Correlation between postoperative chemotherapy regimen and survival in patients with resectable gastric adenocarcinoma accompanied with vascular cancer thrombus

BACKGROUND Patients with resectable gastric adenocarcinoma accompanied by vascular cancer thrombus(RGAVCT)have a poor prognosis,with a 5-year survival rate ranging from 18.42%-53.57%.These patients need a reasonable postoperative treatment plan to improve their prognosis.AIM To determine the most effective postoperative chemotherapy regimen for patients with RGAVCT.METHODS We retrospectively collected the clinicopathological data of 530 patients who un-derwent radical resection for gastric cancer between January 2017 and January 2022 and who were pathologically diagnosed with gastric adenocarcinoma with a choroidal cancer embolus.Fur-thermore,we identified the high-risk variables that can influence the prognosis of patients with RGAVCT by asse-ssing the clinical and pathological features of the patients who met the inclusion criteria.We also assessed the significance of survival outcomes using Mantel-Cox univariate and multivariate analyses.The subgroups of pa-tients with stages Ⅰ,Ⅱ,and Ⅲ disease who received single-,dual-,or triple-drug regimens following surgery were analyzed using SPSS 25.0 and the ggplot2 package in R 4.3.0.RESULTS In all,530 eligible individuals with RGAVCT were enrolled in this study.The median overall survival(OS)of patients with RGAVCT was 24 months,and the survival rates were 80.2%,62.5%,and 42.3%at 12,24,and 59 months,respectively.Preoperative complications,tumor size,T stage,and postoperative chemotherapy were identified as independent factors that influenced OS in patients with RGAVCT according to the Cox multivariate analysis model.A Kaplan-Meier analysis revealed that chemotherapy had no effect on OS of patients with stage Ⅰ or Ⅱ RGAVCT;however,chemotherapy did have an effect on OS of stage Ⅲ patients.Stage Ⅲ patients who were treated with chemotherapy consisting of dual-or triple-agent regimens had better survival than those treated with single-agent regimens,and no significant difference was observed in the survival of patients treated with chemo-therapy consisting of dual-or triple-agent regimens.CONCLUSION For patients with stage Ⅲ RGAVCT,a dual-agent regimen of postoperative chemotherapy should be recom-mended rather than a triple-agent treatment,as the latter is associated with increased frequency of adverse events.

Randomized Trial Comparing Cyclophosphamide, Methotrexate, and 5-Fluorouracil (CMF) Regimen with Rotational CMFEV Regimen (E=Epirubicin, V=Vincristine) as Adjuvant Chemotherapy in Moderate Risk Operable Breast Carcinoma

Objectives: The CMFEV (cyclophosphamide, methotrexate, 5-fluorouracil, epirubicin, vincristine) regimen is an innovative schedule, designed by our Group, aimed at administering five partially or totally no cross-resistant cytotoxic agents in breast carcinoma. It was randomly compared to CMF (cyclophosphamide, methotrexate, 5-fluorouracil) as primary treatment in operable disease and demonstrated a short-term significant increase in clinical complete response rate and a long-term significant locoregional relapse-free survival in premenopausal patients. So, it seemed worth comparing this regimen with CMF as adjuvant chemotherapy in moderate risk operable breast carcinoma. Methods: Four hundred and eighty-nine patients with stage I or II moderate risk breast carcinoma were randomized to receive CMF or CMFEV regimen for 6 cycles after surgery. Main end points were overall survival (OS), invasive disease-free survival (IDFS) and recurrence-free interval (RFI), as estimated by Kaplan-Meier analyses and log-rank tests. Results: At a median observation time of 7.3 years (range 5.4 months-10.3 years), no significant differences in OS and IDFS were observed between the two arms. Deaths from breast carcinoma were more frequent with CMF (58.5%) than with CMFEV regimen (41.7%) as well as recurrences from breast carcinoma (58.8% with CMF and 41.2% with CMFEV). These differences were not statistically significant. Conclusion: CMFEV appears more effective than CMF in preventing recurrences from primary disease in patients with moderate risk stage I-II breast carcinoma. The lack of statistical significance of the observed differences was probably due to the limited number of patients enrolled which rendered the study underpowdered.

