吉西他滨联合培门冬酶、顺铂、地塞米松方案治疗晚期结外鼻型NK/T细胞淋巴瘤的临床效果分析

目的:分析吉西他滨联合培门冬酶、顺铂、地塞米松方案治疗晚期结外鼻型NK/T细胞淋巴瘤的临床效果。方法:选取2017年4月至2018年6月于本院收治的50例结外鼻型NK/T细胞淋巴瘤患者为研究对象,将其随机划分为观察组与对照组。对照组采取吉西他滨联合培门冬酶治疗方案,观察组采取吉西他滨联合培门冬酶、顺铂、地塞米松方案,对比两组患者临床治疗效果。结果:观察组患者与对照组患者接受2~6周的化疗,在治疗过程中,观察组死亡2例,死亡率为8.0%。对照组患者死亡6例,死亡率为24.0%。两组患者临床疗效、治疗过程中不良反应率对比,观察组明显优于对照组。两组患者各项指标对比,组间数据差异具有统计学意义(P<0.05)。结论:吉西他滨联合培门冬酶、顺铂、地塞米松方案治疗晚期结外鼻型NK/T细胞淋巴瘤,应用疗效显著,可最大程度减少患者治疗过程中的不良反应与过敏发生率。

吉非替尼联合唑莱磷酸治疗肺癌骨转移十例

目的研究分子靶向药治疗癌症是否是肿瘤治疗的最高境界。唑来膦酸与吉非替尼是否有协同作用。方法来膦酸与吉非替尼联合治疗晚期、高龄肺腺癌。结果副反应轻,疗效显著,耐受性好。结论见效快,简单高效,保证生活质量,这才是肿瘤治疗的最高境界。

中药联合XELOX方案对晚期胃癌患者症状及生活质量的影响

目的:分析健脾消癥滋生汤加减联合XELOX方案治疗晚期胃癌的临床效果.方法:按照治疗方法不同将寿光市中医医院肿瘤内科收治的120例晚期胃癌患者分为试验组60例和对照组60例,对照组患者单纯采取XELOX方案治疗,试验组患者采取健脾消癥滋生汤加减联合XELOX方案治疗,比较两组患者临床疗效及治疗前后中医症状积分和生活质量评分变化情况.结果:试验组患者治疗总证候有效率显著高于对照组(93.34%vs 73.33%),差异具有统计学意义(P<0.05);两组患者治疗后中医症状积分均显著下降,生活质量评分均显著升高,与治疗前比较(4.56分±1.24分vs 9.33分±3.24分,40.53分±3.55分vs 33.35分±3.33分,7.69分±2.03分vs 8.78分±4.67分,36.88分±2.00分vs 33.75分±3.80分),差异具有统计学意义(P<0.05);试验组患者治疗后中医症状积分显著低于对照组,生活质量评分显著高于对照组(4.56分±1.24分vs 7.69分±2.03分,40.53分±3.55分vs 36.88分±2.00分),差异具有统计学意义(P<0.05).结论:健脾消癥滋生汤加减联合XELOX方案治疗晚期胃癌,能够有效改善患者临床症状、提高胃癌患者生活质量,临床疗效显著.

顺铂联合替吉奥方案在晚期胃癌疗效及安全性研究

目的探讨在晚期胃癌患者中采用顺铂联合替吉奥方案治疗的疗效与安全性。方法选择2015年2月至2016年2月来我院进行晚期胃癌治疗的患者82例最为此次的研究对象,将其分成对照组与观察组,均41例。观察组患者采用顺铂联合替吉奥方案治疗,对照组采用5—氟尿嘧啶联合顺铂治疗。对比两组患者的疗效与安全性。结果在治疗期间,两组患者均未发现与药物相关的死亡情况。4个周期的治疗后,观察组的治疗有效率(73.17%)明显高于对照组(46.34%),两组患者差异具有统计学意义(P<0.05)。结论顺铂联合替吉奥方案治疗晚期胃癌能提高治疗的有效率,安全有效,值得在临床上应用并推广。

Does gemcitabine-based combination therapy improve the prognosis of unresectable pancreatic cancer?

