Utility of cooling patches to prevent hand-foot syndrome caused by pegylated liposomal doxorubicin in breast cancer patients

BACKGROUND Pegylated liposomal doxorubicin(PLD)uses the hydrophilic layer of liposomes to reach the sweat on the skin surface or accumulate in the sweat glands,producing toxic free radicals and oxidative damage,resulting in hand-foot syndrome(HFS).Regional cooling can induce vasoconstriction to reduce the release of drugs in the limbs and reduce the accumulation of drugs in sweat glands;thus,decreasing the incidence and severity of HFS.AIM To study the efficacy of cooling patches to prevent HFS caused by PLD in the short-term.METHODS This is a retrospective cohort study.Female breast cancer patients(n=101)who were treated with PLD in two breast wards at our department from February 2020 to February 2021 were enrolled in the study and were randomly divided into the cooling group(51 patients)and the control group(50 patients).Patients in the control group only received routine care,while the patients in the cooling group applied cooling patches,based on routine care,to the palm and back of the hands 15 min before chemotherapy infusion for 10 h.All patients took a corresponding dose of dexamethasone orally one day before chemotherapy,on the day of chemotherapy,and one day after chemotherapy.SPSS23.0 version was used to analyze the data in this study.The occurrence and severity of HFS was analyzed by the Mann-Whitney U test,and scores were analyzed by the Student’s t test or Wilcoxon rank-sum test.A P value<0.05 was regarded as statistically significant.RESULTS In this study,neither group of patients developed Grade 3 HFS.In the control group,the incidence of Grade 1 HFS and Grade 2 HFS was 38%and 2%,respectively.However,in the cooling group,only one person developed Grade 1 HFS(2%),and none of the patients developed Grade 2 HFS.These findings showed that cooling patches can effectively reduce the frequency and severity of HFS(P<0.0001)in the short-term.Before the fourth chemotherapy cycle,although general self-efficacy scale scores in the cooling group were low,they were still significantly higher than those in the control group(17.22±5.16 vs 19.63±6.42,P=0.041).Compared with the control group,the mean Hand-Foot Skin Reaction and Quality of Life Questionnaire score in the cooling group was significantly lower(18.08±7.01 vs 14.20±7.39,P=0.008).CONCLUSION Cooling patches can effectively reduce the frequency and severity of HFS caused by PLD in the short-term.In addition,it may help delay the decline in patients’self-efficacy.

First line anlotinib plus liposomal doxorubicin for locally advanced or metastatic soft tissue sarcoma:A prospective,single-arm trial

Objective:To examine the efficacy and safety of anlotinib as first-line therapy to treat locally advanced or metastatic soft-tissue sarcoma.Methods:This is a single-arm trial.Treatment-naïve patients(≥14 years)with locally advanced or metastatic soft tissue sarcoma were eligible.Each treatment cycle lasted for 3 weeks,and included liposomal doxorubicin(40-50 mg/m^(2))on day 1 and anlotinib(12 mg)on days 8-21.Starting from the 9th cycle,treatment consisted of only anlotinib.Treatment continued until disease progression or intolerable toxicities.The primary efficacy end point was progression-free survival(PFS).Results:Eight patients were enrolled between July 25,2019 and January 8,2020.The median number of treatment cycles was 5.5.Within 5.9 months median follow-up,PFS events occurred in 4(4/8,50%)patients.The median PFS was 11.3 months and the 6-month PFS rate was 56%.No patients attained complete response and 2 patients(fibrosarcoma,1 patient and undifferentiated pleomorphic sarcoma,1 patient)achieved partial response.Three patients(fibrosarcoma,2 patients and synovial sarcoma,1 patient)had stable disease.The objective response rate was 25%(2/8)for the study population,and the disease control rate was 75%(6/8).No new safety concerns emerged.Conclusions:Anlotinib plus liposomal doxorubicin demonstrated antitumor activities in previously untreated locally advanced or metastatic soft tissue sarcomas.Due to the small sample size,further investigations with a larger population should be undertaken to confirm the study findings.

