艾迪注射液联合DP化疗方案对NSCLC血清肿瘤标志物水平的影响

目的探讨艾迪注射液结合多西他赛+顺铂(DP)化疗对非小细胞肺癌(NSCLC)患者血清肿瘤标志物水平的影响。方法选取2020年10月至2022年10月在本院收治的96例NSCLC患者,使用随机数字表法将其分为艾迪联合DP组和DP组各48例,并比较两组的疗效、血清肿瘤标志物水平以及不良反应的差异。结果艾迪联合DP组有效率41.67%,明显高于DP组(22.92%)(P<0.05)。治疗后,艾迪联合DP组和DP组的CEA和CYFRA21-1水平均显著降低(P<0.05),而艾迪联合DP组的降低幅度显著低于DP组(P<0.05)。此外,两组不良反应发生率也存在显著差异(P<0.05)。结论艾迪注射剂和DP化疗的联合治疗对NSCLC疗效显著,有助于降低肿瘤标志物水平并减少不良反应发生率。

Docetaxel, cisplatin, and 5-fluorouracil compared with epirubicin,cisplatin, and 5-fluorouracil regimen for advanced gastric cancer:A systematic review and meta-analysis

BACKGROUND As the first-line regimens for the treatment of advanced gastric cancer, both docetaxel, cisplatin, and 5-fluorouracil(DCF) and epirubicin, cisplatin, and 5-fluorouracil(ECF) regimens are commonly used in clinical practice, but there is still controversy about which is better.AIM To compare the efficacy and safety of DCF and ECF regimens by conducting this meta-analysis.METHODS Computer searches in PubMed, EMBASE, Ovid MEDLINE, Science Direct, Web of Science, The Cochrane Library and Scopus were performed to find the clinical studies of all comparisons between DCF and ECF regimens. We used progression-free survival(PFS), overall survival(OS), objective response rate(ORR), disease control rate(DCR), and adverse effects(AEs) as endpoints for analysis.RESULTS Our meta-analysis included seven qualified studies involving a total of 598 patients. The pooled hazard ratios between the DCF and ECF groups were comparable in PFS(95%CI: 0.58-1.46, P = 0.73), OS(95%CI: 0.65-1.10, P = 0.21),and total AEs(95%CI: 0.93-1.29, P = 0.30). The DCF group was significantly better than the ECF group in terms of ORR(95%CI: 1.13-1.75, P = 0.002) and DCR(95%CI: 1.03-1.41, P = 0.02). However, the incidence rate of grade 3-4 AEs was also greater in the DCF group than in the ECF group(95%CI: 1.16-1.88, P = 0.002),especially for neutropenia and febrile neutropenia.CONCLUSION With better ORR and DCR values, the DCF regimen seems to be more suitable for advanced gastric cancer than the ECF regimen. However, the higher rate of AEs in the DCF group still needs to be noticed.

Phase I Study to Determine MTD of Docetaxel and Cisplatin with Concurrent Radiation Therapy for Stage Ⅲ Non-Small Cell Lung Cancer

Objective： To evaluate the maximum tolerated dose （MTD） of docetaxel （DCT） and cisplatin （DDP） concurrently with three dimensional （3D） conformal radiotherapy or IMRT for patients with locally advanced non-small cell lung cancer （stage IIIa and IIIb） after 2–4 cycles of induction chemotherapy. Methods： Fourteen patients with histological/cytological proven stage III non–small-cell lung cancer were eligible. 3D or IMRT radiotherapy （60-70Gy in 30-35 fractions, 6-7weeks, 2 Gy/fraction） was delivered concurrently with cisplatin and docetaxel, 2 cycles during concurrent chemoradiotherapy （CCRT）. The level I dosage was composed of 56 mg/m2 DCT, on day 1 and 28mg/m2 DDP, on day 1 and day 2. The level II was composed of 60 mg/m2 DCT, on day 1 and 30 mg/ m2 DDP, on day 1 and day 2. The level III was composed of 64 mg/m2 DCT, on day 1 and 32 mg/ m2 DDP, on day 1 and day 2. Results： Fourteen patients were allocated and finished concurrent chemoradiotherapy. The dose-limiting neutropenia was at the dose Level III （64 mg/m2） and occurred in 2 of 5 patients. No dose limiting non-hematologic or hematologic toxicity occurred in the other patients. Conclusions： Patients with locally advanced non-small cell lung cancer may tolerate 60mg/m2 docetaxel and 60mg/m2 cisplatin for 2 cycles during concurrent radiotherapy after 2-3 cycles of induction chemotherapy.

