复方苦参注射液预防化疗药物毒副反应的临床观察

目的观察复方苦参注射液预防肿瘤化疗药物毒副反应的效果。方法将78例经病理组织学确诊的恶性肿瘤患者随机分为治疗组和对照组。两组均于化疗及对症处理,治疗组加用复方苦参注射液20 mL静滴,每日1次,20天为1疗程。结果治疗组化疗毒副反应的发生率明显低于对照组,K arnofsky评分明显高于对照组。结论复方苦参注射液可明显降低化疗药物的毒副反应,提高患者的生活质量。     

Acetamides: chemotherapeutic agents for inflammation-associated cancers

Now clear evidences are available to support the hypothesis that inflammation accelerates the conditions including events and molecules that reach to various types of cancers. Inflammation is a normal response to infection containing the innate and adaptive immune systems. However, when allowed to continue, unresolved, perturbation of cellular microenvironment takes place; therefore, it leads to adaptations in genes that are linked to cancer. In addition, a lot of data are accessible confirming the concept that tumour microenvironment is orchestrated by various inflammatory cells and goes to neoplastic process and finally invasion, migration and metastasis. However, infiltrations of leucocytes lead to angiogenesis, propagation and invasion. An inflammatory microenvironment that perhaps fostering impact of angiogenesis include cytokines, chemokines, enzymes and growth factors that play key role for expansion and invasion of cancer cells. This insight highlights the pathogenesis of inflammation-associated cancers and also touches and fosters the role of acetamides for the treatment and chemoprevention of carcinomas that are allied with inflammation.     

Combinations of three chemotherapeutic agents and two chemotherapeutic agents plus a targeted biologic agent in the treatment of advanced non small-cell lung cancer

Lung cancer is the most common cause of cancer death in the world. In the United States, more than 28% of all cancer deaths are from lung cancer. In the past decade, a number of new drugs were introduced into the treatment of lung cancer including taxanes, gemcitabine, vinorelbine, and irinotecan. Combinations of one of these drugs with cisplatin, with carboplatin, or with one another were shown to be superior to best supportive care, to single-agent cisplatin, and in some instances, to a podophyllotoxin and cisplatin. Comparisons of the various two-drug combinations showed that they are equivalent in efficacy although there are differences in convenience, cost, and toxicity. Many of these two-drug combinations are less toxic than older combinations, which allowed for the development of three-drug combinations that could be given in full dose and with acceptable toxicity. Phase II trials of several three-drug combinations including carboplatin/paclitaxel/gemcitabine and cisplatin/vinorelbine/gemcitabine showed response rates and survival rates that were somewhat higher than anticipated with a two-drug combination. These data led to three randomized trials of a doublet combination versus a triplet combination. Each of these trials showed a higher response rate and higher toxicity rates with the triplet combination. The toxicity rates were still acceptable with the triplet combinations. The survival was also superior in the triplet arms of each of the randomized trials. Unfortunately, the sample size in each of these studies was small and the survival differences are not statistically significant. Therefore, additional larger randomized trials are sorely needed. During the past decade, new molecularly targeted agents were introduced into the treatment of lung cancer and completed phase I and II trials. Objective responses were noted with many of these new agents. Several combinations of doublet chemotherapy with a new targeted agent have completed phase II trials with encouraging results. Some of these new triplets are now in phase III randomized trials.     

Gastrointestinal toxicity of chemotherapeutic agents

Chemotherapy-induced toxicities commonly occur in sites within the gastrointestinal (GI) tract and account for dose-limiting effects. These toxicities are major contributing factors to dose reduction, delays, and cessation of cancer treatment. Through intensive therapies including surgery, combination chemotherapy, hormonal therapy, and targeted therapy, an increasing number of patients with cancer are experiencing improved survival and long-term disease-free survival, as well as palliation of disease-related symptoms. Thus, GI toxicities should be predicted and appropriate interventions initiated to prevent them when possible and provide effective supportive measures and comprehensive follow-up care. This review will discuss the etiology, incidence, prevention, and treatment of GI toxicities of cancer chemotherapy.     

Dermatologic toxicity of chemotherapeutic agents

Due to its high metabolic rate, skin represents one of the major target organs of chemotherapy-associated toxicity. Reactions range from common, nonspecific exanthematous eruptions to rare but distinctive cutaneous lesions that may not become apparent until a drug transitions from clinical trials to widespread oncologic use. The challenge of the physician is to recognize reaction patterns that reflect a drug reaction, identify a likely causative drug, and determine whether the reaction is a dose-limiting toxicity. This review will focus on the cutaneous side effects of the newer classes of chemotherapy drugs, including targeted monoclonal antibody therapy and small molecule inhibitors.     

Our experience with chemotherapeutic agents in the treatment of breast cancer

We are reporting about 300 female patients with progressive breast cancer and metastases. One hundred them had been treated by single agent in 5 sub-groups consisting each of 20 patients. Their medial survival was 18.5 month in complete response (CR) patient. One hundred of the patients had 5-drugs chemotherapy with median survival in complete responders of 26 months. One hundred patients had a 5-drug combination chemotherapy including adriblastina with median survival for complete responders of 34 months. In the present work it is apparent that adriblastina prolongs the life of the patients. Our findings and the data of other investigators urge us to consider future experimental pilot protocols which will allow us to individualize treatment by defining for each patient the optimal mix of modalities and agents. We emphasize the use of tumor cell markers and ER receptors.     

Clinical evaluation of chemotherapeutic agents in the treatment of primary liver cancer

For the comparison of effect of FT-207 alone and FT-207 + MMC combination chemotherapy on primary hepatocellular carcinoma, 41 patients were entered into the trial. Thirty-two cases whose data were evaluable were studied by Koyama's classification. There was only one effective case (6.6%) in single agent group (15 cases) and 5 cases (29.4%) were effective in combination chemotherapy (17 cases). MMC combination chemotherapy was more effective on regression in size of hepatomegaly than FT-207 alone. By osaka group classification, 5 cases (33.3%) in single agent group (15 cases) were effective, and 10 cases in combination group (17 cases) (58.8%) were effective. The slight side effect often necessitated upon cessation of the treatment in 31 cases but the disappeared on cessation or by decrease of dose.     

Management of extravasation of chemotherapeutic agents

Extravasation of chemotherapeutic agents can potentially cause severe skin damage such as ulceration, resulting in a dramatic decrease in quality of life in patients receiving chemotherapy. Although guidelines for treating extravasation were published in Japan a few years ago, practical procedures on how to deal with it, have not been presented in the guidelines yet due to a lack of supporting evidence. Therefore, each hospital should provide its own procedures to manage the extravasation of chemotherapeutic agents. We describe here the treatment of extravasation by topical injection of steroids. We have never experienced significant skin damage in patients after treatment with topical steroid injections.