洛铂与奥铂治疗复发转移食管癌临床疗效比较

目的探讨洛铂与奥铂治疗复发转移食管癌的临床疗效及毒性反应。方法80例放疗和化疗后复发转移的食管癌患者随机分为两组,分别采用洛铂和草酸铂化疗方案,比较两组患者近期疗效评定、中位生存时间、CBR评价、毒性反应。结果完成两个周期化疗时,两组患者毒性反应中血小板下降发生率、神经毒性反应发生率有明显差异(P<0.01);其余指标均无统计学意义。结论洛铂和奥铂对复发转移食管癌有一定疗效,洛铂主要毒性反应为血小板下降,奥铂主要毒性反应是神经毒性反应。

奥铂治疗恶性心包积液的临床疗效观察

目的 观察奥铂治疗恶性心包积液的临床疗效。方法 本组29例，支气管肺癌21例（NSCLC19例，SCLC2例），乳腺癌4例，食管-胃癌4例。随机分组：奥铂治疗组15例，对照组（顺铂）14例。超声引导下心包置管引流，心包腔注入奥铂（治疗组）50～100mg／次或顺铂（对照组）30～50mg／次，5％GS或NS稀释至20～40ml，间歇性给药2～3次。结果 奥铂治疗组和对照组的完全缓解率及有效率分别为26．7％、21．4％和73．3％、64．3％（P〉0，05）。奥铂治疗组与对照组的疗效差异无显著性，毒副作用轻微，无心脏骤停，心肌、冠状血管损伤等严重并发症。结论 奥铂治疗恶性心包积液疗效显著，毒副作用轻。

洛铂、奥铂治疗复发转移性结直肠癌的临床观察

目的探讨洛铂与奥铂治疗复发转移结直肠癌的临床疗效及毒性反应。方法 60例放疗和化疗后复发转移的结直肠癌患者随机分为两组,分别采用洛铂和奥铂化疗方案,比较两组患者近期疗效评定、中位生存时间、CBR评价、毒性反应。结果完成两个周期化疗时,两组患者毒性反应中血小板下降发生率、神经毒性反应发生率有明显差异(P<0.01);而其两组间近期疗效、中位生存时间、CBR等指标均无统计学意义(P>0.05)。结论洛铂和奥铂对复发转移结直肠癌有一定疗效,两者近期疗效相当;但两者毒性反应不同:洛铂主要为血小板下降,奥铂主要是神经毒性反应。

国产奥铂联合化疗治疗晚期大肠癌30例近期疗效分析

目的 观察国产奥铂联合化疗治疗晚期大肠癌的临床疗效。方法 本组 3 0例。用奥铂 13 0mg/m2 静脉滴注 2h ,CF 0 2 /m2静脉滴注 2h ,5 Fu 0 5继CF滴完后持续 8h静滴。治疗 2周后评定疗效。结果 3 0例中CR 3例 ,PR 11例 ,PD 16例 ,总有效率CR+PR 47%。毒副反应多为Ⅱ度。结论 国产奥铂联合化疗对晚期大肠癌有较好的治疗效果 ,主要毒副反应为中度粒细胞减少及感觉神经障碍 ,未见有肾毒性。

国产奥铂联合化疗治疗晚期胃肠道肿瘤30例近期疗效观察

目的:观察国产奥铂联合化疗治疗晚期胃肠道肿瘤的临床疗效.方法: 奥铂130 mg/m2静脉滴注2 h,亚叶酸钙200 mg静脉滴注2 h,5氟尿嘧啶350mg/m2继亚叶酸钙应用后持续4 h静脉滴注.治疗2个周期后评定疗效.结果:30例中CR3例,PR11例,PD9例,总有效率CR+PR47%.不良反应Ⅰ～Ⅱ度.结论: 国产奥铂联合化疗对晚期消化道肿瘤有较好的治疗效果,主要不良反应为一过性轻度粒细胞减少及感觉神经障碍.