Modified docetaxel, cisplatin and capecitabine for stage Ⅳ gastric cancer in Japanese patients: A feasibility study

AIM To evaluate the feasibility of chemotherapy including fluoropyrimidine, platinum and taxane with modified dosages for unresectable gastric cancer in Japanese patients.METHODS We performed a feasibility study of a modified docetaxel, cisplatin and capecitabine (DCX) regimen for stage Ⅳ gastric cancer. In particular, 30 or 40 mg/m^2 of docetaxel on day 1, 60 mg/m^2 of cisplatin on day 1, and 2000 mg/m^2 of capecitabine for 2 wk were administered every three weeks.RESULTS Three patients were treated with modified DCX(m DCX) with 30 mg/m^2 docetaxel, and five patients were treated with this regimen with 40 mg/m^2 docetaxel. Grade 3 or 4 neutropenia was observed in six of the eight patients; no patients exhibited febrile neutropenia. Partial response was achieved in four of the eight patients. Three patients underwent gastrectomy, which achieved R0 resection without residual tumors in dissected lymph nodes. In one of these three patients, resected specimens revealed pathological complete response in the primary lesion and in lymph nodes.CONCLUSION m DCX was well tolerated by Japanese patients with stage Ⅳ gastric cancer. This regimen might be useful for allowing gastric cancer patients with distant lymph node metastasis to undergo conversion surgery.

Successful treatment of multiple lung metastases of hepatocellular carcinoma by combined chemotherapy with docetaxel, cisplatin and tegafur/uracil

We report the successful treatment of multiple lung metastases after hepatic resection for hepatocellular carcinoma (HCC) with combined docetaxel, cisplatin (CDDP), and enteric-coated tegafur/uracil (UFT-E). A 68-year-old man was diagnosed with multiple lung metastases of HCC 7 mo after partial hepatectomy for HCC. Oral UFT-E was given daily and docetaxel and CDDP were given intra-arterially (administered just before the bronchial arteries) every 2 wk via a subcutaneous injection port. One month after starting chemotherapy, levels of tumor marker, protein induced by vitamin K absence(PIVKA--), decreased rapidly,and after a further month, chest X-ray and computed tomography revealed the complete disappearance of multiple liver metastases. Two years after the combined chemotherapy, HCC recurred in the liver and was treated but no pulmonary recurrence occurred. In the absence of a standardized highly effective therapy, this combined chemotherapy with docetaxel, CDDP and UFT-E may be an attractive option for multiple lung metastases of HCC.

Randomized trial of weekly docetaxel and cisplatin combined with concurrent 3DCRT in patients with locally advanced esophageal cancer

Abstract Objective： This randomized controlled clinical study was to assess and compare the efficacy and safety of two chemoradiotherapy regimens [cisplatin ＋ 5-fluorouracil ＋ 3 dimensional conformal radiation therapy （3DCRT） and cisplatin ＋ weekly docetaxel ＋ 3DCRT] in patients with locally advanced esophageal squamous cell carcinoma. Methods： A total of seventy-four patients with clinical stages liB to IIIB esophageal squamous cell carcinoma were enrolled. Chemotherapy for PF group comprised 5-fluorouracil at days 1-5 （250 mg/m2/d） and cisplatin （20 mg/m2） at days 1-3 of every 28-day cycle; full treatment course included 2 cycles. Chemotherapy for DP group comprised docetaxel （20 mg/m2） and cisplatin （20 mg/m2） at days 1,8, 15, 22, 29, and 36. Both groups treated with concurrent 60 Gy 3DCRT at 200 cGy/d. Results： Seventy-four patients were enrolled and 71 completed the planned treatment, with a follow-up rate of 95.94%. Short-term curative effect was not statistically significant between the two groups （P = 0.471）. The 2-year survival rates were 65.7% and 61.1%, respectively （P = 0.806）, 5 years survival rates were 34.29% and 27.78%, respectively （P = 0.221）, and there was no significant difference by Fisher test （P = 0.734）. As common side effects, incidence rates of radioactive esophagitis and hematological toxicity were lower in DP group. Conclusion： For locally advanced esophageal cancer patients, current chemoradiotherapy with chemo- therapy regimen of weekly docetaxel plus cisplatin has equal curative effect with 5-fluorouracil plus cisplatin, but well-tolerated by reducing side effects such as radioactive esophagitis and bone marrow suppression.

