吉西他滨同期放射治疗对不能手术的Ⅲ期非小细胞肺癌患者的疗效观察

背景与目的:放射治疗是肺癌的一种有效的治疗方式,加入吉西他滨后能否提高放射治疗疗效尚无定论.本研究探讨吉西他滨同期放射治疗对不能手术的Ⅲ期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的疗效、毒副反应和生存情况.方法:共入选60例患者,分为试验组和对照组,每组各30例.试验组采用吉西他滨400 mg/m2,30 min内静滴完,每周一次,同期放射治疗,放射治疗为常规分割,DT 60～66 Gy/30～33F/6～6.5W,同时给予支持治疗.对照组除不给予吉西他滨外,其它与试验组相同.用WHO的标准评价疗效;用x2检验比较有效率、毒副反应和长期生存;用Kaplan-Meier方法计算生存率.结果:58例患者随访资料完整,随访率为96.7%.试验组和对照组的有效率分别为70.0%和60.0%(P＞0.05);消化道和血液学的毒副反应比较,差异无统计学意义(P＞0.05).Kaplan-Meier生存分析显示,试验组1、2、3年生存率分别为77.7%、58.6%、26.4%,对照组1、2、3年生存率分别为70.3%、30.1%、16.1%,经比较两者差异无统计学意义(P＞0.05).结论:对不能手术的Ⅲ期NSCLC患者,吉西他滨同期放射治疗的有效率和1、2、3年生存率均较单纯放疗有所提高,但两组比较未达统计学意义,不良反应可以耐受.     

Biweekly gemcitabine and cisplatin in platinum-resistant/refractory, paclitaxel-pretreated, ovarian and peritoneal carcinoma

OBJECTIVES: Synergism between gemcitabine and cisplatin is supported by preclinical and clinical data. The present study explores the efficacy of a biweekly regimen in platinum-resistant/refractory, paclitaxel-pretreated ovarian and peritoneal cancer. METHODS: 50 paclitaxel-pretreated patients with platinum-resistant/refractory ovarian or peritoneal carcinoma who had previously received paclitaxel chemotherapy, were treated with six cycles of gemcitabine 1000 mg/m(2) followed by cisplatin 40 mg/m(2) on days 1 and 15, repeated every 4 weeks. RESULTS: The median platinum-free interval (PFI) was 4 months while the median number of previous treatment lines was 2. Chemotherapy was well tolerated. Objective responses were observed in 31.5% of evaluable patients (n=35). CA125 response was observed in 68% of patients with elevated CA125 (n=41). Median overall survival (OS) was 13.2 months (95% Confidence Interval, CI: 10.2-16.2) while progression-free survival (PFS) was 4.9 months (95%CI: 3.5-6.4). A PFI of less than 3 months was associated with lower objective response rates (15.8% versus 50%, p=0.03). CONCLUSIONS: Biweekly gemcitabine and cisplatin is feasible for patients with platinum-resistant ovarian or peritoneal cancer and is associated with a favorable toxicity profile. In a population with recent exposure to platinum, a PFI of less than 3 months was the major factor influencing response to chemotherapy.     

Stearoyl-CoA desaturase 1 inhibitor supplemented with gemcitabine treatment reduces the viability and fatty acid content of pancreatic cancer cells in vitro

Objective::Pancreatic cancer (PC) is an aggressive cancer with ineffective treatment. Inhibition of stearoyl-CoA desaturase 1 (SCD1) suppresses cancer prolifera...     

