薏苡仁油注射液联合培美曲塞一线治疗老年晚期非小细胞肺癌的疗效分析

目的 比较单药一线培美曲塞联合或不联合薏苡仁油注射液治疗老年晚期非小细胞肺癌( NSCLC)患者的疗效和不良反应. 方法 老年晚期NSCLC患者共47例,随机分为治疗组和对照组.治疗组24例,培美曲塞500 mg/m2,第1天静脉滴注,每3～4周为1周期;同时给予薏苡仁油注射液10 g,第1天至第15天静脉滴注;对照组23例,单药培美曲塞化疗. 结果 治疗组和对照组有效率(RR)分别为41.6％、39.1％,肿瘤控制率(TGCR)分别为70.8％、69.6％,差异无统计学意义(P＞0.05).2组患者对不良反应均可耐受,治疗组耐受性及生存质量均高于对照组,差异有统计学意义(P＜0.05). 结论 老年晚期NSCLC患者可从单药一线培美曲塞中获益;培美曲塞联合薏苡仁油注射液可减轻化疗相关不良反应,改善患者生存质量.     

培美曲塞治疗老年晚期非小细胞肺癌疗效分析

目的观察培美曲塞单药二线治疗老年晚期非鳞癌NSCLC的疗效及毒性反应;方法经病理学或细胞学确诊的25例老年晚期NSCLC患者,均接受培美曲塞化疗,培美曲塞以500 mg/m2,第一天静脉滴注,21天为一周期,每例患者至少行2周期化疗;结果 CR 0例,PR 5例,SD 12例,PD 8例,有效率(RR)20.0%,临床获益率(CBR)68.0%。主要不良反应为骨髓抑制和胃肠道反应;结论培美曲塞治疗老年晚期NSCLC具有一定的疗效,毒性反应轻,耐受性好。     

单药培美曲塞一线治疗老年晚期非鳞非小细胞肺癌的疗效分析

目的 探讨培美曲塞单药一线治疗老年晚期非鳞非小细胞肺癌的临床疗效及不良反应.方法 经病理或细胞学确诊老年(70～85岁)晚期(ⅢB～Ⅳ期)肺腺癌患者86例,46例患者接受培美曲塞500mg/m2治疗;40例患者接受多西他赛75 mg/m2治疗,每组至少接受2个周期以上化疗,每2个周期评估疗效、不良反应.结果 培美曲塞组和多西他赛组有效率分别是26.1％和22.5％(P=0.699);疾病控制率分别是65.2％和60.0％(P=0.618);中位无进展生存期分别是4.0个月和3.5个月(P=0.500).两组主要的不良反应是骨髓抑制和胃肠道反应,但差异无统计学意义;培美曲塞组脱发和乏力的发生率低于多西他赛组(P＜0.05).结论 培美曲塞单药治疗老年非鳞非小细胞肺癌疗效均较好,且培美曲塞不良反应低于多西他赛,可以推荐作为一线药物使用.     

培美曲塞与多西他赛治疗老年晚期肺腺癌病人的疗效比较

目的探讨培美曲塞联合顺铂与多西他赛联合顺铂治疗老年晚期肺腺癌病人的疗效以及不良反应,明确哪种方案治疗效果更佳。方法收集2013年6月至2017年1月在我院治疗的80例老年晚期肺腺癌病人的临床资料,根据化疗方案的不同分为培美曲塞组(41例)和多西他赛组(39例)。培美曲塞组给予培美曲塞500 mg/m2、顺铂70 mg/m2,第1天静滴;多西他赛组给予多西他赛75 mg/m2、顺铂70 mg/m2,第1天静滴。每21 d为1个周期,2个周期后行影像学检查评价疗效。结果培美曲塞组的总有效率(RR)、疾病控制率(DCR)、中位疾病进展时间(TTP)、中位生存期(MST)、1年生存率与多西他塞组相比,差异无统计学意义(P0.05)。培美曲塞组的恶心呕吐、便秘、腹泻、骨髓抑制、疲劳乏力以及脱发不良反应发生率较多西他赛组低,差异具有统计学意义(P0.05),其他不良反应发生率2组比较差异无统计学意义。结论培美曲塞联合顺铂与多西他赛联合顺铂治疗老年晚期肺腺癌病人的效果相近,但培美曲塞联合顺铂治疗产生的不良反应低于多西他赛联合顺铂。     