Newly emerging standard chemotherapies for gastric cancer and clinical potential in elderly patients

With the increase in average life expectancy,the rate of occurrence of gastric cancer in elderly patients is also rising.While many clinical trials have been conducted to examine the effect of chemotherapy treatment on gastric cancer,age limits for eligible subjects have prevented the establishment of standards for chemotherapy in elderly patients with gastric cancer.As of March 2009,evidence-based standard chemotherapy regimens were established.In the Western world,debates centered on the ECF(Epirubicin/cisplatin/5FU) or DCF(Docetaxel/cisplatin/5-FU) regimens based on the phase □ randomized controlled trial at the Royal Marsden Hospital(RMH) or the V325 study,respectively.The JCOG9912 and SPIRITS trials emerged from Japan indicating attractive regimens that include S-1 for advanced gastric cancer patients.Using these active anticancer drugs,the trials that studied the eff icacy of adjuvant therapies or surgical approaches,such as the Int-116/MAGIC/ACTS-GC trials,have actually succeeded in demonstrating the benefits of adjuvant therapies in gastric cancer patients.For cases of gastric cancer in elderly patients,treatment policies should consider these studies while analyzing not only the therapeutic effects but also drug toxicity,individual general health conditions,and social factors to select treatments that emphasize quality of life.

Clinical study of FOLFOX4 regimen for patients of advanced hepatocellular carcinoma

Objective:The aim of our study was to observe the efficiency and toxicity of oxaliplatin (L-OHP) combined with CF/5-FU in patients with advanced primary hepatocellular carcinoma.Methods:Twenty patients with advanced primary hepatocellular carcinoma had recurrence/metastasis after multiple courses of TACE (cisplatin and epirubicin,etc.).All patients were treated with FOLFOX4 regimen of the combination of oxaliplatin and leucovorin and 5-fluorouracil.Treatment was repeated every 2 weeks until disease progression or unacceptable adverse effects occurred.The efficiency was evaluated according to RECIST criteria,and toxicities according to American National Cancer Institute Common Toxicity Criteria (NCI CTC),respectively.Results:Twenty patients were assessable for the objective efficiency and for toxicity.No patient achieved complete response (CR),4 patients were partial response (PR),8 patients were stable disease (SD),8 patients were disease progression (PD);Time to tumor progression (TTP) of the patients ranged from 1.5 to 4.8 months,median TTP was 2.2 months;Overall survival (OS) of the patients ranged from 3 to 10.2 months,median OS was 5 months.The 2 patients' serum AFP level decreasing.Sixteen patients relieved the symptoms obviously,stabilized or raised up Karnofsky Score.The toxicities were mainly grade I-II arrest of bone marrow (50%),mild neurotoxicity (30%) and mild reaction of gastrointestinal tract (40%).Conclusion:FOLFOX4 regimen is effective and safe for patients with advanced primary hepatocellular carcinoma.It can be worthy of further clinical investigation.

FOLFIRI regimen in metastatic pancreatic adenocarcinoma resistant to gemcitabine and platinum-salts