OVC奥菲克V12＆奥铂V30耳塞

说到随身听耳塞市场，我们眼中几乎从来都是被一系列围外品牌所垄断，而现在，我们终于可以嗅到一丝清新的中国风——来自奥凯华科OVC品牌耳塞的声音。

奥沙利铂联合氟脲嘧啶与甲酰四氢叶酸治疗晚期大肠癌临床观察

目的:观察奥沙利铂联合化疗治疗晚期大肠癌的临床疗效。方法:33例晚期大肠癌患者,用奥沙利铂(Oxaliplatin,L-OHP由法国赛诺菲公司生产,商品名为乐沙定Eloxatin)130mg/m2,静脉滴注2小时;甲酰四氢叶酸(CF)200mg/m2,静脉滴注2小时;5-氟脲嘧啶(5-FU)0.5g在CF滴完后静推,然后5-FU3.0g/m2用一次性便携式静脉输液器持续静脉滴注48小时,每3周重复1次,治疗2周期后评定疗效,有效病例在4周后确认疗效。结果:33例中CR3例,PR13例,SD13例,PD4例,总有效率(CR+PR)48.5%。毒副作用主要是Ⅰ～Ⅱ度恶心呕吐、腹泻、感觉神经毒性、粘膜炎、骨髓抑制、静脉炎等。结论:奥沙利铂联合5-FU+CF治疗晚期大肠癌效果良好,不良反应能耐受,值得临床推广使用。

顺铂或奥沙力铂联合热疗对人胃癌细胞系BGC-823抑制作用的比较

目的:比较顺铂或奥沙力铂联合热疗对人未分化胃腺癌细胞系BGC823增殖的抑制作用。方法:使用MTT法检测细胞增殖,确定顺铂和奥沙力铂对BGC823抑制的工作浓度,并以该浓度进行化疗或与热疗联合应用,根据Veleriote法判断热、化疗联合应用后24h或48h的作用效果,并将顺铂和奥沙力铂联合热疗的作用进行比较。结果:以20%～30%抑制率的药物浓度作为试验的工作浓度,确定顺铂和奥沙力铂的工作浓度分别为1μg/ml和5μg/ml。单纯43℃热疗1h后,在24h时和48h时对BGC823的抑制作用无统计学意义(P>0.05);应用顺铂1μg/ml和奥沙力铂5μg/ml后24h对BGC823无显著的抑制作用(P>0.05),48h时呈现显著的抑制作用(P<0.01)。应用两药联合43℃热疗1h,在24h和48h对BGC823均有显著的抑制作用(P<0.05),随着时间的延长,对BGC823的抑制作用增强(P<0.05)。单药化疗在24h或48h时,两药的抑制作用无统计学差异(P>0.05),顺铂联合热疗对BGC823的抑制作用在24h和48h时均比奥沙力铂联合热疗的抑制作用强(P<0.05)。根据Veleriote法判断:顺铂1μg/ml联合热疗在24h和48h时均呈明显的协同作用;奥沙力铂5μg/ml联合热疗在24h时产生次加作用,在48h产生协同作用。结论:顺铂或奥沙力铂联合热疗在24h和48h时呈现次加或协同作用,两种药物相比,顺铂比奥沙力铂作用更强。

奥沙利铂、四氢叶酸及氟尿嘧啶治疗晚期胃癌28例临床观察

对晚期胃癌患者28例采取奥铂、四氢叶酸(CF)、5-Fu联合化疗,总有效率46.4%,完全缓解率3.6%,患者呈现较好的耐受性,有一定的临床应用价值。

奥沙力铂与卡培他滨联合治疗晚期胃肠癌30例疗效观察

目的：卡培他滨（Capecitabine）与奥沙力铂（oxaliplatin）及甲酰四氢叶酸钙（caocii folinas）联合治疗晚期胃肠癌的疗效及安全性。方法：均经病理或细胞学明确诊断晚期胃肠癌患者30例，第1～14天，卡培他滨片1250mg·m^-2，bid；奥沙力铂130mg·m^-2，第1天用药。第1～14天，甲酰四氢叶酸钙200-300mg。结果：30例中完全缓解（CR）4例（13．3％），部分缓解（PR）14（46．7％），维持稳定（SD）8例（26．7％），病情进展（PD）4例（13．3％），近期客观有效率CR＋PR为60％（18／30），肿瘤控制率CR＋PR＋SD为86．7％（26／30）。不良反应主要为外周神经损害、手足综合征、恶心和呕吐，患者均可耐受。结论：卡培他滨与奥沙力铂及甲酰四氢叶酸钙联合治疗晚期胃肠癌治疗晚期胃癌具有较好的疗效和较轻的不良反应。

