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Objective To investigate the clinical efficacy of intraoperative fluorouracil implant combined with raltitrexed chemotherapy in advanced gastric cancer. Methods The clinical data of patients with advanced gastric cancer from November 2013 to November 2014 were retrospectively analyzed. The patients were divided into 2 groups according to intraoperative treatment method. Sixty-two cases (observation group) received intraoperative fluorouracil implant combined with raltitrexed regional chemotherapy, and 54 cases (control group) were not given the intraoperative chemotherapy drugs. The postoperative ventilation time, incidence of complications, peripheral blood white blood cell and platelets 1st, 3rd, 5th and 7th day after operation, cumulative recurrence rate and cumulative survival rate 3 years after operation were compared between 2 groups. Results There were no significant differences in postoperative ventilation time and incidence of complications between 2 groups (P > 0.05). The white blood cell 1st and 3rd day after operation in observation group was significantly lower than that in control group: (5.21 ± 1.03)×109/L vs. (6.52 ± 1.08)×109/L and (5.29 ± 1.11)×109/L vs. (6.37 ± 1.06)×109/L, the platelet 1st, 3rd and 5th day after operation in observation group was significantly lower than that in control group: (172.64 ± 31.48) × 109/L vs. (188.34 ± 30.05) × 109/L, (175.81 ± 31.77) × 109/L vs. (190.36 ± 31.12) ×109/L and (178.46 ± 32.04) ×109/L vs. (191.18 ± 31.29) ×109/L, and there were statistical differences (P＜0.05); but the white blood cell and platelets in 2 groups were in the normal range at all time points. The 3-year cumulative recurrence rate in the observation group was significantly lower than that in control group: 75.8% (47/62) vs. 83.3% (45/54), the 3-year cumulative survival rate was significantly higher than that in control group: 71.0% (44/62) vs. 51.9% (28/54), and there were statistical differences (P＜0.05). Further analysis of patients with recurrent 3 years after operation, the incidence of local recurrence and extensive peritoneal metastasis in observation group was significantly lower than that in control group: 40.4% (19/47) vs. 68.9% (31/45), and there was statistical difference (P＜0.01). Conclusions It is a safe and effective treatment for intraoperative fluorouracil implant combined with raltitrexed regional chemotherapy to inhibit local recurrence and peritoneal metastasis in patients with advanced gastric cancer.
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Objective To investigate the effect of transcriptional internediary factor 1 gamma (Tif1γ)and its signal pathway related proteinson apoptosis of human pancreatic cancer cell line Capan-1 treated with either gemcitabine (GEM) or raltitrexed (RTX).Methods Capan-1 cells were treated with GEM of 559 μmol/L or RTX of 0.86 μmol/L for 36 h.The cell apoptosis of Capan-1 was determined using flow cytometry.Protein levels of Tif1γ,TGF-β1,Smad3,p-Smad3,Smad4,Bcl2,BAX and Caspase3 in Capan-1 cells were determined by Western blot.Results The late apoptosis and death ratio after RTX treatment were 28.7％ ± 5.1％ and 3.7％ ± 0.5％,respectively,showing significant difference from that after GEM treatment or untreated control group (P＜0.01).The results of Western blot showed that the relative protein levels of Tif1 γ,TGF-β1,p-Smad3,BAX and Caspase3 in Capan-1 cells were increased in RTX group compared with those in GEM group or control group (P＜0.05).The relative protein levels of Smad4 and the Bcl2/Bax ratio were decreased in RTX group compared with those in GEM group or control group (P＜0.05).Conclusions Increased level of Til1γ by RTX treatment resulted in decreased level of Smad4 to regulate the balance of Bcl2/Bax,increased Caspase3 and increased apoptosis in Capan-1 cells.