AIM: To evaluate the efficacy and safety of the FOLFIRI regimen in patients with metastatic pancreatic adenocarcinoma (PAC) after the failure of gemcitabine and platinum salts. METHODS: All consecutive patients with histologically confirmed, metastatic PAC and World Health Organiza-tion performance status (PS) ≤ 2 received FOLFIRI-1 [irinotecan 180 mg/m2 on day 1 and leucovorin 400 mg/m2 followed by 5-fluorouracil (5-FU) 400 mg/m2 bolus, then 5-FU 2400 mg/m2 as a 46-h infusion, biweekly] or FOLFIRI-3 (irinotecan 100 mg/m2 on day 1 and leucovorin 400 mg/m2, then 5-FU 2400 mg/m2 as a 46-h infusion and irinotecan 100 mg/m2 repeated on day 3, biweekly) after failure of gemcitabine and platinum-based chemotherapies as a systematic policy in two institutions between January 2005 and May 2010. Tumor response, time to progression (TTP), overall survival rate (OS) and grade 3-4 toxicities were retrospectively studied. Subgroup analyses were performed to search for prognostic factors. RESULTS: Sixty-three patients (52.4% male, median age 59 years) were analyzed. Among them, 42.9% were PS 0, 38.1% were PS 1 and 19.0% were PS 2. Fifty one patients (81.0%) had liver metastases. Before the FOLFIRI regimen, patients had received 1 line (n = 19), 2 lines (n = 39) or 3 lines (n = 5) of chemotherapy. Median TTP obtained with the line before FOLFIRI was 3.9 mo (95% CI: 3.4-5.3 mo). A total of 480 cycles was completed (median: 6 cycles, range: 1-51 cycles). The main reason for discontinuing FOLFIRI was tumor progression (90.3%). Tumor control was achieved in 25 patients (39.7%) (partial response: n = 5, stable disease: n = 20) with FOLFIRI. Median TTP was 3.0 mo (95% CI: 2.1-3.9 mo) and median OS was 6.6 mo (95% CI: 5.3-8.1 mo). Dose adaptation was required in 36 patients (57.1%). Fifteen patients (23.8%) had grade 3-4 toxicities, mainly hematological (n = 11) or digestive (n = 4). Febrile neutropenia occurred in 3 patients. There was no toxic death. PS 2 was significantly associated with poor TTP [hazard ratio (HR): 16.036, P < 0.0001] and OS (HR: 4.003, P = 0.004). CONCLUSION: The FOLFIRI regimen had an acceptable toxicity and an interesting efficacy in our study, limited to patients in good condition (PS 0-1).

Analysis of Efficacy of DICE(Dexamethasone,Ifosfamide,Cisplatin and Etoposide)Regimen on Recurrent and Refractory Intermediate and High Grade Non-Hodgkin's Lymphoma

OBJECTIVE Thus far there is no standard salvage regimenfor patients with recurrent and refractory intermediate and highgrade non-Hodgkin's lymphoma (NHL). This study intends toinvestigate the therapeutic efficacy of the DICE (dexamethasone,isofosfamide, cisplatin and etoposide) regimen on the recurrentand refractory NHL, and to observe the related adverse effects.METHODS Clinical records of 22 patients with recurrent andrefractory NHL, who failed to achieve a remission from theCHOP [cyclophosphamide, hydroxydaunomycin/doxorubicin(adriamycin), oncovin, prednisone] regimen within 2 to 6 cyclesof treatment, were reviewed. DICE, as a salvage regimen with amedian course of treatment of 4 cycles (ranging from 2 to 7 cycles),was now used, and evaluation of the therapeutic efficacy andadverse effect of DICE was conducted in all the patients. Of the 22NHL cases, 8 were of T-cell origin and the other 14 B-cell origin.Salvage treatment was performed in the patients, with appraisal,prevention and treatment of the toxic reactions.RESULTS Following DICE treatment in the 22 patients, thetotal effective rate of the regimen was 63.6%, and the completeremission (CR) rate was 40.9%. The effective rates of DICE onthe T and B-cell sourced NHL were 75.0% and 57.1%, and the CRrate were 37.5%, 42.9%, respectively (P >0.05). An increase of thelactate dehydrogenase (LDH) level accompanied by a giant lumpwas the short-term effect on patients with recurrence (mean P <0.05) who were drug resistant. Myelosuppression, digestive systemreaction and alopecia were the commonly-seen complications inthe patients who received DICE regimen. All patients recoveredafter treatment, and no chemotherapy-related death occurred.CONCLUSION DICE regimen is effective in treating refractoryand recurrent NHL.

Clinical observation of Fufangchangtai decoction combined with FOLFOX4 regimen for postoperative colorectal cancers

Objective:The aim of the study was to observe the therapeutic effect of FOLFOX4 regimen plus Fufangchangtai decoction on postoperative colorectal cancers.Methods:Thirty postoperative colorectal cancer patients were allocated into control and experiment groups respectively.Patients in experiment group were given Fufangchangtai decoction combined with FOLFOX4 regimen.Patients in control group were given FOLFOX4 regimen alone.Efficacy was evaluated after 2 periods of treatment.Results:The improvement rate of symptoms were 86.6% in experiment group compared to 53.3% in control group.KPS was stable in experiment group,and decreased in control group.QOL was increased in experiment group,and stable in control group after the treatment.For impact of immunity parameters,there were enhancements of CD3+ and CD4+ in experiment group,while they did not change in control group.In experiment group,WBC reduction was slighter than that of control group.The differences were not remarkable in PLT reduction,alimentary response,and toxicity of liver and kidney and nervous system.Conclusion:The clinical observation showed that Fufangchangtai decoction plus FOLFOX4 regimen could effectively enhance KPS,improve the symptoms,the quality of life and the immunity state,and down-regulate the side effects.In conclusion,Fufangchangtai decoction can decrease the toxicity so as to increase the treatment effect.

