目的 探讨吉西他滨+米托蒽醌+足叶乙甙（GME）方案诱导化学疗法（化疗）治疗复发难治性急性白血病的疗效。 方法 2010年5月－2011年4月对20例复发难治性急性白血病应用GME方案化疗，以了解其有效性、毒副反应。 结果 随访7个月20例复发难治性白血病经过GME方案诱导化疗1个疗程后总反应率为50%，其中5例完全缓解，4例部分缓解，1例形态学完全缓解而血细胞计数未完全缓解，均无早期死亡患者。 结论 GME方案可作为复发难治性急性髓系白血病的一种安全、有效的诱导化疗方案，值得临床尝试。
ObjectivesTo evaluate the economic efficacy of nab-paclitaxel (NAB-P) combined with gemcitabine (GEM) versus GEM alone in the treatment of metastatic pancreatic cancer in China.MethodsA Markov model simulating the costs and health outcomes was developed to estimate quality-adjusted life years (QALYs) and incremental cost-effectiveness ratio (ICER). The impact of parameter uncertainty on the model was assessed by deterministic one-way sensitivity analysis.ResultsNAB-P combined with GEM was shown superior efficacy compared to gemcitabine monotherapy, however with higher costs. The ICER between the two groups was 964 780.79￥/QALY.ConclusionsCompared with gemcitabine monotherapy, NAB-P combined with GEM is not cost-effective. The conclusion is confirmed by deterministic one-way sensitivity analysis.
摘要:目的:观察吉西他滨(GEM)联合长春瑞滨(NVB)对老年晚期非小细胞肺癌(N SCLC)患者的疗效和毒副反应。方法:36例经病理组织学或细胞学确诊的晚期NSCLC患者给予吉西他滨1000 mg/m2,第1、 8 天;长春瑞滨25 mg/m2,加入100 m l生理盐水中静脉冲注,第1、 8 天。每21天为一周期,每月CT扫描,观察疗效,有效者共用四周期后停药,按照WHO疗效评价标准评价疗效,并定期复查随访。结果:36例入选患者中,可评价疗效者31例,完全缓解(CR)0例,部分缓解(PR)7例,稳定(NC)13例,病情进展(PD)11例。有效率(RR)为22.58%(7/31),疾病控制脊髓(CR+PR+NC)为64.52%(20/31),中位肿瘤进展时间为5.8个月,1年生存率42%。最常见的毒副反应为Ⅱ―Ⅲ度抑制。结论:对于失去手术或放疗治疗的老年晚期非小细胞肺癌(N SCLC)患者,吉西他滨(GEM)联合长春瑞滨(NVB)是有效的姑息治疗方案之一,值得临床进一步研究。
ObjectiveTo expolre the effect and safety of gemcitabine combined with docetaxel in the treatment of advanced breast cancer. MethodsForty-eight breast cancer patients who got treatment by gemcitabine combined with docetaxel from March 2013 to March 2014 were prospectively enrolled in this study. ResultsOf all the 48 patients, the completely responded (CR) rate was 16.7%(8/48), partial responded (PR) rate was 35.4%(17/48), stable disease (SD) rate was 33.3% (16/48), progressive disease (PD) rate was 14.6% (7/48), and the response rate was 52.1% (25/48), the clinical benefit rate was 85.4% (41/48). The response rates of hormone receptor (HR)-positive group, human epidermal growth factor receptor 2 (HER-2)-positive group, and Basal-like group were 43.5% (10/23), 54.5% (6/11), and 64.3% (9/14) respectively, the clinical benefit rates of HR-positive group, HER-2-positive group, and Basal-like group were 82.6% (19/23), 81.8% (9/11), and 92.9% (13/14) respectively. There was no significant difference among the 3 groups in the effect, response rate, and clinical benefit rate (P=0.293, P=0.462, P=0.663). All patients suffered from varying degrees of toxicities during chemotherapy, including leukopenia, neutropenia, decreased hemoglobin, thrombocytopenia, rash, nausea, vomiting, hair loss, diarrhea, fatigue, and elevated alanine aminotransferase, wherein leukopenia (27.1%, 13/48), neutropenia (22.9%, 11/48), thrombocytopenia (4.2%, 2/48), and fatigue (10.4%, 5/48) were included inⅢ-Ⅳ degree of adverse reactions. In addition, all of 48 patients were followed-up for 1-19 months, with a median follow-up time of 12 months. During follow-up period, 6 patients died, and the overall survival rate was 87.5% (42/48). There was no significant difference among the 3 groups in overall survival and progression free survival (P > 0.050). ConclusionGemcitabine combined with docetaxel may be an effective therapy in treatment of advanced breast cancer.
