Electrochemical Studies of Pirarubicin and Its Interaction with DNA at a Co/GC Ion Implantation Modified Electrode

The electrochemical behavior of pirarubicin(THP) and its interaction with DNA at a Co/GC modified electrode was studied by linear sweep and cyclic voltammetries. In a 0.01 mol/L B-R buffer solution(pH=7.0), the reaction of DNA with THP formed an electrochemical nonactive complex, resulting in a decrease in the THP equilibrium concentration and its reduction current. The composition of the complex was THP∶DNA=2∶1. The combining constant is 2.73×10 10 . The electrode reaction rate constant k s and the electron transfer coefficient α are 1.32 s -1 and 0.56, respectively. The decrease in the peak current was proportional to the DNA concentration and was used to determine the DNA concentration. The experiment of XPS showed that Co was surely implanted into the surface of GCE(glassy carbon electrode) and the implanted Co at GCE can improve the electrocatalytic activity.

Efficacy of transcatheter arterial chemoembolization using pirarubicin-loaded microspheres combined with lobaplatin for primary liver cancer

BACKGROUND Drug-eluting beads show good safety and promising efficacy when used as part of a transarterial chemoembolization regimen for primary liver cancer.However,data on the clinical efficacy and safety of pirarubicin-loaded beads combined with lobaplatin are lacking in China.AIM To evaluate the efficacy and safety of transcatheter arterial chemoembolization using pirarubicin-loaded beads combined with lobaplatin for primary liver cancer.METHODS Between January 2019 and March 2020,60 patients with primary liver cancer were selected at Hebei North University Affiliated First Hospital.According to different treatment methods,the participants were categorized into two groups with 30 patients treated with pirarubicin-loaded microspheres combined with lobaplatin included in an observation group and 30 patients treated with pirarubicin emulsion with lipiodol combined with lobaplatin were included in a control group.The progression-free survival,overall survival,clinical response rate,disease control rate,liver and kidney function and adverse reactions were compared between the two groups.RESULTS The progression-free survival was 14 mo in the observation group,which was significantly higher than 9 mo of the control group(P<0.05).The 6-mo,12-mo and 18-mo survival rates were 93.33%(28/30),66.67%(20/30)and 23.33%(7/30),respectively in the observation group,which were significantly higher than 83.33%(25/30),50.00%(15/30)and 13.33%(4/30),respectively,of the control group(all P<0.05).The clinical efficacy rate and disease control rate were 73.33%and 93.33%,respectively,in the observation group,which were significantly higher than those of the control group(53.55%and 80.00%,respectively,all P<0.05).There was no significant difference in alpha-fetoprotein between the two groups before the treatment(P>0.05).After the treatment,alpha-fetoprotein was 289.06±76.21 ng/m L in the observation group and 365.01±73.11 ng/m L in the control group,which were low in both groups compared with those before the treatment(all P<0.05).The incidence of nausea and vomiting was significantly lower in the observation group than in the control group(P<0.05).There was no significant difference for the adverse reactions of pain and fever between the two groups(P<0.05).CONCLUSION The combination of pirarubicin-loaded beads and lobaplatin can improve treatment efficacy resulting in mild liver function damage and postoperative complications in patients with primary liver cancer.It can be used in clinical practice.

Effects of pirarubicin and mitoxantrone for bladder cancer perfusion chemotherapy on the expression of malignant molecules in serum and lavage fluid

Objective: To study the effects of pirarubicin and mitoxantrone for bladder cancer perfusion chemotherapy on the expression of malignant molecules in serum and lavage fluid. Methods:Patients with advanced bladder cancer who underwent bladder cancer perfusion chemotherapy in our hospital between March 2015 and December 2017 were selected and randomly divided into the THP group who accepted pirarubicin perfusion chemotherapy and the MTZ group who accepted mitoxantrone perfusion chemotherapy. The serum was collected before and after chemotherapy to determine the contents of tumor markers in serum;the lavage liquid was collected after chemotherapy to determine the contents of malignant molecules. Results:Compared with those of same group before chemotherapy, CXCL5, VEGF, CYFRA21-1, DKK1 and DKK3 contents in serum of both group of patients decreased chemotherapy, and CXCL5, VEGF, CYFRA21-1, DKK1 and DKK3 contents in serum of MTZ group after chemotherapy were lower than those of THP group;ILP-2, CyclinD1, Twist, EpCAM and MMP2 contents in lavage liquid of MTZ group were significantly lower than those of THP group whereas Bad, Bax, TRAIL, FasL, E-cadherin and TIMP4 contents were significantly higher than those of THP group. Conclusion: Mitoxantrone for bladder cancer perfusion chemotherapy can be more effectively than pirarubicin to regulate the expression of malignant molecules.

