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Objective:To analyze the related factors of neurotoxicity induced by oxaliplatin chemotherapy in patients with colorectal cancer and its prevention and treatment strategies.Methods:A total of 300 patients with colorectal cancer treated with oxaliplatin in Zhejiang Cancer Hospital from January 2018 to December 2020 were randomly selected for baseline collection using the convenience sampling method. The occurrence of oxaliplatin-induced peripheral neurotoxicity (OIPN) was statistically analyzed. The factors that affect the occurrence of OIPN were analyzed using univariate analysis.Results:There was a significant difference in OIPN score between patients of different genders, between patients who had different education levels, between patients who had different occupations, and between patients who lived in different long-term residence places ( t = 7.29, 3.39, 2.53, 18.11, all P < 0.05). There was no significant difference in OIPN score between patients adhering to different religion's beliefs, between patients married and not, between patients who lived with and without members, between patients who paid medical costs and not, and between patients who had a previous history of smoking and not ( t = 3.25, 0.37, 0.69, 2.39, 0.15, all P > 0.05). There was a significant difference in OIPN score between patients with different tumor-node-metastasis stages, between patients who received medication via different administration routes, and between patients who received different times of oxaliplatin administration ( t = 8.40, 3.34, 3.49, all P < 0.05). Conclusion:Medical staff should pay attention to the occurrence of OIPN in patients with colorectal cancer treated with oxaliplatin, focus on the patient's factors related to the disease, and take correct and effective coping strategies promptly to reduce the adverse reactions, improve the quality of life, and ensure the therapeutic effect.
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Background: Worldwide, diffuse large B-cell lymphoma (DLBCL) represents the most common subtype of non-Hodgkin lymphoma (NHL), accounting for 30%-40% of all newly diagnosed cases. The response rate to currently available chemotherapy in DLBCL is much unsatisfactory. Dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin (DA-EPOCH) was developed in an effort to improve outcome in patients with diffuse large B-cell lymphoma. To assess the efficacy and safety of DA-EPOCH chemotherapy in patients with diffuse large B-cell lymphomas.Material & Methods:This quasi experimental study was conducted in the department of Hematology, DMCH, from January 2016 to December 2017. 20 patients with diffuse large B-cell lymphomas were treated with etoposide, vincristine, and doxorubicin for 96 hours with bolus doses of cyclophosphamide and oral prednisone (DA-EPOCH chemotherapy). The doses of etoposide, doxorubicin and cyclophosphamide were adjusted to achieve a nadir absolute neutrophil count below 0.5× 109/L. Cycles were repeated after 21 days. After 3rd and 6th cycle patients were evaluated for interim analysis and response evaluation respectively. Evaluation was done in aspect of clinical parameter (lymph node size, physical complaint), laboratory parameter (CBC) and radiological imaging (CT scan of chest and abdomen). The median age of the patient was 46.5 years (range, 25-62 years); 20% were older than 50 years; and 25% were at high-intermediate risk according to International Prognostic Index (IPI) criteria. The statistical analyses were done by appropriate methods.Results:There was a complete response in 73.7% of patients and partial response 10.5% of patients, which were evidenced by significant reduction of size of the lymph nodes after chemotherapy. The mean Serum LDH was also significantly lower after chemotherapy in comparison to before chemotherapy in those patients who achieved complete or partial response. Moreover, size of the liver and spleen were significantly lower after chemotherapy in response group patients who had either hepatomegaly or splenomegaly or both. Doses were escalated in 12.50% cycles and toxicity levels were acceptable.Conclusion:DA-EPOCH chemotherapy is an effective regimen for treatment of diffuse large B-cell lymphoma patients.
