鬼臼乙叉甙静脉5天用药治疗老年人小细胞肺癌临床分析(附30例报告)

目的 观察单独应用鬼臼乙叉甙(VP-16)静脉给药5d治疗老年人小细胞肺癌的临床效果及其毒性反应。方法30例老年人小细胞肺癌患者，采用VP-16单药静脉化疗。结果 完全缓解9例(30．0％)、部分缓解15例(50．0％)、微效4例(13．3％)、稳定1例(3．3％)、进展1例(3．3％），有效率80．0％。全组中位生存期15个月，其中有效者中位生存时间20．5个月，无效者中位生存时间8个月，两者比较有显著性差异(P=0．013)。1、2、3年生存率分别为66．7％、40．0％、20．0％。毒性反应较轻，患者均能耐受，以轻度骨髓抑制和肝功能受损为主，恶心、呕吐少见。结论 静脉5d单独用VP-16治疗老年人小细胞肺癌的疗效可靠、使用方便、毒副反应轻。     

降低蛋白激酶D3的表达和活性增强前列腺癌细胞DU-145对依托泊甙的敏感性

目的 探讨蛋白激酶D3(protein kinase D3,PKD3)是否会影响依托泊甙对激素抵抗性前列腺癌(hormonal refractory prostate cancer,HRPC)的生长抑制.方法 在HRPC细胞系DU-145中瞬时转染PKD3的siRNA,Western blot检测细胞中内源性PKD3的表达变化;siRNA转染48 h后,分别以0、30、70、100、300 μmol/L的依托泊甙处理对照siRNA、siRNA-PKD3-1、siRNA-PKD3-2转染的DU-145细胞24 h,并以细胞活力测定观察敲定内源性PKD3的表达有无影响依托泊甙对DU-145的生长抑制;利用PKC单一抑制剂、PKC-PKD双重抑制剂处理DU-145细胞,以观察二者是否增强DU-145对依托泊甙的敏感性.结果 Western blot证实siRNA-PKD3的转染敲低DU-145细胞内源性PKD3的表达;细胞活力测定表明,在非特异性siRNA(si-CTL)转染的DU-145细胞中,依托泊甙剂量依赖地抑制DU-145细胞的生长,而敲低PKD3的表达不仅可显著抑制DU-145的生长(P<0.01),还可显著增强依托泊甙对DU-145生长的抑制(P<0.01);G06976(PKC-PKD的双重抑制剂)可明显抑制前列腺癌DU-145细胞生长(P相似文献   

Enhanced bioavailability of etoposide after oral or intravenous administration of etoposide with kaempferol in rats

This study was to investigate the effect of kaempferol on the pharmacokinetics of etoposide after oral or intravenous administration of etoposide in rats. The oral (6 mg/kg) or intravenous (2 mg/kg) etoposide was administered to rats alone or 30 min after the oral kaempferol (1, 4, or 12 mg/kg) administration. Compared to the oral control group, the presence of kaempferol significantly (4 mg/kg, P < 0.05; 12 mg/kg, P < 0.01) increased the area under the plasma concentrationtime curve (AUC) and the peak concentration (C_max) of the oral etoposide. Kaempferol decreased significantly (4 or 12 mg/kg, P < 0.05) the total body clearance (CL/F) of oral etoposide, while there was no significant change in the terminal halflife (t_1/2), the elimination rate constant (K_el) and the time to reach the peak concentration (T_max) of etoposide in the presense of kaempferol. Consequently, the absolute bioavailability (AB%) of oral etoposide with kaempferol was significantly higher (4 mg/kg, P < 0.05; 12 mg/kg, P < 0.01) than those from the control group. Compared to the intravenous control group, the presence of kaempferol enhanced the AUC of intravenously administered etoposide, however, only presence of 12 mg/kg of kaempferol significant (P < 0.05) increased AUC of etoposide. The enhanced bioavailability of oral etoposide by kaempferol could have been due to an inhibition of cytochrom P450 (CYP) 3A and P-glycoprotein (P-gp) in the intestinal or decreased total body clearance in the liver by kaempferol. The dosage regimen of etoposide should be taken into consideration for potential drug interaction when combined with kaempferol or dietary supplements containing kaempferol in patients.     

中剂量依托泊苷联合粒细胞集落刺激因子动员恶性淋巴瘤的外周血造血干/祖细胞

 目的　观察中剂量依托泊苷（VP16）和粒细胞集落刺激因子（G-CSF）在恶性淋巴瘤患者动员采集自体外周血造血干／祖细胞的有效性和安全性。方法　31例恶性淋巴瘤患者（非霍奇金淋巴瘤30例,霍奇金淋巴瘤1例）,VP16 1.2 g／m2分3 d静脉滴注,外周血白细胞降至最低点时给予G-CSF每天5 μg／kg,分2次,皮下注射,直至采集结束。结果　VP16应用后12 d（10～15 d）开始采集外周血造血干／祖细胞,获得单个核细胞（MNC）7.8×108／kg[（5.2～11.3）×108／kg],CD+34细胞7.2×106／kg [（5.3～13.1）×106／kg]。18例患者采集1次,13例采集2次。所有患者移植后均恢复造血,外周血粒细胞>0.5×109／L的中位时间为12 d（9～18 d）,血小板>20×109／L的中位时间为14 d（10～21 d）。患者无严重不良反应。结论　中剂量VP16和G-CSF 动员恶性淋巴瘤患者外周血干／祖细胞有效、安全,可获得满意的动员采集效果。     

