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双语推荐:化疗失败

通过回顾性分析奥沙利铂及伊立替康化疗失败的转移性结直肠癌化疗疗效,探索结直肠癌的解救化疗方案。方法:回顾2005年1月~2013年3月本院经奥沙利铂及伊立替康化疗失败的转移性结直肠癌患者37例,分析化疗的有效率(RR)及无进展生存(PFS)。结果:化疗总有效率13.51%(5/37),5例PR,12例SD,20例PD;以培美曲塞为基础化疗方案总有效率略高于其他方案(17.64%vs.10.00%,P=0.64),未延长PFS(2.00个月vs.1.63个月,HR=0.79,95%CI:0.35~1.78,P=0.58);以雷替曲塞为基础的化疗方案有效率略高于其他方案(16.67%vs.12.00%,P=0.34),未延长PFS(1.58个月vs.1.90个月,HR=2.24,95%CI:0.98~5.12,P=0.06)。结论:以培美曲塞或雷替曲塞为基础的联合化疗方案对奥沙利铂及伊立替康化疗失败的转移性结直肠癌患者有一定疗效,值得进一步开展临床研究。
Objective:This retrospective study aims to determine the efficacy of chemotherapy and improve a salvage chemother-apy agent for metastatic colorectal cancer (MCRC) after failure of treatment with irinotecan and oxaliplatin. Methods:Between Janu-ary 2002 and March 2013, 37 patients with metastatic MCRC who had progressed after treatment with irinotecan and oxaliplatin were analyzed for their response rate (RR) and progression-free survival (PFS). Results:The overall RR of the 37 patients was 13.51%, with 5 cases of partial response (PR), 12 cases of disease stabilization (SD), and 20 cases of progression (PD). Compared with other chemo-therapy regimens, treatment with a pemetrexed-based chemotherapy agent had a higher RR (17.64%vs. 10.00%, P=0.64) without a lon-ger PFS (2.00 months vs. 1.63 months, HR=0.79, 95%, CI:0.35 to 1.78, P=0.58). Compared with other chemotherapy regimens, treat-ment with a raltirexed-based chemotherapy agent had a higher RR (16.67%vs. 12.00%, P=0.34) without a l

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目的:研究不适手术的局部晚期食管癌患者行TP方案诱导化疗联合DDP同期放化疗的毒性及疗效。方法:33例胸段食管鳞癌T3N0M0,~T4N2M0期患者(不包括腹腔淋巴结转移),第1天和第22天行TP方案诱导化疗,多西他赛(艾素)75mg/m0,DDP75mg/m2。第43天开始放疗,采用三维适形放疗,总剂量60Gy,2Gy/)L,5次/周。同期化疗:DDP30mg/m2,1次/周,放疗开始的第1、8、15、22、29、36天给药。结果:诱导化疗Ⅳ级骨髓毒性为12.12%(4/33),无Ⅲ级或以上的肝、肾毒性。同期放化疗骨髓毒性最高为Ⅲ级,红细胞、粒细胞、血小板Ⅲ级毒性分别为21.21%(7/33)、15.15%(5/33)、3.03%(1/33),无Ⅱ级以上的肝肾毒性。Ⅲ级放射性食管炎为9.10%(3/33),未发现Ⅲ级以上的放射性食管炎及I级以上的急性放射性肺炎。治疗结束评价显效(CR+PR)84.85%(28/33),稳定(SD)12.12%(4/33),进展(PD)3.03%(1/33);治疗后2个月评价显效(CR+PR)75.76%(25/33),稳定(SD)9.10%(3/33),进展(PD)15.15%(5/33)。全组死亡病例15例。1年生存率66.4%,最主要失败模式是局部失败46.67%(7/15),局部+远处失败26.67%(4/15)。结论:局部晚期食管癌患者行TP方案诱导化疗+DDP同期放化疗的毒性可以耐受,局部失败仍然是主要的失败模式。
Objective:To assess the safety and efficacy of induction chemotherapy with cisplatin and docetaxel followed by radia-tion concurrent with weekly cisplatin for unresectable, locally advanced esophageal cancer. Methods: Thirty-three patients with T3N0M0 to T4N2M0 thoracic esophageal squamous cell carcinoma without celiac lymph node metastasis were included in the study. They were treated with cisplatin (75 mg/m2 d1, d22) and docetaxel (75 mg/m2 d1, d22) neoadjuvant chemotherapy followed by three-dimensional conformal radiotherapy (60Gy/30F/6w) concurrent with cisplatin (30 mg/m2 d1, 8, 15, 22, 29, 36 from the beginning of radiation). Results:Grade 4 hematological toxicities were observed in 13.33%(4/33) of the patients after the neoadjuvant chemother-apy. No grade 3 or above hepatic or renal toxicities were found. During concurrent chemoradiation, the highest grade 3 hematological toxicities were observed in the erythrocyte, granulocyte, and macrophage at 21.21%(7/33), 15.15%(5/33), and