Serum basic fibroblast growth factor and interleukin-1βpredict the effect of first-line chemotherapy in patients with advanced gastric cancer

BACKGROUND The incidence and mortality rates of gastric cancer in China are the second-highest in the world,and most patients with gastric cancer lose their chance of surgery by the time of their diagnosis.AIM To explore the predictive potential of serum basic fibroblast growth factor and interleukin-1βlevels for the effect of first-line chemotherapy in patients with advanced gastric cancer.METHODS From the gastric cancer patients admitted to our hospital from May 2019 to April 2023,84 patients were selected and randomly and equally assigned to the experimental or control group.The FLOT group received the FLOT chemotherapy regimen(composed of oxaliplatin+calcium folinate+fluorouracil+paclitaxel),while the SOX group received the SOX chemotherapy regimen(composed of oxaliplatin+tiga capsules).The clinical efficacy,tumor marker levels,adverse reactions,and survival rates of the two groups were compared 7 days after the end of the relevant treatments.RESULTS The target effective rate of the FLOT group was 54.76%,which was much higher than that of the SOX group(33.33%;P<0.05).After treatment,both the groups demonstrated lower levels of cancer antigen(CEA),carbohydrate antigen 199(CA199),and peptide tissue antigen(TPS).For several patients before treatment(P<0.05).Third and fourth grades.In terms of adverse reactions,the level of white blood cells in both the groups was lower.Moreover,the incidence of hand-foot skin reactions in these two study groups was lower(P<0.05),while those of peripheral neuritis,vomiting,diarrhea,and abnormal liver function were significant(P<0.05).No statistically significant difference was noted between the two groups(P<0.05).The 1-year survival rate was higher in the FLOT group(P<0.05).CONCLUSION The FLOT regimen was effective in reducing the serum CEA,CA199,and TPS levels as well as in improving the 1-year survival rate of patients with good tolerability,making it worthy of clinical promotion and application.

养阴清肺颗粒联合HRZE化疗方案治疗初治敏感肺结核的效果

目的探讨养阴清肺颗粒联合异烟肼+利福平+吡嗪酰胺+乙胺丁醇(HRZE)化疗方案治疗初治敏感肺结核的临床效果。方法回顾性收集2022年6月至2023年3月河南省胸科医院收治的95例初治敏感肺结核患者的临床资料,根据治疗方案分为对照组(47例,HRZE化疗方案治疗)和观察组(48例,HRZE化疗方案+养阴清肺颗粒治疗),均持续治疗6个月。比较两组疗效、肺功能指标(用力肺活量、呼气峰流速、第1秒用力呼气容积)、免疫功能指标,以及治疗期间不良反应发生情况。结果观察组总有效率高于对照组(P<0.05)。治疗6个月时,观察组肺功能指标、免疫功能指标均高于对照组(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论初治敏感肺结核患者采用HRZE化疗方案联合养阴清肺颗粒治疗效果显著,可改善患者免疫功能和肺功能,且不会增加不良反应。

