黄新恩医生的科普号

摘要:目的：评价周剂量紫杉醇联合顺铂方案( wTP 方案) 作为乳腺癌术后辅助化疗方案的远期疗效和安全性。方法：20 例乳腺癌术后患者均给予wTP 方案化疗， 21 ～ 28 d 为1 个周期，共4 ～ 6 个周期。给药后监测毒副反应和生存情况。结果：全组20 例患者的5 年生存率为90%。主要毒副反应为骨髓抑制、胃肠道反应，均为可逆性。结论：wTP 方案作为乳腺癌术后辅助化疗方案毒副反应可耐受，患者长期生存率高。

【摘要】目的 研究培美曲塞联合顺铂方案治疗复发转移性非小细胞肺癌的近期疗效和毒副反应。方法 23 例晚期复治的非小细胞肺癌患者接受培美曲塞500 mg ／ m2， d1， 顺铂25 mg ／ m2， d1－3， 3 周后重复， 连用两个周期评价疗效。结果 23 例患者有效率（CR ＋ PR） 为30．4％。疾病控制率（CR ＋ PR ＋ SD） 为78．2％。主要毒副反应为骨髓抑制、皮疹和胃肠道反应。结论 培美曲塞联合顺铂治疗复发转移性非小细胞肺癌具有较好的疗效， 毒副反应可以耐受。

摘要目的 探讨含表柔比星化疗方案作为乳腺癌术后辅助治疗的疗效。方法 对555 例接受含表柔比星方案辅助化疗的乳腺癌患者的总生存率( OS) 及不良反应进行分析。结果 380 例接受5氟脲嘧碇/ 表柔比星/ 环磷酰胺( FEC 组) 方案、5 6 例接受长春瑞滨/ 表柔比星( NE 组) 方案、8 2例接受紫杉醇/ 表柔比星( TE 组) 方案、37 例接受紫杉醇/ 表柔比星/ 环磷酰胺( TEC 组) 方案, 四种方案的5 年生存率分别为83. 6%、8 9. 3%、86.7%和91.7% 。III度以上骨髓抑制、消化道反应及心脏事件发生率: FEC 方案组分别为37. 0%、2 4.9%、0. 2%, NE 方案组分别为34.6%、1 9. 6%、0%, TE 方案组分别为38. 8%, 17.0%, 1.2%, TEC 方案组分别为37.8%, 18.9%, 2.7%。结论 含表柔比星的四种辅助治疗方案均能延长生存期, 毒副作用可耐受。

AbstractPurpose: We conducted a phase II study of combination chemotherapy with irinotecan (CPT-11) andnedaplatin (NDP), (INP regimen), to determine the effects and toxicities in patients with extensive stage smallcell lung cancer (SCLC). Methods: From March 2005 to December 2010, 60 patients with histologically or cytologically confirmed extensive SCLC were enrolled into this study. All received treatment CPT-11 at a dose of 60mg/m2 on days 1 and 8, and NDP 20mg/m2 on days1-5, every 3-4 weeks as a cycle. Patients were treated until tumor progression or unacceptable toxicity. Results: Main toxicities included: myelosuppression, nausea or vomiting, diarrhea, elevation of alanine aminotransferase,and bilirubin. No treatment related death occurred in this study. Thirteen patients had complete response, forty-two had partial response, three remained stable, and two had progressive disease. Median progression-free survival was 13 months (95% confidence interval: 9-17) and median overall survival was 22 months (95% confidence interval: 19-25). Conclusion: INP is an effective and well tolerated regimen for treatment of extensive staged SCLC.

AbstractObjective: To evaluate the influence of multi-drug resistance 1 (MDR1) gene codon 3435 polymorphisms on response to platinum-based chemotherapeutic regimens for advanced non small cell lung cancer (NSCLC). Methods: Responses and overall survival were evaluated in a series of patients presenting between March 1, 2005 and December 31, 2010. MDR1 gene C3435T polymorphisms were genotyped using peripheral blood with real time polymerase chain reaction (RT-PCR) and relationships between the MDR1 C3435T genetic polymorphismand response rate of chemotherapy were analyzed by SPSS 13.0. Results: Overall response to chemotherapy in the eligible 103 patients was 21.4%. Patients with C/C genotype in MDR1 codon 3435 had a significantly higher response rate (24.5%) than those for C/T(19.0%) and T/T(12.5%) (P<0.05). The overall median survival time (MST) of patients was 19 months, values with C/C, C/T and T/T genotype were 21, 15.5 and 17 months, respectively (P=0.487). Conclusion: Our research suggested that patents with the C/C genotype in MDR1 codon 3435 could be more sensitive to platinum-based chemotherapy than patients with C/T and T/T; however, no significant difference was found between overall survival and MDR1 codon 3435 genetic polymorphisms.

AbstractObjective: To evaluate the effect of ubenimex capsule on general performance and chemotherapy relatedtoxicity in patients with advanced gastric cancer undergoing chemotherapy. Methods: Patients with advanced gastric cancer were randomly divided into two groups: with or without ubenimex. All received the following regimen for 2 cycles: docetaxel 40mg/m2 intravenous infusion on days 1 and 8, cisplatin 15mg/m2 and tegafur 600mg/m2 intravenous infusion from days 1 to 5. Oral ubenimex capsule at 30mg daily was continued for 8 weeks from the start of chemotherapy. Study targets included Karnofsky performance status (KPS), body weight, leukocytes, hemoglobin, variation of several immunologic index prior,during and after chemotherapy. Results:Sixty-three patients were recruited into this study, 32 randomly entered into the ubenimex capsule and 31 into the control group. KPS score and body weight after chemotherapy were more stable in the treatment group (P <0.05), and myelosuppression, including reduction of leukocytes, hemoglobin and platelets, was milder (P<0.05). T lymphocytes (CD3 +), T assisted- induced lymphocytes (CD3 +, CD4 +), T suppressor and NK cells (CD16 +, CD56 +) all increased after ubenimex capsule intake, while decreasing in the control group (P <0.05).Conclusion: Ubenimex capsule could improve general performance and reduce chemotherapy related toxicityin patients with advanced gastric cancer.