Activity and safety of pegylated liposomal doxorubicin,5-fluorouracil and folinic acid in inoperable hepatocellular carcinoma:A phase Ⅱ study

AIM: To improve the results of New therapeutic strategies in hepatocellular carcinoma (HCC). We have conducted a phase Ⅱ study with pegylated liposomal doxorubicin (PLD), 5-fluorouracil (5FU) and folinic acid (FA). METHODS: Thirty-one patients with hystologically- confirmed, inoperable HCC, received combination chemotherapy with PLD 25 mg/mq on d 1, 5FU 1200 mg/mq in 48 h continuous infusion, and oral FA 30 mg on d 1 and 2 every 3 wk until disease progression or intolerable toxicity. RESULTS: The median age was 65 years (range 41-82) and 28 patients were hepatitis C virus seropositive (90%). The majority of patients were Child-Pugh Class B (55%). Two patients showed a partial response (PR), and 16 had stable disease (SD). With a median follow-up of 14 mo, the median time to progression of all evaluable patients was 4 mo (95% CI 1.7-7). Median overall survival was 9 mo (95% CI 3-24 mo). After 1 year, 9 of 18 PR/SD patients were alive. Chemotherapy was well tolerated. CONCLUSION: PLD/FU/FA combination seems capable of achieving durable stabilization of HCC. The manageable toxicity supports a role for combination with other anticancer agents.

Pegylated liposomal doxorubicin/carboplatin combination in ovarian cancer, progressing on single-agent pegylated liposomal doxorubicin

AIM: To assess the efficacy and safety of the combination of pegylated liposomal doxorubicin(PLD) and carboplatin in patients with recurrent epithelial ovarian carcinoma(ROC), following disease progression on single agent PLD. METHODS: An analysis of the medical records of 10 patients with ROC, treated in our institution with a combination of PLD and carboplatin following progression on single-agent PLD therapy was performed. The median age was 59.1 years(range, 45 to 77 years). All diagnoses were histological-proven. Eight of the 10 patients were platinum-resistant. Following disease progression on single-agent PLD treatment, carboplatin area under the curve(AUC)-5 was added to PLD in all 10 patients. In order to assess disease status, Ca-125 was assessed before each PLD/carboplatin treatment. Relative changes in Ca-125 values were calculated, and response defined as a greater than 50% reduction in Ca-125 from baseline. Radiographic studies were reevaluated and responses to therapy based on com-puter tomography(CT) scans carried out on a regular basis every 2-3 mo in each patient. Statistical analysis was performed using SPSS(V19).RESULTS: A median of 10 cycles(range, 2-26) of the carboplatin-PLD combination was given. Of the 10 treated patients, 6 had > 50% reduction in Ca-125 levels from baseline, 4 of these had a partial response according to Response Evaluation Criteria in Solid Tumors(RECIST) criteria, and the other 2 patients had no measurable disease. In a further 2 patients with a best response of disease stabilization and < 50% reduction of Ca-125 levels, one had progression of disease after 26 cycles, and the second progressed with brain metastases following 12 cycles. Seven of the eight patients who were platinum-resistant showed evidence of clinical benefit on carboplatin-PLD combination therapy; 5 of these had > 50% reduction in Ca-125 level, 4 also showed a partial response on CT scan. The treatment was generally well-tolerated by the patients. CONCLUSION: Addition of carboplatin to PLD, after disease progression on single-agent PLD therapy, is both effective and safe in patients with ROC, even in those with Platinum-resistant disease.

Predictive and Prognostic Factors for the Outcome of the Patients Receiving Pegylated Liposomal Doxorubicin for Advanced Breast Cancer