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Objective To assess the influence of different interventional injection routes of raltitrexed on the liver function, histology and pharmacokinetics in experimental rabbits, and to discuss the feasibility, safety and advantages of local application of raltitrexed. Methods A total of 25 New Zealand white rabbits were randomly and equally divided into 5 groups with 5 rabbits in each group: group A (using peripheral intravenous injection), group B (employing hepatic arterial infusion), group C (adopting hepatic artery embolization with Lipiodol), group D (hepatic artery embolization with gelfoam particles), and group E (direct puncture of liver and injection). Clinical equivalent dose (0. 17 mg/kg) raltitrexed injection was given to each experimental rabbit. At 5, 15, 30, 60, 120 and 180 min after the treatment, venous blood sample was collected for pharmacokinetic analysis. At 6 h and one week after administration of drug, liver functions were tested, and histological specimens of liver tissues were made at the same time. Results The peripheral blood drug concentrations at 5 and 60 min in group A were 0. 91 μg/mL and 0 μg/mL respectively, at 5 and 180 min in group B were 1. 73 μg/mL and 0. 37 μg/mL respectively, at 5 and 180 min in group C were 0. 82 μg/mL and 0. 08 μg/mL respectively, at 5 and 180 min in group D were 0. 94 μg/mL and 0. 08 μg/mL, and at 5 and 60 min in group E were 0. 39 μg/mL and 0. 13 μg/mL respectively. Six hours after administration of drug, the serum levels of AST, ALT in group C, group D and group E were significantly increased (P＜0. 0l), which returned to normal levels in one week after the treatment. The severity of liver tissue degeneration and necrosis detected in each group varied, in a severity - decreasing order, from group E, group C, group D, group B and group A. In group E, the surrounding normal liver tissue had no obvious necrosis. Conclusion The rabbit' s liver has no significant first pass elimination effect to raltitrexed. The equivalent dose of raltitrexed administered through the hepatic artery can cause obvious hepatocellular injury. Direct puncture and injection produce limited liver injury. Clinically, the dose of raltitrexed can be adjusted based on the degree of super selective catheterization condition and tumor size. (J Intervent Radiol, 2018, 27:247-251)
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Objective To study the pharmacokinetics of raltitrexed using different ways of drug delivery, including femoral venous infusion, hepatic artery perfusion, hepatic artery injection of lipiodol suspension, hepatic artery perfusion followed by embolization with Gelfoam. Methods According to the administration way of raltitrexed, a total of 40 New Zealand rabbit models with VX2 liver tumor were randomly divided into group A (femoral venous perfusion), group B (hepatic arterial perfusion), group C (hepatic artery injection of lipiodol suspension), and group D(hepatic artery perfusion followed by embolization with Gelfoam). Drug concentration in plasma were determined by using LC-MS/MS method and the pharmacokinetic parameters were calculated. Results After administration of raltitrexed, the Tmax was 5 minutes in all 4 groups. In group A, B, C and D, the values were (5.88±1.39), (7.31±2.60), (9.86±5.10) and (7.19±2.27) respectively, with group C having the longest t1/2 value, which was significantly different with that of group A (P＜0.05); the (ng·ml-1·h-1) values were (2 056.40± 139.17), (1 389.21±180.28), (911.84±105.62) and (1 133.41±181.42)respectively, with the value of group A being obviously higher than that of group B, C and D (P＜0.05) and the value of group C being the lowest; the AUC0-t(ng· ml-1·h-1) values were (5 482.72±1 007.07), (4 156.99±1 475.77), (2 785.13±1 107.36) and (3 903.64±947.25) respectively, with the value of group A being remarkably higher than that of group B, C and D (P＜0.05) and the value of group C being the lowest. Conclusion Compared with the femoral vein infusion way, the ways of hepatic artery infusion, hepatic artery lipiodol suspension injection and hepatic artery perfusion followed by embolization with Gelfoam may promote more raltitrexed to deposit in the tumor area, thus, the curative effect is enhanced, the drug concentration in plasma is lowered and the side effects are alleviated.
