多西他赛联合卡铂治疗老年晚期非小细胞肺癌临床观察

目的观察多西他赛（docetaxel）联合卡铂（carboplatin）治疗老年晚期非小细胞肺癌的临床疗效及毒副反应。方法老年晚期非小细胞肺癌患者共40例,多西他赛用量75mg/m^2,每天静脉滴注,同时配伍卡铂AUC=5mg·ml^-1·min^-1,每天静脉滴注。21～28d为1个疗程,每例患者至少接受2个疗程的治疗。结果40例患者均可评价疗效,无完全缓解病例（CR）,15例获部分缓解（PR）,20例稳定（SD）,5例疾病进展（PD）,总有效率为37．5％（15／40）,其中位疾病进展时间为4．5个月,中位生存时间10．2个月（3～20个月）,1年生存率为45．1％。毒性反应主要有骨髓抑制、恶心、呕吐和腹泻以及白细胞下降导致的发热等。但患者多为Ⅰ、Ⅱ度反应,耐受良好。结论多西他赛联合卡铂是一种对老年晚期非小细胞癌有效的治疗方法,毒性反应轻,临床使用安全。     

多西他赛与顺铂联合治疗晚期非小细胞肺癌的疗效

目的研究多西他赛联合顺铂治疗晚期非小细胞癌的疗效及不良反应。方法随机选取在我科住院的60例非小细胞肺癌老年患者,予多西他赛75 mg/m2静脉滴注(60 min),顺铂75 mg/m2分3 d静脉滴注,3 w为1个周期,每个患者治疗2～4个周期。结果 56例患者可以评价疗效,部分缓解16例(28.57%),有效率34%,1年生存率35.71%(20例),中位生存时间为8.9个月。3例因不良反应重终止治疗,1例死亡。主要不良反应为骨髓抑制,其次为消化道反应。结论多西他赛联合顺铂治疗老年晚期非小细胞肺癌具有较好的疗效,大多数患者不良反应轻,耐受性较好,是较好的一线临床治疗方案。     

国产多西他赛联合顺铂治疗晚期非小细胞肺癌疗效观察

目的观察国产多西他赛联合顺铂（DDP）治疗晚期非小细胞肺癌的近期疗效、临床受益和毒副反应。方法70例晚期NSCLC患者给予DP方案化疗：国产多西他赛75mg/m^2,静滴,d1;顺铂75mg/m^2,静滴,d1;21d为1周期。每例患者治疗2周期以上。结果全组完全缓解2例,部分缓解29例,稳定36例,进展3例,总有效率44．3％。中位生存期10．1个月,1年生存率38．6％（27／70）。临床受益疗效：行为状态阳性率51．4％,体重阳性率47．1％。毒副反应主要为骨髓抑制,脱发和消化系统反应。其中白细胞减少占75．7％,G-CSF治疗后较快恢复。结论国产多西他赛联合顺铂无论一线还是二线治疗晚期NSCLC近期疗效和临床受益良好,毒副反应可耐受。     

多西他赛单药与联合奥沙利铂二线治疗非小细胞肺癌的临床研究

目的 本研究旨在评价多西他赛单药或联合奥沙利铂二线治疗晚期非小细胞肺癌(NSCLC)的疗效和安全性.方法 将57例ⅢB期或Ⅳ期的一线治疗失败的NSCLC患者分成多西他赛联合奥沙利铂组(27例)(多西他赛60 mg/m2,第1天静脉输注+奥沙利铂100 mg/m2,第2天静脉输注)和多西他赛单药组(30例)(多西他赛75 mg/m2,第1天静脉输注),均为3周方案,每例患者接受2～6个周期治疗,评价疗效及不良反应.结果 联合治疗组和多西他赛单药组疾病控制率分别为70.4％和43.3％(P=0.04),中位无进展生存期分别为5.2个月和3.6个月(P=0.03),中位生存时间分别为9.8个月和7.2个月(P=0.06).而在主要的3～4级毒副反应中,联合治疗组和多西他赛单药组比较,差异均无统计学意义.结论 多西他赛联合奥沙利铂二线治疗NSCLC取得了较好的疗效,毒副反应可以耐受,值得进一步研究.     

