小剂量FP方案联合周剂量多西他赛治疗晚期食管癌临床研究

28例晚期食管癌患者采用小剂量FP方案联合周剂量多西他赛(DOC)治疗,5-氟尿嘧啶(5-FU)200mg/(m2·d),采用便携式微量泵持续滴注24 h,3～4周;顺铂(DDP)6 mg/(m2·d),静脉输注1 h,每周用5 d,连用3周;DOC 25 mg/m2,1次/周,连用3周,28 d为1周期.化疗2周期后休息1个月评定疗效.发现全组可评价28例,总有效率64.3%,初治组和复治组有效率比较无统计学差异.毒副反应主要是骨髓抑制、消化道反应和脱发,大多数患者能耐受.提示小剂量FP方案联合周剂量D0C治疗晚期食管癌疗效好,毒副反应轻.     

健择联合顺铂治疗晚期非小细胞肺癌30例

目的　评价健择联合顺铂治疗晚期非小细胞肺癌化疗方案的疗效。方法　病理明确诊断的 30例晚期非小细胞肺癌患者 ,应用健择 0 .8～ 1.0· m2 - l· d- 1 ,1、9、15 ;顺铂 2 0～ 4 0 mg· m2 - l· d- 1 ,l、8、15静脉滴注 ,同时配合水化利尿、碱化尿液。每 2 8日为一周期 ,化疗中记录毒副反应。结果　 CR 0例 ,PR 12例 ,SD 10例 ,PD 8例 ,有效率 4 0 .0 % (12 / 30 ) ,不良反应主要为骨髓抑制和消化道反应。结论　健择和顺铂联合方案治疗晚期非小细胞肺癌 ,疗效较高且毒副作用较少     

三氧化二砷联合化疗治疗难治性及复发性恶性血液病的临床疗效观察

目的 :观察三氧化二砷 (As2 O3 )联合化疗治疗难治性及复发性恶性血液病的疗效和不良反应。方法 :As2 O3 联合蒽环类药物、阿糖胞苷及足叶乙甙治疗难治性及复发性恶性血液肿瘤患者 33例 ,治疗方法是用As2 O3 (0 .1%溶液 ) 10ml加入 5 %葡萄糖溶液 5 0 0ml中静脉滴注 3～ 5h ,每天 1次 ,共治疗 30天 ;对复发性早幼粒细胞白血病、加速期慢性粒细胞白血病及骨髓增生异常综合征患者用As2 O3 联合柔红霉素 4 5mg·m-2 ·d-1× 3天加阿糖胞苷 10 0mg/m2 q12h× 7天治疗 ;对进展期多发性骨髓瘤和ⅢB～Ⅳ期非霍奇金淋巴瘤患者用As2 O3 联合米托蒽醌 8～ 10mg·m-2 ·d-1× 3天加足叶乙甙 6 0mg·m-2 ·d-1× 5天加Pred 1mg/kg× 7天加长春新碱 2mg× 1天治疗。结果 :33例患者中 ,19例获得完全缓解 (CR) ,2 7例有效 ,CR率为 5 7.8% ,有效率为 81.8%。结论 :As2 O3 联合化疗治疗难治性及复发性恶性血液病疗效好 ,不良反应少     

多西他赛联合5-氟尿嘧啶、顺铂治疗晚期复治食管癌疗效观察

目的 探讨多西他赛联合5-氟尿嘧啶、顺铂组成的化疗方案治疗晚期复治食管癌的临床疗效和安全性.方法 将77晚期复治食管癌患者随机分为两组,治疗组采用多西他赛联合顺铂、5-氟尿嘧啶方案化疗,对照组采用顺铂、5-氟尿嘧啶方案化疗,21 d为一周期,连用2个周期后评价疗效.结果 治疗组的有效率、疾病控制率均高于对照组,但两组仅疾病控制率比较有统计学差异（P〈0.05）;治疗组骨髓抑制发生例数多于对照组（P〈0.05）,其余不良反应相似.结论 多西他赛联合顺铂、5-氟尿嘧啶方案治疗晚期复治食管癌有效率较高,不良反应可耐受,可作为老年食管癌患者的首选化疗方案.     