Purpose:?The treatment of advanced breast cancer (ABC) is still challenging aiming mainly to improve or maintain the quality of life. The efficacy of pegylated liposomal doxorubicin (PLD) was proven in patients with ABC.?Because its expensive treatment?there is a great need to find the predictive factors for the clinical outcome of PLD.?Our purpose was to evaluate the factors which?would affect the clinical outcomes in patients receiving PLD for advanced breast cancer. Methods: Retrospectively, we studied the medical records of 60 eligible patients during the period of seven years (Jan.?2011-Dec.?2017).?All patients?were treated in Medical Oncology Department, South Egypt Cancer Institute, Assiut?University,?Egypt. We included only patients with visceral metastasis who received at least 2 cycles of PLD and had radiological assessment after that. Clinical benefit rate of PLD and survival outcome were assessed and correlated with patients and disease?characteristic. Results:?The majority of patients had a performance status grade II (81.7%), recurrent disease (86.7%), more than one metastatic site (83.3%), and chemoresistance to previous anthracycline (75%).?The clinical benefit rate (CBR) to PDL was 30%. We found statistical?significant association between higher CBR and biological subtypes (p??0.001), type of metastatic breast disease (p?=?0.003), chemosensitivity to anthracycline (p??0.001), and the number of previous lines of chemotherapy (p?=?0.041).?The median progression-free survival (PFS) was five months. There was a statistically-significant improvement of PFS among patients with anthracycline-sensitive tumors compared to those with anthracycline-resistant tumors (10 months vs. 5 months, respectively, p?=?0.004). The most common toxicity was palmar-plantar erythrodysesthesia (28% for all grade and 9% for grade 3 or more). There was no severe cardiotoxicity or treatment-related death.?Conclusion:?Pegylated liposomal doxorubicin appears to be more effective in patients?with (luminal B with Her2neu?positive, triple-negative and in her2neu amplified), also we noticed that de novo metastatic disease, patient who are not heavily pretreated tumors and patients with the anthracycline-sensitive tumor get more benefit from PLD than others.

Cardiac Safety with High Cumulative Dose of Pegylated Liposomal Doxorubicin in Patients with Metastatic Breast Cancer Previously Treated with Conventional Anthracyclines

Introduction: The treatment of metastatic breast cancer (MBC) is still challenging. Many studies documented the efficacy of pegylated liposomal doxorubicin (PLD) in patients with MBC, but there is a limited data about the cardiac safety with high cumulative dose (HCD) of PLD. Aim of the work: We conducted this trial to outline the cardiac safety of HCD of PLD in patients with MBC who previously received conventional anthracyclines. Methods: During the period of nine years (January 2011 to December 2019). We extracted the data of the patients with MBC receiving PLD at Medical Oncology Department, South Egypt Cancer Institute, Assiut University. These included patients’ demographics and therapeutic data including the full data of PLD, prior conventional anthracyclines, prior trastuzumab, and prior radiotherapy. Also, data about comorbidities as well as cardiac and other toxicities of PLD were obtained. The data was analysed using SPSS v. 21. Results: For all 81 eligible patients, the mean age was 43.9 years (±standard deviation (SD) 13.2). The mean cumulative dose of PLD was 378.4 mg/m2 (± SD of 250.2) and a range of 100 - 1200 mg/m2. About thirty-one (38.3%) patients received high cumulative dose (400 mg/m2 or more), while the remaining 50 patients did not. The decline in left ventricular ejection fraction (LVEF) was relatively rare;and of low grade. Grade 2 decline in LVEF occurred in only two patients who received high cumulative dose of PLD, and only one patient who did not reach HCD (p = 0.555). Grade 3 or 4 decline in LVEF did not occur in patients either with or without HCD. Regarding other toxicities, there was a significant increase in incidence of all grades palmar plantar erythrodysesthesia (PPE) in patients who received HCD of PLD when compared to those who did not reach the HCD (38.7% versus 16% respectively;p = 0.021). Conclusion: Our study concluded that the use of PLD seems to be a justified agent in the treatment of MBC who previously treated by conventional anthracyclines in the adjuvant, metastatic or both settings, even in patients reaching the cumulative dose of conventional anthracycline.

An Open-Label Study of Pegylated Liposomal Doxorubicin,Vincristine, and Reduced-Dose Dexamethasone Combination Therapy in Newly Diagnosed Multiple Myeloma Patients in the Chinese Population