Effect of interleukin-2+pirarubicin infusion chemotherapy combined with systemic chemotherapy on the malignant biological behavior of advanced bladder cancer

Objective: To study the effect of interleukin-2 + pirarubicin infusion chemotherapy combined with systemic chemotherapy on the malignant biological behavior of advanced bladder cancer. Methods: Patients with advanced bladder cancer who were treated in Tongcheng People's Hospital between April 2015 and July 2016 were selected as the research subjects and randomly divided into group A who received interleukin-2 + pirarubicin infusion chemotherapy combined with systemic chemotherapy and the group B who received pirarubicin infusion chemotherapy combined with systemic chemotherapy. The contents of tumor markers and cytokines and the expression of apoptosis molecules in the urine were detected before and after chemotherapy. Results: 8 weeks after chemotherapy, BLCA-1, BLCA-4, CYFRA21-1, TGF-β1, VEGF, EGF, HGF and IGF-2 contents in urine of both groups of patients were significantly lower than those before treatment, Fas, Bad, PTEN and Beclin-1 mRNA expression in urine were significantly higher than those before treatment and BLCA-1, BLCA-4, CYFRA21-1, TGF-β1, VEGF, EGF, HGF and IGF-2 contents in urine of group A were significantly lower than those of group B, Fas, Bad, PTEN and Beclin-1 mRNA expression in urine were significantly higher than those of group B. Conclusion: Interleukin-2+ pirarubicin infusion chemotherapy combined with systemic chemotherapy can be more effective than pirarubicin infusion chemotherapy combined with systemic chemotherapy in inhibiting the malignant biological behavior of advanced bladder cancer.

Mechanism research of pirarubicin postoperative immediately bladder irrigation combined compound matrine injection on treating superficial bladder cancer

Objective:Investigate the mechanism of Pirarubicin postoperative immediately bladder irrigation combined compound matrine injection on treating superficial bladder cancer, thus to provide assistance for clinical therapy of superficial bladder cancer.Methods:A total of 90 cases of patients with superficial bladder cancer treated in our hospital were selected, and randomly divided to be control group and combination group, 45 cases for each. For patients in control group, treatment of Pirarubicin postoperative immediately bladder irrigation was provided after transurethral resection of bladder tumors. For patients in combination group, combined treatment of Pirarubicin postoperative immediately bladder irrigation and compound matrine injection were provided after transurethral resection of bladder tumors. T lymphocyte subsets, cytokines, liver and renal functions of patients in each group were detected before and after treatment.Results: No statistical difference showed on T lymphocyte subsets, cytokines, liver and renal functions between two groups of patients with superficial bladder cancer before and after treatment. Compared with prior treatment, CD8+, cytokines (IFN-γ and IL-2), liver function indexes (AST and ALT) and renal function indexes (BUN and Cre) were significantly increased in two groups of patients after treatment, while T lymphocyte subsets (CD3+, CD4+ and CD4+/CD8+) and cytokines (TNF-α, IL-6 and CRP) were significantly decreased. Differences showed statistical significance. After combined treatment given, T lymphocyte subsets (CD3+, CD4+ and CD4+/CD8+) and cytokines (IFN-γ and IL-2) in combination group were significantly higher than in control group after treatment, cytokines (TNF-α, IL-6 and CRP), CD8+, liver function indexes (AST and ALT) and renal function indexes (BUN and Cre) were significantly lower than in control group after treatment. Differences between the two groups showed statistical significance.Conclusion:Combination of Pirarubicin postoperative immediately bladder irrigation and compound matrine injection could enhance immune functions, improve inflammatory reactions and decrease chemotherapeutics toxicities for patients with superficial bladder cancer. It is of great significance on clinical therapy for those patients.

