴顺铂和表阿霉素的基础上恒速持续静脉滴注FUDR 500mg／24h,持续72h;对照组在上述化疗基础上间歇静脉滴注FUDR 500mg／d,2-3h／次,1～5d。化疗期间及结束后,查血常规、肝肾功能,观察毒副反应。结果治疗组仅29例完成化疗,均在化疗后d3出现逐渐加重的口腔炎,重者无法进食,饮水;对照组40例全部完成化疗,仅2例发生以口腔炎为主的毒副反应,且程度轻,不影响进食,饮水;两组病人肝肾功能及造血功能无明显改变。结论长时间（72h）恒速持续静脉滴注FUDR可导致较为严重的、以口腔炎为主的化疗毒副反应。     

两种5-FU持续输注方案的毒副作用观察

目的 探讨5-Fu持续输注的适宜治疗方案。方法 收集经手术和病理确诊大肠腺癌患者33例，随机分成A、B两组，A组15人，B组18人。于根治术后两周内开始给予CF／5-FU(亚叶酸钙／氟尿嘧啶)辅助化疗。A组给予5-FU持续输注120小时的4周方案，B组给子5-Fu持续输注46小时的双周方案。观察每次给药后2周内毒副反应和静脉炎的发生情况，并以X^2检验进行统计学分析。结果 B组中的I～Ⅱ度口腔炎、I～Ⅱ度腹泻、静脉炎的发生率均低于A组。结论 双周方案的5-Fu剂量虽比4周方案大，但某些毒副反应和静脉炎的发生率均比4周方案低，并且缩短了患者每次住院时间。     

氟脲嘧啶静脉持续输注与间断输注联合顺铂治疗鼻咽癌

鼻咽癌是我国南方常见的恶性肿瘤之一,目前仍以放射治疗为首选,但近年新辅助化疗在鼻咽癌的治疗中也取得了较好的疗效。我科自2002年5月起应用便携式泵持续静脉输注5-Fu联合PDD治疗鼻咽癌,并与间断静脉输注5-Fu联合PDD的方案进行了比较,现将结果报告如下：     

低剂量诺维本持续静脉输注与常规用法治疗晚期非小细胞肺癌的比较

目的:比较诺维本持续静脉输注与常规用法治疗晚期非小细胞肺癌的疗效和毒性.方法:统计分析持续静脉输注和常规用法组治疗的49例晚期非小细胞肺癌病例的临床资料.结果:持续输注组有效率为48%,常规用法组有效率为41.7%,前者略高于后者,两者比较无显著差异(P ＞0.05),但达到有效所用的时间前者平均56天,后者为89天,两者比较有显著差异(P＜ 0.05).毒副反应主要为骨髓抑制和局部静脉炎.结论:持续静脉输注诺维本是治疗晚期非小细胞肺癌较为有效而安全的新方法.     

曲马多、芬太尼持续静脉输注术后镇痛疗效观察

术后疼痛严重影响患者的康复和围手术期生活质量 ,近年来 ,术后镇痛得到广泛开展 ,本文旨在评价微量泵持续静脉输注术后镇痛的效果。1　资料与方法1.1　一般资料　选择 6 0例腹部肿瘤手术患者 ,ASA 、 ,随机分为两组。对照组 30例 ,男性 13例 ,女性 17例 ,年龄(5 3.6± 11.3)岁     

诺维本持续静脉输注联合顺铂治疗转移性乳腺癌临床观察

目的 探索诺维本不同用药方法联合顺铂治疗转移性乳腺癌的疗效和不良反应。方法 对６７例转移性乳腺癌采用随机分组，其中４２例予诺维本持续静脉输注联合顺铂（Ａ组），２５例予诺维本常规静脉冲入联合顺铂（Ｂ组）。结果 Ａ组有效率（ＣＲ＋ＰＲ）４７．６２％。Ｂ组有效率（ＣＲ＋ＰＲ）４０．０％，毒副反应Ａ组明显低于Ｂ组。结论 诺维本持续静脉输注较常规静脉冲入联合顺铂治疗转移性乳腺癌疗效有所提高，毒副反应明显减轻。     

低剂量诺维本持续静脉输注与常规用法治疗晚期非小细胞肺？…

目的：比较诺维本持续静脉输注与常规用法治疗晚期非小细胞肺癌的疗效和毒性。方法：统计分析持续静脉输注和常规用法组治疗的４９例晚期非小细胞肺癌病例的临床资料。结果：持续输注组有效率为４８％,常规用法组有效率为４１．７％,前者略高于后者,两者比较无显著差异（Ｐ〉０．０５）,但达到有效所有的时间前者平均５６天,后者为８９天,两者比较有显著差异（Ｐ〈０．０５）。毒副反应主要为骨髓抑制和局部静脉炎。结论：持续     