AbstractPurpose: Studies of the association between the cyclin D1 (CCND1) G870A genetic polymorphism and riskof colorectal cancer (CRC) have generated conflicting results. In order to derive a more precise estimation, ameta-analysis was here performed. Materials and methods: An extensive search of relevant studies was carried out as a meta-analysis of twenty studies with 5,975 cases and 8,333 controls. Results: Overall, a significantly elevated colorectal cancer risk was associated with variant allele 870A when all studies were pooled (AA vs.GG: OR = 1.23, 95%CI = 1.04-1.44; GA vs. GG: OR = 1.13, 95%CI = 1.01-1.26; dominant model: OR = 1.16, 95%CI = 1.03-1.31). In the subgroup analysis by ethnicity, significantly increased risks were detected among Caucasians (AA vs. GG: OR = 1.27, 95%CI = 1.04-1.44; and dominant model: OR = 1.17, 95%CI = 1.02-1.34). With stratification into sporadic CRC and hereditary nonpolyposis colorectal cancer (HNPCC), the former demonstrated increased cancer susceptibility (AA vs. GG: OR = 1.24, 95%CI = 1.04-1.48; dominant model: OR = 1.17, 95%CI = 1.04-1.33). However, no significant associations were found in either Asians or HNPCC patients for any genetic model. Conclusion: The results suggest that the cyclin D1 870A allele is a low-penetrant risk factor for development of sporadic colorectal cancer, especially among Caucasians.

AbstractObjective: To investigate the feasibility of extended full-thickness transanal local excision for rectal cancersinvading anorectal junction. Methods: Four patients with small (size ≤3cm) unfixed rectal cancer, which extended into the upper anal canal, were submitted to transanal local excision with a dissection plane extended to the striated muscle layer around the upper anal canal, so that a portion of striated muscle beneath or around the tumor was excised en bloc with the anorectal wall. The defect in the anorectal wall was laid open to granulate and epithelize. Results: The mean operative time was 28±6 min, with no related mortality. Postoperative pathologicalexamination confirmed clear resection and revealed 1, T2, 2, T1, and 1 Tis carcinomas. The median follow-upwas 3.2 months (range, 1.5-13.0 months). Minor soiling with flatus incontinence was common during the firstpostoperative month. Two patients with a follow-up longer than 3 months had perfect anal continence. No local recurrence was observed. Conclusion: Extended full-thickness transanal local excision for rectal tumors lying at the anorectal junction is safe and simple. Patients with partial excision of striated muscle around the upper anal canal may still enjoy good anal continence. Further studies on extended full-thickness transanal excision are worthwhile.

Asian Pacific J Cancer Prev, 11, 1115-1118AbstractObjective: To compare the safety and efficacy of a combination of vinorelbine and epirubicin (NE) with fluorouracil/epirubicin/cyclophosphamide (FEC) as a postoperative adjuvant chemotherapy for breast cancer. Methods: Breast cancer patients were treated postoperatively in Jiangsu Cancer Hospital and Research Institute from 1997 to 2006 with either the NE regimen (vinorelbine 40mg/m2 iv on day 1 and day 8, epirubicin 50mg/m2 iv on day 1 and day 2, and a cycle repeated every 21-28 days for totally 4-6 cycles) or the FEC regimen (5-Fu 500mg/m2 iv gtt on day 1, epirubicin 50mg/m2 iv on day 1 and day 2, CTX 500mg/m2 iv on day 1 and a cycle repeated every 21-28 days for totally 4-6 cycles). Toxicity was evaluated after each cycle of chemotherapy. Results: Main side effects in both NE and FEC groups were neutropenia and gastrointestinal syndrome, with a 5 year survival rate of 87.9% in the NE and 85.2% in the FEC group. Conclusions: NE regimen is safe with good long-term survival rate, and thus could be recommended as a postoperative chemotherapy regimen for breast cancer.

Asian Pacific J Cancer Prev, 11, 1115-1118AbstractObjective: To compare the safety and efficacy of a combination of vinorelbine and epirubicin (NE) with fluorouracil/epirubicin/cyclophosphamide (FEC) as a postoperative adjuvant chemotherapy for breast cancer. Methods: Breast cancer patients were treated postoperatively in Jiangsu Cancer Hospital and Research Institute from 1997 to 2006 with either the NE regimen (vinorelbine 40mg/m2 iv on day 1 and day 8, epirubicin 50mg/m2 iv on day 1 and day 2, and a cycle repeated every 21-28 days for totally 4-6 cycles) or the FEC regimen (5-Fu 500mg/m2 iv gtt on day 1, epirubicin 50mg/m2 iv on day 1 and day 2, CTX 500mg/m2 iv on day 1 and a cycle repeated every 21-28 days for totally 4-6 cycles). Toxicity was evaluated after each cycle of chemotherapy. Results: Main side effects in both NE and FEC groups were neutropenia and gastrointestinal syndrome, with a 5 year survival rate of 87.9% in the NE and 85.2% in the FEC group. Conclusions: NE regimen is safe with good long-term survival rate, and thus could be recommended as a postoperative chemotherapy regimen for breast cancer.