芪参还五胶囊通过抑制心肌坏死性凋亡改善小鼠急性心肌损伤的实验研究

目的观察芪参还五胶囊改善吡柔比星致小鼠急性心肌损伤并探寻其作用机制。方法12周龄雄性C57BL/6小鼠30只,随机分为对照组、模型组及芪参低、中、高剂量组。通过吡柔比星造模,取材前称量体重并通过心脏超声检测左心室结构和功能,ELISA检测血清心肌肌钙蛋白(cTnI)和氨基端前脑钠素(NT-proBNP)含量;HE染色评价小鼠心肌组织形态学改变;RT-qPCR检测心肌组织中焦亡相关基因NOD样受体热蛋白结构域相关蛋白3(NLRP3)、消皮素D(GSDMD)、半胱氨酸天冬氨酸蛋白酶1(Caspase1)和坏死性凋亡相关基因白细胞介素-1α(IL-1α)、白细胞介素-33(IL-33)、肿瘤坏死因子-α(TNF-α)、高迁移率族蛋白B1(HMGB1)的mRNA水平;Weston blotting检测焦亡相关蛋白NLRP3、GSDMD、Cleaved-Caspase1和坏死性凋亡相关蛋白磷酸化混合谱系激酶样蛋白(MLKL)、磷酸化受体相互作用蛋白激酶3(RIP3)、HMGB1水平。结果与对照组相比,模型组小鼠精神状态萎靡,体重下降(P<0.05),射血分数(LVEF)下降(P<0.05),血清c TnI和NT-proBNP水平升高(P<0.05),心肌损伤评分升高(P<0.05),坏死性凋亡相关基因和蛋白水平均有升高(P<0.05);与模型组相比,芪参还五胶囊可以改善小鼠精神状态,增加体重(P<0.05),升高LVEF(P<0.05),降低血清中cTnI和NT-proBNP水平,改善心肌损伤(P<0.05),降低坏死性凋亡相关基因及蛋白表达(P<0.05);5组间焦亡相关基因及蛋白表达无明显差异(P>0.05)。结论芪参还五胶囊可以改善吡柔比星造成的小鼠急性心肌损伤,其机制可能与抑制心肌细胞坏死性凋亡有关。

鸦胆子结合吡柔比星对膀胱癌细胞作用的影响

目的探究鸦胆子结合吡柔比星对膀胱癌细胞的作用。方法选取2023年4—5月期间黑龙江省医院泌尿科1株人BIU-87膀胱癌细胞株为研究对象,细胞培养后,将其接种于96孔板中,以随机数表法分为5组,每组细胞均进行3个平行样本,每个样本细胞均设置5个复孔(每组共计15个样本量),将5组细胞以不同浓度鸦胆子油乳(0、5、10、20、30 mL/L)与吡柔比星(5μmol/L)联合作用,分析不同浓度鸦胆子油乳对膀胱癌细胞增殖抑制作用、细胞凋亡及细胞周期影响,并检测联合用药对核因子κB(Nuclear FactorκB,NF-κB)影响、对细胞中三磷酸腺苷(AdenosineTriphosphate,ATP)结合转运蛋白G家族成员2(ATP-bindingCassette TransporerG2,ABCG2)表达情况影响。结果鸦胆子油乳浓度升高,BIU-87细胞增殖抑制率、坏死率、凋亡率逐渐升高,差异有统计学意义(P均<0.05);鸦胆子油乳浓度为5 mL/L时细胞增殖抑制率、细胞坏死率显著提升,浓度≥10 mL后,细胞凋亡率显著提升,差异有统计学意义(P均<0.05);随鸦胆子油乳浓度升高,BIU-87细胞中S期细胞占比降低,C0/C1期细胞占比升高,差异有统计学意义(P均<0.05);随鸦胆子油乳浓度升高,细胞质中NF-κB表达量逐渐下降,细胞核中NF-κB表达量逐渐升高,细胞膜表面ABCG2表达量下降,差异有统计学意义(P均<0.05)。结论鸦胆子油乳结合吡柔比星,可抑制BIU-87膀胱细胞株增殖,低浓度可促进细胞坏死,高浓度可促进细胞凋亡,并促进NF-κB从细胞质转入细胞核中,抑制ABCG2表达,其效果均存在剂量依赖性。