地西他滨联合预激方案治疗首程标准诱导化疗未缓解初诊AML患者的效果观察

目的:探讨地西他滨联合预激方案治疗首程标准诱导化疗未缓解初诊急性髓系白血病(AML)患者的疗效及对调节性T淋巴细胞(Treg)相对含量的影响。方法:收集2013年3月-2019年3月陕西省人民医院收治的102例初诊经首程标准诱导化疗未缓解的AML患者(除急性早幼粒细胞白血病)的临床资料进行回顾性分析,根据治疗方案不同对患者进行分组,51例采用预激方案治疗为常规组,51例采用地西他滨联合预激方案治疗为联合组。比较两组疗效、毒副反应发生率、治疗前后生活质量核心量表(QLQ-C30)评分、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、Treg)及3年总生存率。结果:联合组治疗总有效率为80.39%,显著高于常规组的62.75%(P<0.05);治疗后联合组QLQ-C30评分为60.27±6.96,较常规组65.73±7.96低(P<0.001);两组毒副反应发生率比较,差异无统计学意义(P>0.05);治疗后联合组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平较常规组高(均P<0.001),而Treg水平较常规组低(P<0.001);联合组3年总生存率为72.55%,高于常规组的52.94%(P<0.001)。结论:地西他滨联合预激方案治疗初诊首程标准诱导化疗未缓解AML患者效果显著,可通过调节Treg相对含量减少抗肿瘤免疫抑制,增强机体免疫功能,从而延长患者生存时间,提高生存质量,且未增加不良反应。

FOLFIRI标准化疗方案联合不同剂量贝伐单抗治疗对晚期转移性结直肠癌近、远期疗效及毒副反应分析

目的探讨FOLFIRI标准化疗方案联合不同剂量贝伐单抗治疗对晚期转移性结直肠癌患者近、远期疗效及毒副反应。方法收集2019年1月~2021年12月在本院进行治疗的92例晚期转移性结直肠癌患者的临床资料。2组均予FOLFIRI标准化疗方案联合贝伐单抗治疗,根据贝伐单抗剂量分为观察组(7.5mg/kg贝伐单抗)及对照组(5mg/kg贝伐单抗)。对比2组近、远期疗效及毒副反应总发生率。结果(1)观察组疾病控制率81.25%明显高于对照组61.36%(P<0.05)。(2)2组毒副反应发生率对比无明显差异(P>0.05)。(3)对照组1年存活率18.18%明显低于观察组37.50%(P<0.05);经过log-rank检验显示观察组PFS、OS均显著长于对照组(P<0.05)。结论7.5mg/kg贝伐单抗治疗晚期转移性结直肠患者的临床疗效要明显高于5mg/kg贝伐单抗治疗,有利于延长患者生存期,安全性较高。

含奥沙利铂化疗方案联合艾迪注射液对晚期结直肠癌患者免疫功能及生活质量的影响

目的探讨含奥沙利铂化疗方案联合艾迪注射液对晚期结直肠癌(CRC)患者免疫功能及生活质量的影响。方法选取2021年3月至2023年3月江西中医药大学附属医院收治的93例CRC患者,按照随机数字表法分为对照组(47例)与试验组(46例)。对照组给予含奥沙利铂化疗方案治疗,在其基础上,试验组给予艾迪注射液治疗,比较两组临床疗效、免疫功能、肿瘤标志物水平与生活质量。结果试验组总有效率、CD4^(+)与CD3^(+)、生活质量总改善率均高于对照组,CD8^(+)、糖类抗原125(CA125)、癌胚抗原(CEA)与糖类抗原19-9(CA19-9)均低于对照组,差异有统计学意义(P<0.05)。结论含奥沙利铂化疗方案、艾迪注射液联合治疗晚期CRC疗效确切,可降低肿瘤标志物水平,增强免疫功能,提高生活质量。

重组人血管内皮抑制素注射液联合GP化疗方案治疗晚期NSCLC的可行性

目的观察重组人血管内皮抑制素注射液联合GP化疗方案治疗晚期非小细胞肺癌(NSCLC)的可行性。方法回顾性选取2020年5月—2022年12月皖北煤电集团总医院肿瘤内科收治的晚期NSCLC患者80例,将采用GP化疗方案治疗者纳入GP化疗组(n=40),重组人血管内皮抑制素注射液联合GP化疗方案治疗者纳入联合用药组(n=40),2组均以3周为1个治疗周期,共治疗2个周期。比较2组患者近期疗效,用药前后实验室指标、生活质量评分,不良反应及1年存活率。结果联合用药组客观缓解率为85.00%,高于GP化疗组的52.50%(χ^(2)=9.833,P=0.002)。用药2个周期后,2组血清癌胚抗原、糖类抗原125水平低于用药前,凝血酶时间、活化部分凝血活酶时间短于用药前,凝血酶原时间长于用药前,血浆纤维蛋白原、D-二聚体水平高于用药前,且联合用药组各指标优于对照组(P<0.05或P<0.01);2组生理功能、躯体功能、精神状态、社会关系评分高于用药前,且联合用药组高于GP化疗组(P<0.01)。联合用药组与GP化疗组不良反应总发生率分别为22.50%、15.00%,组间比较差异无统计学意义(χ^(2)=0.738,P=0.390)。联合用药组1年存活率为65.00%,高于GP化疗组的42.50%(χ^(2)=4.073,P=0.044)。结论晚期NSCLC治疗中采用重组人血管内皮抑制素注射液联合化疗药物的可行性较高,可有效降低肿瘤标志物水平,延缓病情进展,提高患者生活质量及1年存活率,且具有一定安全性。

