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实用肿瘤杂志 2014年第6期29卷 576-579页

作者：赵月李金凤初桂伟秦皇岛市第四医院肿瘤内科河北秦皇岛066000

目的比较TE与TC方案用于三阴乳腺癌(triple-negative breast cancer,TNBC)新辅助化疗的疗效及不良反应。方法收集术前接受新辅助化疗的三阴性乳腺癌患者82例,随机分为TE组和TC组。TE组接受紫杉醇联合表柔比星(44例),方案为:表柔比星75 m... 详细信息

目的比较TE与TC方案用于三阴乳腺癌(triple-negative breast cancer,TNBC)新辅助化疗的疗效及不良反应。方法收集术前接受新辅助化疗的三阴性乳腺癌患者82例,随机分为TE组和TC组。TE组接受紫杉醇联合表柔比星(44例),方案为:表柔比星75 mg/m2,d1;紫杉醇175 mg/m2,d2。TC组接受紫杉醇联合卡铂(38例),方案为:紫杉醇175 mg/m2,d1;卡铂AUC=5,d2。两组均21天为1周期,完成化疗2周期后疗效评定,决定是继续化疗还是手术治疗。结果除2例中途退出,所有患者均可评价疗效。TE组与TC组的有效率分别为66.7%(28/42)和65.8%(25/38)。其中常见的不良反应有骨髓抑制、恶心、呕吐、周围神经毒性,均可耐受,无化疗相关死亡。结论紫杉醇联合表柔比星与紫杉醇联合卡铂治疗三阴乳腺癌新辅助化疗的疗效相当,不良反应均可耐受。

关键词：乳腺肿瘤/药物疗法化学疗法,辅助紫杉醇/投药和剂量表柔比星/投药和剂量卡铂/投药和剂量抗肿瘤联合化疗方案治疗结果对比研究

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吉西他滨与铂类联合治疗晚期非小细胞肺癌

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实用肿瘤杂志 2004年第4期19卷 352-354页

作者：朱利明黄穗徐农郭根法浙江省肿瘤医院化疗中心浙江杭州310022 浙江大学医学院附属第一医院化疗科浙江杭州310003

目的　观察吉西他滨与铂类联合治疗晚期非小细胞肺癌的临床疗效及不良反应。方法　 5 4例 b～期非小细胞肺癌患者 ,38例采用吉西他滨 +顺铂 (Gem - DDP)方案 :吉西他滨 10 0 0 mg/ m2 ,第 1、8天 ,顺铂 30 m g/(m2 · d) ,第 1... 详细信息

目的　观察吉西他滨与铂类联合治疗晚期非小细胞肺癌的临床疗效及不良反应。方法　 5 4例 b～期非小细胞肺癌患者 ,38例采用吉西他滨 +顺铂 (Gem - DDP)方案 :吉西他滨 10 0 0 mg/ m2 ,第 1、8天 ,顺铂 30 m g/(m2 · d) ,第 1～ 3天化疗 ;16例采用吉西他滨 +卡铂 (Gem - CBP)方案 :吉西他滨 10 0 0 m g/ m2 ,第 1、8天 ,卡铂以AUC 5的相应剂量为第 1天化疗给药量 ,两方案均 3周重复。结果　 5 4例患者总有效率 2 9.6 % ,中位疾病进展时间 3.9个月 ,中位生存时间 7.7个月 ,1年生存率 2 7.5 % ;初治组有效率及 1年生存率高于复治组 ,Gem - DDP方案与 Gem - CBP方案疗效相似。全组毒副反应主要为骨髓抑制 ,Gem - CBP方案尤其突出。结论　吉西他滨联合铂类治疗晚期非小细胞肺癌对初治患者疗效较好 ,初步观察 Gem - CBP方案疗效与 Gem - DDP方案相似 ,但 Gem - CBP方案血液学毒性较重 ,Gem -

关键词：癌,非小细胞肺/药物疗法肺肿瘤/药物疗法顺铂/投药和剂量卡铂/投药和剂量抗肿瘤,多剂联用/治疗应用

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Ifosfamide, carboplatin, etoposide (ICE)-based second-line chemotherapy for the management of relapsed and refractory aggressive non-Hodgkin's lymphoma

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ANNALS OF ONCOLOGY 2003年第Sup1期14卷 5-10页

作者： Zelenetz, AD Hamlin, P Kewalramani, T Yahalom, J Nimer, S Moskowitz, CH Mem Sloan Kettering Canc Ctr Lymphoma & Hematol Dis Management Teams New York NY 10021 USA