吡柔比星载药微球联合洛铂在原发性肝癌介入栓塞治疗中的临床效果及不良反应分析

目的探究吡柔比星载药微球联合洛铂在原发性肝癌介入栓塞治疗中的临床效果及不良反应。方法选取2020年6月—2022年6月河北北方学院附属第一医院收治的原发性肝癌中晚期患者92例,按随机数字表法分为对照组(n=46)和观察组(n=46)。所有患者均接受介入栓塞治疗,对照组患者给予洛铂灌注治疗,观察组患者在对照组的基础上联合吡柔比星载药微球进行治疗。比较两组患者的疗效,血管内皮生长因子(VEGF)、骨桥蛋白(OPN)、肿瘤坏死因子-α(TNF-α)、总胆红素(TBil)、丙氨酸转氨酶(ALT)水平和不良反应发生情况。结果观察组患者总有效率(84.78%)显著高于对照组(65.22%)(P<0.05);治疗后两组患者VEGF、OPN、TNF-α、TBil、ALT水平均显著低于治疗前,且观察组均显著低于对照组(P<0.05);两组患者不良反应总发生率比较,差异无统计学意义(P>0.05)。结论吡柔比星载药微球联合洛铂在原发性肝癌介入栓塞治疗中的效果较好,可提高疾病控制率,改善患者的肝功能。

血清CEA、CA19-9、β_(2)-MG表达与膀胱癌患者吡柔比星膀胱灌注化疗疗效和生存期相关分析

目的探讨膀胱癌患者血清癌胚抗原(CEA)、癌抗原199(CA19-9)、β_(2)微球蛋白(β_(2)-MG)水平与膀胱癌患者吡柔比星膀胱灌注化疗疗效和生存期的关系。方法选取2021年3月~2023年4月在南阳市第一人民医院接受吡柔比星膀胱灌注化疗的98例膀胱癌患者作为研究对象,根据化疗结果分为化疗有效组(52例)和化疗无效组(46例)。比较两组患者的临床资料和血清CEA、CA19-9、β_(2)-MG水平,并进行单因素和多因素分析、生存分析及Cox回归分析。结果化疗有效组血清CEA、CA19-9、β_(2)-MG水平均低于化疗无效组(P<0.001)。进一步经多因素Logistic回归分析显示血清CEA水平是影响化疗效果和生存期的独立危险因素,高表达者化疗效果差,预后不良。血清CA19-9、β_(2)-MG水平也与化疗效果相关,但不是独立影响因素。结论血清CEA水平是预测膀胱灌注化疗疗效和生存期的重要指标,建议对膀胱癌患者进行血清CEA、CA19-9、β_(2)-MG检测,以指导个体化治疗方案的制定。