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Neoadjuvant chemotherapy (NAC) has shown promising results in patients with locally advanced penile cancer. However, no consensus exists on its applications for locally advanced penile cancer. Thus, it is unclear which kind of chemotherapy regimen is the best choice. Consequently, a systematic search of PubMed, Web of Science, and EMBASE was performed in March 2021 to assess the efficacy and safety of NAC for the treatment of patients with locally advanced penile cancer. The Newcastle-Ottawa Scale was used to assess the risk of bias in each study. This study synthesized 14 published studies. The study revealed that patients who achieved an objective response to NAC obtained a better survival outcome compared with those who did not achieve an objective response. In addition, the objective response rates (ORRs) and pathological complete response (pCR) rates were 0.57 and 0.11, respectively. The incidence of grade ≥3 toxicity was 0.36. Subgroup analysis found that the ORR and pCR of the taxane-platinum (TP) regimen group performed better than those of the nontaxane-platinum (NTP) regimen group (0.57 vs 0.54 and 0.14 vs 0.07, respectively). Moreover, the TP regimen group had more frequent toxicity than the NTP regimen group (0.41 vs 0.26). However, further studies were warranted to confirm the findings.
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Humans , Male , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Neoadjuvant Therapy/methods , Penile Neoplasms/drug therapy , Platinum , Treatment OutcomeABSTRACT
Objective To evaluate the efficacy and safety of XELOX regimen combined with hepatic artery chemoembolization in the treatment of gastric cancer with liver metastasis.Methods 50 cases of gastric cancer with liver metastasis were randomly divided into two groups,the experimental group (25 cases) received chemotherapy regimen of XELOX first:Xeloda tablets 1 000 mg/m2,orally,twice a day,days1-14;Oxaliplatin 130 mg/m2,intravenous drip,day 1.Hepatic artery chemoembolization was performed one a week later,and a cycle consists of 4 weeks.The control group (25 cases) received chemotherapy regimen of XELOX,3 weeks as a cycle.All patients were evaluated for efficacy and toxicity every 2 cycles.Results In the experimental group,the overall response rate was 56％,the tumor control rate was 80％,the increase rate of Karnofsky was 60％,and 10 patients got chance of tumor resection.In the control group,the overall response rate was 32％,the tumor control rate was 52％,the increase rate of Karnofsky was 48％,and 6 patients got chance of operation.The overall response rate,tumor control rate,surgical treatment rate and the increase rate of Karnofsky in the experimental group were significantly different from those in the control group (P ＜0.05).The median total survival time was 12.5 months in the experimental group and 10.5 months in the control group (P ＜0.05).There was no significant difference in toxicity and side effects between the two groups.Conclusion XELOX regimen combined with hepatic artery chemoembolization is effective and safe in the treatment of gastric cancer with liver metastasis.
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Postoperative adjuvant chemotherapy for breast cancers was one of the ways to decrease the tumor recurrencerate of patients and improve the overall survival.It reviewed related articles about cost-utility analysis of postoperative adjuvant chemotherapy regimens for breast cancers before 2016,which could provide references for selecting economic and effective treatment for clinicalpractice.
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Objective To analyze the efficacy and safety of transarterial chemoembolization (TACE) with chemotherapy regimen containing platinum in the treatment of primary liver cancer. Methods 86 patients with advanced hepatocellular carcinoma treated in our hospital from December 2015 to December 2016 were selected and randomly divided into two groups with 43 cases each group. Lipiodol chemotherapy was performed with Lobaplatin, epirubicin hydrochloride and mitomycin in the study group, control group while Lipiodol chemotherapy was performed with oxaliplatin, epirubicin hydrochloride and mitomycin in the control group. The gelatin sponge was used to block tumor blood vessels and the treatment lasted for 2 courses. According to the curative effect evaluation standard of solid tumor (RECIST), the curative effect was evaluated and the adverse reactions were compared between the two groups. Results The total effective rates of the two groups were not significantly different , but the effective rate of the study group (20.93%) was significantly higher than that of the control group (6.98%), and the difference was statistically significant (P<0.05). The incidence of hematologic toxicity in the study group (30.23%) was slightly higher than that in the control group (20.93%), the incidence of gastrointestinal reactions (44.19%) and liver and kidney damage (13.95%) were lower than that of the control group respectively by 60.47% and 25.58%, but there was no significant difference . The incidence of neurotoxicity in the study group (2.33%) was significantly lower than that in the control group (27.91%), and the difference was statistically significant (P<0.05). Conclusion For patients with advanced hepatocellular carcinoma, there was no significant difference between the efficacy and safety of transarterial chemoembolization with chemotherapy regimen containing platinum and oxaliplatin chemotherapy regimen, and adverse reactions are similar, but the incidence of neurotoxicity is low.