Despite advances in the management of aggressive non-Hodgkin's lymphoma, the treatment of relapsed and primary refractory disease remains a major challenge. High-dose chemotherapy or radio-chemotherapy followed by autologous or allogeneic stem cell transplantation (SCT) is a potentially curative treatment approach;however, the applicability of this approach is restricted to patients responding to second-line chemotherapy. Thus, second-line therapy must be both efficacious and without stem cell or organ toxicity that would compromise the ability to proceed to SCT. The ifosfamide, carboplatin and etoposide (ICE) regimen was developed to address these challenges. In a series of prospective clinical trials, 222 patients were treated with the ICE regimen. with an overall response rate of 72%. The mobilization of stem cells with this regimen was excellent, with 86% of patients mobilizing at least 2.0 x 10(6) CD34+ cells/kg. The incidence of treatment-related toxicity precluding SCT after ICE is very low. Herein, we report the clinical results of this treatment program for 222 patients with 5-year median follow-up for surviving patients, Rituximab was subsequently added to the ICE regimen for patients with diffuse large B-cell lymphoma (DLBCL) to improve upon these favorable results. This resulted in an increased complete remission rate. Additional follow-up is necessary to determine if this improvement in the complete remission rate will confer an increase in the overall survival following SCT.

关键词：抗肿瘤联合化疗方案/投药和剂量抗肿瘤联合化疗方案/治疗应用卡铂/投药和剂量临床试验(主题)/统计学和数值数据依托泊甙/投药和剂量随访研究异环磷酰胺/投药和剂量淋巴瘤非霍奇金/药物疗法淋巴瘤非霍奇金/外科学二级预防干细胞移植/方法人类

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A phase II double-blind randomized study of the simultaneous administration of recombinant human interleukin-6 and recombinant human granulocyte colony-stimulating factor following paclitaxel and carboplatin chemotherapy in patients with advanced epithelial ovarian cancer

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GYNECOLOGIC ONCOLOGY 1999年第3期72卷 292-297页

作者： Hochster, H Speyer, JL Mandeli, JP Runowicz, C Wadler, S Berk, G Wallach, R Holland, JF NYU Med Ctr Kaplan Comprehensive Canc Ctr New York NY 10016 USA NYU Sch Med New York NY USA Mt Sinai Med Ctr New York NY 10029 USA Cornell Univ Med Ctr New York Hosp New York NY 10021 USA Albert Einstein Coll Med Bronx NY 10467 USA NYU Med Ctr Dept Med New York NY 10016 USA

Purpose. Recombinant human interleukin-6 (rhuIL-6) is a glycosylated cytokine with hematopoietic stimulatory effects. In particular, preclinical studies suggest the agent can stimulate thrombopoiesis, even in conjunction with chemotherapy. We attempted to determine whether higher dose chemotherapy for ovarian cancer was possible given the pharmacologic use of this important growth factor. Methods. We conducted a randomized, double-blind phase II study of IL-6 plus granulocyte colony-stimulating factor (G-CSF) versus placebo plus G-CSF in combination with a standard chemotherapy regimen. Patients with epithelial ovarian cancer, stages Ic to IV, were eligible. All patients were previously untreated with chemotherapy and had Karnofsky performance status greater than or equal to 60. rhuIL-B (Escherichia coli, SDZ ILS 969) 1.0 mu g/kg or placebo was given subcutaneously on days 2-8 every cycle together with G-CSF 5.0 mu g/kg subcutaneously days 2-15, following administration of paclitaxel 175 mg/m(2) as a 3-h infusion and carboplatin given to a desired AUC of 7.5 on day 1 every 21 days. Results. Fifty patients were entered in this study, although the study was temporarily suspended by the FDA in midstudy over manufacturing concerns. Therefore, 37 patients were evaluable for efficacy of growth factor;19 patients received placebo plus G-CSF and 18 rhIL-6 plus G-CSF, There was no difference in prognostic variables between these two groups. Platelet nadirs were lower in the first cycle for the placebo group (P = 0.004, Wilcoxon sum-rank test) but not in other cycles. There was no statistically significant difference in cycle treatment delays, carboplatin dose delivered, number of patients with grade 4 thrombocytopenia, or platelet transfusion. Nonetheless, the trend of the data favored IL-6 in all cases. Conclusions. This study demonstrated a minimal effect (statistically significant in the first cycle only) on thrombopoiesis in women undergoing paclitaxel and carboplatin th