Preirradiation ifosfamide,carboplatin, and etoposide (ICE) for the treatment of high-grade astrocytomas in children

Background Astrocytomas are the most common form of primary intracranial tumor; however, survival of patients with high-grade tumors has not changed much compared with that reported in the early 1970s.Objective Our objective was to assess the efficacy, security, and survival rate of postoperative chemotherapy with ifosfamide, carboplatin, and etoposide (ICE) in pediatric patients with anaplastic astrocytomas (AA) and glioblastoma multiforme (GM).Methods In a phase II study, we evaluated 25 children with AA or GM. The proposed treatment was four courses of chemotherapy with ICE followed by hyperfractionated radiotherapy, and then four more courses of ICE. Patients were evaluated using MRI after surgery, after the second course of chemotherapy, and again after the last. Toxicity was determined before each course.Results The overall and disease-free survival at 60 months was 67% and 56% respectively. For supratentorial localization it was 92% at 60 months and 20% at 18 months for brain stem tumors. Fourteen patients had a complete response and 9 died as a result of tumor progression.Conclusions Postoperative chemotherapy with ICE reduces the tumor size and increases the survival rate of pediatric patients with malignant astrocytomas with minimal toxicity.A commentary on this paper is available at     

Inhibition of intestinal P-glycoprotein and effects on etoposide absorption

 P-glycoprotein (Pgp) actively pumps a number of antineoplastic drugs, such as etoposide, out of cancer cells and causes multidrug resistance. Pgp is also expressed at the brush–border membrane of the small intestine under normal physiological conditions. We hypothesized that inhibition of intestinal Pgp might decrease the efflux of etoposide from the blood into the intestinal lumen, thereby, increasing the bioavailability of etoposide. The absorption of etoposide was studied using everted gut sacs prepared from rat jejunum and ileum. The addition of C219, a monoclonal antibody of Pgp, at 100 ng/ml or of 0.2 M 5′-adenylylimidodiphosphate, a nonhydrolyzable adenosine triphosphate (ATP) analog, increased the absorption of etoposide. Quinidine, an antiarrythmic agent, has been demonstrated to circumvent multidrug resistance in cell lines, possibly by interfering with Pgp function. Adding quinidine at 1 mg/ml to the everted gut sac increased the absorption of etoposide. In vivo absorption of etoposide was also studied by intraluminal perfusion of the drug in the small intestine of anesthetized rats. Intravenous infusion of quinidine at either 1 or 2 mg/h increased the serum level of etoposide in a dose-dependent manner. Intravenous infusion of etoposide at 0.2 mg/h resulted in luminal exsorption of the drug in the small intestine. The intestinal clearance of etoposide was 41.7±7.2 ml kg^-1, which decreased to 18.4±3.9 ml kg^-1 with the infusion of quinidine at 1 mg/h. The present data confirm that intestinal Pgp mediates the efflux of etoposide and that the use of Pgp-inhibiting agents such as quinidine may increase the bioavailability of etoposide. Received: 19 May 1994/Accepted 16 August 1994     

Cardiac tamponade in chronic myelomonocytic leukemia: a case report.

Serous effusion is a rare complication of chronic myelomonocytic leukemia. We present a patient with chronic myelomonocytic leukemia who developed a massive pericardial effusion with cardiac tamponade as early manifestations. Numerous clumps of monocytes were observed in the effusion. The patient obtained rapid relief following the intravenous administration of etoposide (100 mg daily for 5 days). Few reports have documented details of such a case.     

Treatment of early recurrent medulloblastoma in children with cisplatin and etoposide: a preliminary report

The prognosis of recurrent medulloblastoma remains extremely poor. Combination chemotherapy with cisplatin (CDDP) and etoposide (VP-16) was given to five children with early recurrent medulloblastoma. As a rule, CDDP 20 mg/m² per day and VP-16 60 mg/m² per day were administered intravenously for 5 days. This cycle was repeated three times at 4-week intervals. After this therapy, cerebellar signs improved in one case and were unchanged in four cases. Weakness and sensory disturbance, however, improved in three of four patients. Moreover, neck and/or back pain resolved in all these four. Radiological findings improved in three cases. Myelosuppression appeared in all patients, but receded rapidly. No other significant complications were noticed. Two patients died 5 and 6 months after this therapy. There results seem to suggest that this therapy has a use in improving neurological symptoms, particularly neck and/or back pain, although its efficacy is limited.     

Flowcytometric Analysis of DNA Pattern of Cells Derived from Xeroderma Pigmentosum A– Hypersensitivity to Vincristine, Etoposide and Methotrexate–

Xeroderma pigmentosum complementation gropu A(XPA) is one of the DNA repair deficient syndromes. The cell biological features of XPA were examined by flowcytometry using Epstein Barr (EB) virus-transformed lymphoblastoid cells. Cellular sensitivity to vincristine (VCR), etoposide (VP-16) and methotrexate (MTX) were assayed by DNA pattern changes by flowcytometry. Recently, ataxia-telangiectasia (AT), one of the same kindof disorder, has been reported to have an increased sensitivity to VCR and VP-16. Howerver, AT showed some resistance ot MTX according to other reports. Our results showed that XPA had an; increased sensitivity to VCR and also to VP-16. Moreover, different from AT, XPA showed some sensitivity to MTX. Thus there is some cell biological similarity between XPA and AT, as well as some difference of the abnormality in the DNA repair pathway.