Retrospective evaluation of the impact of non-oncologic chronic drug therapy on the survival in patients with bladder cancer

International Journal of Clinical Pharmacy - Background Chronic drug therapy may impact recurrence and survival of patients with bladder cancer and thus be of concern regarding drug choice and...     

紫杉醇在卵巢癌化疗病人中的非线性药物动力学(英文)

目的:探讨紫杉醇在卵巢癌病人体内的药物动力学特点。方法:15名紫杉醇化疗病人3小时内输注剂量分别为135mg/m~2,175mg/m~2和235mg/m~2。输注过程中及输注后24小时采集病人血样。由非房室和房室模型评价药物动力学参数。结果:化疗病人符合二室模型,三组的T_((1/2)β)分别为(5.18±3.49,6.26±2.21和6.99±1.45)h,AUC(14.71±0.76,39.09±13.10和66.52±12.23)mg·h·L~(-1),Cl(14.29±0.74,7.52±2.15和6.25±1.93)L·h~(-1)。结论:紫杉醇具有非线性药物动力学特征,病人的代谢存在个体差异。     

不同剂型紫杉醇联合卡铂对复发性卵巢癌患者的成本-效果分析

目的 探讨不同剂型紫杉醇联合卡铂对复发性卵巢癌患者的成本-效果。方法 选取滁州市第一人民医院2016年5月—2018年5月收治的60例复发性卵巢癌患者为研究对象,随机将其分为对照组与观察组,每组30例。对照组患者第1日给予175 mg/m²的传统紫杉醇注射液,加入到5%葡萄糖注射液500 mL中,静脉滴注3 h,给药前给予地塞米松预处理。次日采用5 AUC卡铂注射液,加入5%葡萄糖注射液500 mL,静脉滴注2 h。观察组患者给予175 mg/m²注射用紫杉醇脂质体,加入5%葡萄糖注射液500 mL,静脉滴注3 h;5 AUC卡铂注射液加入到5%葡萄糖注射液500 mL中,静脉滴注2 h。21 d为1个周期,两组共治疗6个周期。结果 治疗后,观察组临床总有效率为66.67%,与对照组的60.00%相比,差异不具有统计学意义。治疗期间,观察组患者的毒副反应率为20.00%,显著低于对照组46.67%,两组比较差异具有统计学意义（P<0.05）。观察组的化疗药物使用费用高于对照组,毒副反应治疗药物低于对照组,两组比较差异有统计学意义（P<0.05）。观察组的增量成本-效果比（△C/△E）为7 234.65,即增加1个效果单位,观察组需多花7 234.65元。结论 复发性卵巢癌患者采用传统紫杉醇联合卡铂治疗具有较高的疗效及经济性,值得临床推广应用。     

肾癌预后及生存风险COX分析研究

目的：探讨与肾癌患者预后的影响因素及与生存相关的风险因素。方法：选取本院泌尿外科收治的肾癌患者临床资料37份,采用回顾性方法对患者临床资料进行分析,采用χ2检验对患者预后影响因素进行初步筛选,采用COX生存风险分析对影响患者预后的独立危险因素进行分析。结果：肾癌患者中位生存期19个月,患者的年龄、肿瘤的组织学类型、肿瘤TNM分期、分化程度、是否根治切除、是否接受放化疗及首发症状至就诊时间是影响患者预后的相关因素,多因素分析结果显示肿瘤TNM分期、肿瘤分化程度、手术根治性切除与否是与患者预后相关的独立危险因素。结论：肾癌患者预后较差,中位生存期较短,肿瘤的生物学特点及治疗情况是影响患者预后的主要因素。     

紫杉醇联合卡铂化疗治疗卵巢癌的临床观察

目的观察紫杉醇联合卡铂化疗方案治疗卵巢癌的疗效和毒副反应。方法40例卵巢癌患者用“紫杉醇＋卡铂”全身化疗或“紫杉醇＋卡铂”腹腔化疗,观察其疗效及不良反应。结果40例中,CR12例,PR18例,SD6例,PD4例,总有效率75％,主要不良反应为骨髓抑制、脱发、恶心、呕吐,但均可耐受。结论紫杉醇联合卡铂化疗方案治疗卵巢癌有较好疗效,不良反应可耐受。     