Docetaxel and cisplatin combination chemotherapy in anthracyclines-resistant advanced breast cancer

Objective： To observe the effect and toxicity of docetaxel with cisplatin in anthracyclines-resistant advanced breast cancer. Methods： Forty-five female patients received docetaxel 60 mg/m^2 on dl and cisplatin 30 mg/m^2 on d1-d3 of every 28 days. Every patient was treated with at least 2 cycles and a median of 3 cycles （2-6 cycles ）. Results： Five patients achieved complete response （11.1%） and 18 partial response （40.0%）, 10 stable disease （22.2%）. The overall response rate was 51.1%. The clinical disease control rate was 73.3%, median time to tumor progression （TTP） was 7.8 months （1.0-34.5 months）, median survival time was 17.6 months （range 1.9-48.0 months）, and one year survival rate was 65.2%. The main side effect was marrow suppression. The treatment was well tolerated with grades Ⅲ and Ⅳ leukopenia in nine （20%） and ten （22.2%） patients. Conclusion： Combinative chemotherapy of docetaxel and cisplatin has a good anti-tumor activity on refractory advanced breast cancer with manageable toxicity.

First-line cisplatin,docetaxel,and cetuximab for patients with recurrent or metastatic head and neck cancer:A multicenter cohort study

BACKGROUND The targeted therapy cetuximab[directed at the epidermal growth factor receptor(EGFR)]in combination with 5-fluorouracil and platinum-based chemotherapy(the EXTREME regimen)has shown substantial efficacy for patients with recurrent or metastatic squamous cell carcinoma of the head and neck(R/M SCCHN).Thus,this scheme has been established as the preferred first-line option for these patients.However,more recently,a new strategy combining platinum,taxanes,and cetuximab(the TPEx regimen)has demonstrated similar efficacy with a more favorable toxicity profile in clinical trials.AIM To evaluate the safety and efficacy of the TPEx scheme as first-line therapy in advanced SCCHN in a multicenter cohort study.METHODS This retrospective multicenter cohort study included patients with histologically confirmed recurrent or metastatic SCCHN treated with first-line TPEx at five medical centers in Argentina between January 1,2017 and April 31,2020.Chemotherapy consisted of four cycles of docetaxel,cisplatin,and cetuximab followed by cetuximab maintenance therapy.Clinical outcomes and toxicity profiles were collected from medical charts.Treatment response was assessed by the investigator in accordance with Response Evaluation Criteria in Solid Tumors(version 1.1).Adverse events were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events(version 4.0).RESULTS Twenty-four patients were included.The median age at diagnosis was 58 years(range:36-77 years).The majority of patients(83.3%)received at least four chemotherapy cycles in the initial phase.In the included group,the overall response rate was 62.5%,and 3 patients achieved a complete response(12.5%).The median time to response was 2.4 mo[95% confidence interval(CI):1.3-3.5].With a median follow-up of 12.7 mo(95%CI:8.8-16.6),the median progression-free survival(PFS)was 6.9 mo(95%CI:6.5-7.3),and the overall survival rate at 12 mo was 82.4%.Patients with documented tumor response showed a better PFS than those with disease stabilization or progression[8.5 mo(95%CI:5.5-11.5)and 4.5 mo(95%CI:2.5-6.6),respectively;P=0.042].Regarding the safety analysis,two-thirds of patients reported at least one treatment-related adverse event,and 25% presented grade 3 toxicities.Of note,no patient experienced grade 4 adverse events.CONCLUSION TPEx was an adequately tolerated regimen in our population,with low incidence of grade 3-4 adverse events.The median PFS were consistent with those in recent reports of clinical trials evaluating this treatment combination.This regimen may be considered an attractive therapeutic strategy due to its simplified administration,decreased total number of chemotherapy cycles,and treatment tolerability.