OBJECTIVE Though doxorubicin is highly activein the treatment of multiple myeloma, its toxicityprofile limits its therapeutic index. We performed thisstudy to evaluate the efficacy and safety of pegylatedliposomal doxorubicin (PLD, Caelyx^(?)), vincristine,and reduced-dose dexamethasone combinationtherapy in newly diagnosed multiple myeloma (MM)patients in a Chinese population.METHODS This was an open-label, single-armstudy in which newly diagnosed patients with MMreceived PLD 40 mg/m^2 intravenously on Day 1,vincristine 1.4 mg/m^2 intravenously (maximum 2 mg)on Day 1, and 40 mg of dexarnethasone (intravenouslyor orally) from Day 1 to Day 4. Treatment wasrepeated every 28 days for at least 4 cycles.RESULTS In the intent-to-treat (ITT) analysis, theoverall response rate was 68.29%, and the completeremission rate was 10.98%. The incidence of alladverse events was 46.34%. The most commonnon-hematologic toxicities were palmar-plantarerythrodysesthesia (13.4%) and stomatitis (6.1%).CONCLUSION PLD, vincristine, and a reduceddosedexamethasone combination (DVd) is aneffective and safe regimen in newly diagnosed MMpatients in a Chinese population.

Meta-Analysis of Trials Comparing Gemcitabine and Pegylated Liposomal Doxorubicin for Treatment in Women with Progressive or Recurrent Ovarian Cancer

OBJECTIVE To evaluate the efficacy and adverse effects ofgemcitabine versus pegylated liposomal doxorubicin in patientswith progressive or recurrent ovarian cancer.METHODS We conducted a systematic literature search toidentify all randomized controlled trials comparing gemcitabineand pegylated liposomal doxorubicin for progressive orrecurrent ovarian cancer. Trial data were reviewed and extractedindependently by 2 reviewers. We evaluated the quality of theincluded studies using the Handbook 5.0 recommend standardsand then analyzed data by Cochrane Collaboration's RevMan 5.0.RESULTS Two trials which included a total of 348 patients wereanalyzed. The results of meta-analysis showed that gemcitabineimproved disease control rates significantly better than pegylatedliposomal doxorubicin. A greater number of patients receivinggemcitabine experienced neutropenia compared with patientsreceiving pegylated liposomal doxorubicin; however, hand-footsyndrome and mucositis were more severe in patients receivingpegylated liposomal doxorubicin.CONCLUSION Gemcitabine provided a limited advantagecompared with pegylated liposomal doxorubicin. There existsan urgent need for more high-quality, multicenter, adequaterandomized, controlled clinical trials for comparing gemcitabinewith pegylated liposomal doxorubicin in patients withprogressive/recurrent ovarian cancer.

Pegylated Liposomal Doxorubicin as a Single Agent or as Combination Therapy with Carboplatin in Patients with Recurrent or Refractory Epithelial Ovarian Cancer

OBJECTIVE Pegylated liposomal doxorubicin (PLD;CAELYX^(?)), a novel formulation of doxorubicin with enhancedtherapeutic efficacy and reduced toxicity, has demonstratedimproved progression-free survival in recurrent or refractoryovarian cancer. The objective of this open-label, noncomparative,observational study was to determine the efficacyand safety of PLD monotherapy or combination therapy withcarboplatin for patients with recurrent or refractory ovariancancer.METHODS Sixty-two patients with recurrent or refractoryovarian cancer who completed a platinum-based chemotherapyregimen and demonstrated platinum sensitivity for first-linetreatment at least 6 months prior to study entry were enrolledin 20 centers in China. PLD was given as monotherapy (50mg/m^2 infused over 60 minutes) or as combination therapy(30 mg/m^2 1-hour infusion) with carboplatin (area under thecurve 5 mg.min/mL 1-hour infusion) on day 1 every 28 daysfor 4 cycles. The primary endpoint was objective response (OR)rate or CA-125 level. Secondary endpoints included time toresponse, time-to-progression, health-related quality of life, andsafety.RESULTS Overall, 48% of the 62 evaluable patients achieveda confirmed OR. More patients receiving PLD and carboplatinachieved an OR vs the PLD monotherapy group (63% vs. 37%).The median time to response and disease progression was58.5 days and 56.0 days, respectively. Overall and drug-relatedadverse events were reported for 39% and 34%, respectively.The most commonly reported adverse events were stomatitis(22.6%) and palmar-plantar erythroderma (9.7%). Two deathswere reported.CONCLUSION PLD is an effective and well tolerated agentin women with recurrent or refractory epithelial ovarian cancer.