度伐利尤单抗联合PP化疗方案治疗Ⅲ期非小细胞肺癌患者的效果

目的:观察度伐利尤单抗联合PP化疗方案治疗Ⅲ期非小细胞肺癌(NSCLC)患者的效果。方法:回顾性分析2021年5月至2023年5月该院收治的66例Ⅲ期NSCLC患者临床资料,按治疗方案不同将其分为观察组和对照组各33例。对照组采用PP化疗方案治疗,观察组在对照组基础上联合度伐利尤单抗注射液治疗,比较两组疾病缓解率、KPS评分、癌症治疗功能评价系统-肺癌模块(FACT-L)评分、血清生化因子[Ⅳ型胶原蛋白α3(COL4A3)、G蛋白偶联受体相关分选蛋白1(GASP-1)]水平和不良反应发生率。结果:观察组疾病缓解率为60.61%,明显高于对照组的36.36%,差异有统计学意义(P<0.05);治疗后,两组KPS评分高于治疗前,且观察组高于对照组,两组FACT-L评分和血清COL4A3、GASP-1水平低于治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05);治疗期间,两组腹泻、脱发、骨髓抑制、恶心等不良反应发生率比较,差异均无统计学意义(P>0.05)。结论:度伐利尤单抗联合PP化疗方案治疗Ⅲ期NSCLC患者可提高疾病缓解率和KPS评分,降低FACT-L评分及血清COL4A3、GASP-1水平,效果优于单纯PP化疗方案治疗。

贝伐珠单抗联合TP化疗方案治疗晚期NSCLC的疗效

目的观察贝伐珠单抗联合TP化疗方案治疗晚期非小细胞肺癌(NSCLC)的临床疗效。方法回顾性选取2020年1月-2022年12月滨州市中心医院收治的晚期NSCLC患者60例,依据用药方法不同分为TP化疗组(n=30)、联合化疗组(n=30)。TP化疗组患者采用TP化疗方案治疗,联合化疗组患者在TP化疗组基础上给予贝伐珠单抗注射液治疗,2组均以3周为1个周期,共治疗4个周期。比较2组近期疗效,化疗前后肿瘤标志物(癌胚抗原、糖类抗原125、细胞角蛋白19片段抗原21-1、神经元特异性烯醇化酶)、血管生成促进因子[碱性成纤维细胞生长因子(bFGF)、血管内皮生长因子(VEGF)]、免疫指标(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、视觉模拟评分法(VAS)评分、生活质量评定量表(QOL)评分,不良反应,中位生存期,无进展生存期。结果联合化疗组疾病控制率为96.67%,高于TP化疗组的73.33%(χ^(2)=4.706,P=0.030)。化疗4个周期后,2组癌胚抗原、糖类抗原125、细胞角蛋白19片段抗原21-1、神经元特异性烯醇化酶、bFGF、VEGF水平低于化疗前,且联合化疗组低于TP化疗组(P<0.05或P<0.01);2组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于化疗前,CD8^(+)低于化疗前,且联合化疗组高/低于TP化疗组(P<0.01);2组VAS评分低于化疗前,QOL评分高于化疗前,且联合化疗组低/高于TP化疗组(P<0.01)。TP化疗组与联合化疗组不良反应发生率比较,差异无统计学意义(P>0.05)。联合化疗组中位生存期、无进展生存期长于TP化疗组(P<0.01)。结论贝伐珠单抗与TP化疗方案联合应用于晚期NSCLC的治疗,效果显著,能有效降低患者的肿瘤标志物水平,提高免疫功能,抑制肿瘤进展,并提升生活质量,可延长患者的生存期,且不会增加不良反应。