经尿道等离子电切术联合吡柔比星膀胱灌注治疗腺性膀胱炎后复发的影响因素及其风险预测

目的探讨经尿道等离子电切术联合吡柔比星膀胱灌注治疗腺性膀胱炎(CG)后复发的影响因素及其风险预测。方法回顾性分析2017年8月-2020年8月联勤保障部队第九八〇医院收治并行经尿道等离子电切术后吡柔比星膀胱灌注化疗的240例CG患者临床资料。分析患者复发情况,比较复发与未复发患者临床资料,采用Logistic多因素回归分析CG复发的危险因素并建立风险模型,绘制受试者工作特征(ROC)曲线评估风险模型的预测效能。结果CG复发34例,复发率为14.17%。复发组患者年龄、RDW、NLR及尿路感染、尿路结石、高危型、肠化生型、弥漫型比例高于未复发组(P<0.05)。临床分型[OR=4.335,95%CI 2.470~7.607]、病理类型[OR=1.709,95%CI 1.059~2.757]、红细胞分布宽度(RDW)[OR=1.799,95%CI 1.173~2.757]、中性粒细胞与淋巴细胞比值(NLR)[OR=1.900,95%CI 1.282~2.818]是CG经尿道等离子电切术联合吡柔比星膀胱灌注化疗后复发的独立危险因素(P<0.05)。风险模型预测CG复发的曲线下面积(AUC)为0.843(95%CI:0.791~0.887),最佳阈值为0.221,敏感度67.5%,特异度87.9%。结论经尿道等离子电切术联合吡柔比星膀胱灌注可减少CG复发,但复发率仍较高,不能使患者显著获益,临床分型、病理类型、RDW、NLR是CG复发的主要危险因素,建立风险模型对CG复发具有一定预测价值。

经尿道电切术联合丝裂霉素膀胱灌注治疗腺性膀胱炎的疗效分析

目的探讨经尿道电切术联合丝裂霉素膀胱灌注治疗腺性膀胱炎的临床疗效。方法将本院收治的腺性膀胱炎患者随机分为观察组和对照组,每组35例。经尿道电切术后,对照组给予盐酸吡柔比星膀胱灌注,观察组给予盐酸吡柔比星、丝裂霉素进行膀胱灌注。采用生活质量评分量表对2组患者生活质量进行评分,并比较灌注后的临床疗效。结果观察组总有效率有高于对照组的趋势,但差异无统计学意义;观察组各项生活质量评分均显著高于对照组,而不良反应发生率明显低于对照组,差异均有统计学意义。结论经尿道电切术联合丝裂霉素膀胱灌注治疗腺性膀胱炎疗效确切,不良反应发生率低,患者各项生活质量均有提高,值得临床推广。

荧光光谱法研究抗癌新药吡柔比星与DNA的相互作用

目的：研究抗癌新药吡柔比星（ＴＨＰ）与ＤＮＡ的作用方式。方法：利用荧光光谱法和吸收光谱法，以ＴＨＰ为荧光探针研究测定ＤＮＡ。结果：ＴＨＰ与ＤＮＡ的结合常数为１６６×１０５Ｌ·ｍｏｌ－１，结合位点数为２６ｂａｓｅｐａｉｒｓ。此外，利用ＤＮＡ对ＴＨＰ的荧光猝灭作用研究了对ＤＮＡ的分析应用。ＤＮＡ的检出限为０９１μｇ·ｍＬ－１，线性范围为０９１～９０μｇ·ｍＬ－１和９０μｇ·ｍＬ－１～２６μｇ·ｍＬ－１。结论：ＴＨＰ的蒽醌环与ＤＮＡ的碱基对发生嵌入作用，而ＴＨＰ的含糖侧链与ＤＮＡ有小沟槽作用。

吡柔比星为主方案治疗晚期乳腺癌517例的临床研究

目的 :对以THP及ADM为主联合化疗治疗晚期乳腺癌疗效、毒性反应对比研究。方法 :采用随机方法分为A、B两组。A组 (THP组 )357例 ,B组 (ADM组 )160例。结果 :A组有效率达63 % ,B组有效率59.4%。A组疗效略有增高 ,但两组之间无统计学差异 (P>0.05)。但A组胃肠道反应 (8.4 % ) ,脱发 (23.5 % ) ,心脏毒性 (2.3% ) ,明显低于B组 (P<0.01)。结论 :以THP为主联合方案治疗晚期乳腺癌 ,疗效高、毒性低、使用方便、价格适中 ,值得临床广泛推广应用。

