结直肠癌组织中ERCC1和BRCA1的表达及其与铂类化疗疗效的相关性

目的 探讨结直肠癌组织中核苷酸切除修复交错互补基因1(excision repair cross-complementing gene 1,ERCC1)及乳腺癌易感基因1(breast cancer susceptibility gene 1,BRCA1)的表达及其临床意义。方法 采用免疫组化的方法检测结直肠癌组织中E...     

SOX与FOLFOX4方案治疗晚期胃癌的临床对照研究

目的比较SOX方案与FOLFOX4方案治疗晚期胃癌的临床疗效和毒副反应。方法 51例晚期胃癌患者随机分为2组。SOX方案组27例接受替吉奥＋奥沙利铂治疗,而FOLFOX4方案组24例接受氟尿嘧啶＋亚叶酸钙＋奥沙利铂治疗。结果 51例患者均可评价疗效,SOX方案组有效率48.1%,中位疾病进展时间6.0个月,中位生存时间10.3个月;FOLFOX4方案组分别为45.8%、5.8个月、10.0个月,2组比较差异无统计学意义（P〉0.05）。SOX方案组Ⅲ、Ⅳ度恶心呕吐发生率低于FOLFOX4方案组（P〈0.05）。结论SOX与FOLFOX4 2种方案治疗晚期胃癌疗效相似,但前者的毒副反应更轻。     

浅谈中药静脉注射剂集中配置的稳定性

目的：对中药的静脉注射在临床上配伍的的稳定性进行探讨分析.方法：检索“中国万方数据库”中2000年-2014年的有关中药注射剂配伍的相关文献进行归纳整理并统计分析.通过药物对滴注速度、pH值、温度、溶液浓度,光照、微粒等方面进行系统的分析,可以直观的反映出中药静脉注射稳定性最好时pH值、温度、溶液浓度等因素处于何种状态,为今后的临床的用药工作提供重要的理论依据.结果：通过对文献的归纳整理,大多数中药注射剂需要选择合适的溶媒,还要结合适宜的温度、pH值、溶液浓度,而有些药物在选择溶媒后药剂仍然不稳定,那么在临床上应该采用现用现配的原则.结论：由于中药药剂制取过程复杂,成分多样,且注射过程中大多数中药会产生不良反应,因此中药静脉注射剂几种配置的稳定性和减少相关不良反应是保证临床工作质量的重要因素之一.     

High expression of organic anion transporter 2 and organic cation transporter 2 is an independent predictor of good outcomes in patients with metastatic colorectal cancer treated with FOLFOX-based chemotherapy

Although metastatic colorectal cancer (mCRC) is commonly treated with 5-fluorouracil (5-FU)/leucovorin/oxaliplatin (FOLFOX), their response to FOLFOX varies, and no biomarkers predictive of treatment outcome have been validated. Organic anion transporter 2 (OAT2) and organic cation transporter 2 (OCT2) are critical determinants in uptake of 5-FU and oxaliplatin, respectively. In this study, we evaluated whether OAT2 and OCT2 levels can predict effectiveness of FOLFOX-based therapy. We retrospectively assessed 90 patients with mCRC who were treated with first-line FOLFOX with or without bevacizumab. We immunohistochemically determined OAT2 and OCT2 expression levels at invasion fronts of their tumors and correlated the levels to clinicopathological parameters, including objective tumor response (OTR) and progression-free survival (PFS). High expression of OAT2 (OAT2^High) and OCT2 (OCT2^High) were detected in 36% and 60% of the tumors, respectively. OCT2^High was significantly associated with invasion depth (P=0.03), whereas OAT2^High was not associated with any clinicopathological parameters. In univariate analysis, OAT2^High was significantly correlated with good OTR (P=0.02), and OCT2^High with long PFS (P=0.03). Multivariate analyses showed that OAT2^High and OCT2^High, respectively, were the sole independent predictors of good OTR (P=0.02) and long PFS (P=0.03). We found that patients with OAT2^High/OCT2^High showed the best treatment outcomes (good OTR and long PFS) with significantly higher frequency than patients with other expression patterns (P=0.003). OAT2^High/OCT2^High status was also the only independent predictive factor in multivariate analysis. This study suggests that OAT2^High and OCT2^High are important independent predictors of good outcomes in FOLFOX-treated mCRC.     

黄芪桂枝五物汤加减治疗奥沙利铂所致周围神经病变的回顾性研究

[目的]探讨黄芪桂枝五物汤加减治疗奥沙利铂所致周围神经病变气虚血瘀证患者的疗效.[方法]回顾性分析78例接受奥沙利铂化疗后引起周围神经病变气虚血瘀证患者的临床资料,根据治疗方案的不同将其分为治疗组和对照组,每组各39例.治疗组给予口服黄芪桂枝五物汤加减治疗,对照组口服甲钴胺片治疗,疗程为4周.观察2组患者治疗前后周围神...     

Gemcitabine–oxaliplatin plus prednisolone is active in patients with castration-resistant prostate cancer for whom docetaxel-based chemotherapy failed

Background:

There has been no previous study on the activity of gemcitabine in combination with oxaliplatin (GemOx) for castration-resistant prostate cancer (CRPC).

Methods:

The GemOx was preclinically tested for cytotoxic activity in human prostate cancer cell lines. Clinically, patients with CRPC who failed prior docetaxel were treated with gemcitabine 1000 mg m⁻² and oxaliplatin 100 mg m⁻² intravenously every 2 weeks and prednisolone 5 mg orally twice daily. The primary end point was the prostate-specific antigen (PSA) response rate.