清肺化痰汤治疗痰热郁肺证老年晚期非小细胞肺癌患者的临床疗效及对其生活质量、血清癌胚抗原、神经元特异性烯醇化酶、细胞角质素片段抗原水平的影响

目的探讨清肺化痰汤治疗痰热郁肺证老年晚期非小细胞肺癌患者的临床疗效及对其生活质量、血清癌胚抗原(Carcinoembryonic antigen,CEA)、神经元特异性烯醇化酶(Neuron specific enolase,NSE)、细胞角质素片段抗原(Cytokeratin 19 fragment antigen21-1,CYRAF21-1)水平的影响。方法选取2019年7月—2020年10月期间在东南大学医学院附属南京同仁医院接受治疗的非小细胞肺癌患者80例,采用随机数字表法分为对照组和观察组,每组各40例。对照组采用DP化疗方案治疗,观察组在对照组基础上联合清肺化痰汤治疗,每个疗程为21 d,连续治疗4个疗程。观察比较两组患者临床疗效、不良反应情况,治疗前后痰热郁肺证证候积分(咳嗽,咳痰、咯痰黄稠,气喘或气急,喉中痰鸣,发热,口渴)、血清肿瘤标记物(CEA、NSE、CYRAF21-1)、生命质量量表(QOL-38)评分改善情况。结果治疗后观察组总缓解率62.5%(25/40)、临床获益率85.0%(34/40)均明显高于对照组总缓解率40.0%(16/40)、临床获益率65.0%(26/40),差异有统计学意义(P<0.05)。治疗后两组患者咳嗽、咳痰、咯痰黄稠、气喘或气急、喉中痰鸣、发热、口渴评分均较治疗前降低,差异有统计学意义(P<0.01);且观察组痰热郁肺证证候积分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清CEA、NSE及CYRAF21-1水平均较治疗前明显降低,差异有统计学意义(P<0.01);且观察组血清CEA、NSE及CYRAF21-1水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者身体状况、情绪状况、功能状况、肺癌相关症状、社会/家庭状况评分均较治疗前明显降低,总体健康状况评分较治疗前明显升高,差异有统计学意义(P<0.01);且观察组QOL-38评分改善情况明显优于对照组,差异有统计学意义(P<0.05)。治疗期间,观察组不良反应发生率明显低于对照组,差异有统计学意义(P<0.05)。结论清肺化痰汤治疗痰热郁肺证老年晚期非小细胞肺癌疗效显著,能够有效降低血清CEA、NSE及CYRAF21-1水平,缓解临床症状,减轻化疗药物不良反应,提高患者生活质量。

康莱特注射液联合AP化疗方案治疗晚期NSCLC的疗效

目的观察康莱特注射液联合AP化疗方案治疗晚期非小细胞肺癌(NSCLC)的疗效。方法选取2020年1月—2022年12月遵义市中医院收治的晚期NSCLC患者60例作为研究对象,以随机抽签法将患者分为AP化疗组30例和联合化疗组30例。AP化疗组患者采取AP化疗方案治疗,联合化疗组患者在AP化疗组基础上予康莱特注射液治疗,2组均以3周为1个化疗周期,持续治疗4个化疗周期。比较2组近期疗效,治疗前后免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、血清肿瘤标志物[糖类抗原125(CA125)、癌胚抗原(CEA)和神经元特异性烯醇化酶(NSE)]及不良反应。结果联合化疗组客观缓解率为70.00%,高于AP化疗组的43.33%(χ^(2)=4.344,P=0.037)。治疗4个化疗周期后,2组IgG及血清CA125、CEA、NSE水平及AP化疗组IgA、IgM水平均较治疗前降低,但联合化疗组IgG、IgA、IgM水平高于AP化疗组,血清CA125、CEA、NSE水平低于AP化疗组(P<0.05或P<0.01)。联合化疗组血小板减少、血红蛋白减少、恶心呕吐发生率低于AP化疗组(P<0.05)。结论晚期NSCLC患者采取康莱特注射液联合AP化疗方案治疗能够降低免疫耐受及血清肿瘤标志物表达,延缓病情进展,降低不良反应发生率,增强疗效。