Microwave ablation combined with transarterial chemoembolization containing doxorubicin hydrochloride liposome for treating primary and metastatic liver cancers

Aims:To determine the safety and efficacy of microwave ablation(MWA)and transarterial chemoembolization(TACE)with doxorubicin hydrochloride liposome(DHL)in patients with primary liver cancer(PLC)and metastatic liver cancer(MLC).Materials and methods:The medical records of patients with primary or metastatic liver cancer who underwent MWA combined with TACE containing DHL from March 2019 to March 2022 were collected and analyzed.Treatment-related adverse events(AEs)were recorded.Local tumor response was evaluated according to the modified RECIST criteria.Local tumor progression-free survival(LTPFS)and overall survival(OS)were calculated using the Kaplan-Meier method.Results:Altogether,96 patients with liver cancer were included(PLC,n=45;MLC,n=51).Forty(41.7%)patients experienced AEs during treatment,and eight(8.3%)patients developed grade 3 AEs.Compared to before treatment,the serum total bilirubin level and neutrophil to lymphocyte ratio significantly increased after treatment.The median LTPFS was 14.5 months in patients with PLC and 10.7 months in patients with MLC.The median OS was not reached in patients with PLC or MLC.The 1-month and 3-month disease control rates reached more than 80%in both groups.Conclusion:MWA combined with TACE with DHL may be a safe and effective method for the treatment of liver cancer.

Nonclinical Study of the Active Components of Doxorubicin Hydrochloride Liposome Injection in Vivo

Objectives: A non-clinical study was performed to establish a LC-MS/MS method to determine the in vivo active components of doxorubicin hydrochloride liposome injection in the plasma of Sprague-Dawley rats. Methods: Ten male SD rats were administered tail vein with a single dose of 10 mg/kg, and the concentrations of doxorubicin hydrochloride in plasma, heart, liver, spleen, lung, and kidney were determined by liquid chromatography-tandem mass spectrometry, and the pharmacokinetic parameters were calculated. Results: The final concentration of doxorubicin hydrochloride ranged from 500 ng/mL to 250,000 ng/mL, and the lower limit of quantification was 500 ng/mL;the main pharmacokinetic parameters: T1/2 was (19.282 ± 10.305) h, Cmax was (118514.828 ± 26155.134) ng/mL, AUC0-24 and AUC0-∞ were (1216659.205 ± 192706.268) ng/mL⋅h and (2082244.523 ± 860139.487) ng/mL⋅h, MRT0-24 and MRT0-∞ were (9.237 ± 0.423) h and (26.52 ± 14.015) h, respectively, and clearance (CL) was (0.005 ± 0.002) mL/h⋅ng. Conclusions: The method is simple, rapid, and sensitive, which can be used for the determination of doxorubicin hydrochloride concentration in the plasma of SD rats and pharmacokinetic non-clinical studies.

手足低温法预防盐酸多柔比星脂质体致手足综合征的效果

目的 从临床角度探究局部冷敷法在盐酸多柔比星脂质体(PLD)致相关手足综合征(HFS)中的应用效果。方法 采取非同期随机对照试验,选取2021年6月至2023年6月河北工程大学附属医院乳腺外科已治疗的乳腺癌患者为研究对象,以2021年6月至2022年5月化疗的乳腺癌患者为常规护理组(n=58),2022年6月至2023年6月化疗的乳腺癌患者为局部冷敷法组(n=55)。比较两组在4次PLD化疗阶段HFS的发生率、患者治疗依从性、诊疗满意度及患者就医体验感。结果 局部冷敷法组HFS发生率为23.6%(13/55),常规护理组为44.8%(26/58);局部冷敷法组HFS发生率低于常规护理组(χ^(2)=5.609,P=0.018)。局部冷敷法组HFS严重程度轻于对照组(P<0.05)。局部冷敷法组Ⅱ级及以上HFS发生率为10.9%、常规护理组为25.9%;局部冷敷法组Ⅱ级及以上HFS发生率低于常规护理组(P<0.05)。局部冷敷法组治疗依从性及满意度均高于常规护理组(P<0.05)。结论 局部冷敷法可有效预防和降低PLD化疗过程中HFS的发生率和严重程度、提高患者护理干预的依从性、患者满意度较高。