BRCA1 and EGFR as prognostic biomarkers in triple negative metastatic breast cancer patients treated with cisplatin plus docetaxel

Objective： The triple negative （TN） metastatic breast cancer （MBC） patients are known to have worse prognosis, shorter progressive free survival （PFS）, and overall survival （OS）, that mandates using aggressive chemotherapy regimens. This phase II study aimed at investigating the efficacy and safety of using cisplatin and docetaxel in patients with triple negative metastatic breast cancer, and the possibility of using breast cancer susceptibility genel （BRCA1） expression as a predictive marker of chemotherapy response, and epidermal growth factor receptor （EGFR） as prognostic marker. Method： Between January 2006 and March 2009, 40 eligible patients with TN MBC were included in the study. We examined BRCA1 expression and EGFR protein in their specimens using immunohistochemistry. The patients were treated with cisplatin 75 mg/m2 and docetaxel 75 mg/m2 every 3 weeks, TN measurable MBC patients previously treated with anthracycline in their adjuvant or neo adjuvant settings were included in the study. Results： The median age of the treated patients was 43.5 years. Nearly half of the patients had an ECOG performance status of 0 or 1, and about third of them had one metastatic site. These metastatic sites were predominantly visceral in 80% of the patients. Fifty-five percent of TNMBC stained positive for BRCA1 and sixty-five percent for EGFR. Positivity for both markers was significantly associated with grade III tumors （P = 0.004）, OS, and PFS （P = 0.001 and 0.009） respectively. Overall, the regimen was well tolerated as Gill vomiting and neurological side effects were observed in 20% of the patients. Other toxiciUes were generally mild and medically manageable; with no treatment mortality was recorded. The overall disease control rate （ODCR） was 60%; the median PFS was 8 months, with a median overall OS of 17.5 months; while the median OS among responders was 23 months （95% CI 21.35 to 25.32）. The patients with negative EGFR had a significantly better OR, PFS, and OS than EGFR positive cases. There was no significant difference concerning OR, PFS, and OS, between positive and negative BRCA1 cases, which could be attributed to the better efficacy of cisplatin in the positive BRCA1 cases. Conclusion： This chemotherapy regimen is effective with tolerable toxicity profile, our results point out the importance of BRCA1 expression as predictive marker of chemotherapy response, and EGFR as prognostic marker, which could identify a certain group of patients with more aggressive disease who might benefit from using anti EGFR targeted therapy plus cisplatin.

The efficacy and toxicity of modified docetaxel,cisplatin and 5-fluorouracil combination therapy for 27 patients with advanced stage gastric adenocarcinoma