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Objective To evaluate the efficacy and safety of trascatheter arterial chemoembolization (TACE) with raltitrexed and oxaliplatin (RO) regimen as well as lipiodol emulsion in treating BCLC B/C hepatocellular carcinomas.Methods A total of 183 patients with BCLC B/C hepatocellular carcinoma were treated with TACE by using RO regimen and lipiodol emulsion.The therapeutic regimen included raltitrexed 3 mg/m2 for hepatic artery perfusion,oxaliplatin 130 mg/m2 mixed with lipiodol 5-30 ml emulsion for embolization.The toxicities were assessed according to WHO anti-cancer drug toxicity grading standards.Liver damage was determined by Child-Pugh classification.All the patients were followed up and the survival time was calculated.Results In 183 patients,the hematologic toxicity was characterized by bone marrow suppression.The incidences of neutropenia,anemia and thrombocytopenia were 21.9％,8.3％ and 2.7％,respectively.The degree Ⅰ,Ⅱ,Ⅲ and Ⅳ of neutrophil count decrease were seen in 15.85％,5.46％,0.55％ and 0％ of patients,respectively.Nausea and vomiting of degree Ⅰ-Ⅱ was observed in 71.58％ of patients.Liver function damage was presented as elevated transaminase and elevated bilirubin level.Preoperative Child-Pugh grade A was seen in 96 patients and grade B in 87 patients.Child-Pugh grade was elevated from preoperative grade A to postoperative grade B in 48 patients,from preoperative grade A to postoperative grade C in 6 patients,and from preoperative grade B to postoperative grade C in 12 patients.In this series,no symptoms or signs of cardiac,urinary or nervous system toxicity were observed.The survival time of 183 patients was 5-35 months,with the median survival time being 20 months.Conclusion For the treatment of BCLC B/C hepatocellular carcinomas,TACE using RO regimen and lipiodol emulsion is safe and effective,and it can reliably improve the quality of life of patients.
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Objective To investigate the short-term safety of raltitrexed intraperitoneal perfusion in patients with rectal cancer undergoing laparoscopic Dixon surgery.Methods Totally 175 patients with rectal cancer at the Department of Colorectal Oncological Surgery,Shengjing Hospital of China Medical University were analyzed retrospectively from June 2016 to December 2017.All the patients were divided into raltitrexed intraperitoneal perfusion group (n =89) and saline intraperitoneal peffusion group (n =86) according to whether given raltitrexed intraperitoneal perfusion or not.The hematological indexes of the two groups before operation and 3 days after operation were recorded.The postoperative exhaust time and postoperative drainage volume within 24 hours were calculated.The postoperative complications including anastomotic leakage,peritoneal irritation sign,incision infection and pulmonary infection were evaluated.Results The surgery was performed successfully in all patients.There were no significant differences in the sex (x2 =0.000,P =0.990),depth of tumor invasion (x2 =0.003,P =0.956),degree of lymph node metastasis (Z =-0.590,P =0.556),TNM stage (Z =0.081,P =0.936) or pathological type (Z =1.092,P =0.896) between the two groups.There were no significant differences in postoperative exhaust time [(75.49 ± 3.97) h vs.(74.28 ±3.46) h,t =0.479,P =0.523],postoperative drainage volume within 24 hours [(201.1 ±54.1) ml vs.(242.8±25.7) ml,t=0.338,P=0.656],anastomotic leakage (1.1％ vs.2.3％,x2 =0.351,P=0.554),peritoneal irritation sign (1.1％ vs.2.3％,x2 =0.351,P =0.554),incision infection (2.2％ vs.3.5％,x2 =0.243,P =0.622) and pulmonary infection (2.2％ vs.2.3％,x2 =0.001,P =0.972) between the two groups.Additionally,there were no significant differences in the counts of erythrocytes [(3.56 ±0.27) × 1012/L vs.(3.63 ±0.26) × 1012/L,t =0.716,P =0.152],leukocytes [(7.63 ±0.20) x 109/L vs.(8.24 ±0.26) × 109/L,t =0.176,P =0.872],blood platelets [(170.13 ±20.12) × 109/L vs.(180.18 ±21.03) × 109/L,t =0.103,P =0.975],glutamic-pyruvic transaminase [(13.25 ± 2.31) U/L vs.(13.28 ± 1.46) U/L,t =0.321,P =0.713],glutamic-oxalacetic transaminase [(16.51 ± 1.28) U/L vs.(16.23 ±2.03) U/L,t=0.131,P=0.894] and creatinine [(77.36 ±6.49) μmol/L vs.(78.39 ±6.64)μmol/L,t =0.499,P =0.519] 3 days after operation between the two groups.Conclusion Raltitrexed intraperitoneal perfusion in Dixon surgery exhibits high safety,and no significant effect on postoperative recovery.It is easy to operate and has good feasibility,which is worthy to be used in clinic.