多西他赛联合铂类治疗126例晚期非小细胞肺癌临床观察

目的探讨多西他赛联合顺铂、卡铂及奈达铂治疗晚期非小细胞肺癌的疗效和毒副反应。方法应用多西他赛75 mg/m2联合顺铂75 mg/m2(或卡铂AUC=5,或奈达铂75 mg/m2)方案治疗126例晚期非小细胞肺癌患者。结果总有效率达48.4%,临床获益率为83.3%,其中初治与复治病例、ⅢB期与Ⅳ期病例组间的疗效差异有统计学意义(P<0.05),腺癌与鳞癌两组之间、合并使用顺铂、卡铂或奈达铂三组之间疗效差异无统计学意义(P>0.05)。主要毒副反应为骨髓抑制、恶心呕吐、腹泻及脱发。结论多西他赛联合顺铂、卡铂及奈达铂治疗晚期非小细胞肺癌疗效确切,毒副反应可耐受。     

多西他赛联合顺铂治疗晚期非小细胞肺癌23例疗效观察

2003年2月-2006年12月，我院采用多西他赛联合顺铂（PPD）治疗晚期非小细胞肺癌（NSCLC）患者23例，现将结果报告如下。     

奈达铂联合多西他赛二线治疗晚期非小细胞肺癌的临床观察

目的探讨奈达铂联合多西他赛二线治疗晚期非小细胞肺癌（NSCLC）的有效性及安全性。方法选择100例一线治疗失败的晚期NSCLC患者,随机分为试验和对照两组,试验组接受奈达铂＋多西他赛化疗,对照组接受多西他赛单药化疗,评价两组患者的疗效、无进展生存时间（PFS）、中位总生存时间（OS）和不良反应。结果试验组与对照组患者的疾病控制率（DCR）分别为80％和62％,两组差异有统计学意义（P〈0．05）。试验组与对照组患者的中位PFS分别为4．2个月和4．0个月,中位OS分别8．8个月和8．1个月,1年生存率分别为24％和22％,两组差异无统计学意义（P〉0．05）。试验组的不良反应包括白细胞减少、血小板减少及恶心、呕吐,发生率均明显高于对照组。结论与多西他赛单药相比,奈达铂联合多西他赛二线治疗晚期NSCLC,可提高DCR,但未延长PFS,未显著增加OS,血液学及消化道不良反应更明显,但可耐受。     

多西他赛联合洛铂或顺铂治疗晚期非小细胞肺癌的临床研究

目的观察多西他赛联合洛铂与联合顺铂治疗晚期非小细胞肺癌(NSCLC)的疗效和毒副反应。方法将80例初治的晚期NSCLC患者,随机分为两组。观察组:多西他赛75 mg/m2静滴,dI;洛铂30mg/m2静滴,d 1。对照组:顺铂25 mg/m2,静滴,d 1~3,多西他赛剂量及用法同上,21~28天为1周期。结果观察组患者的有效率和疾病控制率分别为42.5%(17/40)和80%(32/40),对照组为47.5%(19/40)和82.5%(33/40),差异均无统计学意义(P0.05)。在骨髓抑制和肝肾毒性方面,其差异无统计学意义(P0.05);但观察组恶心、呕吐及便秘发生率明显低于对照组(χ2=4.9,χ2=6.42,P0.05)。结论多西他赛联合洛铂和顺铂治疗晚期NSCLC的临床疗效基本相似,但多西他赛联合洛铂毒副反应相对较低,病人更易耐受,值得进一步研究。     