AIM:To assess whether gemcitabine-based combination therapy improves the prognosis of unresectable pancreatic cancer compared with gemcitabine treatment alone.METHODS:A quantitative up-to-date meta-analysis was undertaken to investigate the efficacy of gemcitabine-based combination treatment compared with gemcitabine monotherapy in locally advanced or metastatic pancreatic cancer.Inclusion was limited to highquality randomized clinical trials.RESULTS:Twenty-six studies were included in the present analysis,with a total of 8808 patients recruited.The studies were divided into four subgroups based on the different kinds of cytotoxic agents,including platinum,fluoropyrimidine,camptothecin and targeted agents.Patients treated with gemcitabine monotherapy had significantly lower objective response rate [risk ratio(RR),0.72;95% confidence interval(CI):0.63-0.83;P < 0.001],and lower 1-year overall survival(RR,0.90;95%CI:0.82-0.99;P = 0.04).Gemcitabine monotherapy caused fewer complications,including fewer grade 3-4 toxicities:including vomiting(RR,0.75;95%CI:0.62-0.89;P = 0.001),diarrhea(RR,0.66;95%CI:0.49-0.89;P = 0.006),neutropenia(RR,0.88;95%CI:0.72-1.06;P = 0.18),anemia(RR,0.96;95%CI:0.82-1.12;P = 0.60),and thrombocytopenia(RR,0.76;95%CI:0.60-0.97;P = 0.03) compared with gemcitabine combination therapies.CONCLUSION:Gemcitabine combination therapy provides a modest improvement of survival,but is associated with more toxicity compared with gemcitabine monotherapy.

Concomitant lung metastasis in patients with advanced hepatocellular carcinoma

AIM:To investigate the clinical features and prognostic factors of advanced hepatocellular carcinoma (HCC)patients presenting with lung metastasis at initial diagnosis. METHODS:Between 2001 and 2010,we recruited 76 consecutive HCC patients initially presenting with lung metastasis,without co-existing metastasis from other sites.These patients were divided into three groups:untreated group(n=22),single treatment group(n= 19),and combined treatment group(n=35). RESULTS:Metastasis of bilateral lung lobes was common and noted in 35 patients(46.1%),and most of patients(59/76,77.6%)presented with multiple lung metastatic nodules.Nineteen patients(25.0%) received single-method treatment,including hepatectomy in 4,transcatheter arterial chemoembolization in 6,radiotherapy in 5,and oral sorafenib in 4.Thirty-five patients(46.1%)received combined treatment modalities.The overall median survival of the all patients was 8.7±0.6 mo;4.1±0.3,6.3±2.5 and 18.6±3.9 mo, respectively in the untreated group,single treatment group and combined treatment group,respectively, with a significant difference(log-rank test,P<0.001). Multivariate analysis revealed that Child-Pugh score, the absence or presence of portal vein tumor thrombus,and treatment modality were three independent prognostic factors affecting survival of patients with advanced HCC and concomitant lung metastasis. CONCLUSION:Combined treatment modalities tend to result in a better survival as compared with the conservative treatment or single treatment modality for HCC patients initially presenting with lung metastasis.

117 cases of advanced malignancies treated with recombinant human endostatin plus chemotherapy

Objective: The aim of this study was to evaluate the recent efficacy and adverse reactions of recombinant human endostatin (Endostar) plus chemotherapy in the treatment of advanced malignancies. Methods: One hundred and seventeen cases of advanced malignancies were diagnosed and confirmed by histopathological examination, patients were treated with Endostar combined with chemotherapeutic drugs with no cross-resistance. Evaluate the efficacy and adverse reactions after finished two cycles of combination therapy. Results: All the 117 cases of patients were evaluated according to relevant standards, and there were 12 cases of complete remission (CR), 30 cases of partial remission (PR), 58 cases of stable disease (SD), 17 cases of progressive disease (PD). The response rate (RR) was 35.8%, disease control rate (DCR) was 85.4%. Conclusion: The protocol of Endostar combined with chemotherapy could improve the quality of life of patients with malignances, it also has the advantage of low toxicity. Considering the time span of the study, the long-term efficacy remains to be observed.