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Objective To investigate the curative effect and safety of transcatheter arterial chemoembo -lization (TACE) containing raltitrexed scheme for primary hepatocellular carcinoma (PHCC).Methods From May 2013 to June 2014,a total of 90 patients with inoperable PHCC were treated with TACE containing raltitrexed scheme.The short-term effect,long-term effect and adverse reactions were analyzed.Results Of the 90 patients,complete response was obtained in 23,partial response in 36,stable disease in 24 and progressive disease in 7,the effective rate was 65.6％.The one-year survival rate was 72.2％,the median survival time was 15.9 months,and the progression free survival was 9.1 months.Single factor analysis showed that the statistically significant differences in survival rate existed among the patients with different BCLC staging,combination therapy,lipiodol deposit pattern and vascular tumor thrombus (P＜0.05).Multivariate analysis of Cox model indicated that BCLC staging (x2=9.83,P=0.002) and combined therapy (x2=6.40,P=0.011) were independent prognostic factors.The main adverse reactions were fever,pain,vomiting and bone marrow suppression.Grade Ⅲ-Ⅳ adverse reactions were rare and no treatment-related death occurred.Conclusion For the treatment of inoperable PHCC,TACE containing raltitrexed scheme is effective and safe,and this therapy can be well tolerated by patients.
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Objective To investigate the clinical efficacy and safety of transcatheter arterial chemoemblization (TACE) using raltitrexed and lobaplatin in treating advanced hepatocellular carcinoma (HCC).Methods From March 2009 to November 2014,95 cases were treated by raltitrexed combined with lobaplatin (raltitrexed group) through TACE and 124 cases by fluorouracil combined with oxaliplatin (fluorouracil group) through TACE.Disease control rate (DCR),median progression-free survival (mPFS) time and median overall survival (mOS) time were compared between the two groups.Survival rate were analyzed using Kaplan-Meier method and Log-rank analysis in SPSS 16.0.Results The disease control rate of raltitrexed group was 91.6％ (87/95),compared with fluorouracil group of 84.6％ (105/124) in fluorouracil group (x2 =2.505,P =0.474).The mPFS of raltitrexed group was 6.8 months and that of fluorouracil group was 5.9 months (x2 =5.542,P =0.019);mOS of raltitrexed group was 13.6 months and fluorouracil group was 11.4 months (x2 =5.953,P =0.015).The main adverse reactions in the two groups were not statistically significant (P ＞ 0.05).Conclusions TACE using rahitrexed and oxaliplatin prolongs the progression free survival and overall survival time of patients with advanced hepatic carcinoma.