多西他赛注射液与顺铂联合治疗非小细胞肺癌的临床疗效

目的：观察多西他赛注射液联合顺铂治疗非小细胞肺癌(NSCLC)的疗效和安全性。方法选取我院收治的经病理组织学确诊的Ⅲ/Ⅳ期 NSCLC 患者136例,随机分成研究组和对照组,各68例,对照组给予多西他赛单药治疗,研究组采用多西他赛联合顺铂方案治疗。评估治疗2个周期后的治疗效果及不良反应发生情况。结果治疗2个周期后,研究组总有效率高于对照组(67.6% vs 47.1%,χ2=5.892,P =0.015),研究组患者白细胞减少、血小板降低、血清转氨酶上升的发生率明显高于对照组(χ2值分别为15.070、19.608、7.863,P 值均<0.05);但两组患者恶心呕吐、腹泻、脱发和乏力不良反应发生率差异无统计学意义(P 值均>0.05)。结论多西他赛注射液联合顺铂对晚期 NSCLC 患者的治疗效果较好,血液毒性略增高,但可以耐受,可以考虑在临床应用。     

多西他赛联合顺铂治疗晚期非小细胞肺癌的临床观察

肺癌在我国城市属常见恶性肿瘤的首位,在农村居第四位,近年来我国的肺癌发病率呈明显上升趋势,其中80％的患者就诊时已属晚期。非小细胞肺癌（NSCLC）约占肺癌的80％。约3／4的非小细胞肺癌患者诊断时已是Ⅲ期或Ⅳ期,失去了手术切除的机会,因此联合化疗是治疗中晚期非小细胞肺癌的重要手段,近年来以多西他赛（商品名：艾素）联合顺铂治疗晚期非小细胞肺癌的化疗方案,     

每周化疗合并局部放疗治疗晚期肺癌的临床研究

目的　对比每周化疗加局部放疗与单纯化疗对晚期非小细胞肺癌的疗效。方法　对初次化疗失败的非小细胞肺癌患者行每周化疗合并局部放疗 ,对初次化疗有效的病例继续行同一方案化疗。结果　放化疗组有效率为 6 6 .6 % ,单纯化疗组有效率为 70 .2 % ,二者之间无显著性差异 (P>0 .0 5 )。二者副作用 - 级白细胞减少的发生率 ,放化疗组较单纯化疗组明显下降 (P<0 .0 5 )。结论　每周化疗结合局部放疗是改善晚期肺癌初次化疗失败的一种有效方法     

小剂量多西他赛治疗老年晚期非小细胞肺癌的疗效研究

目的 观察小剂量多西他赛单药治疗老年晚期非小细胞肺癌（NSCLC）的疗效和不良反应.方法 46例老年NSCLC（Ⅲ～Ⅳ期）患者均经病理学或细胞学检查确诊.应用江苏恒瑞生产多西他赛（艾素）35mg/m2,1次/周,连用6周,休息两周为1周期,两周期后评价疗效.结果 46例患者均可评价疗效,CR 1例,PR 11例,有效率26.0%,中位生存期8.3个月,中位疾病进展时间（TTP）7.2个月,1年生存率45.5%.主要不良反应为白细胞减少和过敏反应,均可耐受.结论 小剂量多西他赛单药治疗老年晚期NSCLC疗效确切,可改善老年患者生存质量,延长生存期,不良反应轻.     

二甲双胍联合奥沙利铂抗肿瘤作用

目的:探究二甲双胍联合奥沙利铂对结肠癌移植瘤小鼠的抗肿瘤作用。方法:32只BALB/C雄性小鼠左前肢腋下接种c26小鼠结肠腺癌细胞,随机分为恶病质组、二甲双胍组、奥沙利铂组以及联合组,另外8只小鼠作为正常组。奥沙利铂组小鼠每周1次腹腔注射奥沙利铂注射液0.01 mg/g,同时每日灭菌蒸馏水0.1 m L/g灌胃;二甲双胍组小鼠每日给予二甲双胍0.2 mg/g灌胃,同时每周1次腹腔注射生理盐水0.02 m L/g;联合组小鼠每日给予二甲双胍0.2 mg/g灌胃,同时每周1次腹腔注射奥沙利铂注射液0.01 mg/g;正常组和恶病质组小鼠每日灭菌蒸馏水0.1 m L/g灌胃,同时每周1次腹腔注射生理盐水0.02 m L/g。每日检测小鼠体重、肿瘤大小、自发性活动、精神毛发等。连续给药42 d后,颈椎脱臼法处死小鼠,解剖分离并称重右下肢腓肠肌组织,ELISA法检测腓肠肌组织炎症因子水平,HE染色观察腓肠肌形态。结果:荷瘤小鼠体重、腓肠肌质量、腓肠肌横切面积较正常组均明显降低(均P0.05),奥沙利铂组和联合组小鼠肿瘤重量及体积均明显减少,且联合组减少最为明显(均P0.05),各荷瘤小鼠腓肠肌组织中IL-6及TNF-α水平较正常组均明显升高,其中二甲双胍组及联合组较恶病质组则明显下降(均P0.05)。结论:二甲双胍联合奥沙利铂能够抑制肿瘤生长,且能延缓癌性恶液质的发生。     