Gemcitabine and oxaliplatin combination chemotherapy in 30 patients with advanced pancreatic carcinoma

Objective: To evaluate the activity and safety of combination chemotherapy with gemcitabine plus oxaliplatin (GEMOX regimen) in patients of advanced pancreatic carcinoma. Methods: 30 patients with advanced pancreatic cancer were enrolled into this study. All patients received gemcitabine 1000 mg/m2, given by 30-minute intravenous infusion, on days 1 and 8 of each 21-day cycle. Oxaliplatin 100 mg/m2 was administered as a 2 h infusion on day 1 of each 21 day. Clinical outcomes for patients treated with two cycles of chemotherapy were evaluated according to WHO criteria. Results: All 30 patients were eligible for effectiveness and safety analysis. Objective response rate was approximately 20.0%. Clinical benefit response (CBR) was a composite of assessment of pain, performance status and body weight. The pain relief rate, improve-ment rate of performance status and body weight were 53.3%, 46.7% and 36.7%, respectively. The main adverse effects were bone marrow depression, peripheral nerve toxicity and gastrointestinal reaction. There was no treatment-related death during the chemotherapy. Conclusion: The high response rate with low toxicity observed in this study suggests that GEMOX regimen may be an effective alternative curative treatment for patients with advanced pancreatic carcinoma and can be used more extensively in clinical practice.

Study of hepatic arterial infusion of Endostar combined with TACE on advanced hepatocellular carcinoma

Objective:To study the efficacy and safety of hepatic arterial infusion of Endostatin(YH-16,Endostar),combined with transcatheter arterial chemoembolization(TACE) on advanced hepatocellular carcinoma.Methods:Thirty patients with advanced hepatocellular carcinoma were enrolled in the study.The patients received hepatic arterial infusion of Endostar combined with TACE.The efficacy was evaluated strictly after 1-2 cycles according to RECIST criteria and the value of AFP;quality of life(QOL) was evaluated according to Karnofsky scores.Adverse effects were evaluated too.Results:29 cases' efficacy was evaluated among the total 30 cases.The KPS were significantly increased after the treatment(80.39 ± 8.37 vs 73.93 ± 9.22,P = 0.002).Compared with control group,the objective response rate(CR and PR) and the rate of AFP negative changed were significantly higher(P = 0.021,P = 0.046).The adverse effects were not obvious.Conclusion:The QOL and preliminary efficiency of patients of advanced hepatocellular carcinoma may be improved by hepatic arterial infusion of Endostar combined with TACE,the rate of AFP negative changed were significantly higher too,and there are little of adverse effects.It is worthy to clinical generalization and further clinical observation.

Clinical study of docetaxel combined with concurrent radiotherapy in patients with advanced nasopharyngeal carcinoma

Objective： The aim of this study was to study the short-term curative effects and adverse reactions of docetaxel （DOC） in concurrent chemoradiotherapy compared to DDP plus 5-Fu （DF） combined with concurrent radiotherapy in patients with advanced nasopharyngeal carcinoma. Methods： Thirty-three patients in the experimental group （DOC group） were given DOC 25 mg/m2 ivgtt, dl, 7 times, concurrent radiotherapy was performed from dl. Thirty-three patients in the control group （DF group） were given cisplatin 25 mg/@ivgtt dl-3 and 5-Fu 550 mg/m2iv, dl-5, 3 weeks a cycle, 2 cycles, and concurrent radiotherapy was performed from dl. Six MV X-ray and 9 MeV electronic line for external irradiation were adopted in concur- rent radiotherapy. Results： The response rates of DOC group and DF group were 90.9% and 93.9%, the rates of neutropenia were 45.45% and 67.74%, and the rates of oral mucositis were 60.61% and 90.32%. Conclusion： The difference of short- term curative effects between DOC group and DF group was not statistically significant in patients with advanced nasopha- ryngeal carcinoma. The rates of adverse reactions were lower in DOC group. DOC combined with concurrent radiotherapy could be a new choice for patients with advanced nasopharyngeal carcinoma.