The pharmacogenetic impact of inflammatory genes on bladder cancer recurrence

Although superficial bladder cancer can generally be treated successfully, tumor recurrence is a serious clinical problem, with a recurrence rate of approximately 70%. Clinicopathologic markers for superficial bladder cancer recurrence remain the best prognostic predictors in clinical decision making. Biomarkers that may complement clinicopathological parameters and increase the accuracy of outcome prediction have been extensively studied. A large number of molecular markers, including inflammatory genes, have been suggested to have predictive value for bladder cancer recurrence. The role of inflammation in the development and progression of bladder cancer, as in other malignancies, is gaining increased recognition. This review will summarize recent data regarding the impact of genetic variations in inflammatory genes on de novo bladder cancer recurrence, as well as recurrence in the context of bacillus Calmette-Guerin (BCG) treatment. Genomic variation as a mechanism that may modify BCG efficacy is discussed in detail.     

Chronic administration of single weekly paclitaxel in heavily pretreated ovarian cancer patients

Ovarian cancer patients with paclitaxel-resistance have been reported to respond to a weekly schedule of the same drug. In this report, two cases with long progression free interval by weekly paclitaxel (T) are presented. Case 1. A 41-year-old Japanese woman, gravida 2, para 0, was referred to our hospital in September 16, 1998, because of abdominal mass accompanying large amount of ascites with elevated CA125 (8400 U/ml) and CA19-9 (770 U/ml). Exploratory laparotomy (tumor biopsy plus partial omentectomy) was performed September 21, 1998. After the surgery, the tumor was diagnosed as serous cystadenocarcinoma of the ovary (stage IV) and 6 cycles of treatment consisting of cyclophosphamide, adriamycin and cisplatin (CAP) were performed. The CA 125 level (8400 U/ml) rapidly declined to 150 U/ml by this CAP therapy. After second cytoreductive surgery (SRS) (total hysterectomy and bilateral salpingo-oophorectomy), residual tumor was less than 2 cm. Although 7 cycles of CAP was added, ascites and elevation of CA 125 (5100 U/ml) were observed. Therefore, treatment with single weekly T was performed and CA 125 levels remained between 70-90 U/ml during 13 cycles of this therapy (progression free interval; more than 1 year). Thereafter, she is alive with disease and followed-up. Case 2. A 48-year-old Japanese woman, gravida 3, para 2, was referred to our hospital in July 22, 1998, because of abdominal swelling and pain. Computing tomography (CT) and magnetic resonance imaging (MRI) revealed large amount of ascite and pelvic mass (9 x 7 x 7 cm), and low density area (3 x 3 cm) suggesting metastasis in right lobe of liver. Serum CA 125 level elevated to 5100 U/ml. Bilateral salpingo-oophorectomy and infracolic omentectomy were performed on August 5, 1998. The tumor was diagnosed as endometrioid adenocarcinoma of the ovary, stage IV and chemotherapy with CAP was initiated on September 5, 1998. After 6 cycles of CAP, SRS was performed. After SRS, 3 cycles of CAP were added and changed to weekly T because of damage of renal function. The CA 125 level returned within normal range during weekly T. Total 13 cycles of weekly T were performed and progression free interval was about 18 months. Thereafter, she received treatments with gamma knife and CAP for brain metastasis. She is alive without disease and followed-up. Side effects by weekly T were mild and tolerable despite of long term treatment. In addition, weekly T can be safely used in outpatient setting and even in patients with poor performance status (PS), and warrant long time to progression.     