Objective: The aim of this study was to evaluate the efficacy and toxicity of modified docetaxel, cisplatin and calcium folinate (CF)/5-fluorouracil (mDCF) combination therapy for 27 patients with recurrent or metastatic gastric adeno- carcinoma (R/MGC). Methods: From May 2006 to July 2007, 27 R/MGC patients (18 were male and 9 were female) with a median age of 49 years (range19-66) were consecutively enrolled. The mDCF protocol included 50 mg/m2 docetaxel for 1 day and 25 mg/m2 cisplatin on d2-3, 200 mg/m2 CF on d2-3 and 2000 mg/m2 5-fluorouracil (5-FU) CIV (continous infusion) for 46 h on d2-3, repeated every 2 weeks. Results: Twenty-seven patients were evaluable for efficacy and toxicity. A median of 4.5 cycles was given. One complete and 12 partial responses were observed for an overall intent to treat response rate (RR) 48.1% [95% CI (confidence intervals): 32%-64%]. Median time-to-progression (TTP) was 6.2 months and overall survival (OS) was 11.8 months. Twenty-seven (100%) patients experienced bone marrow suppression, and of them 48.9% were Grade 3-4 (16.3% were Grade 4). Two patients (7.4%) ceased chemotherapy because of bone marrow suppression. WHO Grade 1-4 non-hematological toxicity, such as oral mucositis, nausea/emesia, peripheral neuropathy, liver dysfunction, diarrhea, nephrotoxicity and cardiotoxicity, occurred in 59.2%、51.9%, 48.1%, 44.4%, 25.9%, 18.5% and 11.1% patients, respectively, and most of them were Grade 1-2. No patient died due to chemotherapy toxicity. Conclusion: mDCF regimen is effective in treating R/MGC with a high RR and long TTP/OS in this trial. Despite its severe hematotoxicity, this regimen has some advantages such as no cross-resistance with paclitaxel (paclitaxel-resistant patients RR 2/6). These results suggested that the mDCF regimen worth further investigation in clinical study of R/MGC treatment.

Induction chemotherapy with docetaxel,cisplatin and fluorouracil followed by concurrent chemoradiotherapy for unresectable sinonasal undifferentiated carcinoma: Two cases of report

BACKGROUND Sinonasal undifferentiated carcinoma(SNUC) is a rare aggressive tumor that is often unresectable. Optimal treatment for patients with unresectable,locally advanced SNUC(LA-SNUC) has not been established,and the patient outcome remains poor. We report two cases of unresectable LA-SNUC in which induction chemotherapy with docetaxel,cisplatin and fluorouracil(TPF) followed by radiotherapy with concurrent cisplatin(CCRT),a standard treatment option for locally advanced head and neck cancer,demonstrated promising outcomes.CASE SUMMARY A 39-year-old man presented with tearing and pain in the right eye. A biopsy of the tumor invading the sinonasal cavities,right orbit and cranial base confirmed the diagnosis of LA-SNUC. Induction TPF chemotherapy induced remarkable tumor shrinkage and rapidly improved the symptoms. He subsequently received CCRT and achieved complete remission of the disease. The other case is a 21-year-old man who presented with worsening vision. The unresectable tumor involving the nasal septum and cranial base was pathologically diagnosed as SNUC. TPF chemotherapy followed by CCRT yielded complete remission of the disease with preserved visual function. Both patients have been disease-free for44 mo.CONCLUSION Induction TPF chemotherapy followed by CCRT may remarkably improve the outcomes in LA-SNUC patients.

Synergistic and attenuated effect of active protein P23 in combination treatment with docetaxel plus cisplatin in NSCLC SPC-A-1 tumor xenograft

Aim Platinum based combination regimens are first-line treatment option in treatment of NSCLC but the clinical utility has been limited because of their toxicities. Many reports indicated that patients with tumors can ben- efit from adjuvant chemotherapy drugs. The aim of this study was to confirm adjuvant chemotherapy of active protein P23 with docetaxel plus cisplatin （DP） against non-small cell lung cancer （NSCLC） by evaluating synergistic anti- tumor activity and attenuated effect. Methods In vivo SPC-A-1 xenograft model was established to evaluate antitu- mor activity and toxicity of P23 along or combination with DP. Evaluation indexes include the relative tumor prolif- eration rate, tumor growth inhibition rate, body weight, food consumption, hematological and biochemical analysis. Results P23 treatment showed inhibited tumor growth and increased tumor inhibition of DP treatment. No signifi- cant toxicity was found in P23-treated mice, but significant toxicity was found in DP-treated mice. P23 combination with DP could reduce toxicity of DP treatment by improving body weight and food consumption, and increasing the number of WBC and PLT, decreasing the level of ALT, AST and BUN. Conclusion P23 combined with DP treat- ment has additive effect which contributes to enhance tumor growth inhibition of DP treatment and attenuated effect which contributes to reduce toxicity of DP treatment. These findings indicate potential benefit for use of P23 adju- vant chemotherapy for NSCLC treatment.