Combination gemcitabine, platinum, and bevacizumab for the treatment of recurrent ovarian cancer

ObjectiveTo describe the response rate (RR), progression-free survival (PFS), and toxicity profile of combination gemcitabine, platinum, and bevacizumab (GPB) for the treatment of recurrent epithelial ovarian cancer (EOC).MethodsA chart review of all patients with recurrent EOC who were treated with D1, D15 GPB in a 28-day cycle at a single institution was performed. Standard doses were gemcitabine 1000 mg/m², cisplatin 30 mg/m² or carboplatin AUC 3, and bevacizumab 10 mg/kg. All patients were analyzed for toxicity. RR and PFS were assessed in all patients who received at least 2 cycles of GPB.ResultsThirty-five patients were identified, and 33 received at least 2 cycles of GPB. The majority of patients (80%) were platinum sensitive. Patients received a median of 6 cycles of GPB (range 1–24). Sixteen patients (48%) had a complete response (CR), and 10 patients (30%) had a partial response (PR), for a total RR of 78%. An additional 5 patients (15%) had stable disease, and only 2 (6%) patients had progressive disease. The median overall PFS was 12 months (95% CI 7–15), with a median follow-up time of 10 months (2–22). Two patients (6%) had bowel perforations, and both survived. Hematologic toxicities were most common, with 29% and 14% of patients experiencing grade 3 or 4 neutropenia and thrombocytopenia respectively.ConclusionsThe combination of GPB demonstrated excellent efficacy for the treatment of recurrent EOC. However, serious toxicities occurred, and the safety profile of this combination requires further study.     

Gemcitabine-induced peripheral vascular disease and prolonged response in a patient with metastatic pancreatic adenocarcinoma: A case report

BACKGROUND Gemcitabine is an antimetabolite used in the treatment of pancreatic cancer. One of the side effects of gemcitabine is vascular toxicity. Here, we report the case of a patient treated with gemcitabine who had peripheral vascular disease concomitant with a prolonged antitumor response.CASE SUMMARY A 75-year-old man was diagnosed with locally recurrent pancreatic cancer. Partial response was achieved after 9 mo of gemcitabine. At the same time, the patient reported peripheral vascular d...     

吉西他滨联合长春瑞滨治疗晚期非小细胞肺癌的临床研究

目的:观察吉西他滨联合长春瑞滨治疗晚期非小细胞肺癌(NSCLC)的临床疗效及毒副反应。方法:38例初治NSCLC给予吉西他滨1000mg/m2,d1、d8,静脉滴注30分钟,长春瑞滨25mg/m2,d1、d8,静脉推注,21d为1个周期,至少治疗2个周期。结果:全组38例均可评价,无CR,PR13例,总有效率(CR PR)34·2%(13/38),SD31·6%(12/38),PD21·1%(8/38),中位生存期为11个月,疾病进展时间为5·9个月;1年生存率及2年生存率分别为44·7%(17/38)和23·7%(9/38)。血液学毒性反应主要是Ⅰ~Ⅱ度白细胞下降占73·7%(28/38),Ⅲ~Ⅳ度白细胞下降占10·5%(4/38),Ⅰ~Ⅱ度血红蛋白及血小板下降分别占26·3%(10/38)和31·6%(12/38),非血液毒性包括食欲减退、Ⅰ~Ⅱ度恶心及呕吐、局部静脉炎等,所有不良反应经对症处理及支持治疗后均恢复正常。结论:吉西他滨联合长春瑞滨组成GN方案对于晚期NSCLC疗效较好,毒副反应可耐受,值得临床推广。     

吉西他滨与胰腺癌化疗耐药

目的探讨胰腺癌对吉西他滨化疗产生耐药性的相关机理。方法复习近年国、内外相关文献，对介导胰腺癌吉西他滨耐药性的主要基因及信号通路加以综述。结果癌基因c—Src与bcl—X1、NF-κB炎症信号通路、细胞因子IL-1β及NO等与介导胰腺癌对吉西他滨的耐药性密切相关；多药耐药基因MDR1／P-gP与胰腺癌吉西他滨耐药的相关性仍有待研究。结论癌基因c—Src与bcl—X1、NF-κB炎症信号通路等可能成为新的治疗靶点以增加胰腺癌的化疗敏感性；介导胰腺癌化疗耐药的关键基因与中心信号通路尚有待阐明。