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Objective To observe the clinical efficacy and adverse reactions of raltitrexed containing regimen for advanced colorectal cancer as the second-line and multi-line treatment.Methods A total of 42 patients with advanced colorectal cancer were treated with raltitrexed containing regimen.The objective response rate (ORR),disease control rate (DCR),median progression-free survival (mPFS) and adverse reactions were evaluated.Results The ORR of the 42 patients was 16.67％,DCR was 80.96％,and mPFS was 4.90 months (95％ CⅠ:2.99-6.81 months).The most of adverse reactions were grade Ⅰ-Ⅱ,including leucopenia (30.95％),thrombocytopenia (2.38％),anemia (40.48％),nausea and vomiting (2.38％),anorexia (4.76％),diarrhea (2.38％),transaminase elevation (47.62％) and fatigue (11.90％).Grade Ⅲ-Ⅳ transaminase elevation was found in only 4.76％ of patients.Conclusion Raltitrexed containing regimen for advanced colorectal cancer as the second-line and multi-line treatment is effective and well tolerated,and further clinical application is recommended.
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Objective To investigate the clinical efficacy and safety of transcatheter arterial chemoemblization (TACE) using raltitrexed and lobaplatin in treating advanced hepatocellular carcinoma (HCC).Methods From March 2009 to November 2014,95 cases were treated by raltitrexed combined with lobaplatin (raltitrexed group) through TACE and 124 cases by fluorouracil combined with oxaliplatin (fluorouracil group) through TACE.Disease control rate (DCR),median progression-free survival (mPFS) time and median overall survival (mOS) time were compared between the two groups.Survival rate were analyzed using Kaplan-Meier method and Log-rank analysis in SPSS 16.0.Results The disease control rate of raltitrexed group was 91.6％ (87/95),compared with fluorouracil group of 84.6％ (105/124) in fluorouracil group (x2 =2.505,P =0.474).The mPFS of raltitrexed group was 6.8 months and that of fluorouracil group was 5.9 months (x2 =5.542,P =0.019);mOS of raltitrexed group was 13.6 months and fluorouracil group was 11.4 months (x2 =5.953,P =0.015).The main adverse reactions in the two groups were not statistically significant (P ＞ 0.05).Conclusions TACE using rahitrexed and oxaliplatin prolongs the progression free survival and overall survival time of patients with advanced hepatic carcinoma.
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Objective To observe the clinical efficacy and adverse reactions of raltitrexed containing regimen for advanced colorectal cancer as the second-line and multi-line treatment.Methods A total of 42 patients with advanced colorectal cancer were treated with raltitrexed containing regimen.The objective response rate (ORR),disease control rate (DCR),median progression-free survival (mPFS) and adverse reactions were evaluated.Results The ORR of the 42 patients was 16.67％,DCR was 80.96％,and mPFS was 4.90 months (95％ CⅠ:2.99-6.81 months).The most of adverse reactions were grade Ⅰ-Ⅱ,including leucopenia (30.95％),thrombocytopenia (2.38％),anemia (40.48％),nausea and vomiting (2.38％),anorexia (4.76％),diarrhea (2.38％),transaminase elevation (47.62％) and fatigue (11.90％).Grade Ⅲ-Ⅳ transaminase elevation was found in only 4.76％ of patients.Conclusion Raltitrexed containing regimen for advanced colorectal cancer as the second-line and multi-line treatment is effective and well tolerated,and further clinical application is recommended.