吡柔比星或表柔比星联合紫杉醇新辅助化疗治疗局部晚期乳腺癌的随机对照研究

目的观察吡柔比星或表柔比星联合紫杉醇新辅助化疗治疗局部晚期乳腺癌(LABC)的近期临床疗效和毒副反应。方法采用随机对照研究,40例LABC行吡柔比星联合紫杉醇方案(PT组)或表柔比星联合紫杉醇方案(PE组)行新辅助化疗。记录患者每周期肿块大小、术后病理以及毒副反应分度。结果两组患者均接受共6个疗程的化疗。其中39例新辅助化疗2～4个周期后行手术治疗,手术后完成剩余疗程;1例新辅助化疗6周期后行手术治疗。PT组20例病理完全缓解率(pCR)、临床完全缓解率(cCR)以及临床部分缓解率(cPR)分别为10.0%、20.0%和75.0%,PE组为5.0%、30.0%、70.0%,两组总有效率(RR)无统计学差异。化疗过程中两组心脏毒性和造血系统毒性均为Ⅰ～Ⅱ度,且无统计学差异;PT组Ⅲ度胃肠道反应(恶心、呕吐)发生率45.0%,低于PE组的90.0%(P<0.05)。结论吡柔比星或表柔比星联合紫杉类新辅助化疗治疗LABC近期疗效较好,化疗后手术切除率高,心脏毒性及骨髓抑制较轻,但PT较PE方案胃肠道毒副反应有显著改善。

吡喃阿霉素与大剂量碘油联合治疗中晚期肝癌

目的 :探讨吡喃阿霉素 (THP)与大剂量碘油肝动脉栓塞化疗治疗不能手术切除原发性肝癌的方法和疗效。方法 :经皮肝动脉栓塞化疗 ,治疗组 146例 ,注入单次剂量为 6 0mg吡喃阿霉素和 2 0～ 6 0ml超化碘油 (Lipiodol)混悬液 ;对照组 188例 ,用 6 0mg表阿霉素和 5～ 19ml超化碘油。结果 :术后副作用不大 ,未见严重并发症。治疗组146例的 1、2、3年生存率为 71.2 %、39.4%、2 7.1% ;对照组 188例分别为 49.5 %、2 7.7%、2 0 .3% (P =0 .0 342 )。结论 :对ChildA级和ICGR 15小于 2 0 %的富血管型肝癌 ,THP与大剂量的碘油联合用药 ,绝大多数患者能够耐受 ,不会出现严重的并发症 。

吡柔比星与吉西他滨膀胱灌注化疗治疗膀胱癌的疗效比较

目的：评价吡柔比星与吉西他滨膀胱内灌注预防膀胱癌术后复发的疗效。方法：将42例保留膀胱手术治疗的膀胱癌患者分为A、B组，A组24例，B组18例。分别使用吡柔比星与吉西他滨进行预防灌注，全部患者均术后即刻膀胱内灌注化疗，每周1次，共6次；以后每月1次直至1-2年，并做随访和疗效比较。结果：A、B两组生存率均为100％；A组复发率为25％（6/24），B组复发率为27.8％（5/18），两组患者2年生存率、复发率比较差异无显著性意义（ P〉0.05）。A组和B组用药后膀胱刺激症状发生率、尿道狭窄发生率、全身不良反应发生率比较差异无显著性意义（ P〉0.05）。结论：吡柔比星与吉西他滨均可降低膀胱癌术后复发的机率，两者疗效无明显差异。膀胱内灌注预防浅表性膀胱癌术后复发近期疗效满意，副作用较轻，耐受性良好。

比较吡柔比星和丝裂霉素于膀胱灌注对预防浅表性膀胱癌术后复发的疗效与安全性

目的比较吡柔比星(蒽环类抗肿瘤药)与丝裂霉素(抗肿瘤药)膀胱灌注对预防浅表性膀胱移行细胞癌术后复发的效疗与安全性。方法将83例浅表性膀胱肿瘤术后的患者,随机分成2组,分别用吡柔比星和丝裂霉素作膀胱灌注化疗,定期行膀胱镜及血常规、肝肾功能检查,观察疗效与副作用。结果吡柔比星组1例(2.3%)复发,丝裂霉素组6例(14.6%)复发,复发率吡柔比星组明显低于丝裂霉素组(P<0.05);膀胱刺激症,吡柔比星组6例(14.3%),丝裂霉素组未出现。结论与丝裂霉素相比,吡柔比星具有膀胱内保留时间短、疗程短、疗效高及门诊治疗方便等优点。