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目的对比替吉奥联合奈达铂与标准二线化疗用于一线化疗失败的中晚期肺腺癌的疗效和安全性。方法一线化疗失败的ⅢB~Ⅳ期非小细胞肺腺癌患者95例,分为A组(n=51):替吉奥联合奈达铂化疗;B组(n=44):培美曲塞或多西紫杉醇单药化疗。21天为1个周期,共完成4个周期。结果A、B两组客观有效率(ORR)分别为33.0%和19.3%(P0.05),差异有统计学意义。临床获益率(CBR)分别为57.1%和40.9%(P0.05),两组间差异有统计学意义。中位PFS分别为99 d和40 d,差别有统计学意义(P0.05)。A、B两组一年生存率分别为51.3%4和33.7%(P0.05),差异有统计学意义。logistic多因素回归分析显示ORR和CBR与患者的性别、年龄、Ps评分,一线化疗方案均无相关性。结论替吉奥联合奈达铂用于一线化疗失败中晚期肺腺癌的疗效要优于标准的二线化疗,耐受性良好,为晚期肺腺癌的二线化疗提供了一种新的选择。
Objective To compare the efficacy and safety of S-1 plus nedaplatin and standard second-line chemotherapy in the treatment of advanced lung adenocarcinoma that failure in the first-line chemotherapy.Methods A total of 95 cases with IIIb-IV stage non-small cell lung adenocarcinoma that failure in the first-line chemotherapy was included in this paper and divided into two groups:group A(n=5 1 )was treated with S-1 combined with nedaplatin chemotherapy;group B(n=44)was treated with pemetrexed or docetaxel single-agent chemotherapy,21 days were a cycle of treatment,and totally 4 cycles of chemotherapy. Results The objective response rates(CRR)in group A and group B were 33.0% and 19.3%respectively(P<0.05),and the difference was significant;the clinical benefit rates(CBR)in two groups were 57. 1% and 40.9% respectively (P <0.05 ),and there was significant difference between two groups. The median perfect forward secrecy(PFS)was 99 days and 40 days respectively,and the difference between two