诺维本持续静脉输注联合顺铂治疗转移性乳腺癌临床观察

目的　探索诺维本不同用药方法联合顺铂治疗转移性乳腺癌的疗效和不良反应。方法　对 67例转移性乳腺癌采用随机分组 ,其中 42例予诺维本持续静脉输注联合顺铂 (A组 ) ,2 5例予诺维本常规静脉冲入联合顺铂 (B组 )。结果　A组有效率 (CR PR)47 62 % ,B组有效率 (CR PR) 40 .0 %。毒副反应A组明显低于B组。结论　诺维本持续静脉输注较常规静脉冲入联合顺铂治疗转移性乳腺癌疗效有所提高 ,毒副反应明显减轻。     

诺维本持续静脉输注联合顺铂治疗晚期乳腺癌的临床观察与护理

探讨诺维本（NVB）持续静脉输注（CIV）联合顺铂（PDD）治疗晚期乳腺癌的观察和护理。方法 对16例晚期乳腺癌经锁骨下静脉穿刺置管处行NP方案化疗2个周期。化疗期间除密切观察化疗反应外，重点是锁穿护理和微泵的使用及观察。结果 全组病例总有效率为43．75％，中位 绘解期6个月，中位生存期16个月。白细胞下降占43．75％，无Ⅳ度毒性，静脉炎发生率及严重程度明显下降。结论 诺维本持续静脉输联合顺铂治疗晚期乳腺癌具有疗效好、副作用小的优点，护理措施的改进也给这一新方案的应用带来了方便。     

重度癌痛患者应用吗啡持续静脉泵入法进行快速滴定的临床观察

目的:观察吗啡静脉持续泵入法对重度癌性疼痛患者进行快速滴定的疗效和优势。方法:7例重度癌性疼痛患者,采用静脉输液泵（型号SY-1200）,进行吗啡快速滴定。滴定前计算24h所需静脉吗啡的总量,以其总量的10%做为滴定的起始剂量。设定在15分钟内匀速静脉泵入,每隔15min评估疗效和不良反应,调整吗啡泵入速度。以疼痛评分降至1-3分的有效止痛剂量,然后计算24h所需吗啡的总量,最终制定个体化的止痛给药方案。结果:7例重度癌性疼痛患者均在24小时内完成了吗啡快速滴定,使疼痛评分降至1-3分;其中1例在滴定过程中嗜睡,及时下调剂量后,不良反应缓解。结论:采用吗啡静脉持续泵入的方法进行吗啡滴定可以迅速起效镇痛,明显缩短吗啡滴定时间,血清吗啡浓度可维持恒定有效水平,避免吗啡静推所致的波峰和波谷现象,并且不良反应可控,安全性强。     

Long-term ambulatory treatment of metastatic colorectal adenocarcinoma by continuous intravenous infusion of 5-fluorouracil

To delineate the efficacy of continuous intravenous 5-fluorouracil (5-FU) infusion therapy for advanced colorectal adenocarcinoma, a study of 36 patients with measurable metastatic disease was conducted. Patients received a daily intravenous infusion of 300 mg/m2 5-FU over a 24-h period utilizing portable infusion devices and central venous catheters. In a population characterized by substantial pretreatment exposure to radiotherapy, chemotherapy, and other indicators of poor prognosis, 13/36 (36%) patients achieved an objective response. An additional 10/36 (28%) patients manifested stable disease (no change) and experienced survival comparable to that of patients with objective response. Toxicity was minimal; patients were able to continue 5-FU infusions 95% of the total time on protocol. There were no adverse hematologic effects or catheter complications. Because previously untreated patients benefited more frequently (positive response, 50%), continuous intravenous infusion should be evaluated further as a primary modality option when 5-fluorouracil antitumor chemotherapy is contemplated.     