Pemetrexed Monotherapy and Pemetrexed Plus Platinum Combination Therapy as Non-First-Line Treatments for Advanced Non-Small Cell Lung Cancer

OBJECTIVE Data on the efficacy profiles of pemetrexed mono- therapy and pemetrexed plus platinum combination therapy in the non-first-line setting for patients with advanced non-small cell lung cancer （NSCLC） are limited, and previous studies have reported contradictory results. This study investigated and compared the efficacy and toxicity profiles of these two regimens to provide a broader understanding of their dynamics. METHODS Previously treated patients with advanced and/or recurrent NSCLC who received pemetrexed monotherapy or peme- trexed plus platinum combination therapy between January 1, 2006, and December 31, 2009, at Sun Yat-sen University Cancer Center were evaluated. The primary endpoint of this study was progres- sion-free survival （PFS）, whereas the secondary endpoints were overall response rate （ORR）, disease control rate （DCR）, overall survival （OS）, and toxicity. Survival was analyzed using the Kaplan- Meier method. Univariate analysis was performed to identify the factors potentially influencing OS, and chi-square analysis was carried out to compare ORR and DCR. RESULTS Forty-six patients with advanced and/or recurrent NSCLC were analyzed; of these patients, 25 were given pemetrexed monotherapy and 21 received pemetrexed plus platinum combina- tion therapy. The following correspond to the rates recorded for the pemetrexed monotherapy group and the pemetrexed plus platinum group： median PFS, 1.97 and 2.3 months （P=0.565）; median OS, 30.93 and 30.33 months （P=0.877）; ORR, 8% （2/25） and 9.5% （2/21） （P=0.857）; and DCR, 32% （8/25） and 57.1% （12/21） （P=0.09）. Univariate analysis revealed that no factor was correlated with OS from NSCLC （P〉0.05 for all）. Gastrointestinal toxicity in the pemetrexed plus platinum group was modestly higher than that in the pemetrexed monotherapy group （P=0.034）, but other adverse events were similar between the groups. CONCLUSION Compared with pemetrexed monotherapy, peme- trexed plus platinum combination therapy causes more gastro- intestinal toxicities and does not exhibit improved efficacy, in terms of ORR, DCR, PFS, and OS, in the non-first-line setting for NSCLC. However, further research with a higher patient population is necessary to validate this finding.

Bilateral oophorectomy combined with exemestane treating advanced refractory breast cancer

Objective： Taking tamoxifen orally is the main endocrine therapy of the premenopausal breast cancer with positive hormone receptor, but numerous patients developed to be advanced refractory breast cancer because of drug resistance. Our study investigated a role of the combination of bilateral oophorectomy and exemestane in the management of advanced refractory breast cancer. Methods： The bilateral oophorectomy was carried out in 17 patients. One week after the operation, exemestane was taken orally （25 mg/d）. The median time to progression （TTP）, the median survival time and the survival rate were calculated using Kaplan-Meier methods. Results： Seventeen patients age ranged from 26 to 44 years （median, 36 years） were treated with an overall response rate of 64.70%, TTP was 8 months and the median survival time was 31 months. The survival rate of 1-year, 3 years and 5 years was 88.24%, 64.71%, 29.41%, respectively. There have no grade Ⅲ/Ⅳ side effects appeared. Conclusion： Bilateral oophorectomy combined with exemestane is safe and effective for advanced refractory premenopausal breast cancer with positive hormone receptor and it is well-torerated.