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目的 探讨清金化痰汤联合吉非替尼治疗化疗失败晚期肺腺癌的临床疗效及安全性,为临床治疗化疗失败晚期肺腺癌提供经验.方法 选取26例化疗失败晚期肺腺癌的患者,按照随机数字表法将其分为对照组和观察组,每组均为13例,对照组连续服用吉非替尼,观察组在对照组的基础上加用清金化痰汤进行治疗,比较两组临床治疗效果、毒副作用等.结果 经治疗后,两组临床有效率均为53.85%,观察组疾病控制率为84.62%,对照组为69.23%,观察组疾病控制率显著高于对照组(x2 =4.92,P<0.05);对照组1年生存率为23.1%,观察组为38.5%.观察组显著高于对照组(x2 =3.86,P<0.05);两组均未出现严重的毒副作用.结论 采用清金化痰汤联合吉非替尼用于治疗化疗失败晚期肺腺癌的临床效果较好,毒副作用小,患者容易接受.
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化疗是晚期肿瘤患者综合序列治疗的重要组成部分,但肿瘤细胞的耐药性常导致临床化疗失败。肿瘤干细胞能驱动肿瘤生成,如果化疗药物不能有效靶向作用于肿瘤干细胞,即使肿瘤缩小,残存的肿瘤干细胞也会迅速驱动肿瘤的复发。本文主要总结近年来关于肿瘤干细胞参与化疗耐药可能分子机制的研究成果,和靶向使肿瘤干细胞对治疗敏感性增加的新方法。
Chemotherapy is an indispensable component of systemic therapy on patients with advanced malignancies, yet the outcome is not always success due to the drug resistance of cancer cells. Cancer stem cells are a subpopulation of tumor cells that can initiate tumor formation. If chemotherapy kills bulk of cells within a tumor but not cancer stem cells, the surviving cancer stem cells can initiate the formation of recurrent tumors. This article discusses recent progresses related to cancer stem cell and drug resistance. Approaches to target cancer stem cells to improve the efficacy of chemotherapy will also be discussed.

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部分临床常用药物虽并不作为抗肿瘤药物应用,却可增进化疗药物和分子靶向药物的疗效,或逆转肿瘤对化疗药物和分子靶向药物的耐药性。对于晚期、多线治疗失败的难治性肿瘤,值得尝试单独应用或与化疗药物、分子靶向药物联用。这些药物包括pH值调节药物、血糖调节药物及心血管类药物等。
A number of medications have been proved to be able to either improve the antitumor effect of chemotherapeutics and molecular targeted drugs or reverse the resistance of tumors to chemotherapeutics and molecular targeted drugs,which are not traditionally used as anticancer drugs.Especially for late-stage tumors after multiple treatments,these agents are good alternatives when used independently or in combination with chemotherapeutics and molecular targeted drugs.These drugs include proton modulators,hypoglycemic agents and cardiovascular agents,etc.

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脱发是常见肿瘤化疗方案化疗所致的一个令患者痛苦的皮肤毒性反应,虽然没有生命危险,但脱发让患者经历身体形象变化,由此导致他们承受巨大的心理压力和自尊变化,给患者尤其是女性患者带来了极大的精神上的痛苦和心理上的压力[1],有极端者甚至因此而放弃化疗,导致治疗失败.我们自2012年以来采用头皮条形止血带阻断法预防化疗性脱发,经临床应用,效果良好,现报道如下.
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目的探讨单用培美曲塞或多西他赛二线化疗药物治疗化疗失败的晚期非小细胞肺癌(NSCLC)的临床疗效及安全性。方法共纳入60例一线治疗失败的局部晚期NSCLC患者,采用随机数字法平均分为A组、B组。A组单用培美曲塞化疗,B组单用多西他赛治疗。观察2组患者的近远期临床疗效及不良反应的发生情况。结果 A组、B组总有效率分别为66.67%、63.33%,2组比较,差异无统计学意义(P0.05)。A组患者白细胞降低、脱发发生率明显低于B组患者,2组比较差异有统计学意义(P0.05);血小板降低、贫血、恶性呕吐、皮疹等比较差异不明显(P0.05)。A组患者6个月、1年生存率分别为46.67%、30.00%,B组6个月、1年生存率分别为40.00%、23.33%,2组比较差异无统计学意义(P0.05)。结论单用培美曲塞或多西他赛治疗化疗失败的晚期NSCLC均有较好的临床疗效,可作为二线化疗药物,但培美曲塞白细胞降低不良反应较多西他赛发生率低。
Objective To study the efficacy and safety of second-line chemotherapy drug for advanced non-small cell lung cancer .Methods 60 patients with advanced non-small cell lung cancer were included .All patients had failed on first-line chemotherapy drugs treatment ,and they were divided into group A and group B .Group A was given pemetrexed alone and group B was given docetaxel alone .The curative effect and the occurrence of adverse reactions were observed .Results The effective rates of group A and group B were 66.67%,63.33%,respectively.The difference was not statistically significant (P>0.05).The rates of leucopenia and alopecia in group A were lower than those of group B ,the differences were statistically significant (P 0.05).The 6-month,1-year survival rates in group A were 46.67% and 30.00%,respectively.The 6-month,1-year survival rates in group B were 40.00%and 23.33%,respectively.The difference was not statistically significant (P>0.05).Conclusion Single pemetrexed or docetaxel as

