【摘要】 目的 探讨替吉奥胶囊联合奥沙利铂治疗晚期胃癌的近期疗效和毒性反应。 方法 2010年1-7月，16例晚期胃癌患者根据体表面积来确定初始剂量，体表面积lt;1.25 m2，替吉奥胶囊40 mg/次，2次/d；体表面积1.25~1.5 m2，替吉奥胶囊50 mg/次，2次/d；体表面积gt;1.5 m2，替吉奥胶囊60 mg/次，2次/d，早、晚饭后分别口服1次，连续服用28 d，停药14 d。奥沙利铂注射液130 mg/m2加入5%葡萄糖注射液500 mL避光缓慢静gt;2 h，第1、21天重复，连用2周期。按RECIST 1.1标准评价客观疗效和不良反应。 结果 16例患者中PR 9例（56.3%），SD3例（18.8%），PD 4例（25%），总有效率为69.0%。不良反应主要是血液学毒性、胃肠道反应及外周神经毒性，且均在Ⅰ~Ⅱ。 结论 替吉奥胶囊联合奥沙利铂方案治疗晚期胃癌的近期疗效较好，不良反应可以耐受，值得进一步研究应用。【Abstract】 Objective To explore the early efficacy of Oxaliplatin combined with S1 capsule on advanced gastric cancer and observe the toxicity. Methods A total of 16 patients with advanced gastric cancer from January to July 2010 were treated with chemotherapy: oxaliplatin 130 mg/m2 mixed with 5% glucose injection 500 mL in the first day and repeated in the 21st day; Po after breakfast and dinner: S1 capsule with an initial dose according to the body surface area. Body surface lt;1.25 m2, 40 mg once, twice per day; body surface:1.25-1.5 m2,50 mg once, twice per day; body surface gt;1.5 m2, 60 mg once, twice per day. The medication lasted for 28 days, withdrew for 14 days. All of the patients underwent the treatment for two cycles. Efficacy and toxicities were evaluated according to the RECIST 1.1 standard. Results Of the 16 patients, partial remission (PR) was in nine (56.3%), stable disease was in three (18.8%) (SD), and progression disease was in four (PD). The total response rate was 69.0%. The major toxicities included leucopenia, nausea, vomiting and neurosensory abnormity. Conclusion Oxaliplatin combined with S1 capsule is effective on advanced gastric cancer, and the adverse effects are tolerable.
ObjectiveTo investigate the clinical manifestations, imaging manifestations, etiology, histological origin, pathological characteristics, diagnosis and differential diagnosis, selection of treatment methods, and prognosis of primary diffuse large B cell lymphoma of livers (PDLBCLL), so as to improve understanding and reasonable diagnosis and treatment of this kind of disease.MethodThe clinicopathologic data of a case of PDLBCLL diagnosed in the West China Hospital of Sichuan University in June 2019 were analyzed retrospectively.ResultsIt was very difficult to diagnose PDLBCLL preoperatively and to distinguish PDLBCLL from primary liver cancer and other liver space occupying lesions. It was also easy to ignore the possibility of invasion of liver by lymphopoietic tissue tumor, which was often diagnosed by postoperative pathological diagnosis or puncture biopsy, and after the elimination of hematological diseases by various examinations. This patient was admitted to the hospital as a space occupying in right liver. Preoperative imaging examination considered that may be a tumor. After MDT discussion, considering that the nature of the tumor should be confirmed by surgical resection, and then go to the Department of Oncology. Irregular right hemihepatectomy + cholecystectomy + hilar lymphadenectomy + diaphragmatic repair was performed after MDT discussion. The diagnosis of PDLBCLL was confirmed by postoperative pathological examination. The operation duration was about 230 min, and the intraoperative blood loss was about 200 mL. The patient recovered well without complications and was discharged on the 10th day after operation. The patient was followed up for 9 months. The liver and kidney function, electrolytes and abdominal Doppler ultrasound examination were regularly reviewed every month. No obvious abnormality was found in these results.ConclusionsAt present, there is no unified treatment principle, most of them will undergo surgery, chemotherapy, radiotherapy or combined treatment. Due to its unknown etiology and unclear mechanism, clinicians can only implement individualized treatment according to the characteristics of patients’ conditions.
目的 观察替吉奥胶囊联合奥沙利铂治疗晚期结直肠癌的近期疗效和毒性反应。 方法 2011年5月－12月，将30例晚期结直肠癌患者根据体表面积来确定初始剂量，体表面积＜1.25 m2者，替吉奥胶囊40 mg/次，2次/d；体表面积1.25～1.50 m2者，替吉奥胶囊50 mg/次，2次/d；体表面积＞1.50 m2者，替吉奥胶囊60 mg/次，2次/d。早饭后和晚饭后分别口服1次，第1～4天服用奥沙利铂注射液 130 mg/ m2，静脉滴注，第1、21天重复，此为1个月周期。连用2周期后，按美国国立癌症研究所拟定的药物不良反应的分级评价标准3.0版本评价不良反应，按实体瘤治疗疗效评价标准评价疗效。 结果 30例患者中，完全缓解1例（3.3%），部分缓解7例（23.3%），稳定12例（40%），进展10例（33.3%），疾病控制率为66.6%。不良反应主要是血液学毒性、胃肠道反应、皮肤色素沉着及外周神经毒性；1例Ⅳ度骨髓抑制，3例3度贫血，2例3度腹泻，2例3度皮肤色素沉着，2例3度恶心、呕吐，其余且均在Ⅰ～Ⅱ度骨髓抑制。 结论 替吉奥胶囊联合奥沙利铂方案治疗晚期结直肠癌可获得较高的疾病控制率，不良反应可控。