老年晚期食管癌生化调节疗法45例临床观察

目的观察和分析生化调节疗法治疗老年晚期食管癌的临床疗效和生存质量。方法治疗≥75岁老年晚期食管癌45例。DDP(顺铂)(25～5)mg·m-2·d-1,静滴2h,每周5d,连用2w;5Fu(150～200)mg·m-2·d-1,第1～14天静脉滴注6～8h,3w1周期,2～3周期为1疗程。结果无完全缓解(CR)病例,部分缓解(PR)15例,总有效率333%,稳定病例占489%(22/45)。初治有效率351%,复治有效率25%。Karnofsky评分,26例提高5～10分,11例稳定,8例下降。主要毒副作用为白细胞下降、恶心、口腔黏膜炎、腹泻等。结论该方案治疗老年晚期食管癌,毒性反应小,能明显减轻临床症状,提高患者生存质量。住院时间短,治疗费用少,便于开展,值得临床推广研究。     

紫杉醇脂质体与普通紫杉醇治疗胃癌疗效比较

目的比较周疗法紫杉醇脂质体联合方案和普通紫杉醇联合方案治疗晚期胃癌的疗效和毒副作用。方法 31例晚期胃癌患者分别接受紫杉醇脂质体（实验组）或紫杉醇（对照组）75 mg/m2,第1、8天;草酸铂130 mg/m2,第1天;亚叶酸钙200 mg于5-氟尿嘧啶前静脉滴注,第1～5天,5-氟尿嘧啶500 mg/m2,第1～5天。21 d为1个周期。结果实验组有效率61.54%（8/13）,对照组有效率55.56%（10/18）,P〉0.05;2组不良反应在血液学和消化道毒性以及乏力、脱发、手脚麻木、皮疹、呼吸困难等方面无差异,但对照组关节痛、肌肉痛、面色潮红发生率高于实验组（P均〈0.05）。结论周疗法紫杉醇脂质体联合方案与紫杉醇普通剂型的联合方案相比疗效相似,毒副作用减少。     

FOLFIRI方案用于晚期胃腺癌二线化疗的疗效

以化疗为主的综合治疗能明显提高晚期胃癌患者的生活质量,延长生存期〔1〕。目前晚期胃癌的治疗仍缺乏标准的化疗方案,尤其一线治疗失败后二线治疗的选择更是难点。研究表明伊立替康联合持续静点5-氟尿嘧啶(5-FU)(即FOLFIRI方案)在晚期胃腺癌治疗中无论作为一线还是二线治疗,均有一定疗效〔2～4〕。本文就FOLFIRI方案作为二线化疗方案对晚期胃腺癌患者的疗效进行了观察。     

泼尼松联合甲氨蝶呤氯喹治疗系统性红斑狼疮的研究

目的　回顾性研究 ,旨在探讨PMC治疗 (小剂量泼尼松合并甲氨蝶呤、氯喹 )对于轻、中度活动期SLE患者的疗效及副作用 ,以减少药物用量和副作用。方法　将入选的门诊患者按起始激素剂量 ,分为A (泼尼松剂量≤ 0 2mg·kg-1·d-1)和B (泼尼松 0 5～ 0 6mg·kg-1·d-1)两组 ,并联合应用甲氨蝶呤 7 5～ 10mg/周及氯喹 0 2 5g/d ,各 30例。观察疗效和副作用 ,为期 1年。结果　A组积分由治疗前的 2 1± 1 4降至 0 9± 0 7,B组感染多于A组 (2 2∶7,P <0 0 0 1) ,其中多为肺部感染 ,其次为皮肤感染。B组由 2 9± 2 3降至 1 3± 1 3。二组治疗前后相比疗效显著 ,但A、B两组间的疗效差异无显著性。B组中出现了库兴综合征及股骨头无菌性坏死 ,A组没有。结论　PMC方案对没有严重内脏累及的轻到中度的SLE患者有效。但在加大激素剂量的B组 ,感染问题比较突出     

多西他赛联合FOLFOX4方案治疗晚期胃癌40例临床观察

目的探讨多西他赛＋FOLFOX4方案对晚期胃癌的疗效及毒副作用。方法晚期胃癌患者40例,给予以下化疗方案：多西他赛60 mg/m2静脉滴注,第1天;奥沙利铂85 mg/m2静脉滴注,第1天;亚叶酸钙（CF）200 mg/m2静脉滴注,第1、2天;5-氟尿嘧啶（5-Fu）400 mg/m2静脉推注,第1天,5-Fu 600 mg/m2持续静脉滴注46 h。14 d为1个周期,所有患者至少接受3个周期以上的化疗。结果 40例均可评价疗效,总有效率45.0%,中位生存时间9.3个月,中位肿瘤进展时间6.1个月。主要毒副反应为胃髓抑制、腹泻和脱发。结论多西他赛联合FOLFOX4方案治疗晚期胃癌的近期疗效好,毒副作用可以耐受。     

多西他赛联合氟尿嘧啶和亚叶酸钙双周方案治疗晚期胃癌的临床疗效研究

目的研究多西他赛联合氟尿嘧啶和亚叶酸钙双周方案治疗晚期胃癌的临床疗效和不良反应。方法选择2009年6月—2011年8月我科收住的符合条件的晚期胃癌患者40例,治疗方案为多西他赛45mg/m2,静脉滴注1h;亚叶酸钙200mg/m2,静脉滴注2h;氟尿嘧啶375mg/m2,静脉推注10min;氟尿嘧啶2g/m2,静脉灌注46h,以上方案每2周重复1次,每2次为1个疗程,所有患者至少接受2个疗程的治疗。结果 40例均可评价疗效,有效率为62.5%(25/40);无治疗相关死亡,主要不良反应为骨髓抑制、口腔炎及脱发。结论多西他赛+氟尿嘧啶和亚叶酸钙联合化疗双周方案治疗晚期胃癌缓解率较高,不良反应耐受好,是治疗晚期胃癌安全有效的化疗方案。     

Randomized trial of 5-fluorouracil, leucovorin and cisplatin in advanced pancreatic cancer.