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OBJECTIVE:To observe the clinical efficacy and safety of Aidi injection combined with TP regimen in the treat-ment of non-small cell lung cancer. METHODS:62 patients with non-small cell lung cancer were randomly divided into control group and observation group,31 cases in each group. Control group received TP regimen alone,observation group additionally re-ceived 40 ml Aidi injection,dissolved in 500 ml 0.9% Sodium chloride injection by intravenous infusion. 21 d was a treatment course,and it lasted 4 courses. The level of inflammatory cytokines before and after treatment and post-treatment quality of life, short-term efficacy,patients’satisfaction and toxicity reactions in 2 groups were compared. RESULTS:After treatment,the level of inflammatory cytokines in 2 groups were significantly lower than before,and observation group was lower than control group, the differences were statistically significant (P<0.05). The effective rate of life quality (80.64%) and short-term efficacy (83.87%)in observation group significant were higher than control group(32.25%,64.52%,respectively),the differences were statistically significant (P<0.05). Satisfaction degree (96.77%) in observation group was significantly higher than control group (77.42%);and the incidences of thrombocytopenia,leukopenia,abnormal liver function were significantly lower than control group,the differences were statistically significant (P<0.05). CONCLUSIONS:Aidi injection combined with TP regimen shows good efficacy and little toxicity in the treatment of non-small cell lung cancer,and it helps to reduce the level of inflammatory cyto-kines in patients,improving immune function and the quality of life of patients.
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Objective To investigate the clinical efficacy and side reaction of brucea javanica oil ( BJO) combined with 125I and chemotherapy on stageⅢ?Ⅳpatients with non?small cell lung cancer ( NSCLC) . Methods One hundred and twenty cases on stageⅢ?Ⅳpatients with NSCLC were randomly divided into two groups,60 cases received BJO combined with 125I and chemotherapy treatment(observation group),the other 60 cases received 125I combined with chemotherapy treatment(control group). Results The objective response rate(ORR) and disease control rate (DCR) were 71. 7%,86. 7% of observation group and 66. 7%,85. 0% of control group,there were no significant difference(χ2=0. 352,0. 069;P>0. 05) . The improvement rate of KPS score in observation group was significantly superior to that in control group, the difference was significant (76. 7% vs. 55. 0%;χ2=6. 261,P<0. 05) . The incidence of myelosuppression and gastrointestinal adverse e?vents in observation group was significantly lower that in control group ( 68. 3% vs. 83. 3%,41. 7% vs. 61. 7%;χ2=3. 883,4. 805;P<0. 05) . Conclusion BJO combined with 125I and chemotherapy for treating on stageⅢ?Ⅳ patients with NSCLC can reduce the toxicity and side effects caused by chemotherapy,and significantly im?prove the clinical symptoms and quality of life of patients.
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Objective To discuss the efficiency and safety of thalidomide combined with mFOLFOX in trea-ting advanced colon cancer.In addition,to observe the influence of mFOLFOX combined with thalidomide on serum vascular endothelial growth factor(VEGF)leveles.Methods One hundred patients with advanced colon cancer were divided randomly into two groups by digital table method.In the combined group,fifty patients were treated by mFOL-FOX combined with thalidomide.In the control group,fifty patients were treated by mFOLFOX alone.All the patients were tested serum VEGF before and after four cycle of chemotherapy.Results The response rate was 42% in the combined group vs.38% in the control group.Higher clinical benefit rate was found in the combined group (78% vs. 68%).The median time to progression(TTP)was 110 days vs.107 days.The differents between the two groups were not statistically significant(all P >0.05).After treatment of 4 cycles,the serum VEGF concentration of combined group and control group were respectively(317.40 ±55.54)ng/L and (330.84 ±64.48)ng/L,which were signifi-cantly decreased compared with pretreafment.The combination group decreased more obviously,the difference between the two groups were statistical significance(t =11.634,P =0.000).Conclusion Combined thalidomide with mFOL-FOX can′t improved clinical curative effect on the advanced colon cancer significantly.However,thalidomide can re-duce the levels of serum VEGF,and improve the quality of life.