Safety and efficacy of subcutaneous and continuous intravenous infusion rIL-2 in patients with metastatic renal cell carcinoma

A retrospective analysis was conducted on data from four open-label, nonrandomised, phase II trials of recombinant interleukin-2 (rIL-2) in patients with metastatic renal cell carcinoma to compare the safety and efficacy of administration by subcutaneous (s.c.) and continuous intravenous (c.i.v.) infusion (n=103 s.c. and n=225 c.i.v.). No statistically significant differences were found between the cohorts in terms of overall response rate (s.c.: 13.6% vs c.i.v.: 12.4%, P=0.77), response duration (s.c.: 9.8 months vs c.i.v.: 10.1 months, P=0.99), and overall survival (P=0.08). Compared with c.i.v. administration, more patients in the s.c. cohort experienced stable disease (50.5 vs 29.8%) and fewer underwent disease progression (35.0 vs 43.6%). Subcutaneous administration was associated with a significantly lower incidence of grade 3 or 4 adverse events (46 vs 76%; P<0.001), and fewer s.c. patients required dose reductions because of toxicity (20 vs 82%). At the doses and within the schedules tested, this comparative analysis did not detect any difference in efficacy between s.c. and c.i.v. administration of rIL-2 in terms of overall survival, duration of response and response rate in patients with metastatic renal cell carcinoma. However, s.c. delivery of rIL-2 was associated with improved tolerability.     

Hepatic arterial infusion of floxuridine and dexamethasone plus high-dose Mitomycin C for patients with unresectable hepatic metastases from colorectal carcinoma

BACKGROUND: In vitro data suggest increased cytotoxicity with Mitomycin C (Mit-C) and Floxuridine (FUDR). Based on these data, we performed a phase II trial of hepatic arterial infusion (HAI) of FUDR and Dexamethasone (Dex) plus high-dose Mit-C for patients with unresectable hepatic metastases from colorectal carcinoma. METHODS: High-dose Mit-C (15 mg/m2) was added via the pump sideport to HAI FUDR and Dex for 14 days of a 28-day cycle. Mit-C was given on days 1 and 29, and FUDR was given indefinitely until disease progression or discontinuation of therapy due to toxicity. RESULTS: Sixty-three patients with unresectable liver metastases were entered. The chemotherapy-na?ve group (n = 26) and those previously treated (n = 37) had similar response and median survival: 73% and 70%, and 23 and 20 months, respectively. The major toxicities were liver bilomas (7.9%), elevation in bilirubin level >3 (22%), and biliary sclerosis (9.5%). Hematologic and gastrointestinal toxicity was less than 2%. CONCLUSION: The addition of high-dose Mit-C to HAI FUDR and Dex produced a high response rate even in previously treated patients. The median survival was 21 months even though half the patients were previously treated with chemotherapy. Biliary toxicity was higher than expected; therefore, alternatives to high dose Mit-C should be investigated when exploring additions to HAI therapy with FUDR and Dex.     

国产长春瑞滨持续静脉输注治疗晚期食管癌的临床观察

目的：探讨小剂量国产长春瑞滨(NVB)持续静脉输注联合顺铂(PDD)治疗晚期食管癌的疗效与安全性。方法：NVB首剂10mg静脉推注,接用NVB 10mg静脉持续滴注24小时,第1～5天;PDD30mg／m^2静脉滴注2小时,第1～3天。21天为1周期,2周期后评价疗效。结果：27例共化疗61周期,平均2．3周期。食管原发病灶有效率为40．7％,吞咽功能得到改善的患占92．3％。转移病灶缓解率为42．0％,其中淋巴结转移的有效率较高(66．7％)。总的中位生存期为10个月(5-19个月)。主要不良反应为血液学毒性和消化道反应,Ⅲ-Ⅳ度白细胞下降为35．4％,恶心呕吐发生率41．3％,末梢神经炎10．2％。结论：NVB持续输注联合PDD方案治疗晚期难治性食管癌,近期疗效较好,毒副反应轻,值得进一步临床研究。     

Gastroduodenal artery-duodenal fistula: a complication of continuous floxuridine (FUDR) infusion into the gastroduodenal artery

This case report describes a patient who for 31 months has received regional intrahepatic chemotherapy from a continuous infusion pump and who developed a gastroduodenal artery-duodenal fistula, a previously unreported complication of regional infusion therapy. The patient presented with signs and symptoms of upper gastrointestinal bleeding. The clinical evaluation and management are described. An angiogram was performed through the auxillary septum to identify the source of bleeding. The possible etiologic factors in this case are discussed. We believe that this complication will continue to be rare, but health care providers should be aware of its presentation and its preferred method of evaluation and management.     