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OBJECTIVE:To observe clinical efficacy and safety of irinotecan combined with tegafur,raltitrexed or 5-fluoroura-cil for advanced gastric cancer. METHODS:One hundred advanced gastric cancer patients with first-line regimen failure were se-lected as research objects from our hospital during May 2013-May 2016. According to random number table,they were divided into observation group(n=32),control group A(n=33)and control group B(n=35). Observation group was given Irinotecan hydro-chroride injection 180 mg/m2,ivgtt(d1)+Tegafur capsule 60 mg/m2,po,bid(after meal),2 weeks as a cycle. Control group A was given Irinotecan hydrochroride injection 180 mg/m2,ivgtt(d1)+ Raltitrexed for injection 3 mg/m2,ivgtt(d1,15 min),3 weeks as a cycle. Control group B was given Irinotecan hydrochroride injection 180 mg/m2,ivgtt(d1)+Calcium folinate injection 200 mg/m2, ivgtt(d1)+5-fluorouracil injection 400 mg/m2,iv+2400~3000 mg/m2,ivgtt(46 h),d1,2 weeks as a cycle. On the 7th day after 2 courses of treatment,clinical efficacies of observation group and control group A were evaluated;on the 12th day after 3 courses of treatment,clinical efficacies of control group B were evaluated. Clinical efficacy and the occurrence of ADR were observed in 3 groups. RESULTS:One patient withdrew from control group A and 2 from control group B. 97 patients were included in the study finally,including 32 cases in observation group,32 cases in control group A,33 cases in control group B. The total remission rate of observation group(53.13%)was significantly higher than that of control group A(43.75%)and control group B(36.36%);to-tal control rate of observation group(81.25%)was significantly higher than that of control group A(68.75%)and control group B (57.58%),with statistical significance(P0.05). CONCLUSIONS:Clinical efficacy of irinotecan combined with tegafur is better than irinotecan combined with ralti-trexed or 5-fluorouracil in the treatment of advanced gastric cancer with good safety.
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Objective To investigate the clinical effect and survival quality of raltitrexed and radiotherapy in treatment of esophagus cancer. Methods 100 cases with esophagus cancer were selected. There were 50 cases using raltitrexed combined with concurrent radiotherapy as observation group. Others were treated with 5-Fu combined with concurrent radiotherapy as control group. The clinical therapeutic effect and survival situation of two groups were evaluated. Results After treatment, the total response rate of observation group (86.0%) was higher than control group (58.0%), the differences between the two groups was statistical difference(P<0.05).The one- and two-year survival rates in observation group were higher than control group (χ2 = 4.32, 7.954, P=0.038, 0.005<0.05).There was no significant difference between the two groups in incidence rate of acute esophagitis, acute bone marrow suppression and acute skin reaction. Conclusion The clinical therapy of raltitrexed plus radiotherapy in treatment of esophagus cancer is distinct, and improve the survival time and the quality of life of patients.
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OBJECTIVE:To improve HPLC method for determining optical isomers in raltitrexed raw material.METHODS:After improved,the column was CHIRALPAK AD-H with mobile phase consisted of n-hexane-anhydrous ethanol-trifluoroacetate (70∶30∶0.1,V/V/V).The sample size was 100 μL.The flow rate of 1.0 mL/min.The detection wavelength was set at 226 rm,and column temperature was 35 ℃.RESULTS:The linear range of optical isomers was 99.68-398.7 ng(r=0.999 9).The quantitation limit was 4.945 ng,and detection limit was 1.648 ng.RSDs of precision,stability and reproducibility tests were all lower than 1.0％;the recoveries ranged 99.43％-100.14％ (RSD=0.25％,n=9).CONCLUSIONS:The optimized method is simple,accurate,sensitive and reproducible,which can be used for the determination of optical isomers in raltitrexed raw material.
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Objective To evaluate the clinical effects and adverse reaction of raltitrexed combined with radiation for esophageal carcinoma in elderly patients.Methods Sixty patients were randomly divided into two groups by the envelope method, 30 patients in experimental group received raltitrexed combined with radiotherapy and 30 patients in control group received radiotherapy only.Patients in both groups received conventional radiotherapy with a total dose of 56-60 Gy/28-30 F.In experimental group, raltitrexed 2.6 mg/m2 was administered concurrently with the radiotherapy on d1 and d22.Two cycles of concurrent chemotherapy were administered during radiotherapy.The short-term effects, survival times and adverse reactions of the two groups were compared.Results The total effective rates of experimental group and control group were 93.3% and 73.3%, respectively, and there was statistically significant difference between the two groups (χ2=4.320, P=0.038).The median survival times of experimental group and control group was 24.0 months and 12.0 months, respectively, and there was statistically significant difference by Log-rank test (χ2=6.048, P=0.014).The major adverse reactions of grade 3-4 in experimental group and control group were radiation-induced esophagitis (10.0% vs.3.3%;χ2=0.268, P=0.605), leukopenia (13.3% vs.10.0%;χ2=0.000, P=1.000), thrombocytopenia (3.3% vs.0;P=1.000), nausea and vomiting (6.7% vs.0;χ2=0.517, P=0.472), and the differences were not statistically significant.Conclusion Raltitrexed combined with radiotherapy can enhance the short-term effect and prolong the survival time for the elderly esophageal carcinoma patients, and the adverse reactions are mild.It is worthy of further clinical study.