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化疗是肿瘤治疗的重要方法之一,但多药耐药(MDR)一直是影响其疗效的主要因素.肿瘤细胞中MDR1基因的扩增及其相关耐药蛋白的过度表达,细胞周期和细胞凋亡通路的信号转导相关机制的改变等,是导致化疗失败的重要原因.
Chemotherapy is one of the most important methods of cancer treatment.However,multidrug resistance (MDR) has been the main factors affecting their efficacies.Recent studies show that the amplification of MDR1 gene in tumor cells,the over expression of the related drug resistance protein and the cell cycle and apoptosis pathway in signal transduction are the main causes for the failure of chemotherapy.

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目的 观察吉西他滨联合洛铂治疗对含紫杉类联合化疗一线方案失败的晚期肺鳞癌近期疗效和主要毒副反应.方法 共入组经含紫杉类联合化疗一线方案治疗失败的晚期肺鳞癌患者71例,患者均要求接受不少于2个周期的二线化疗,给予吉西他滨1 000 mg/m2(第1、8天)静脉滴注;洛铂30 mg/m2(第2天)静脉滴注;3~4周为1个周期,治疗中密切观察化疗相关毒副反应;根据实体瘤RECIST1.0实体瘤近期疗效标准进行疗效评价和生存时间的随访.结果 71例患者共完成175.0个周期化疗,人均2.6个周期;其中最少完成1个周期,最多4个周期化疗终止治疗;未完成2个周期患者共3例,未作疗效分析,仅对毒性反应进行评价.共有68例患者参与疗效评价与分析,其中完全缓解(CR)0例;部分缓解(PR) 15例,占22.0%(15/68);稳定(SD)18例,占26.4%(18/68);临床获益(DCR)33例,占48.5% (33/68);中位生存时间(mOS)至疾病进展时间(TTP) 13.6周,mOS为7.9个月,1年生存率42.6%(29/68).主要毒性反应为白细胞、血小板减少为主的骨髓抑制,约38.3% (67/175).结论 吉西他滨联合洛铂对曾经含紫杉类方案一线化疗失败的晚期肺鳞癌患者的挽救治疗具有较好疗效,安全性较好,可用于晚期肺鳞癌一线方案耐药后继续化疗.
Objective To evaluate the effiacy and adverse reactions of domestic gemcitabine combined with lobaplatine in salvage treatment of taxanes-refractory advanced lung squamous canceroma.Methods 71 patients with squamous carcinoma of lung,all had been failer to combined chemotherapy with taxanes treatment before,received the treatment with domestic gemcitabine (1 000mg/m2,d1,8) combined with lobaplatine (30mg/m2,d2),21-28 days as a cycle,at least 2 cycles should been recieved.The therapeutic efficacy was evaluated after 2 cycles of chemotherapy,according to RECIST1.0 standard.Results All of 175 cycles had been observed.In terms of the treatment efficacy,68 patients could be evaluated objectively of 71 cases patients,partial response (PR) was 15 cases (22.0%),stable disease(SD) was 18 cases(26.4%),with an overall response rate(RR) was 22.0% (15/68),disease control rate (DCR) was 48.5 % (33/68).The median time to progression (TTP) was 13.6 weeks.the median survival time (OS) was

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