扶正口服液联合mFOLFOX6化疗在结直肠癌患者中的临床应用研究

目的:探究扶正口服液联合mFOLFOX6(奥沙利铂+亚叶酸钙+氟尿嘧啶)化疗在结直肠癌患者中的临床应用效果。方法:随机选取江阴市中医院2020年1月—2022年12月间收治的80例结直肠癌患者纳入本次研究,依据电脑随机数字法将其分为对照组和研究组,每组40例。对照组行mFOLFOX6化疗方案,研究组行mFOLFOX6化疗方案增加扶正口服液治疗。对两组疗效、肿瘤标志物水平、炎症水平、用药安全性及生存质量进行对比分析。结果:研究组总缓解率(ORR)和疾病控制率(DCR)均高于对照组(P<0.05)。治疗前,两组肿瘤标志物及免疫水平差异无统计学意义(P>0.05)。治疗后,两组糖类抗原125(CA125)、CA19-9、癌胚抗原(CEA)水平均低于治疗前(P<0.05),研究组明显低于对照组(P<0.01);治疗后,两组C反应蛋白(CRP)、白细胞介素-6(IL-6)水平均低于治疗前(P<0.05),研究组低于对照组(P<0.01)。研究组不良反应明显少于对照组(P<0.05)。治疗前,两组KPS评分差异无统计学意义(P>0.05)。治疗后,两组KPS评分均高于治疗前(P<0.05),研究组高于对照组(P<0.01)。结论:对结直肠癌患者应用扶正口服液联合mFOLFOX6化疗方案进行治疗,可明显提升疗效,改善肿瘤标志物及炎症水平,同时能有效减少化疗所致不良反应,从而有效改善患者生存质量。

胶质瘤化疗中国专家共识

胶质瘤是最常见的颅内原发性恶性肿瘤。目前,治疗以手术切除为主,辅以放疗和化疗。临床实践证明,胶质瘤化疗极具意义,已被广泛应用于新诊断的胶质瘤术后辅助治疗和复发胶质瘤的挽救治疗。为进一步规范胶质瘤的化疗过程,提高治疗效果,中国抗癌协会神经肿瘤专业委员会组织相关专家,编写了《胶质瘤化疗中国专家共识》(以下简称《共识》),为广大同仁提供临床实际操作参考。《共识》从胶质瘤化疗相关的病理知识、化疗过程中患者管理、影像学评价、不同级别胶质瘤、新诊断或复发患者、如何结合其他治疗策略等角度对化疗方案进行了介绍。

贝伐珠单抗联合XELOX化疗方案治疗转移性结直肠癌患者的有效性及安全性

目的:探讨贝伐珠单抗联合XELOX化疗方案治疗转移性结直肠癌患者的有效性及安全性。方法:随机选取2020年6月—2022年6月淮南东方医院集团总医院收治的60例转移性结直肠癌患者。根据随机数表法将其分为对照组和观察组,各30例。对照组给予XELOX化疗方案,观察组在对照组基础上给予贝伐珠单抗注射液。比较两组临床疗效,治疗前后肿瘤标志物、免疫功能、生活质量及不良反应、生存率。结果:观察组总缓解率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组癌胚抗原(carcinoembryonic antigen,CEA)、血清淀粉样蛋白A(serum amyloid A protein,SAA)、糖类抗原19-9(carbohydrate antigen 19-9,CA19-9)水平均低于治疗前,观察组CEA、SAA、CA19-9水平均低于对照组,差异有统计学意义(P<0.05)。治疗后,两组CD4^(+)、CD4^(+)/CD8^(+)均升高,CD8^(+)降低,观察组CD4^(+)、CD4^(+)/CD8^(+)均高于对照组,CD8^(+)低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05);观察组生存率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组社会功能、心理功能、生理功能、躯体功能评分均高于治疗前,观察组社会功能、心理功能、生理功能、躯体功能评分均高于对照组,差异有统计学意义(P<0.05)。结论:贝伐珠单抗联合XELOX化疗方案可提高临床疗效和生存率,增强免疫功能,降低肿瘤标志物水平。