卡培他滨联合奥沙利铂在晚期胃癌中的临床效果研究

目的探讨卡培他滨联合奥沙利铂在晚期胃癌中的临床效果研究。方法选取2007年2月—2010年2月于我院进行治疗的64例晚期胃癌患者为研究对象,将其随机分为对照组（奥沙利铂、氟尿嘧啶联合醛氢叶酸组）32例和观察组（卡培他滨联合奥沙利铂组）32例,并对其进行相应的护理方法,后将两组患者的治疗效果、不良反应发生率、患者满意率及治疗前后的血清CEA、CA50、CA199、CA125及β2-MG水平进行检测及比较。结果经比较发现,观察组的治疗总有效率高于对照组,不良反应发生率低于对照组,患者满意率高于对照组,而治疗后血清CEA、CA50、CA199、CA125及β2-MG水平均低于对照组,均有显著统计学意义（P〈0.05）。结论卡培他滨联合奥沙利铂在晚期胃癌中的临床效果较佳,配合以相应的护理,对于改善患者预后作用明显。     

Combination of albumin concentration and neutrophil-to-lymphocyte ratio for predicting overall survival of patients with non-small cell lung cancer

BackgroundLung cancer contributes significantly to the total of cancer-linked deaths globally, accounting for 1.3 million deaths each year. Preoperative albumin (Alb) concentration and neutrophil-to-lymphocyte ratio (NLR) may reflect chronic inflammation and be used to predict lung cancer outcomes.MethodsThe clinical records of 293 patients with non-small cell lung cancer (NSCLC) in Fujian Medical University Cancer Hospital & Fujian Cancer Hospital were reviewed retrospectively in this current study. Clinicopathologic pretreatment, including NLR, Glasgow prognostic score (GPS), and post-treatment value, such as tumor-node-metastasis (TNM) were documented. The cut-off finder application was employed to calculate the optimal threshold values. The significance of Alb concentration combined with NLR (COA-NLR) on the prediction of overall survival (OS) was explored using Kaplan-Meier analysis along with Cox proportional hazards.ResultsThe results revealed that COA-NLR could independently assess the OS of patients with NSCLC [hazard ratio (HR) =1.952, 95% confidence interval (CI): 1.367 to 2.647, P<0.001]. Moreover, the 3-year OS rates were 87.2%, 68.5%, and 52.8% for the COA-NLR =0, COA-NLR =1, and COA-NLR =2, respectively (P<0.001).ConclusionsPreoperative COA-NLR value can effectively stratifies prognosis in NSCLC patients by classified patients into three independent groups. It can be adopted as an effective biomarker for prognosis in NSCLC patients treated with resection.     

Meis1 regulates proliferation of non-small-cell lung cancer cells

As one of the most common cancers, lung cancer remains to be a major public health problem. Non-small-cell lung adenocarcinoma cancer exhibits higher resistance to chemotherapy than small cell lung cancer, which requires novel strategies. To further understand underlying mechanisms for non-small-cell lung adenocarcinoma cancer cell proliferation, we explored the role of Meis1 in non-small-cell lung adenocarcinoma cancer cells. The results show that Meis1 inhibits non-small-cell lung cancer (NSCLC) cell proliferation. Specific knockdown of Meis1 resulted in strengthened proliferative ability of non-small-cell lung adenocarcinoma cancer cells. Cell cycle analysis indicated that DNA synthesis was increased when Meis1 was down-regulated specifically. As well as histone H3 phosphorylation, which is indicative of mitosis. More importantly, forced Meis1 expression repressed the proliferation of non-small-cell lung adenocarcinoma cancer cell. These data demonstrated Meis1 limits the proliferation of non-small-cell lung adenocarcinoma cancer cell and could potentially represent a therapeutic strategy that may control non-small-cell lung adenocarcinoma cancer cell proliferation.     