培美曲塞联合参芪扶正注射液一线治疗老年晚期肺腺癌的临床研究

目的比较培美曲塞联合或不联合参芪扶正注射液一线治疗老年晚期肺腺癌患者的疗效及不良反应。方法老年晚期肺腺癌患者共60例,随机分为治疗组和对照组。治疗组30例:培美曲塞500mg/m2,第1天静脉滴注,每3～4周为1周期;参芪扶正150ml,第1天至第15天静脉滴注;对照组30例,单药培美曲塞化疗。结果治疗组和对照组有效率(RR)分别为46.7%、43.3%,肿瘤控制率(TGCR)分别为73.3%、66.7%,差异均无统计学意义(P0.05)。治疗组的非血液学不良反应低于对照组(P0.05);生存质量优于对照组(P0.05)。结论老年晚期肺腺癌患者可从单药培美曲塞一线治疗中获益;培美曲塞联合参芪扶正注射液可减轻化疗相关不良反应,改善患者生存质量。     

培美曲塞或多西他赛治疗晚期非小细胞肺癌的临床观察

目的观察培美曲塞或多西他赛联合顺铂二线治疗老年晚期非小细胞肺癌的疗效及不良反应。方法分析52例晚期非小细胞肺癌患者,应用培美曲塞联合顺铂治疗25例,多西他赛联合顺铂治疗27例,评价疗效及不良反应。结果 52例中无CR病例。培美曲塞组PR 3例,SD 11例,PD 11例,中位生存期为8.7个月;多西他赛组PR 3例,SD 12例,PD 12例,中位生存期为8.5个月。两组比较,DCR和中位生存期差异均无统计学意义（P〉0.05）。培美曲塞组中性粒细胞减少的发生率低于多西他赛组。结论培美曲塞或多西他赛联合顺铂治疗晚期非小细胞肺癌疗效相当,但培美曲塞不良反应的发生率较低。     

多西他赛与培美曲塞治疗晚期肺腺癌的临床疗效研究简

目的 本研究旨在对比分析多西他赛与培美曲塞治疗晚期肺腺癌的临床疗效,为临床科学用药提供依据.方法 将在我院接受治疗的120例病晚期肺腺癌患者随机分为培美曲塞组60例和多西他赛组60例.培美曲塞组进行培美曲塞化疗,疗程为2周;多西他赛组进行多西他赛化疗,疗程为2周.治疗结束后对两种治疗方法的临床疗效进分析对比研究.结果培美曲塞组的临床总有效率明显高于多西他赛组,其临床总有效率可高达41.7%,具有显著性差异P〈0.05.结论 在治疗晚期肺腺癌的临床疗效上,培美曲塞疗效显著,是一种值得在临床上大力推广的化疗药品.     

多西他赛与培美曲塞治疗晚期肺腺癌的临床疗效研究

目的本研究旨在对比分析多西他赛与培美曲塞治疗晚期肺腺癌的临床疗效,为临床科学用药提供依据。方法将在我院接受治疗的120例病晚期肺腺癌患者随机分为培美曲塞组60例和多西他赛组60例。培美曲塞组进行培美曲塞化疗,疗程为2周;多西他赛组进行多西他赛化疗,疗程为2周。治疗结束后对两种治疗方法的临床疗效进分析对比研究。结果培美曲塞组的临床总有效率明显高于多西他赛组,其临床总有效率可高达41.7%,具有显著性差异P0.05。结论在治疗晚期肺腺癌的临床疗效上,培美曲塞疗效显著,是一种值得在临床上大力推广的化疗药品。     

老年晚期非小细胞肺癌患者培美曲塞与多西他赛单药化疗的疗效对比研究

目的比较培美曲塞与多西他赛对老年晚期非小细胞肺癌患者的疗效和不良反应。方法对54例老年晚期非小细胞肺癌患者的临床资料和随访结果进行研究。结果 19例患者接受了培美曲赛单药化疗,35例接受了多西他赛单药化疗;中位生存时间（OS）在培美曲塞与多西他赛组分别为16个月和19个月;疾病控制率（DCR）两组分别为73.68%和71.43%,差异无统计学意义（P〉0.05）;相比之下,培美曲塞单药化疗引起骨髓抑制和脱发症状的发生率明显低于多西他赛单药化疗;再加以细分,接受培美曲塞单药化疗的非鳞状细胞、非小细胞肺癌患者中,OS及DCR明显优于多西他赛组。结论一般状况及脏器功能较好的老年患者均可耐受培美曲塞与多西他赛单药化疗,但培美曲塞不良反应少,推荐老年非小细胞肺癌患者使用。     