阿帕替尼联合紫杉醇单药化疗对复发性铂类耐药型卵巢癌患者的临床疗效分析

目的 探讨阿帕替尼联合紫杉醇单药化疗对复发性铂类耐药型卵巢癌患者的治疗效果。方法 74例复发性铂类耐药型卵巢癌患者,随机分为观察组和对照组,每组37例。观察组采取阿帕替尼联合紫杉醇单药化疗,对照组采取传统紫杉醇单药化疗。比较两组患者的治疗效果、不良反应发生情况。结果 观察组客观缓解率为67.57%,高于对照组的43.24%,差异具有统计学意义(P<0.05)。观察组不良反应发生率为16.22%,低于对照组的40.54%,差异具有统计学意义(P<0.05)。结论 在对复发性铂类耐药型卵巢癌患者进行治疗时,采用阿帕替尼联合紫杉醇单药化疗治疗方法 ,能够提升患者治疗效果,改善患者的病情,且安全性较高,值得临床推广应用。     

Feasibility study and pharmacokinetics of low-dose paclitaxel in cancer patients with severe hepatic dysfunction

The aim of this study is to investigate the feasibility and determine the pharmacokinetics of low-dose paclitaxel in cancer patients with severe hepatic dysfunction. This was a prospective study. Patients with liver metastases who had either transaminase serum levels higher than 10 times the upper normal limit or bilirubin serum levels higher than 5 times the upper normal limit were eligible. All patients underwent pharmacokinetic evaluation during the first course of treatment. Pharmacokinetics in severe hepatic dysfunction patients were compared with data from a reference group of patients with normal hepatic function who participated in a phase I study. Nine severe hepatic dysfunction patients were treated with paclitaxel 70 mg/m administered as a 1-h infusion every 2 weeks. They received a median three treatment courses (range 1-9) without clinically relevant toxicity. The area under the concentration-time curve of paclitaxel was markedly higher in severe hepatic dysfunction patients when compared with the normal hepatic function control group treated with the same dose (98% increase, P<0.001). Area under the concentration-time curve and the time above 0.1 micromol/l (T>0.1) concentration threshold in the severe hepatic dysfunction patients who received paclitaxel 70 mg/m approximated pharmacokinetics of paclitaxel in patients with normal liver function who received 130 mg/m. Maximum plasma concentration (Cmax) did not differ between the two groups. In conclusion, paclitaxel 70 mg/m was safely delivered every 2 weeks in patients with severe hepatic dysfunction and resulted in adequate plasma concentrations. Paclitaxel at this dosage can be taken as an option for severe hepatic dysfunction patients who are expected to get clinical benefits from taxanes.     

Dose-finding study of paclitaxel and carboplatin in patients with advanced non-small cell lung cancer

This dose-finding study was designed to determine the maximum tolerated dose (MTD), efficacy and toxicity of combined paclitaxel and carboplatin in 35 previously untreated patients with advanced non-small cell lung cancer (NSCLC). Paclitaxel was given as a 3-h infusion at escalating dose levels (100-250 mg/m2) immediately followed by carboplatin as a 30-min infusion (325 or 350 mg/m2) every 3 weeks. The dose-limiting toxicity, paresthesia, occurred at the highest dose level, therefore the recommended dose was established one level below (paclitaxel 225 mg/m2 with carboplatin 325 mg/m2). Neutropenia was the most common hematotoxicity; dose dependency was not apparent. Two patients, at different dose levels, had febrile neutropenia. Thrombocytopenia was rare. Non-hematological toxicities grade 3 or higher included infection, anorexia, alopecia and paresthesia. One patient had a hypersensitivity reaction (transient hypotension). The overall response rate was 23% and median survival time was 7.5 months. Promising activity and acceptable toxicity supports the development of this combination as a useful chemotherapeutic option in advanced NSCLC.     

