参丹活血胶囊联合DP方案治疗不可切除的老年晚期卵巢腺癌的临床研究

目的探讨参丹活血胶囊联合DP方案(多西他赛注射液和顺铂注射液)治疗不可切除的老年晚期卵巢腺癌的临床疗效。方法选取2016年1月—2017年5月绵阳市中心医院收治的不可切除的老年晚期卵巢腺癌患者82例为研究对象,采用随机数字表法将所有患者分为对照组和治疗组,每组各41例。对照组患者给予DP方案治疗,第1天静脉滴注多西他赛注射液,75 mg/m2;第1~3天静脉滴注顺铂注射液,70 mg/m2。治疗组在对照组治疗的基础上口服参丹活血胶囊,6粒/次,3次/d。每个疗程3周,两组患者均连续治疗4个疗程。评价两组患者近期临床疗效,同时比较治疗前后的生活质量评分、免疫功能指标和毒副反应。结果治疗后,对照组和治疗组的客观缓解率分别为60.9%、78.0%,疾病控制率分别为43.9%、58.5%,两组近期临床疗效比较差异有统计学意义(P0.05)。治疗后,两组功能状况评分、社会状况评分均显著升高,附加关注评分、情感状况评分、生理状况评分均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);且治疗后治疗组生活质量评分改善情况明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、免疫球蛋白A(IgA)、CD3~+和CD4~+均显著增高,同组治疗前后比较差异具有统计学意义(P0.05);且治疗后治疗组免疫指标明显高于对照组,两组比较差异具有统计学意义(P0.05)。治疗期间,治疗组各项毒副反应发生率均显著低于对照组,两组比较差异具有统计学意义(P0.05)。结论参丹活血胶囊联合DP方案治疗不可切除的老年晚期卵巢癌具有较好的临床疗效,能够有效改善患者生活质量和免疫功能,毒副作用小,具有一定的临床推广应用价值。     

多西他赛联合顺铂、氟尿嘧啶和亚叶酸的新辅助化疗方案治疗不能切除进展期胃癌的疗效观察

背景与目的：手术治疗目前仍是无远处转移胃癌的标准治疗方法，但大多数胃癌患者就诊时已经是进展期而不宜手术。新辅助化疗足指在外科手术术前给予化疗，其目的之一是通过缩小原发肿瘤使之可以进行手术切除，最终延长生存期。本临床试验目的在于研究多西他赛（商品名：泰索帝）联合顺铂、氟尿嘧啶和亚叶酸给药方案术前进行诱导化疗对不能切除的进展期胃癌的临床疗效及毒副反应。方法：入组患者均为本院2003年6月-2005年6月收治的12例晚期胃癌而无法行根治手术者。术前的新辅助化疗方案为：泰索帝75mg／m^2、顺铂75mg/m^2。第1天；氟尿嘧啶500mg／m^2、亚叶酸200mg／m^2第1～5天，每三周为一个周期，共两个周期。观察新辅助化疗后原发病灶的变化情况并观察用药后的毒副反应。结果：新辅助化疗后9例患者获得肿瘤减期，疗程结束后4～6周8例进行根治性手术切除。临床完全缓解（CR）1例，部分缓解（PR）8例，无变化（NC）3例，进展（PD）0例，有效率75％（9／12），腹水消退率63.6％（7／11）。组织学效果：轻度有效3例，中度有效4例，显著有效1例。副反应主要为骨髓抑制、腹泻、恶心呕吐、脱发，经对症以及营养支持治疗后均能缓解。结论：多西他赛加顺铂、氟尿嘧啶及亚叶酸的新辅助化疗方案在高度进展期胃癌的治疗中，对提高手术切除率疗效显著，耐受性良好。     

Efficacy of modified bevacizumab-XELOX therapy in Japanese patients with stage IV recurrent or non-resectable colorectal cancer

BackgroundNeoadjuvant chemotherapy (NAC) has been conducted for patients with non-resectable colorectal cancer; however, few reports of a systematic approach to NAC exist. At our hospital, bevacizumab with capecitabine and oxaliplatin (B-mab XELOX) has been used as chemotherapy for Stage IV colorectal cancer since 2014. We aimed to evaluate the efficacy and safety of NAC with a molecular-targeting agent for Stage IV colorectal cancer.MethodsA retrospective, single-institute analysis was performed including 27 patients with advanced recurrent cancer following primary tumor resection and 43 patients with non-resectable tumors and remote metastasis. At the time of resection, 17 were receiving chemotherapy. All 70 patients received at least 3 cycles of B-mab XELOX (total: 920 cycles). We determined the 1-year progression-free survival (1Y-PFS), 1-year overall survival (1Y-OS), 3Y-PFS, 3Y-OS, and number of treatment cycles. The objective response rate, clinical benefit rate, and adverse events were assessed. The number of chemotherapy cycles, survival time, and R0 surgery rate were determined for patients who underwent RO conversion surgery.ResultsThe 1Y-PFS was 28.5% [median survival time (MST): 7.4 months], 1Y-OS was 76.6% (MST not reached), 3Y-PFS was 5.5% (MST: 7.4 months), and 3Y-OS was 26.4% (MST: 25.2 months). The mean and median number of cycles of B-mab XELOX was 13.1 and 10.5, respectively. The objective response rate was 28.6%, and the clinical benefit rate was 58.6%. Grade 1 or Grade 2 adverse events occurred in 60 patients (85.7%); however, they all resolved without intervention. A single Grade 4 event (perforation of the primary tumor) occurred in 1 patient (1.4%). RO conversion surgery was performed in 7 patients (10.0%; primary + liver in 2 patients, primary + lung in 1 patient, liver in 3 patients, and primary in 1 patient). These patients received 3 to 10 cycles preoperatively (mean: 7.3; median: 6.5). R0 surgery was achieved in 5 of the 7 patients (71.4%). Postoperative survival ranged from 1 to 26 months (MST: 8 months).ConclusionsThis modified regimen was safe and effective in Japanese patients, and a high quality of life/quality-adjusted life-year was achieved. To further evaluate PFS and OS, more patients are being investigated.     

肝动脉化疗栓塞术对不能手术切除的原发性肝癌的治疗效果

目的评价经导管动脉化疗栓塞术（TACE）对不能手术切除的原发性肝癌（HCC）的治疗效果。方法 21例失去手术机会原发性HCC患者均经包括TACE为主的综合治疗,随后又经临床疗效随访。回顾性分析了所有患者的临床表现、治疗手段以及疗效随防资料。结果继TACE为主的综合治疗后,所有患者的主要症状与体征均得到有效控制或明显改善。本组患者TACE术后6,12和24个月时的生存率分别为100%,71.42%和61.90%。未发生与操作本身有关的严重并发症。结论 TACE可作为治疗不能手术切除的原发性HCC综合治疗中的主要手段。