Results:

The GemOx displayed synergistic effects based on Chou and Talalay analysis. In the phase II study, 33 patients were accrued. The median dose of docetaxel exposure was 518 mg m⁻². A total of 270 cycles were administered with a median of eight cycles per patient. A PSA response rate was 55% (95% CI, 38–72) and radiologic response rate was 82% (9 out of 11). With a median follow-up duration of 20.5 months, the median time to PSA progression was 5.8 months (95% CI, 4.4–7.2) and the median overall survival was 17.6 months (95% CI, 12.6–22.6). The most frequently observed grade 3 or 4 toxicities were neutropenia (13%) and thrombocytopenia (13%).

Conclusions:

The GemOx is active and tolerable in patients with metastatic CRPC after docetaxel failure ({"type":"clinical-trial","attrs":{"text":"NCT 01487720","term_id":"NCT01487720"}}NCT 01487720).     

大肠癌细胞对5-氟尿嘧啶和奥沙利铂的敏感性

目的:比较5-氟尿嘧啶(5-FU)和亚叶酸(FA)联合应用(FUFA)、奥沙利铂(LOHP)以及LOHP加FUFA对DukesB和C期结直肠癌细胞的抑制作用.方法:收集术前未化疗,手术切除的大肠癌标本60例,将肿瘤标本制成浓度为2×105/ml细胞悬液,分别加入终浓度为0.01、0.1和1倍血浆峰值浓度(PPC)的FUFA、LO-HP和LOHP加FUFA,用MTT法测定肿瘤细胞生存率.结果:组间比较显示:FUFA和LOHP之间的综合疗效无统计学差异(P=0.338),FUFA和LOHP加FUFA之间也没有统计学差异(P=0.138).与LOHP单独用药相比较,LOHP、FUFA联合用药的综合肿瘤细胞存活率降低,显示出统计学上的差异(P=0.033).结论:对临床上确诊的DukesB和C期结直肠癌细胞,FUFA和LOHP在单药用药时都具有抑制作用,而该作用在LOHP加FUFA时增强,二药联合具有协同作用,这些作用呈现剂量相关性.     

雷替曲塞与卡培他滨联合奥沙利铂治疗老年晚期结直肠癌的疗效比较

目的探讨雷替曲塞与卡培他滨联合奥沙利铂治疗老年晚期结直肠癌的疗效和安全性。方法64例晚期大肠癌患者随机分为2组,治疗组33例,予以雷替曲塞3mg／m2,第1天,静脉注射15min;奥沙利铂130mg／m2,静脉滴注3h,第1天;每3周重复1次。对照组31例,予以XELOX方案：卡培他滨1000mg／m2,2次／d,口服,第1～14天;奥沙利铂130mg／m2,静脉滴注3h,第1天;每3周重复1次。结果治疗组与对照组分别有32例和30例可评价疗效,有效率（RR）分别为49．2％和47．9％;中位疾病进展时间（TTP）分别为8．2个月与7．9个月,2组疗效比较无统计学意义（P〉0．05）。治疗组转氨酶升高、中性粒细胞减少和疲乏发生率明显高于对照组（P〈0．05）,手足综合征与恶心、呕吐发生率低于对照组（P〈0．05）。结论雷替曲塞联合奥沙利铂方案一线治疗晚期结、直肠癌疗效确切,与XELOX方案相当,不良反应能耐受。雷替曲塞联合奥沙利铂方案用药更为方便,安全一性更好。     

奥沙利铂为基础的方案治疗老年晚期结直肠癌的临床观察

目的探讨奥沙利铂为基础的方案治疗老年晚期结直肠癌的疗效及安全性。方法选择经病理学确诊的46例老年晚期结直肠癌患者,均采用奥沙利铂为基础的方案化疗,其中包括FOLFOX方案18例,XELOX方案25例,另有3例为奥沙利铂联合氟尿嘧啶方案。所有患者至少完成2个周期的化疗,观察客观有效率(RR)、疾病控制率(DCR)、中位疾病进展时间(TTP)、总生存时间(OS)和化疗相关不良反应。结果 46例患者中,RR及DCR分别为39.1%和80.4%,TTP和OS分别为7.0月和24.0月。化疗相关不良反应可以耐受,Ⅰ~Ⅱ度不良反应主要包括中性粒细胞减少、血小板减少、贫血等,Ⅲ~Ⅳ度不良反应少见,主要为中性粒细胞减少和腹泻。结论奥沙利铂为基础的方案治疗老年晚期结直肠癌安全有效,值得在老年人群中进一步研究推广。     

替吉奥联合亚叶酸钙及奥沙利铂治疗晚期结直肠癌病人的观察与护理

[目的]总结替吉奥联合亚叶酸钙及奥沙利铂治疗晚期结直肠癌病人的观察与护理。[方法]对25例无法手术切除的晚期结直肠癌病人采用替吉奥胶囊联合亚叶酸钙、奥沙利铂方案进行治疗,同时加强心理护理、毒副反应的观察与护理等。[结果]治疗过程中出现Ⅰ级和Ⅱ级神经毒性8例,恶心、呕吐、食欲下降12例,骨髓抑制5例,变态反应1例,经处理后均好转;1例病人死亡,其余病人均顺利进行治疗。[结论]加强替吉奥联合亚叶酸钙及奥沙利铂治疗晚期结直肠癌病人的护理,可保证治疗的顺利进行。