培美曲塞与多西紫杉醇二线治疗肺非鳞癌的临床比较

目的比较培美曲塞与多西紫杉醇二线治疗肺非鳞癌的疗效与安全性。方法将符合标准的55例肺腺癌和大细胞癌患者随机分为培美曲塞组和多西紫杉醇组。培美曲塞组给予培美曲塞500 mg/m2,第1天,静滴〉10 min;多西紫杉醇组给予多西紫杉醇75 mg/m2,第1天,静滴2 h。两组均21 d为1周期,至少观察2个周期。结果培美曲塞组和多西紫杉醇组有效率分别为28.4%和7.6%,P〈0.05;疾病控制率分别为64.3%和37.0%,P〈0.05。培美曲赛组中性粒细胞减少、心电图改变、脱发发生率低于多西紫杉醇组（P〈0.05）;两组血小板减少、消化道反应、水肿、皮疹等发生率无差异（P〉0.05）。结论培美曲塞二线治疗肺非鳞癌患者临床疗效优于多西紫杉醇,毒副反应更低。     

培美曲塞联合顺铂治疗晚期非鳞型非小细胞肺癌的临床观察

目的探讨培美曲塞（PMT）联合顺铂（DDP）治疗晚期非鳞型非小细胞肺癌（NSCLC）的疗效及不良反应。方法收集92例经病理组织学或细胞学确诊的晚期非鳞型NSCLC患者,将其随机分为观察组和对照组,观察组42例,接受PMT联合DDP方案化疗：PMT 500 mg/m2静滴,第1天,联合DDP 25 mg/m2第1-3天。对照组50例,接受多西他赛（DOC）联合DDP方案化疗：DPC 75 mg/m2静滴,第1天,联合DDP 25 mg/m2第1-3天。2组治疗周期均为每3周1次。每例患者均治疗＆gt;2个周期,观察2组疗效和不良反应。结果 92例患者完全缓解（CR）5例,部分缓解（PR）34例,稳定（SD）39例,进展（PD）14例。观察组总有效率为52.4%,对照组总有效率为34.0%,2组间比较无统计学差异;观察组主要不良反应包括骨髓抑制、胃肠道反应、脱发等,发生率显著低于对照组（P〈0.05或0.01）,且以Ⅰ-Ⅱ级为主。结论 PMT联合DDP方案治疗晚期非鳞型NSCLC疗效与DOC联合DDP方案的疗效相当,但PMT联合DDP的不良反应发生率低,耐受较好。     

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.     

奈达铂联合多西他赛同步放化疗治疗老年局部晚期非小细胞肺癌临床疗效观察

目的评价奈达铂联合多西他赛同步放化疗治疗老年局部晚期非小细胞肺癌(NSCLC)的近期临床疗效及毒副反应。方法 60例诊断明确的老年局部晚期NSCLC患者随机分为两组,均接受三维适形放疗,照射剂量60~66 Gy;并每周一次同步化疗,方案分别为奈达铂(NDP组)或顺铂(DDP组)联合多西他赛。奈达铂用量为20~25 mg/m2,顺铂为20~25 mg/m2;多西他赛为30 mg/m2;观察两组近期疗效及毒副反应。结果 NDP组和DDP组总有效率均为70.0%;两组中位生存时间分别为17.5个月和16.8个月;差异无统计学意义(P0.05);但NDP组骨髓抑制及胃肠道反应发生率明显低于DDP组(P0.05)。结论奈达铂联合多西他赛同步放化疗治疗老年局部晚期NSCLC有效率不低于顺铂双药方案,且胃肠道反应显著减低,患者耐受性好,更易让患者接受。     

Pemetrexed versus docetaxel in second line non-small-cell lung cancer: Results and subsets analyses of a multi-center, randomized, exploratory trial in Chinese patients