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OBJECTIVE:To investigate clinical efficacy of oxaliplatin+calcium folinate+5-fluorouracil(mFOLFOX6),oxalipl-atin+capecitabine(CapeOX),irinotecan+calcium folinate+5-fluorouracil(FOLFIRI)for metastatic colorectal cancer,and to conduct cost-effectiveness analysis. METHODS:48 patients with colorectal cancer were divided into mFOLFOX6 group(30 cases),Cape-OX group(8 cases)and FOLFIRI group(10 cases). Clinical efficacy and ADR of 3 groups were analyzed,and cost-effectiveness analysis was also conducted. RESULTS:Clinical effective rates of mFOLFOX6 group,CapeOX group and FOLFIRI group were 96.67%,87.50% and 80.00%,respectively,the mFOLFX6 group was significantly higher than the other 2 groups,with statistical significance(P0.05). The C/E of mFOLFOX6 group,CapeOX group and FOLFIRI group were 11 950,15 674 and 18 397 re-spectively,to which results of sensitivity analysis were same. CONCLUSIONS:The cost-effectiveness of mFOLFOX6 regimen is superior to CapeOX and FOLFIRI regimen in the treatment of metastatic colorectal cancer,but it has the high incidence of gastroin-testinal side effects.
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Objective To comparative analysis the effect of radiotherapy,thermoradiotherapy and chemora-diotherapy on esophageal cancer.Methods 120 patients with esophageal carcinoma were selected and randomly divided into the radiotherapy group,thermoradiotherapy groupand chemoradiotherapy group by digital table method, with 40 cases in each group,which were treated with radiotherapy alone,thermoradiotherapy alone and radiotherapy combine with chemotherapy respectively.The effects of treatment of the three groups were compared.Results The main toxic reaction in the three groups during the treatment for adverse reaction were digestive system reaction,hema-tologic toxicities and radioactive esophagitis.The incidence of toxic reaction of the three groups were not statistically significant(P >0.05).Total response rate of simple radiotherapy group,the thermal radiation group,chemoradiothera-py group were 52.5%,75.0% and 85.0%.,The total remission rate of chemotherapy group was higher than those of the radiotherapy group and the thermal radiation group(χ2 =5.218,3.857,all P <0.05).Conclusion The different treatment methods of esophageal cancer can obtain certain curative effect,but there are some adverse reactions.Among different treatment methods,radiotherapy and chemotherapy in the treatment of esophageal carcinoma can get better effect than the radiotherapy and chemoradiotherapy.
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Objective:To select suitable chemotherapy for cervical cancer patients by ATP-tumor chemosensitivity assay. Methods:Seventy-two hospitalized patients with cervical cancer between July 2007 and October 2009 were enrolled. The patients were randomly divided into a trial group (n=35) and a control group(n=37). ATP-TCA was used to detect the sensitivity of 35 samples of cervical cancer in the trial group to 6 combined chemotherapy regimens. The chemotherapy regimen in the trial group was confirmed by the results of susceptibility testing and that in the control group was confirmed by clinical experience. One-year recurrence rate and 3-year survival rate of two groups were compared after 3 year follow-up. Results:ATP-TCA was measured in 32 of the 35 patients in the trial group. The sensitive patients for paclitaxel+carboplatin, paclitaxel+oxaliplatin, bleomycin+ifosfamide+cisplatin, bleomycin+vincristine+cisplatin, fluorouracil+cisplatin, and gemcitabine+cisplatin were 20, 18, 17, 18, 17, and 21, respectively. There was no significant difference in the 1-year recurrence between the two groups (P>0.05), while the 3-year survivors in the trial group were more than those in the control group (P Conclusion:ATP-TCA method is good for patients with cervical cancer because it is sensitive, effective, and individualized.