Pharmacokinetics of paclitaxel and cisplatin in a hemodialysis patient with recurrent ovarian cancer

This is the first report that the combination of paclitaxel and cisplatin is feasible in a patient with recurrent ovarian cancer undergoing hemodialysis. Paclitaxel at a dose of 150 mg/m(2) was administered as a 3-h continuous i.v. infusion. Thirty minutes after paclitaxel administration, cisplatin was administered at a dose of 30 mg/m(2) for 30 min. Hemodialysis was started 30 min after completion of the cisplatin infusion and performed for 5 h. The maximum plasma concentrations of paclitaxel, total platinum and free platinum were 3.26, 2.44 and 1.84 microg/ml, respectively. The AUC of paclitaxel and free platinum were 15.3 and 1.76 microg x h/ml, respectively. The pelvic tumor size was reduced by 42% on MRI after the second course of this therapy. Grade IV neutropenia and grade III thrombopenia were observed. We conclude that paclitaxel and cisplatin combination chemotherapy is efficacious and feasible for an ovarian cancer patient under hemodialysis.     

卵巢癌患者术后力朴素与顺铂联合静脉化疗的疗效观察

目的观察卵巢癌患者术后应用力朴素与顺铂联合静脉化疗的疗效及毒副反应。方法 24例患者术后采用力朴素与顺铂联合静脉化疗。3周1个疗程,共4~6个疗程。化疗后通过患者的临床症状及化验指标等判断治疗效果及化疗毒副作用。结果治疗有效率为91.67%(22/24),血肿瘤标志物CA125下降率91.67%(22/24)。白细胞下降发生率为45.83%(11/24),胃肠道反应率为70.83%(17/24)。所有患者均未因化疗毒副作用中断或退出治疗。结论力朴素与顺铂联合静脉化疗对术后卵巢恶性肿瘤治疗效果好,毒副反应轻。     

紫杉醇脂质体联合顺铂治疗晚期卵巢癌患者的疗效及血清肿瘤标志物水平分析

目的　探讨紫杉醇脂质体联合顺铂治疗晚期卵巢癌患者的疗效及血清肿瘤标志物水平。方法　选取2018年12月至2021年12月聊城市第三人民医院收治的82例晚期卵巢癌患者,依照随机数表法分为研究组和对照组,每组41例。研究组年龄（51.85±5.19）岁,对照组年龄（50.89±5.58）岁。对照组采用TP方案（紫杉醇+顺铂）,研究组采用紫杉醇脂质体联合顺铂治疗。比较两组患者临床疗效、T细胞亚群水平、血清肿瘤标志物癌胚抗原（CEA）及人附睾分泌蛋白4（HE4）水平和不良反应。采用t检验和χ²检验。结果　研究组客观缓解率高于对照组［73.17%（30/41）比51.22%（21/41）,P<0.05］。与治疗前相比,两组治疗后CD3⁺、CD4⁺均呈现升高趋势,且研究组均高于对照组（均P<0.05）。与治疗前相比,两组治疗后CEA、HE4水平均降低,且研究组均低于对照组（均P<0.05）。研究组不良反应发生率低于对照组［7.32%（3/41）比29.27%（12/41）,P<0.05］。结论　晚期卵巢癌患者应用紫杉醇脂质体联合顺铂治疗可提高疗效,改善免疫功能,减低患者肿瘤标志物水平以及不良反应。     

紫杉醇加顺铂同步放疗治疗晚期非小细胞肺癌的近期疗效

目的　探讨低剂量紫杉醇加顺铂同步放疗对晚期非小细胞肺癌 (NSCLC)治疗价值。方法　将 40例晚期NSCLC病人随机分成 2组。放化疗同步组 (RT +CT组 ) :紫杉醇 ( 3 0～ 40mg m2 )加顺铂( 4 0mg m2 )每周应用 ,化疗 4周期。同步胸部放射治疗 60～ 70Gy(常规分割 )。单纯化疗组 (CT组 ) :应用紫杉醇 ( 13 0mg m2 )加顺铂 ( 70～ 80mg m2 ) ,化疗 2周期以上。结果　RT +CT组总有效率 66.7% ,CT组为 3 1.8% (P <0 .0 5 )。RT +CT组主要副作用为放射性食管炎和放射性肺炎 ,骨髓抑制低于CT组 ,CT组主要副作用为血液毒性。结论　低剂量紫杉醇加顺铂方案同步放疗近期有效率高 ,毒副作用可以耐受 ,优于单纯化疗组。