阿霉素及卡铂双载药脂质体治疗卵巢癌腹水的研究

目的研究阿霉素及卡铂双载药脂质体对卵巢癌腹水的治疗。方法采用薄膜分散法结合硫酸铵梯度法制备阿霉素-卡铂脂质体(doxorubicin-carboplatin liposome,DOX/CBP-Lip),考察其粒径、电位、包封率、载药量和体外药物释放性能,对其体外抗肿瘤活性进行初步研究,评价其体内药效,包括腹围、体质量变化和生存率情况。结果DOX/CBP-Lip的粒径为177.90 nm,电位为-32.63 mV,其中CBP的包封率在49.04%左右,DOX的包封率在93.17%左右,且有一定的缓释作用。DOX/CBP-Lip对OVCAR3细胞具有协同抗肿瘤的作用,在相同给药剂量下,DOX/CBP-Lip可以发挥协同作用,增强药物的抗肿瘤活性,降低药物毒性。结论将DOX和CBP制成双载药脂质体可以提高卵巢癌引发腹水的治疗效果,降低DOX和CBP的毒性,为联合使用抗肿瘤药物治疗肿瘤引起的腹水提供参考。

多柔比星脂质体诱发手足综合征的研究进展

尽管多柔比星脂质体是一种有效的抗癌药物,但其引发的手足综合征(HFS)对患者的生活质量和治疗依从性构成了显著影响。近年来,关于其机制的深入研究和新的管理策略的开发为改善患者的治疗体验提供了新的希望。本研究旨在探讨多柔比星脂质体诱发HFS的机制、治疗方法以及未来研究方向的最新进展。

基于深度学习的乳腺癌术后脂质体多柔比星与表柔比星个性化治疗推荐研究

目的比较机器学习(machine learning,ML)与因果领域个体化干预效果(individualized treatment effect,ITE)评估深度学习这两类方法在真实临床数据集上的个性化推荐性能差异,构建乳腺癌术后聚乙二醇脂质体多柔比星(pegylated liposomal doxorubicin,PLD)与表柔比星(epirubicin,EPI)的个体化药物治疗推荐模型,通过评估药物疗效来指导临床治疗方案。方法回顾性收集浙江大学医学院附属邵逸夫医院收治的904名乳腺癌患者临床资料,其中387例采用PLD治疗,517例采用EPI治疗,通过倾向性评分匹配法比较两组患者5年无病生存期(disease free survival,DFS)结局;应用CFR_WASS等6种ITE模型预测患者在两种药物治疗下5年DFS概率,使用随机森林等6种机器学习模型作为基准进行性能分析比较;根据受试者工作特征曲线下的面积(area under the receiver operating characteristic curve,AUROC)评估预测性能,通过计算实际使用治疗与模型推荐治疗一致组和对照组的5年DFS率差异评估治疗推荐有效性。结果153对匹配病例中,PLD组和EPI组5年DFS结局比较差异无统计学意义,16对病例PLD组临床结局优于EPI组,12对病例EPI组临床结局优于PLD组,验证两种药物存在个体治疗收益差异。CFR_WASS模型获得了最优预测性能(AUROC为0.7368);多数ML组与对照组的5年DFS率无明显差异,ITE组5年DFS率均低于对照组,差异有统计学意义(P<0.01),其中CFR_WASS组5年DFS率较对照组低2.13%。结论相比于ML模型,ITE评估深度学习模型能更准确地估计两种药物的个体化治疗效果,给出有效的个体化治疗推荐,具有一定临床应用价值。

表柔比星联用右丙亚胺和多柔比星脂质体对化疗所致心脏毒性的临床效果探究

目的本研究详细评估了表柔比星联用右丙亚胺和多柔比星脂质体在化疗中所产生的疗效与心脏毒性,以确定其临床效果和安全性。方法选择2022年1月至2023年1月,选取成都平安医院收治的90例乳腺癌化疗患者开展此次临床实践研究,采用随机数字表法将其分为A、B、C三组,每组30例,A组患者采用表柔比星化疗,B组患者采用多柔比星脂质体化疗,C组患者采用表柔比星联用右丙亚胺化疗,化疗4周期时,对比三组患者临床缓解率、心脏毒性发生率及生活质量评分。结果化疗4周期时,B、C组患者临床缓解率、生活质量评分高于A组,B、C组患者心脏毒性发生率低于A组,组间对比有差异统计学意义(P<0.05)。结论与单用表柔比星化疗相比,表柔比星联用右丙亚胺和多柔比星脂质体不仅能提高化疗治疗效果,还能降低化疗所致心脏毒性的发生,从而能提高其预后生活质量。