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Objective To investigate the intraoperative intraperitoneal chemotherapy security with raltitrexed in advanced colorectal cancer surgical operation.Methods Sixty patients with colorectal cancer undergone surgery were randomly divided into trial group (n =30) and control group (n =30) according to the random number table method.The trial group was given surgical operation plus with intraperitoneal chemotherapy with raltitrexed.The control group was given surgical operation plus with intraperitoneal saline perfusion.Theroutine blood test,liver and kidney functions,toxic side effects and complications in two groups before and after surgery were investigated.Results The white blood cells in trial group before and after surgery was (6.36 ± 2.63) × 109/L vs.(8.20 ± 2.08) × 109/L,with statistically significant difference (t =3.06,P ＜0.05).The ratio of absolute neutrophil count in trial group before and after surgery was 65.17％ ± 10.36％ vs.72.21％ ± 10.53％ (t =3.22,P ＜ 0.05).The platelets in trial group before and after surgery was (261.03 ±84.74) × 109/L vs.(228.47 ± 58.69) × 109/L (t =2.07,P ＜ 0.05).The white blood cells,the ratio of absolute neutrophil count and the platelets after surgery had no statistically significant differeuces between the two groups (P ＞0.05).The trial group had higher 1,2 level vomiting (60.00％ vs.23.33％;x2 =8.30,P ＜ 0.05),and nausea (30.00％ vs.6.67％;x2 =5.46,P ＜ 0.05) incidence rates,but there was no statistically significant difference in other toxic side effects (P ＞ 0.05).The major complications post operation included intestinal obstruction,incision infection,abdominal cavity bleeding,and anastomotic fistula.There were equivalent complications in two groups (6.67％ vs.3.33％,x2 =0.35,P ＞0.05;10.00％ vs.6.67％,x2 =0.22,P＞0.05;0 vs.0;3.33％ vs.0,P＞0.05).Conclusion For patients with advanced colorectal cancer,intraoperative intraperitoneal chemotherapy with raltitrexed is safe and feasible,and the adverse reactions can be tolerated without increasing postoperative complications.
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Objective To observe the efficacy and adverse reaction of raltitrexed combined with irino-tecan as first-line chemotherapy for recurrent or metastatic gastric cancer.Methods From January 201 4 to March 201 5,39 patients of recurrent or metastatic gastric cancer who received treatment in the First People′s Hospital of Zhangjiagang of Jiangsu Province were collected.All patients received raltitrexed (3.0 mg/m2 , 1 5 min intravenous drip)on the first day and irinotecan (1 80.0 mg/m2 ,90 min intravenous drip)on the first day.One cycle lasted 21 days.The efficacies were evaluated every 2-cycle.Adverse reactions were evaluated every cycle.Results The efficacies and adverse reactions could be evaluated in 39 patients.The study received 0 complete remission,1 6 partial remission,1 1 stable disease,1 2 progression disease.The objective response rate was 41 .03% (1 6 /39).The disease control rate was 69.23% (27 /39).The median overall sur-vival time was 9.3 months (95%CI:8.8-1 1 .1 months).The median progression-free survival time was 6.0 months (95%CI:5.1 -6.8 months).The adverse reactions were mainly neutropenia,anemia,liver dysfunc-tion,the incidence of them were 35.90%,33.33% and 28.21 % respectively.Conlusion Raltitrexed com-bined with irinotecan as first-line chemotherapy for recurrent or metastatic gastric cancer acquires an definite efficacy,and the adverse reactions can be tolerated,which is worthy of further clinical research.