Objective To introduce the research progress in the effect of chemotherapeutic resistance of metabolic enzymes of gemcitabine to pancreatic cancer.Methods Recent literatures about metabolic enzymes that played key roles in mediating gemcitabine chemotherapeutic resistance of pancreatic cancer were collected and reviewed. Results The metabolic enzymes of gemcitabine, such as hENT1, dCK, RRM1 and CDA, were closely related to chemotherapeutic resistance of pancreatic cancer. The relationship between the single nucleotide polymorphism of metabolic enzymes and the resistance to gemcitabine remained to be clarified. Conclusion Multiple factors are involved in the mechanism of chemotherapeutic resistance of pancreatic cancer to gemcitabine, which needs further research.
Objective To evaluate the short-term efficacy and safety of nedaplatin combined with gemcitabine compared with cisplatin combined with gemcitabine in the treatment of advanced lung squamous cell carcinoma. Methods The Cochrane Library, EMbase, PubMed, Web of Science, Wanfang, VIP, CNKI and China General Library of Biomedical Literature were searched. Literatures related to the efficacy and safety of nedaplatin combined with gemcitabine (nedaplatin group) versus cisplatin combined with gemcitabine (cisplatin group) in the treatment of advanced lung squamous cell carcinoma published from the inception to October 2021 were searched. The quality of included studies was assessed by Cochrane bias assessing tool and the meta-analysis was conducted by using RevMan 5.4. Results A total of 10 articles were included covering 914 patients. Meta-analysis showed that the objective remission rate (OR=1.51, 95%CI 1.13-2.01, P=0.005), disease control rate (OR=1.54, 95%CI 1.10-2.15, P=0.01) and 1-year survival rate (OR=2.29, 95%CI 1.25-4.18, P=0.007) of the nedaplatin group were better than those of the cisplatin group. In terms of side effects, the incidence of white blood cell and hemoglobin decline, nausea and vomiting, and diarrhea in the nedaplatin group was lower than that in the cisplatin group (P≤0.05). The differences in the platelet decline and liver and kidney damage between the two groups were not statistically significant (P>0.05). Conclusion For patients with advanced lung squamous cell carcinoma, the short-term efficacy of nedaplatin combined with gemcitabine may be better than cisplatin combined with gemcitabine, and the incidence of adverse reactions is lower.
Objective To evaluate the efficacy and safety of capecitabine combination chemotherapy for advanced pancreatic cancer. Methods The Cochrane Library, PubMed, EMbase, CBM, CNKI and WanFang Data databases were searched to collect randomized controlled trials (RCTs) on capecitabine combination chemotherapy for advanced pancreatic cancer from inception to December, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, data were analyzed by using RevMan 5.3 software. Results Six RCTs were included. The results of meta-analysis showed that compared with the control group, capecitabine combination chemotherapy extended the overall survival (HR=0.86, 95%CI 0.77 to 0.96, P=0.006) and disease progression-free survival (HR=0.83, 95%CI 0.75 to 0.91, P=0.000 2). Moreover, the objective response rate was significantly increased in capecitabine combination chemotherapy (RR=1.64, 95%CI 1.27 to 2.11, P=0.000 1). The results of 3–4 toxic side effects of 6 RCTs indicated that the incidence of neutropenia, stomatitis and hand-foot syndrome of capecitabine combination chemotherapy were obviously higher than those in the control group (P<0.05). Conclusions Capecitabine combination chemotherapy extend the overall survival and disease progression-free survival, and improve the objective response rate. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusion.
【Abstract】Objective To investigate the possible mechanism of gemcitabine resistance in pancreatic cancer chemotherapy. Methods Recent literatures about the genes and signal pathways those play key roles in mediating gemcitabine chemotherapy resistance of pancreatic cancer were collected and reviewed.Results Oncogenes like c-Src and bcl-XL, inflammation pathway of NF-κB, cytokines like IL-1β and NO are closely related with the chemoresistance； the relationship between multiple drug resistance relevant genes like MDR1/P-gP and the resistance to gemcitabine remains to be clarified. Conclusion Genes and pathways like c-Src, bcl-XL, NF-κB, etc. might become new targets to increase the chemotherapeutic sensitivity of pancreatic cancer, however, the mechanism of pancreatic cancer chemotherapy resistance still needs further to be studied.
ObjectiveTo evaluate the efficacy and toxicity of gemcitabine, paclitaxel plus cisplatin (GTP) chemotherapy for advanced urothelial carcinoma in China. MethodsTen patients with advanced urothelial carcinoma who underwent GTP chemotherapy regimens were collected from February to July 2014 in our hospital. According to solid tumor curative effect evaluation standard 1.1, we evaluated the clinical effcacy and collected the adverse reactions. ResultsTen patients with advanced urothelial carcinoma accepted first-line chemotherapy using GTP chemotherapy regimens. There was 1 case of complete remission, 4 cases of partial response, 3 stable cases, and 2 progressive cases. Adverse reactions of degree Ⅲ were mainly of hematology toxicity, including 5 cases of leukocytes and neutrophils reduction, and 1 case of anemia. The remaining adverse reactions included gastrointestinal reaction, hair loss, and abnormal renal function. ConclusionGTP chemotherapy regimen is a promising treatment for advanced urothelial carcinoma.