丹参酮IIA磺酸钠注射液防治奥沙利铂诱导的周围神经病变的临床观察

目的:观察丹参酮IIA磺酸钠注射液对奥沙利铂诱导的外周神经毒性的防治作用。方法:入选36例病例均为含有奥沙利铂的化疗方案,随机平分为丹参酮治疗组和化疗组。化疗组均接受含有奥沙利铂130mg/m2*d1的化疗方案,每21天重复一次,按期化疗4周期。丹参酮治疗组在用奥沙利铂前加用丹参酮IIA磺酸钠80mg加入5%葡萄糖液500ml中静脉滴注,每天1次,连用3天。完成4个周期后评价外周神经病变程度,并分别检测两组治疗前后丙二醛(MDA)含量、超氧化物歧化酶(SOD)活性、腓总神经传导速度MNCV和SNCV。结果:其中丹参酮治疗组外周神经毒性发生率27.8%,化疗组外周毒性总发生率55.6%,两组差异有显著性。化疗后丹参酮治疗组腓总神经传导速度明显增快,MDA含量(6.31±2.74μmol/L)显著低于对照组(11.66±3.50μmol/L),而丹参酮治疗组SOD活性(79.51±7.96k U/L)明显高于对照组(42.24±10.79 k U/L)。结论:丹参酮IIA磺酸钠能降低奥沙利铂神经毒性的发生,可能是通过启动抗氧化作用,发挥神经保护功能。

Paclitaxel based vs oxaliplatin based regimens for advanced gastric cancer

AIM:To compare the efficacy and safety of paclitaxel combined with fluorouracil plus cisplatin(PCF),and oxaliplatin combined with fluorouracil plus leucovorin(FOLFOX-4) regimens for advanced gastric cancer(AGC).METHODS:Ninety-four patients with AGC were randomly assigned to receive paclitaxel(50 mg/m2 iv) on days 1,8 and 15,cisplatin(20 mg/m2 iv) and ? uorouracil(750 mg/m2 iv) on days 1-5,or oxaliplatin(85 mg/m2 iv) and leucovorin(200 mg/m2 iv) on day 1,followed by bolus fluorouracil(400 mg/m2 iv) and fluorouracil(600 mg/m2 iv) on days 1 and 2.The primary end point was the 1-year survival time.RESULTS:The overall response rate(ORR) of the pa-tients was 48.0% and 45.5% to PCF and FOLFOX-4,respectively.The disease control rate(DCR) of PCF and FOLFOX-4 was 82.0% and 81.8%,respectively.The median survival times(MSTs) of the patients were 10.8 and 9.9 mo,respectively,after treatment with PCF and FOLFOX-4.The 1-year survival rate of the patients was 36.0% and 34.1%,respectively,after treatment with PCF and FOLFOX-4.No significant difference was observed in ORR,DCR,MST or 1-year survival rate between the two groups.The most common adverse events were anemia,nausea and vomiting,and grade 3/4 alopecia in PCF treatment group,and anemia,grade 1/2 neurotoxic effect and grade 3/4 neutropenia in FOLFOX-4 treatment group.CONCLUSION:Patients with AGC have a similar response rate to PCF and FOLFOX-4 regimens with a similar survival rate.The PCF and FOLFOX-4 regimens are efficacious and tolerable as a promising therapy for AGC.

Thermotherapy enhances oxaliplatin-induced cytotoxicity in human colon carcinoma cells

AIM： To observe the synergistic effects of hyperthermia in oxaliplatin-induced cytotoxicity in human colon adenocarcinoma Lovo cells.