关键词：腺癌/药物疗法抗肿瘤联合化疗方案/治疗应用卡铂/投药和剂量双盲法用药计划表粒细胞集落刺激因子/投药和剂量白细胞介素6/投药和剂量卡诺夫斯基能力状态卵巢肿瘤/药物疗法紫杉酚/投药和剂量重组蛋白质类/投药和剂量成年人老年人老年人 80以上女(雌)性人类中年人

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Phase I trial of carboplatin, paclitaxel, etoposide, and cyclophosphamide with granulocyte colony stimulating factor as first-line therapy for patients with advanced epithelial ovarian cancer

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GYNECOLOGIC ONCOLOGY 2000年第2期77卷 271-277页

作者： Tung, N Berkowitz, R Matulonis, U Quartulli, M Seiden, M Kim, Y Niloff, J Cannistra, SA Beth Israel Deaconess Med Ctr Program Gynecol Med Oncol Boston MA 02215 USA Beth Israel Deaconess Med Ctr Div Gynecol Oncol Boston MA 02215 USA Harvard Univ Sch Med Dana Farber Partners Canc Care Boston MA 02115 USA

Objectives. The goal of this study was to determine the maximally tolerated doses (MTDs) of carboplatin, paclitaxel (Taxol), etoposide, and cyclophosphamide (CTEC) with granulocyte-colony stimulating factor (G-CSF, Filgrastim) support as first-line chemotherapy in women with advanced epithelial ovarian cancer (EOC). Methods. Newly diagnosed patients with either stage IV EOC, or stage III EOC and any amount of gross residual tumor after surgical debulking were eligible to receive six cycles of CTEC over five different dose levels in this phase I trial (planned 21-day cycle length). Paclitaxel, carboplatin, and cyclophosphamide were administered intravenously on Day 1, and oral etoposide was administered on Days 1, 2, and 3. G-CSF was administered beginning Day 4. Results. Twenty patients received a total of 98 cycles of CTEC over the five dose levels evaluated. Bone marrow suppression was the major toxic effect, with grade 4 neutropenia and thrombocytopenia being observed in 25 and 23% of cycles, respectively. The overall incidence of febrile neutropenia was 10%, and no toxic deaths occurred. No grade IV thrombocytopenia or febrile neutropenia was observed once the carboplatin dose was reduced from AUC of 7 to 5. Nonhematologic toxicity was generally mild (grade 2 or less). Dose-limiting toxicity was not observed at the highest dose level evaluated in this study, preventing assignment of the MTD. The clinical complete response rate was 92%, although 15 of 16 evaluable patients have progressed with a median progression-free interval of 4 months (range, 2-11 months). One patient remains disease-free 9 months from the completion of CTEC. Conclusions. The CTEC regimen is well tolerated and highly active. Although the MTD was not reached in this study, the short median progression-free interval suggests that this regimen is unlikely to be superior to standard treatment with paclitaxel and carboplatin, Strategies to optimize the development of future combination chemothera

关键词：卡铂/投药和剂量癌/药物疗法癌/病理学环磷酰胺/投药和剂量无病生存剂量效应关系药物依托泊甙/投药和剂量粒细胞巨噬细胞集落刺激因子/投药和剂量中性粒细胞减少/化学诱导中性粒细胞减少/预防和控制卵巢肿瘤/药物疗法卵巢肿瘤/病理学紫杉酚/投药和剂量紫杉烷类血小板减少/化学诱导血小板减少/预防和控制治疗结果女(雌)性人类中年人

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Outpatient-based ifosfamide, carboplatin and etoposide (ICE) chemotherapy in transplant-eligible patients with non-Hodgkin's lymphoma and Hodgkin's disease

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ANNALS OF ONCOLOGY 2003年第Sup1期14卷 11-16页

作者： Hertzberg, MS Crombie, C Benson, W Taper, J Gottlieb, D Bradstock, KF Westmead Hosp Dept Haematol Westmead NSW 2145 Australia Nepean Hosp Canc Care Ctr Penrith NSW Australia