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Objective:To compare the therapeutic and adverse effects of concurrent raltitrexed plus oxaliplatin and radiotherapy with those of PF synchronous radiotherapy in the treatment of advanced esophageal cancer. Methods:A total of 84 pathologically con-firmed patients with advanced esophageal carcinoma were randomly distributed to the concurrent raltitrexed plus oxaliplatin and ra-diotherapy group (experimental group, n=40) and to the PF synchronous radiotherapy group (control group, n=44). All patients were treated with 3DCRT at a total dose of 60 Gy/30f. The chemotherapy in the experimental group consists of raltitrexed at 2.5 mg/m2, d1, plus oxaliplatin at 130 mg/m2, d2. The chemotherapy of the control group consists of DDP at 25 mg/m2, Dd1-3, plus 5-FU 500 mg/m2, d1-5. Two cycles of concurrent chemotherapy were administered during radiotherapy on d1 and d29. The comparison results were used to estimate the therapeutic and adverse effects of the two groups. Results:The rerponse rate, complete response, and one-year overall survival rate of the experimental group were higher than those of the control group [(87.50%vs. 79.54%, P=0.3293), (32.50%vs. 18.18%, P=0.13), and (82.50%vs. 79.50%, P=0.701)], but the difference was not statistically significant. The incidence rates of nau-sea and vomiting, appetite degression, leucopenia, radiation-induced esophagitis, and cardiotoxicity were significantly lower (P0.05). Conclusion:Simi-lar to PF chemotherapy and radiotherapy, the concurrent raltitrexed plus oxaliplatin and radiotherapy achieved a similar short-term therapeutic effect but lower adverse effects on patients with esophageal cancer.
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Objective:To investigate the efficacy and toxicity of oxaliplatin reintroduction combined with raltitrexed as second-line che-motherapy after the first-line oxaliplatin-based chemotherapy in advanced colorectal cancer patients. Methods:The 48 evaluable pa-tients with advanced colorectal cancer following disease progression prior to the first-line chemotherapy were treated with oxaliplatin and raltitrexed (raltitrexed 3 mg/m2 ivgtt d1, oxaliplatin 100-130 mg/m2 ivgtt d1, q21d). All 48 patients were divided into two groups:Group A, non-oxaliplatin-based regimens as the first-line chemotherapy, 20 cases;Group B, oxaliplatin-based regimens as the first-line chemotherapy, 28 cases. Each group was evaluated every two cycles. Results:The response rates (RR) of Groups A and B were 30.0%(6/20) and 32.1%(9/28), the disease control rates (DCR) were 80.0%(16/20) and 75.0%(21/28), the median progression free survival time (mPFS) was 6.5 and 7.0 months, and the median overall survival time (mOS) was 10 and 13 months, respectively. No statistical sig-nificance was observed between the two groups in their RR, CR, mPFS, and mOS (P=0.264, 0.514, 0.713, 0.788), respectively. The most common adverse effects observed wereⅠ-Ⅱgrades of bone marrow suppression, aminotransferase abnormality, and digestive toxici-ties. The incidence of neurotoxicity (Ⅰ-Ⅱgrades) between the two groups was similar. Conclusion:Instead of irinotecan combined with raltitrexed, oxaliplatin reintroduction combined with raltitrexed for second-line chemotherapy after the first-line oxaliplatin-based chemotherapy in advanced colorectal cancer patients is feasible.
ABSTRACT
Raltitrexed is a specific inhibitor of thymidylate synthase,and has been confirmed that ralti-trexed has no cross tolerance with 5-fluorouracil.Studies have shown that raltitrexed-based combination chemo-therapy has a beneficial effect on the treatment of advanced gastric cancer,and well tolerance,which is worthy of clinical use.