Is acute dyspnea related to oxaliplatin administration?

The standard adjuvant treatment of colon cancer is fluorouracil plus leucovorin. Oxaliplatin improves the efficacy of this combination in patients with stage 111 colon cancer and moreover its toxicity is well tolerable. We describe a rare clinical case of acute dyspnoea probably related to oxaliplatin at one month from the end of the adjuvant treatment. A 74-year-old man developed a locally advanced sigmoid carcinoma （pT3N1M0）. A port a cath attached to an open-ended catheter was implanted in order to administer primary chemotherapy safely according to the FOLFOX4 schedule. One month following the end of the 6^th cycle, the patient referred a persistent cough and moderate dyspnoea. Chest radiography displayed a change in the lung interstitium, chest CT scan confirmed this aspect of adult respiratory distress syndrome, spirometry reported a decreased carbon monoxide diffusion capacity. Antibiotic and corticosteroids were administered for 10 d, then a repeated chest X ray evidenced a progressive pulmonary infiltration. A transbronehial biopsy and cytology did not show an infective process, a CT scan reported radiological abnormalities including linear and nodular densities which were becoming confluents. Antimicotic and antiviral drugs did not evidence any benefit. The antiviral therapy was stopped and high dose metilprednisolone was started. The patient died of pulmonary distress after 10 d.

Combined treatment of oxaliplatin and capecitabine in patients with metastatic esophageal squamous cell cancer

AIM:To investigate the efficacy and side effects of the combined therapy of oxaliplatin and capecitabine in patients with metastatic esophageal squamous cell cancer(ESCC) and the survival of the patients.METHODS:Sixty-four patients(median age of 63 years) with histological or cytological confirmation of ESCC received oxaliplatin 120 mg/m2 intravenously on day 1 and capecitabine 1000 mg/m2 orally twice daily on days 1 to 14 in a 21-d treatment cycle as palliative chemotherapy.Each patient received at least two cycles of treatment.The efficacy,side effects and patient survival were evaluated.RESULTS:The partial response(PR) rate was 43.8%(28/64).Stable disease(SD) rate was 47.9%(26/64),and disease progression rate was 15.6%(10/64).The clinical benefit rate(PR + SD) was 84.4%.The main toxicities were leukopenia(50.0%),nausea and vomiting(51.6%),diarrhea(50.0%),stomatitis(39.1%),polyneuropathy(37.5%) and hand-foot syndrome(37.5%).No grade 4 event in the entire cohort was found.The median progression-free survival was 4 mo,median overall survival was 10 mo(95% CI:8.3-11.7 mo),and the 1-and 2-year survival rates were 38.1% and 8.2%,respectively.High Karnofsky index,single metastatic lesion and response to the regimen indicated respectively good prognosis.CONCLUSION:Oxaliplatin plus capecitabine regimen is effective and tolerable in metastatic ESCC patients.The regimen has improved the survival moderately and merits further studies.

LY294002 potentiates the anti-cancer effect of oxaliplatin for gastric cancer via death receptor pathway

AIM:To examine the effects of combined treatment of oxaliplatin and phosphatidylinositol 3'-kinase inhibitor,2-(4-morpholinyl) -8-phenyl-4H-1-benzopyran-4-one(LY294002) for gastric cancer. METHODS:Cell viability was evaluated by 3-(4,5-dimethylthiazol-2-yl) -2,5-diphenyltetrazolium bromide assay.Apoptotic cells were detected by flow cytometric analysis and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling assay.Western blotting and immuno-precipitation were used to examine protein expression and recruitment,respectively.Nuclear factorκB(NFκB) binding activities were investigated using electrophoretic mobility shift assay.Nude mice were used to investigate tumor growth. RESULTS:Treatment with combined oxaliplatin and LY294002 resulted in increased cell growth inhibi-tion and cell apoptosis in vitro,and increased tumor growth inhibition and cell death in the tumor mass in vivo.In MKN45 and AGS cells,oxaliplatin treatment promoted both protein kinase B(Akt) and NFκB activation,while pretreatment with LY294002 significantly attenuated oxaliplatin-induced Akt activity and NFκB binding.LY294002 promoted oxaliplatin-induced Fas ligand(FasL) expression,Fas-associated death domain protein recruitment,caspase-8,Bid,and caspase-3 activation,and the short form of cellular caspase-8/FLICEinhibitory protein(c-FLIPS) inhibition.In vivo,LY294002 inhibited oxaliplatin-induced activation of Akt and NFκB,and increased oxaliplatin-induced expression of FasL,inhibition of c-FLIPS,and activation of caspase-8,Bid,and caspase-3. CONCLUSION:Combination of oxaliplatin and LY294002 was therapeutically promising for gastric cancer treatment.The enhanced sensitivity of the combined treatment was associated with the activation of the death receptor pathway.