TURBT术后吡柔比星膀胱灌注预防肿瘤复发的疗效分析

[目的]评价吡柔比星（THP）膀胱灌注预防膀胱肿瘤TURBT术后复发的疗效和安全性。[方法]1999年11月-2003年10月，膀胱肿瘤TURBT术后患者63例，术后接受THP30mg膀胱灌注治疗，随访12-53个月。[结果]膀胱癌TURBT术后THP膀胱灌注，术后1年未复发率89．8％，术后2年未复发率83．1％，术后3年未复发率76．3％；膀胱灌注THP副反应发生率为28．57％。[结论]应用THP30mg／50mL（600μg／mL），TURBT术后尽早膀胱灌注，膀胱内保留30min，采用为期1年的短期疗程，对于预防膀胱肿瘤TURBT术后复发有较好的疗效。

TACE术中灌注氟尿嘧啶、奥沙利铂及吡柔比星治疗原发性肝癌的临床效果分析

目的观察评价肝动脉化疗栓塞(TACE)联合灌注奥沙利铂(OXA)、氟尿嘧啶(5-Fu)及吡柔比星(THP)方案治疗原发性肝癌的疗效和安全性。方法回顾分析采用TACE术中动脉灌注OXA/5-Fu/THP化疗药物治疗的原发性肝癌患者65例,及同期行单纯肝动脉栓塞(TAE)治疗的原发性肝癌患者21例,分为TACE组和TAE组。对TACE灌注OXA/5-Fu/THP的疗效、不良反应发生率、无进展生存时间(PFS)及总生存期(OS)进行综合评价,并与单纯肝动脉栓塞进行对比分析研究。结果 TACE联合OXA/5-Fu/THP治疗的65例患者中,客观缓解率(ORR)55.4%,疾病控制率(DCR)81.5%;患者的中位PFS时间为11.5个月,中位OS时间为18.5个月;单因素分析中,Child-Pugh A级、无门脉癌栓、无肿瘤转移、肿瘤直径小及TACE治疗次数多的患者预后较好,差异有统计学意义(P<0.05);巴塞罗那分期(BCLC)B期的患者预后优于C期的患者,差异有统计学意义(P=0.000);Cox多因素分析中门脉癌栓及肿瘤远处转移是患者预后的独立危险因素。与单纯TAE相比,TACE联合OXA/5-Fu/THP可提高患者的m PFS。结论 TACE术中动脉灌注OXA/5-Fu/THP治疗原发性肝癌的疗效较好,不良反应少。

α-干扰素加吡柔比星灌注化疗对预防膀胱癌术后复发的疗效

背景与目的浅表性膀胱移行细胞癌术后易复发,本研究旨在探讨α-干扰素(interferon-alpha,IFN-α)联合吡柔比星灌注在降低浅表性膀胱癌术后复发方面的价值。方法应用重组人干扰素和吡柔比星(pirarubicin,THP)进行临床前瞻性试验研究。68例膀胱癌患者术后一周随机数字法分为两组(1)IFN-α+THP组33例,IFN-α3000万IU+THP40mg+5%GS40ml膀胱灌注;(2)THP组35例,THP40mg+5%GS40ml膀胱灌注。每周1次,连续8次,以后每月1次,共10次,12个月为一个疗程。结果随访期为6～32个月(中位随访期18.5个月),每3个月行膀胱镜检和组织活检一次。IFN-α+THP组33例患者中复发4例(12.1%),有4例出现膀胱刺激症状,3例有疲倦症状,1例出现皮疹。THP组复发8例(22.8%),有5例出现膀胱刺激症状,疲倦者3例,两组的不良反应发生率无显著性差异(P>0.05)。IFN-α+THP组比单用THP组有更好的疗效(P<0.05),尤其在预防G2、PT1膀胱肿瘤术后复发的效果优于单用THP组。结论IFN-α加THP灌注化疗对预防膀胱癌术后复发的疗效可能优于单用THP,但是其副作用情况以及是否适宜广泛使用还需作进一步的研究。