Nivolumab-induced Vogt-Koyanagi-Harada-like Syndrome and Adrenocortical Insufficiency with Long-term Survival in a Patient with Non-small-cell Lung Cancer

A 58-year-old man was diagnosed with lung adenocarcinoma with a tumor proportion score of 10%. After six cycles of second-line chemotherapy with nivolumab, he achieved a complete response (CR) but developed uveitis and sensorineural hearing disorder, which were consistent with Vogt-Koyanagi-Harada (VKH)-like syndrome. Simultaneously, pituitary adrenocortical insufficiency was identified. Nivolumab discontinuation and systemic corticosteroid administration resolved these immune-related adverse events (irAEs). The patient has maintained a CR without any chemotherapy for approximately two years. We herein report a patient with a long-term progression-free survival despite chemotherapy discontinuation due to irAEs, including VKH-like syndrome, which were appropriately managed.     

Peripheral blood eosinophilia may be a prognostic biomarker in non-small cell lung cancer patients treated with immunotherapy

BackgroundEosinophils have been traditionally associated with the initiation and propagation of inflammatory responses, particularly in allergic diseases and helminth infections. More recently, an association between eosinophils and cancer has been the focus of several studies, but controversial results have emerged. This study aims to evaluate the prognostic role of peripheral blood eosinophilia in non-small cell lung cancer (NSCLC) patients receiving immunotherapy (IO). We also evaluated the impact of peripheral eosinophilia on the occurrence of immune-related adverse effects (irAEs).MethodsAdvanced NSCLC patients under IO were included in a retrospective single-center study. Peripheral blood eosinophilia was defined by a count greater than 500/µL. Patients were analyzed for eosinophil counts, overall survival (OS), progression-free survival (PFS), overall response rate (ORR) and disease control rate (DCR).ResultsA total of 121 NSCLC patients receiving IO were included. Thirty-three (27.3%) patients presented peripheral blood eosinophilia during treatment. Patients with peripheral eosinophilia presented more frequently non-progression as best overall response to IO (83.3% vs. 58.1%, P=0.014), higher median OS (26.6 vs. 9.5 months, P=0.022) and higher median PFS (13.8 vs. 4.6 months, P=0.013). IrAEs were more common in patients with peripheral eosinophilia (66.7% vs. 36.4%, P=0.003).ConclusionsThis study suggests that peripheral blood eosinophilia may predict better outcomes in NSCLC patients receiving IO, despite being associated with an increased risk of irAEs. According to our findings eosinophils may be involved in immune response against tumor. Routine eosinophils count assessment may be an additional prognostic tool in NSCLC patients receiving IO.     

Second Line Therapy with Weekly Low-dose Docetaxel for Pretreated Non-Small-Cell Lung Carcinoma Patients: A Multicenter Italian Phase II Study

Docetaxel is one of the most active drugs in second-line therapy for non-small-cell-lung-carcinoma (NSCLC). The aim of this multicenter study was to evaluate the safety and efficacy of weekly low-dose docetaxel. Forty-two patients with advanced NSCLC pretreated with cisplatinum-based chemotherapy were enrolled. Docetaxel was administered at a dose of 25 mg/m² weekly for 12 consecutive weeks. A total of 386 doses were given with a median number of 10 doses per patient (range: 3–12). Treatment showed low incidence of hematologic toxicity and modest non-hematologic toxicity. An episode of grade 4 thrombocytopenia was reported but no episodes of grade 3 or 4 neutropenia. Most frequent non-hematologic toxicities were asthenia and alopecia. Response rate was 10.5% and median survival time (MST) was 12.8 weeks. Weekly treatment with 25 mg/m² docetaxel for 12 consecutive weeks appears to be a feasible and active regimen with mild toxicity in heavily pretreated NSCLC patients.