Oxaliplatin,Fluorouracil and Leucovorin (FOLFOX) as First-line Chemotherapy for Metastatic or Recurrent Colorectal Cancer Patients

OBJECTIVE To investigate the efficiency and safety of the oxaliplatin, fluorouracil （5-FU） and leucovorin regimen （FOLFOX）in previously untreated patients with metastatic or recurrent colorectal cancer. METHODS Previously untreated patients with metastatic or recurrent colorectal cancer received 100 mg/m^2 of oxaliplatin intravenously （Ⅳ） over 2 h on day 1, and Ⅳ 400 mg/m^2 of leucovorin over 2 h followed by a bolus of 400 mg/m^2 of 5-FU. Then 2,600-3,000 mg/m^2 of 5-FU was administered by continuous infusion over 46 h. RESULTS An evaluated response rate was determined for 97 of 105 treated patients. The overall response rate was 35.1%, 9 patients （9.3%） had a complete response and 25 patients （25.8%） a partial response. Thirtytwo patients （33.0%） developed stable disease and 32.0% of the patients progressed. The median time to progression （TTP） was 7.7 months and the median overall survival 20.5 months. One and 2-year survival rates were 68% and 32%. Toxic effects based on the National Cancer Institute-Common Toxicity Criteria （NCI-CTC）, reaching grade 3/4 were： neutropenia 12.3%, anemia 11.3%, vomiting 4.1% and diarrhea 7.2%. Grade 3 neuropathy was 5.1%. The overall survival rate of patients who had received a radical resection was superior to the patients who had not received a operation, or had received a palliative resection （P=0.0658）. The serum levels of CEA, ALP and LDH had no relationship with survival （P〉0.05）. CONCLUSION The FOLFOX regimen containing oxaliplatin, 5-FU plus leucovorin was an efficacious regimen with good tolerability in previously untreated metastatic or recurrent colorectal cancer patients.

Oxaliplatin-induced severe anaphylactic reactions in metastatic colorectal cancer: Case series analysis

AIM: To investigate oxaliplatin-induced severe anaphylactic reactions (SAR) in metastatic colorectal cancer in a retrospective case series analysis and to conduct a systemic literature review. METHODS: During a 6-year period from 2006 to 2011 at Kaohsiung Veterans General Hospital, a total of 412 patients exposed to oxaliplatin-related chemotherapy were retrospectively reviewed. Relevant Englishlanguage studies regarding life-threatening SAR following oxaliplatin were also reviewed in MEDLINE and PubMed search. RESULTS: Eight patients (1.9%, 8 of 412 cases) were identified. Seven patients were successful resuscitated without any sequelae and one patient expired. We changed the chemotherapy regimen in five patients and rechallenged oxaliplatin use in patient 3. Twenty-three relevant English-language studies with 66 patients were reported. Patients received a median of 10 cycles of oxaliplatin (range, 2 to 29). Most common symptoms were respiratory distress (60%), fever (55%), and hypotension (54%). Three fatal events were reported (4.5%). Eleven patients (16%) of the 66 cases were rechallenged by oxaliplatin. CONCLUSION: SAR must be considered in patients receiving oxaliplatin-related chemotherapy, especially in heavily pretreated patients. Further studies on the mechanism, predictors, preventive methods and management of oxaliplatin-related SAR are recommended.