We have treated 38 transplant-eligible patients with relapsed/refractory non-Hodgkin's lymphoma and Hod kin's disease using an outpatient-based regimen of ifosfamide, carboplatin and etoposide (ICE) for both salvage and peripheral blood stem cell mobilisation. Patients included relapsed or refractory diffuse large B-cell lymphoma (n = 17), follicular lymphoma (n = 11), T-cell lymphoma (n = 2), mantle cell lymphoma (n = 2) and Hodgkin's disease (n = 6). Seven patients with diffuse large B-cell lymphoma and three patients with follicular lymphoma (26%) were considered chemorefractory. Cycles of ICE therapy were administered every 21 days as an outpatient and consisted of ifosfamide 5000 mg/m(2) intravenously (i.v.) fractionated into three equally divided doses over 3 days, carboplatin [mg dose = 5 x area under the curve (AUC)] i.v. on day 1 and etoposide 100 mg/m(2) i.v. daily for 3 days. Subsequently, granulocyte colony-stimulating factor (G-CSF) 5 mug/kg subcutaneously (s.c.) was administered daily from day +5. Of the 11 follicular lymphoma patients, 10 also received rituximab with ICE therapy. Median age of patients was 52 years (range 30-65). Patients received a mean of 2.6 cycles (range 1-4) of ICE. There were no toxic deaths and no significant non-haematological toxicities secondary to ICE therapy. Grade IV thrombocytopenia and grade IV neutropenia with at least one cycle of ICE were seen in 47% and 53% of patients, respectively. Median time to peripheral blood stem cell (PBSC) harvest was 14 days (range 10-20), while the median CD34+ cell yield was 5.2 x 10(6) cells/kg (range 2.3 x 10(6)-27.2 x 10(6)). Only one of the ICE-responders failed to mobilise PBSCs. The overall response rate to ICE was 87%, comprising 14 patients (37%) who achieved a complete response (CR) and 19 (50%) who achieved a partial response (PR). A total of 30 patients have undergone autologous stem cell transplantation (SCT) while two follicular lymphoma patients have received a non-myeloabl

关键词：门诊医疗/方法抗肿瘤联合化疗方案/投药和剂量抗肿瘤联合化疗方案/治疗应用卡铂/投药和剂量依托泊甙/投药和剂量随访研究霍奇金病/药物疗法霍奇金病/死亡率霍奇金病/外科学异环磷酰胺/投药和剂量淋巴瘤非霍奇金/药物疗法淋巴瘤非霍奇金/死亡率淋巴瘤非霍奇金/外科学干细胞移植/方法存活率成年人老年人女(雌)性人类男(雄)性中年人

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A COMPARISON OF PERIPHERAL-BLOOD STEM-CELL APHERESIS USING THE FENWAL CS3000 PLUS AND COBE SPECTRA

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TRANSFUSION SCIENCE 1995年第1期16卷 71-77页

作者： DZIECZKOWSKI, JS MCGONIGAL, M COOK, J SUGRUE, M ANDERSEN, J ANDERSON, KC Department of Pathology Wayne State University Medical School Detroit MI 48201 USA.

We have compared the leukapheresis products collected on the Fenwal CS3000 Plus and COBE Spectra in a well-controlled patient population. While statistically significant differences were found, i.e. in product hematocrit, volume, number of granulocytes and platelets collected, these are not felt to be physiologically important. Similar efficiency in collecting mononuclear cells and colony forming unit assay results indicate that each instrument is capable of harvesting hematopoietic progenitor cells from peripheral blood.

关键词：抗肿瘤联合化疗方案/治疗应用血细胞计数乳腺肿瘤/血液乳腺肿瘤/治疗卡铂/投药和剂量集落形成单位测定综合疗法环磷酰胺/投药和剂量多柔比星/投药和剂量氟尿嘧啶/投药和剂量粒细胞巨噬细胞集落刺激因子/治疗应用血细胞比容/仪器和设备血细胞比容/方法造血干细胞移植造血干细胞白细胞去除术/仪器和设备白细胞去除术/方法乳房切除术噻替派/投药和剂量成年人女(雌)性人类中年人

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Calvert's formula for dosing carboplatin: Overview and concerns of applicability in high-dose setting

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JOURNAL OF THE NATIONAL CANCER INSTITUTE 2000年第17期92卷 1434-1436页

作者： Mazumdar, M Smith, A Tong, WP Motzer, RJ Mem Sloan Kettering Canc Ctr Dept Epidemiol & Biostat New York NY 10021 USA Mem Sloan Kettering Canc Ctr Dept Therapeut Pharmacol New York NY 10021 USA Mem Sloan Kettering Canc Ctr Genitourinary Oncol Serv Div Solid Tumor Oncol Dept Med New York NY 10021 USA