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Objective To observe the efficacy and the influence on the immune function and analgesic effect of Sodium Cantharidinate and Vitamin B6 Injection in treating advanced non-small cell lung carcinoma (NSCLC) patients combined with GP chemotherapy. Methods Totally 79 patients with advanced NSCLC were randomly divided into the observation group and the control group. The observation group accepted GP chemotherapy plus Sodium Cantharidinate and Vitamin B6 Injection, and the control group was treated with GP chemotherapy. After 2 cycles of chemotherapy, the efficacy was evaluated, cellular immune function index and analgesic effect were observed. Results The objective response rate (RR) of the treatment group was 72.50%(29/40), and the control group was 48.72%(19/39). There was no significant difference between the two groups (P>0.05). After 2 cycles of treatment, the ratio of CD3+, CD4+, CD8+, CD4+/CD8+ and NK in the observation group were higher than the control group, with significant differences (P<0.05). The pain relief rate in the observation group was 75.00%(30/40), and it was 51.28%(20/39) in the control group, the difference was significant between the two groups (P<0.05). Conclusion Sodium Cantharidinate and Vitamin B6 Injection combined with GP chemotherapy can improve the short-term effect rate and the cellular immune function. It can also relieve the pain and improve the guality of life of patients with advanced NSCLC.
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Chemotherapy treatment plays an important role in the comprehensive treatment of malignant disease,but the chemotherapy related knowledge and the selection of an appropriate regimen for certain patient are hard to master.The establishment of computer-assisted cancer chemotherapy program and management system with a follow-up database of cancer patients can help the oncologist to master the designing skill of chemotherapy regimen and cancer-related knowledge quickly,improve the teaching qnality and the efficiency of treating malignant diseases.
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Objective To evaluate clinical application of phage amplified biologically assay (PhaB) in susceptibility test of Mycobacterium tuberculosis (MTB) in sputum. Methods The drug susceptibility of MTB was detected by PhaB in 143 patients with sputum-positive pulmonary tuberculosis (PTB),and the chemotherapy regimens were adjusted according to the results of susceptibility test.Independent samples t-tests were used for comparison of means.Count numbers were compared with Chisquare test.If there were count number of 0,Fisher probabilities should be used.ResultsThe total positive rate of PhaB was 94.4％ (135/143) with no differences between three types of PTB (x2 =1.886,P ＞ 0.05 ).The duration of testing for PhaB group was (6.6 ± 1.8) days,while for control was (29.4 ±8.7) days (t =29.01,P ＜ 0.01 ).Compared with control group,the 2-month negative-conversion rate (63.2％ vs.35.1％,x2 =3.989,P ＜ 0.05 ) and cure rate ( 100％ vs.78.4％,P ＜ 0.05 ) of PhaB group in type Ⅱ patients were significantly higher.But there were no differences between PhaB and control groups in type Ⅰ and Ⅲ PTB patients.ConclusionThe results of PhaB drug susceptibility test can be helpful for choosing effective chemotherapy regimen for PTB patients rapidly.
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Comprehensive therapy is the leading method to improve the overall survival for patients with advanced gallbladder cancer, especially the study of new chemotherapy regimen are on demand.From 2010 to 2011, a phase Ⅲ study of new chemotherapy regimen in the treatment of advanced gallbladder carcinoma would be undertaken nationwide to assess the clinical outcome and safety, in 31 clinical centers led by the department of General Surgery of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, and a total of 260 patients would be accrued for this study.Chemotherapy consists of 2 regimes, conventional regime(cisplatin, epirubicin, and 5-fluorouracil, leucovorin)and new regime(conventional regime plus somatostatin).At present, the study has been approved by Clinical Trial Registration Platform of National Institutes of Health in U.S.A., and more than 30 patients are rolling in the study.The clinical trial could provide the high-quality evidence of EBM(evdence based medicine)for the chemotherapy of advanced gallbladder caner, and it will be one of the important components in the large-scale clinical study of chemotherapy for the advanced gallbladder cancer in China and worldwide.
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[Objective] To observe the regulatory effect of Huangqi Injection (HI) on immune function of patients after chemotherapy (CT). [Methods] Thirty-four patients confirmed as acute myelogenous leukemia (AML) received two cycles of CT. During the 1st cycle, the patients were only treated with DA (daunomycin + arabinoside) regimen; in the 2nd cycle, intravenous injection of 20 mL of HI, qd for 2 weeks was added. The effect of CT on myelosuppression and immune function of the patients was observed. [Results] Immunosuppressive manifestations such as myelosuppression, fatigue, spontaneous sweating, impaired appetite, lassitude were found after the 1st cycle of CT, and peripheral immunoglobulin A (IgA), IgG, IgM and complements C3 levels were also decreased (P