Clinical observation of docetaxel plus cisplatin versus gemcitabine plus cisplatin in the treatment of patients with advanced non-small-cell lung cancer

Objective： The aim of this study was to evaluate the clinical efficacy and side effects of docetaxel/cisplatin regiment and gemcitabine/cisplatin regiment in the patients with advanced non-small-cell lung cancer （NSCLC）. Methods： Seventy-six patients with advanced NSCLC who were chemotherapy-naive were enrolled in two groups. In docetaxel group （DP group） the patients received docataxel 75 mg/m^2 and cisplatin 60 mg/m^2 on day 1. In gemcitabine group （GP group） the patients received gemcitabine 1000 mg/m^2 on day 1 and day 8. The dosage of cisplatin was the same as DP group. The two regiments were administrated intravenously every 21 days as a cycle, each patient received 2-4 cycles. All patients were followed up until disease progressed or patients died. Results： The overall response rates were 43.5% in DP group and 45.9% in GP group. The response rate was significantly different between the initial treated group and retreated group in both two groups （53.8% vs 23.0% in DP group and 56% vs 25% in GP group, P 〈 0.05, respectively）. The main side effects were bone marrow suppression and thrombocytopenia. Conclusion： Docetaxel/cisplatin regiment and gemcitabine/cisplatin regiment for the patients with advanced NSCLC were efficient and well-tolerated chemotherapeutic approachs with low toxicity levels. The efficacy and major toxicity in two groups were similar.

Effect of Docetaxel and Cisplatin Chemotherapy Combined with Intensitymodulated Radiotherapy in the Treatment of Postoperative Recurrence of Esophageal Cancer and Its Effect on Serum Tumor Markers

Objective: To investigate the effect of docetaxel and cisplatin combined with intensity-modulated radiotherapy in thetreatment of postoperative recurrence of esophageal cancer and the content of tumor markers in serum. Methods: According tosimple randomization method, 60 patients with postoperative recurrence of esophageal cancer admitted from February 2018 toSeptember 2019 were divided into control group (n = 30 cases) and observation group (n = 30 cases). All patients received IMRT.Fluorouracil + cisplatin was used in the control group and docetaxel + cisplatin was used in the observation group. After 2 coursesof continuous treatment, the therapeutic effect, serum tumor marker content and adverse reactions were compared between thetwo groups. Results: After treatment, the effective rate of observation group was higher than control group, and the difference wasstatistically significant (P < 0.05).The contents of carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC) andcarbohydrate antigen 19-9 (CA19-9) in observation group were lower than those in control group, and the difference was statisticallysignificant (P < 0.05). The incidence of adverse reactions in the observation group was lower than that in the control group, and thedifference was statistically significant (P < 0.05). Conclusion: Docetaxel and cisplatin combined with intensemodulated radiotherapyfor postoperative recurrence of esophageal cancer can improve the therapeutic effect, inhibit the malignant degree of tumor, andreduce the incidence of adverse reactions.

Effects of Pemetrexed and Docetaxel Combined with Cisplatin in the Treatment of Non-small Cell Lung Cancer