The uniqueness of carboplatin as a chemotherapy drug is in the fact that the systemic drug exposure produced by any dose in a patient can be reasonably estimated on the basis of his or her renal function. Calvert's formula (1) of delivering a calculated dose in terms of target carboplatin area under the time–concentration curve (AUC) and a measured or estimated glomerular filtration rate (GFR) has been widely used. Here, we describe the derivation of Calvert's formula and point out some limitations in its development, including violation of an underlying assumption of linear regression theory. We also discuss the related published literature and recommend practicing caution in its use for a high-dose setting. Calvert et al. (1) derived the dosage formula in three stages. Analysis at stage I involved a retrospective look at data from pharmacokinetic studies and produced a preliminary dosing relationship as \[{dose}/{AUC}\ {=}\ {[}1.21({\pm}0.19)\ {\times}\ GFR\ {+}\ 23{(}{\pm}16{)}{]}.\] The error terms given in the parentheses represent the standard errors of estimates of slope (i.e., 1.21) and the intercept (i.e., 23). The correlation between dose/AUC and GFR was high (r = .851; two-sided P<.00001, t test). The formula is simplified in the equation as: \[dose\ {=}\ AUC\ {\times}\ {(}{[}1.2\ {\times}\ GFR{]}\ {+}\ 20{)}.\] In stage II, the authors used this formula to dose 31 patients for target AUCs of 3–8 mg/mL per minute. The model was reported to underpredict AUC by about 20% (1). In stage III, the authors attempted to improve on the underprediction by using the data from stage II and revising the dosing formula as follows (with the error terms given in the parentheses representing the standard errors of estimates of slope [i.e., 0.93] and the intercept [i.e., 26] given below): \[dose\ {=}\ AUC\ {\times}\ {[}0.93{(}{\pm}0.08{)}\ {\times}\ GFR\ {+}\ 26{(}{\pm}6{)}{]}.\ \] The formula was then simplified to \[dose\ {=}\ AUC\ {\times}\ {(}GFR\ {+}\ 25{)}\] and was

关键词：抗肿瘤药/投药和剂量曲线下面积卡铂/投药和剂量用药计划表肾小球滤过率数学计算人类

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Severe ocular and orbital toxicity after intracarotid etoposide phosphate and carboplatin therapy

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AMERICAN JOURNAL OF OPHTHALMOLOGY 1999年第2期127卷 230-233页

作者： Lauer, AK Wobig, JL Shults, WT Neuwelt, EA Wilson, MW Oregon Hlth Sci Univ Casey Eye Inst Dept Ophthalmol Portland OR 97201 USA Oregon Hlth Sci Univ Dept Neurol Portland OR 97201 USA Oregon Hlth Sci Univ Dept Neurosurg Portland OR 97201 USA Univ Colorado Dept Ophthalmol Denver CO 80202 USA Oregon Hlth Sci Univ Blood Brain Barrier Program Portland OR 97201 USA

PURPOSE: To report severe ocular and orbital toxicity after administration of intracarotid etoposide phosphate and carboplatin. METHOD: Case report. RESULTS: A 52-year old man with glioblastoma multiforme underwent left intracarotid administration of etoposide phosphate and carboplatin inferior to the ophthalmic artery. Within 7 hours, a nonpupillary block angle-closure glaucoma developed secondary to uveal effusion in the ipsilateral eye, which was relieved by cycloplegia, Four days later, severe orbital inflammation resulted in a visual acuity of counting fingers, proptosis, optic neuropathy, and total external ophthalmoplegia in the eye. The patient's condition improved after a lateral cantholysis and administration of high-dose intravenous corticosteroids, Two weeks later, an anterior uveitis occurred in the left eye, which responded to topical corticosteroids, During a a-month period, the patient recovered to a visual acuity of 20/70, near normal motility, and normal intraocular pressure, and the ocular and orbital inflammation resolved. Preexisting ipsilateral chemotherapy-induced maculopathy became more pronounced. CONCLUSION: Ocular and orbital toxicity after intracarotid etoposide phosphate and carboplatin therapy is infrequently reported. (Am J Ophthalmol 1999;127: 230-233, (C) 1999 by Elsevier Science Inc. All rights reserved.).

关键词：脑肿瘤/药物疗法卡铂/投药和剂量颈内动脉依托泊甙/投药和剂量依托泊甙/类似物和衍生物眼疾病/化学诱导眼疾病/病理学眼疾病/放射摄影术胶质母细胞瘤/药物疗法输注动脉内眶疾病/化学诱导眶疾病/病理学眶疾病/放射摄影术有机磷化合物/投药和剂量体层摄影术 X线计算机人类男(雄)性中年人

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Is cisplatin still the best platinum compound in non-small-cell lung cancer?

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ANNALS OF ONCOLOGY 2002年第10期13卷 1515-1517页

作者： Soria, JC Le Chevalier, T Inst Gustave Roussy F-94805 Villejuif France

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