BackgroundPemetrexed and docetaxel are established therapies in second line non-small cell lung cancer (NSCLC). Comparative data, concerning the two agents in the designated settings, however, are lacking in Chinese patients who account for the largest lung cancer population in the world.Methods and patientsWe designed and performed a multi-center, randomized, exploratory clinical trial of pemetrexed compared with docetaxel in second line chemotherapy in Chinese NSCLC patients. Eligible patients with histological or cytological diagnosis of stage IIIB or IV NSCLC, who were not suitable for curative therapy and had failed from prior first line chemotherapy regimen for at least 4 weeks, were randomized to receive either pemetrexed 500 mg/m² intravenously day 1 with vitamin B12, folic acid, and dexamethasone, or docetaxel 75 mg/m² intravenously day 1 with dexamethasone. Both regimens were implemented once every 21 days for 2 cycles. This study was designed to be a non-inferiority trial that compared tumor response for overall response rate (ORR) between the two drugs as primary endpoint. The secondary endpoints included disease control rate (DCR), Karnofsky performance status (KPS) scores and toxicities.Results260 patients were enrolled and randomly assigned to receive chemotherapy of either pemetrexed (132 patients) or docetaxel (128 patients). 106 patients in pemetrexed arm and 102 patients in docetaxel arm were evaluable for efficacy. The efficacy of pemetrexed was equivalent to that of docetaxel in the second-line treatment for Chinese NSCLC (ORR: pemetrexed vs. docetaxel = 9.4% vs. 4.9, p = 0.285, DCR: pemetrexed vs. docetaxel = 67.2% vs. 69.6%, p = 0.685). And pemetrexed seemed to slightly promote patients' average KPS score when comparing with docetaxel, although the difference was without statistical significance (changes of average KPS scores: pemetrexed vs. docetaxel = 0.28 ± 5.93 vs. -1.67 ± 8.57, p = 0.149). Patients receiving pemetrexed experienced significantly lower incidences of grade 3/4 neutropenia (7.0% vs. 27.6%, p < 0.001) and leucocytopenia (4.7% vs. 22.8%, p < 0.001) than those who received docetaxel. Also, there were lower incidences of alopecia, stomatitis, and neural abnormality for patients receiving pemetrexed than those receiving docetaxel. Incidence of serum glutamic oxaloacetic transaminase elevation, however, was higher in pemetrexed arm than in docetaxel arm (32.3% vs. 14.9%, p = 0.013). In addition, age ≥ 60 patients benefit from pemetrexed with equivalent efficacies yet much lower toxicities compared to docetaxel (DCR: pemetrexed vs. docetaxel = 66.67% vs. 81.58%, p = 0.146; grade 3/4 hematologic toxicities: pemetrexed vs. docetaxel = 17.25% vs. 39.6%, p = 0.016).ConclusionTreatment with pemetrexed resulted in equivalent efficacy outcomes and better safety profiles compared with docetaxel in second-line therapy for advanced NSCLC in Chinese lung cancer population. And age ≥ 60 patients may benefit from second-line single pemetrexed.     

培美曲塞治疗晚期非小细胞肺癌近期疗效及毒性反应研究

目的研究多靶点叶酸拮抗剂培美曲塞治疗晚期非小细胞肺癌(NSCLC)的近期疗效和毒性反应。方法收集我院2008年1月至2010年1月资料完整的晚期非小细胞肺癌患者共18例,男10例,女8例,中位年龄51岁(范围32～68岁),均经组织学和/或细胞学证实,因化疗后出现复发或进展而采用培美曲塞化疗。化疗方案为培美曲塞500mg/m2单药或联合顺铂75mg/m2,每3周重复;对接受两个或两个以上化疗周期的患者进行化疗效果及副反应评价。结果 18例可评价疗效,无完全缓解(CR)病例,部分缓解(PR)仅2例,稳定者(SD)共12例,4例疾病进展(PD)。全组有效率(CR+PR)为11.1%(2/18),疾病控制率(DCR)为77.8%(14/18)。中位生存时间9.2个月,中位疾病进展时间2.8个月,1年生存率为31.2%。未出现化疗相关死亡,毒副反应主要为I～Ⅲ度胃肠道反应和骨髓抑制。结论培美曲塞治疗复治晚期NSCLC安全有效,耐受性良好。     

Phase I study of docetaxel, cisplatin and concurrent radiotherapy for locally advanced gastric adenocarcinoma

This phase I study is designed to determine the maximal tolerated dose and the dose-limiting toxicity of docetaxel with cisplatin and concurrent radiotherapy in patients with unresectable locally advanced gastric adenocarcinoma. Docetaxel was given once a week with the dosage escalated from 5 mg/m(2) to 15 mg/m(2) in increments of 2.5 mg/m(2). Cisplatin were administered at 20 mg/m(2) once a week. Radiotherapy was delivered to 50.4Gy at 1.8Gy/day. At least three patients were enrolled at each level. The maximal tolerated dose (MTD) and dose-limiting toxicity (DLTs) was determined. The DLTs were defined as grade 3 or 4 hematologic and nonhematologic toxicity. Twenty-one patients with locally advanced gastric adenocarcinoma were enrolled. Grade 1-2 neutropenia and nausea/vomiting were the most common side effects. The first DLT (grade-3 neutropenia) was observed in one of three patients at 12.5 mg/m(2) docetaxel. Three more patients were enrolled, but DLT was not observed and 6 patients were enrolled into 15 mg/m(2) group, DLT occurred in 3 patients (1 Grade 3 neutropenia, 1 Grade 4 neutropenia and 1 Grade 3 nausea/vomiting). Overall tumor response rate was 66.7% with 28.6% complete and 38.1% partial response. In conclusion, the MTD of docetaxel was 15 mg/m(2), and the recommended dose of docetaxel for Phase II study was 12.5 mg/m(2) weekly. The docetaxel and cisplatin with concurrent radiotherapy were tolerable and feasible in treating locally advanced gastric adenocarcinoma.     

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.