The purpose of this study was to compare the clinical effects of pemetrexed and docetaxel combined with cisplatin in the treatment of patients with non-small cell lung cancer.A total of 58 patients with non-small cell lung cancer who were enrolled between January 2017 and January 2018 were enlisted into a randomized digital table.29 patients who have received treatment with combined pemetrexed and cisplatin were assigned to the pemetrexed group,whereas for the other 29 patients which were treated with docetaxel and cisplatin combined,were assigned to the docetaxel group to verify the calculated clinical treatment efficiency of the patients with non-small cell lung cancer,soluble vascular cell adhesion molecule 1(SVCAM-1),and activated leukocyte cell adhesion molecule-1(alCAM-1)concentrations and to evaluate the quality of life scores of the patients after half a year as well as the incidences of adverse reactions following the treatments provided.The differences in SVCAM-1 and alCAM-1 concentrations and incidence of adverse reactions in patients with non-small cell lung cancer in the docetaxel group as compared with patients in the pemetrexed group after the treatments were statistically significant(P<0.05)where the calculations were performed with data sets gathered from and between the two groups.In addition,SVCAM-1 and alCAM-1 concentrations in patients in both pemetrexed group and docetaxel group demonstrated significant differences in concentrations before and after the treatments were provided,P<0.05.The comparative studies of the effects of the treatments on the quality of life scores and clinical treatment efficiency between the two groups after half a year,P>0.05,demonstrated no analytical significance.Both pemetrexed combined with cisplatin and docetaxel in combination with cisplatin as forms of treatments demonstrated significant effects in patients with non-small cell lung cancer.However,based on our study,it was found that the combined treatment involving pemetrexed and cisplatin can further reduce adverse reactions and thus is worthy of clinical application.

升阳除湿防风汤联合化疗治疗晚期胃癌疗效及对患者血清CA72-4、sICAM-1的影响

目的:观察升阳除湿防风汤联合化疗治疗晚期胃癌患者的临床疗效及血清糖类抗原72-4(CA72-4)、可溶性细胞间黏附分子-1(sICAM-1)变化。方法:选择86例晚期胃癌患者,根据治疗方法将其分为两组,各43例,化疗组给予常规化疗治疗,观察组在化疗组基础上给予升阳除湿防风汤治疗,比较两组客观缓解率(ORR)、疾病控制率(DCR)、中医症状积分、血清CA72-4、sICAM-1水平、T淋巴细胞亚群指标(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、不良反应总发生率。结果:观察组ORR、DCR均较化疗组更高(P<0.05)。观察组治疗后畏寒肢冷、脘腹胀满、恶心呕吐、神疲乏力积分均较化疗组更低(P<0.05)。观察组治疗后血清CA72-4、sICAM-1水平均较化疗组更低(P<0.05)。观察组治疗后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均较化疗组更高(P<0.05),CD8^(+)较化疗组更低(P<0.05)。观察组血小板减少、贫血、脱发、恶心、呕吐总发生率与化疗组比较,差异无统计学意义(P>0.05)。结论:升阳除湿防风汤联合化疗可有效提高晚期胃癌客观缓解率、疾病控制率,缓解脘腹胀满等症状,改善免疫功能,纠正免疫失衡,降低血清CA72-4、sICAM-1表达量,且未增加不良反应发生率。

TP方案诱导化疗后同期TP与DDP治疗局部晚期鼻咽癌的对照研究

背景与目的:以往多西紫杉醇(docetaxel)联合顺铂(cisplatin,DDP)(TP方案)治疗鼻咽癌的临床试验的样本量小,得出的结果不一。本研究比较TP方案诱导化疗后TP与DDP同期放化疗在局部晚期鼻咽癌治疗中的近期疗效、不良反应。方法:57例初治鼻咽癌患者随机分为两组:同期TP方案放化疗组(TP组)30例;同期DDP放化疗组(DDP组)27例。两组诱导化疗采用TP方案(Docetaxel 70mg/m2第11天,DDP 80mg/m2d1),每3周1次,共2周期。同期化疗(每3周1次,共2周期):TP组采用TP方案(Docetaxel 60mg/m2d1,DDP 80mg/m2d2);DDP组采用DDP 80mg/m2d1。照射野采用CT-Sim设计,常规分割放疗。结果:57例患者完成诱导化疗111周期;53例患者完成同期化疗103周期。诱导化疗终止4例,同期化疗终止3例。所有入组患者都完成放疗。诱导化疗不良反应主要为血液毒性,同期放化疗不良反应主要为血液毒性和口腔粘膜反应。TP组3～4度白细胞减少、3～4度中性粒细胞减少的发生率明显高于DDP组,差异有统计学意义(P<0.005)。同期放化疗中,TP组患者100%使用G-CSF,明显高于DDP组(72.0%),两组比较差异有统计学意义(P<0.005)。同期放化疗后鼻咽部病灶完全缓解率:TP组93.3%,DDP组96.3%;区域淋巴结完全缓解率:TP组92.9%,DDP组91.3%。两组肿瘤反应比较差异无统计学意义。结论:TP方案诱导化疗后,TP同期放化疗的肿瘤缓解率与DDP同期放化疗相似。TP同期放化疗的不良反应发生比DDP同期放化疗高,但在G-CSF支持下,患者能耐受。TP方案的远期疗效值得进一步临床探讨。