BACKGROUND/AIMS: Phase II trials of combined 5 fluorouracil, leucovorin and cisplatin have demonstrated an 18-28% response rate in advanced pancreatic carcinomas. We investigated the effect of this chemotherapy regime on patients' survival. METHODOLOGY: Patients included gave informed consent. They had an advanced and proven pancreatic adenocarcinoma. The trial was multicentric, prospective and randomized. It compared a 5-day course of leucovorin (200 mg/m2/day), 5-fluorouracil (375 mg/m2/day) and cisplatin (15 mg/m2/day) repeated every 21 days (23 patients) with a control group (22 patients). The main end points were survival time (Kaplan-Meier and log-rank methods) a[not readable: see text]side effects of chemotherapy. RESULTS: Association of leucovorin, 5-fluorouracil and cisplatin failed to demonstrate any advantage of this regimen compared with supported care alone. Median survival times were 8.6 months (SD +/- 1.8) and 7.0 months (SD +/- 0.6), respectively. The modulation of 5-fluorouracil by leucovorin and cisplatin was well tolerated with moderate toxic effects. CONCLUSIONS: This multicentric trial failed to demonstrate any advantage of the evaluated chemotherapy regime in the palliative treatment of cancer of the exocrine pancreas. Other trials including gemcitabine and/or radiotherapy are needed in advanced pancreatic adenocarcinoma.     

多西他赛联合铂类治疗126例晚期非小细胞肺癌临床观察

目的探讨多西他赛联合顺铂、卡铂及奈达铂治疗晚期非小细胞肺癌的疗效和毒副反应。方法应用多西他赛75 mg/m2联合顺铂75 mg/m2(或卡铂AUC=5,或奈达铂75 mg/m2)方案治疗126例晚期非小细胞肺癌患者。结果总有效率达48.4%,临床获益率为83.3%,其中初治与复治病例、ⅢB期与Ⅳ期病例组间的疗效差异有统计学意义(P<0.05),腺癌与鳞癌两组之间、合并使用顺铂、卡铂或奈达铂三组之间疗效差异无统计学意义(P>0.05)。主要毒副反应为骨髓抑制、恶心呕吐、腹泻及脱发。结论多西他赛联合顺铂、卡铂及奈达铂治疗晚期非小细胞肺癌疗效确切,毒副反应可耐受。     

Treatment of recurrent small cell lung carcinoma with vindesine and cisplatin

Thirty-two males with recurrent small cell lung cancer after previous remission were treated with vindesine (3-4 mg/m2) plus cisplatin (60-100 mg/m2). Six patients (19%) responded to this therapy with two complete (CR) and four partial remissions. Minor responses were seen in another ten patients (32%). In patients with CR survival from start of treatment lasted 61 and 38 weeks; in patients who did not achieve CR median survival was 12 weeks. Nausea and vomiting were the predominant side effects, while only mild to moderate myelosuppression was noted. The vindesine and cisplatin regimen demonstrated significant activity against heavily pretreated small cell lung cancer, although chemotherapeutic response was poor in regions of prior irradiation.     

培美曲塞联合顺铂-线治疗肺腺癌疗效分析

目的观察培美曲塞联合顺铂一线治疗肺腺癌的疗效和不良反应。方法肺腺癌42例,以21天为一疗程,予以培美曲塞500 mg/m2（d1,10 min以上静滴）＋顺铂75 mg/m2（d1,2 h以上静滴）;评价疗效及不良反应。结果 42例患者均可评价疗效,无完全缓解病例,部分缓解病例10例,稳定病例25例,进展病例7例,疾病控制率为83.3%（35/42）。常见不良反应为粒细胞减少症、贫血、胃肠道反应。结论培美曲塞联合顺铂一线治疗肺腺癌,疗效确切且不良反应少。     