Comparison of intraperitoneal continuous infusion of floxuridine and bolus administration in a peritoneal gastric cancer xenograft model

Purpose To identify the optimal schedule for intraperitoneal (i.p.) infusion of floxuridine (FUDR) against peritoneal micrometastases from gastric cancer.Methods The efficacy of continuous i.p. infusion of FUDR was compared with that of bolus i.p. administration in peritoneal gastric cancer (MKN45) xenografts. The FUDR continuous delivery system in this study was in the form of injectable poly(lactic-coglycolic) acid (PLGA) microspheres intended for i.p. injection. Animals were treated by continuous i.p. infusion using FUDR-loaded microspheres or bolus i.p. administration of FUDR.Results In vitro testing demonstrated that FUDR was released slowly from the microspheres at a rate of approximately 5% of the total encapsulated drug per day. In in vivo studies, the peritoneal level was found to persist and was approximately 5- to 50-fold higher than that of plasma for more than 2 weeks following a single injection of the microspheres. An in vitro MTT assay showed that exposure time clearly influenced the cytotoxic potency of FUDR. In vivo, continuous infusion was more effective against peritoneal tumor than bolus administration at equivalent doses. However, compared with bolus administration, toxicity was increased, resulting in a reduced maximum tolerated dose (MTD) with continuous infusion. When the treatment was carried out at each MTD (continuous 1 mg/kg, bolus 600 mg/kg), continuous infusion had no advantage in inhibiting tumor growth.Conclusions Owing to the higher toxicity and the equal efficacy of continuous infusion compared with bolus administration, continuous infusion is not recommended in i.p. FUDR treatment.This study was supported in part by a grant from the Japan Society for the Promotion of Science and by a grant from the Setsuro Fujii Memorial Osaka Foundation for Promotion of Fundamental Medical Research.     

生脉注射液结合持续静脉缓慢滴注蒽环类药物降低早期心脏毒性发生风险的临床观察

目的:观察生脉注射液结合持续静脉缓慢滴注蒽环类药物降低早期心脏毒性发生风险的临床效果。方法:所有病例于2016年1月至2018年4月采集自阜宁县人民医院、江苏省人民医院及盐城第三人民医院血液科住院的68例急性白血病患者。根据治疗方法进行分组,纳入采用生脉注射液结合持续静脉缓慢滴注蒽环类药物的38例患者入观察组,纳入常规静脉输注蒽环类药物未使用生脉注射液的30例患者入对照组。比较两组异常心电图发生情况和治疗前后心脏彩超及相关检验指标的变化。结果:观察组出现ST-T改变、QT间隙延长、窦性心动过速、心律失常等异常心电图发生率均低于对照组,差异有统计学意义（P<0.05）;观察组治疗后8 d后cTnI正常率显著高于对照组,异常率显著低于对照组,差异有统计学意义（P<0.05）;观察组治疗后LVEF高于对照组,BNP水平低于对照组,差异有统计学意义（P<0.05）。结论:生脉注射液配合持续静脉缓慢滴注蒽环类药物,具有保护心肌细胞、改善心肌代谢,减轻心肌损伤的作用,从而降低早期心脏毒性反应的发生率。     

A Phase I study of intermittent intravenous bromodeoxyuridine (BUdR) with conventional fractionated irradiation

A Phase I trial of intravenous bromodeoxyuridine (BUdR) and conventional fractionated radiation therapy was performed in 14 patients with glioblastoma multiforme and 7 patients with other poorly radioresponsive tumors. The BUdR was given as a constant intravenous infusion for 12 hr/day for up to 14 days. Thirteen patients received a second 14 day infusion following a 10 to 14 day interruption for bone marrow recovery. Local toxicity (within the radiation field) was minor, with 7 of the 21 patients requiring a brief treatment break for moist skin desquamation. There was no significant CNS toxicity noted clinically nor by autopsy examination. Additionally, no significant enhancement of radiation injury was noted to bowel or liver. However, one patient treated for multiple pulmonary metastases experienced a clinical and radiographic pattern consistent with radiation pneumonitis. Dose-dependent systemic toxicity occurred in bone marrow and skin. Moderate myelosuppression, especially thrombocytopenia, was found following a 14 day cycle of BUdR at and above 650 mg/m2/12 hr infusion. Approximately one-third of patients developed a maculo-papular erythematous rash to the scalp, neck and upper chest. In two patients, the rash became generalized with evidence of epidermolysis on skin biopsy. Pharmacology studies revealed steady-state arterial plasma levels of 2 X 10(-6) M/1 during the 12 hr infusion of 650 to 700 mg/m2. Radiosensitization was measured by a change in the D0 of radiation survival curves of human bone marrow CFUc prior to and following the 14 day infusion in 4 patients. A trend of increasing radiosensitization was noted in most patients as the infusion rate of BUdR was increased from 500 to 870 mg/m2/12 hr. We conclude that the maximum tolerable dose of BUdR is 650 to 700 mg/m2/12 hrs when given as a 2 week intermittent intravenous infusion. Local toxicity is acceptable. The major systemic toxicities are myelosuppression and a maculopapular skin rash.