康艾注射液联合DP方案治疗晚期非小细胞肺癌对照研究

目的观察康艾注射液联合多西他赛和顺铂治疗晚期非小细胞肺癌(NSCLC)的临床疗效和不良反应。方法70例晚期NSCLC患者分为联合康艾注射液化疗组(40例)和单化疗组(30例),观察2组患者化疗2个疗程后有效率(RR)及临床获益率(CB)、化疗期间及化疗后2组患者毒副作用观察及生存质量的改善情况。结果联合康艾注射液化疗组有效率及临床获益率均略高于单化疗组,差异有统计学意义(P<0.05)。康艾+化疗组化疗毒副反应在胃肠道反应、骨髓抑制、脱发及疲劳方面均低于单化疗组,差异有统计学意义(P<0.05)。康艾+化疗组生存质量改善,卡氏评分(KPS评分)提高,改善率达到62.50%,2组比较差异有统计学意义(P<0.05)。结论康艾注射液能提高多西他赛+顺铂的近期疗效,减轻化疗的毒副反应,提高生存质量。

DP方案与NP方案治疗65例晚期乳腺癌疗效及不良反应对比观察

目的:观察多西紫杉醇联合顺铂(DP方案)与诺维本联合顺铂(NP方案)治疗晚期乳腺癌的疗效及不良反应。方法:对65例晚期乳腺癌分别采用DP方案、NP方案治疗。DP方案组:多西紫杉醇75mg/m2,静脉滴注,第1天;顺铂(DDP)30mg/m2,静脉滴注,第1-3天。NP方案组:诺维本(NVB)25mg/m2,快速滴入或静脉冲入,第1,8天;顺铂(DDP),用法同DP方案组。每21天为1个周期。结果:DP方案组总有效率(66.9%,22/33)高于NP方案组(46.9%,15/32);DP方案组中位疾病进展时间(10.9个月)长于NP方案组(8.4个月),P<0.05;DP方案组和NP方案组中位生存期分别为17.2个月和15.9个月(P>0.05)。不良反应以骨髓抑制、胃肠道反应和静脉炎为主。结论:DP方案及NP方案对晚期乳腺癌均有较好的疗效,DP方案治疗晚期乳腺癌较NP方案有效率高,中位TTP长,不良反应可以耐受,可作为蒽环类药物治疗失败的晚期乳腺癌的解救方案。

^(125)I粒子植入联合DP方案治疗中晚期肺鳞癌的临床疗效

目的分析^(125)I粒子植入联合多西他赛和顺铂(DP)方案对治疗中晚期肺鳞癌的临床疗效。方法选取84例中晚期肺鳞癌患者为研究对象,随机将患者分为实验组和对照组,每组各42例,实验组患者给予^(125)I粒子植入联合多西他赛和顺铂(DP)方案治疗,对照组患者给予DP方案化疗,分析比较两组患者的临床疗效及临床不良反应。结果实验组患者的临床治疗有效率为73.81%,明显较高对照组的47.62%(P<0.05);实验组患者的1年生存率(85.71%)及中位无进展生存期[(6.3±1.4)个月]明显高于对照组[54.76%,(3.8±1.1)个月](P<0.05);两组患者临床不良反应主要为白细胞及血小板数目减少、恶心呕吐等症状,但程度均较轻(P>0.05)。结论^(125)I粒子植入联合多西他赛和顺铂(DP)方案治疗中晚期肺鳞癌的临床疗效肯定,患者生存期可得到延长,毒副作用较小,该化疗方案可为临床治疗中晚期肺鳞癌提供参考价值。