吉西他滨联合顺铂对晚期肺鳞癌及肺腺癌治疗的临床疗效比较

目的观察吉西他滨联合顺铂的化疗方案对晚期肺鳞癌及肺腺癌的临床疗效及生存差异。方法肺鳞癌组47例及肺腺癌37例患者给予吉西他滨（1000mg／m2）联合顺铂（75mg／m。）化疗,每21天为一周期,共化疗4个周期。结果肺鳞癌组PR为14例（29．8％）,SD为21例（44．7％）,PD为12例（25．5％）,RR为29．8％,中位生存期为13个月,1年生存率为53．2％;肺腺癌组PR为10例（27．0％）,SD为18例（48．6％）,PD为9例（24．3％）,RR为27．0％,中位生存期为9个月,1年生存率为27．0％;结论吉西他滨联合顺铂对晚期肺癌及鳞癌的临床疗效相当,但肺鳞癌较肺腺癌具有较好的1年生存率及生存时间。     

Cisplatin and etoposide combination chemotherapy for refractory small cell carcinoma of the lung

Twenty-nine patients with refractory recurrent small cell carcinoma of the lung were treated with cisplatin (40 mg/m2) and etoposide (200 mg/m2) each day for 3 days, repeated every 3-4 weeks. Fifteen of these patients had received etoposide in their original treatment regimen. Fifteen (52%) of all patients had a major response, as did nine (60%) of the patients with prior exposure to etoposide. Myelotoxicity was moderately severe. The median duration of responses was 3 months (range, 6-36 weeks). This study suggests synergism between cisplatin and etoposide. The toxicity seen in this heavily pretreated group of patients suggests that smaller doses be studied in this group. The synergism may be best utilized in the initial regimens against small cell lung cancer.     

Comparison of vindesine plus cisplatin or vindesine plus mitomycin in the treatment of advanced non-small cell lung cancer

Fifty-eight patients with advanced non-small cell lung cancer were randomly allocated to receive vindesine (3 mg/m2 every week) plus either cisplatin (80 mg/m2 every 3 weeks) or mitomycin (8 mg/m2 weekly X 3, then every 3 weeks). No patients achieved complete response. Among the 28 patients treated with vindesine plus cisplatin, there were 12 partial responders (42.9%); among the 30 patients treated with vindesine plus mitomycin, there were only three partial responders (10%) (P less than 0.005). The median duration of response was 11.5 weeks (range, 4-25) in the patients treated with vindesine plus cisplatin. The median survival times for patients treated with vindesine plus cisplatin and vindesine plus mitomycin were 10.1 and 10.2 months, respectively; there was no statistical difference in survival time between the two groups. Initial performance status was the strong predictor of patient survival. Toxic effects, including moderate myelosuppression, nephrotoxicity, peripheral neuropathy, and gastrointestinal symptoms, were generally manageable. The combination of vindesine and cisplatin appears to be effective against advanced non-small cell lung cancer.     

Phase II trials of 5-FU, doxorubicin, and cisplatin in advanced, measurable adenocarcinoma of the lung and stomach

A combination of 5-FU (600 mg/m2 on Days 1 and 8), doxorubicin (40 mg/m2 on Day 1), and cisplatin (75 mg/m2 on Day 1) has been used for treatment of 31 patients with advanced measurable adenocarcinoma of the lung and 35 with gastric cancer. The regimen was given every 4 weeks until disease progression to patients who had not received prior chemotherapy. One complete response occurred in the lung cancer group. Ten of the gastric cancer patients (29%) had partial responses. The median duration of response was 5.5 months and the median survival in responding patients was 10.8 months. Toxicity of the regimen was moderate. We conclude that this combination offers no particular advantages over previously described treatments for these diseases.     

Phase II trial of cisplatin in small cell carcinoma of the lung

Eighteen patients with histologically documented small cell carcinoma of the lung who had failed initial combination chemotherapy regimens were treated with single-agent cisplatin in a dose of 100 mg/m2 every 3 weeks, with mannitol and fluid diuresis. Tumor regression was limited to one partial response (response rate, 6%; 95% confidence limits. 1%-27%). Significant toxic effects were gastrointestinal (severe nausea and vomiting in 12 of 14 patients) and hematologic (severe leukopenia in one patient and severe thrombocytopenia in three). The antitumor efficacy of high-dose cisplatin in heavily pretreated patients with small cell carcinoma of the lung appears to be marginal.     

Synchronous primary adenocarcinoma of the lung and leiomyosarcoma of the small intestine

The occurrence of synchronous epithelial cancer of the lung and leiomyosarcoma of the small intestine is rare. We report here the case of a 62-year-old man with adenocarcinoma of the lung in clinical stage IIIB (T4N0M0). After two courses of chemotherapy (cisplatin, 80 mg/m2 and mitomycin C, 8 mg/m2) the patient developed symptoms of a small bowel obstruction. Palliative surgical resection was performed and a leiomyosarcoma of the small intestine was found and defined by an immunohistological study. The resection ameliorated the patient's symptoms. The patient died of disseminated adenocarcinoma 26 months following chemotherapy.