表柔比星联用右丙亚胺和多柔比星脂质体对化疗所致心脏毒性的临床效果探究

目的本研究详细评估了表柔比星联用右丙亚胺和多柔比星脂质体在化疗中所产生的疗效与心脏毒性,以确定其临床效果和安全性。方法选择2022年1月至2023年1月成都平安医院收治的90例乳腺癌化疗患者作为研究对象,采用随机数字表法将其分为A、B、C三组,每组各30例,A组患者采用表柔比星化疗,B组患者采用多柔比星脂质体化疗,C组患者采用表柔比星联用右丙亚胺化疗,化疗4周期时,对比三组患者临床缓解率、心脏毒性发生率及生活质量评分。结果化疗4周期时,B、C组患者临床缓解率、生活质量评分高于A组,B、C组患者心脏毒性发生率低于A组,组间对比差异有统计学意义(P<0.05)。结论与单用表柔比星化疗相比,表柔比星联用右丙亚胺和多柔比星脂质体不仅能提高化疗治疗效果,还能降低化疗所致心脏毒性的发生,从而能提高其预后生活质量。

肿瘤靶向NGR/LPD复合物对人乳腺癌裸鼠移植瘤作用的研究

目的观察肿瘤靶向NGR/LPD复合物对人乳腺癌裸鼠移植瘤的抑制作用。方法抑瘤实验设有空白对照组、反义核酸组、正义NGR/LPD组、PEI/ASODN组、LPD组、NGR/LPD组。其中,PEI/ASODN组、LPD组及NGR/LPD3组分别设置高低浓度组(100μl,200μl)作对照考察剂量-效应相关性。通过激光共聚焦显微镜观察药物在裸鼠体内的分布情况。RT-PCR检测hTERTmRNA表达水平,免疫组化检测hTERT蛋白表达的变化。TUNEL法观察肿瘤细胞的凋亡情况。结果体内分布实验表明,NGR/LPD复合物具有肿瘤靶向性,未经NGR修饰的ASODN、LPD及PEI/ASODN则极少分布在肿瘤组织中。NGR/LPD组的瘤体生长最为缓慢,其最大抑瘤率与其他各组相比具有显著差异(P<0.05),hTERTmRNA和端粒酶活性表达明显低于各对照组(P<0.05),hTERT蛋白表达量下降,肿瘤细胞的凋亡指数明显高于各对照组(P<0.05)。结论 NGR/LPD在体内有很好的肿瘤靶向性和抑制肿瘤细胞生长的作用。

R-CDOP方案治疗弥漫大B细胞淋巴瘤的效果及对免疫功能、预后影响

目的探讨R-CDOP方案治疗弥漫大B细胞淋巴瘤的效果及对免疫功能、预后影响。方法选取2017年10月至2020年6月于浙江省台州市中心医院(台州学院附属医院)诊治且随访至2022年7月的52例弥漫大B细胞淋巴瘤患者作为研究对象,按照随机数字表法分为观察组(予以R-CDOP方案治疗)与对照组(予以R-CHOP方案治疗),各26例。比较两组有效率、免疫功能(CD3^(+)、CD4^(+)、CD8^(+))、毒副作用、2年生存率及生存时间。结果观察组客观有效率、完全缓解率高于对照组,差异有统计学意义(P<0.05)。化疗后,两组CD3^(+)、CD4^(+)低于化疗前,且观察组高于对照组;两组CD8^(+)高于化疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组毒副作用总发生率低于对照组,差异有统计学意义(P<0.05)。观察组2年生存率、生存时间高于对照组,差异有统计学意义(P<0.05)。结论R-CDOP方案治疗弥漫大B细胞淋巴瘤效果显著,有利于减轻对免疫功能的影响,且安全性高。