玉肤解毒膏治疗结直肠癌患者卡培他滨化疗所致手足综合征的疗效观察

摘要 目的：观察玉肤解毒膏治疗结直肠癌患者卡培他滨化疗所致手足综合征的临床疗效,为临床提供合理治疗方案。方法：选择2021年月-2022年5月湖南省肿瘤医院门诊或住院部确诊为结直肠癌行含卡培他滨方案化疗所致手足综合征患者60例。所有患者采用抛掷硬币法分为玉肤解毒膏组和尿素软膏组,各30例。玉肤解毒膏组采用玉肤解毒膏治疗;尿素软膏组采用尿素软膏治疗,2组均连续治疗21 d。观察2组手足综合征分级改善情况、临床疗效、中医证候积分、疼痛视觉模拟评分（VAS）、手足皮肤反应生活质量量（HF-QoL）评分及焦虑自评量表（SAS）评分。结果：玉肤解毒膏组在降低手足综合征分级及提高治疗总有效率上均优于尿素软膏组（P＜0.05）;治疗后2组中医证候积分、VAS评分、HF-QoL评分及SAS评分较治疗前降低（P＜0.05）,且玉肤解毒膏组均低于尿素软膏组（P＜0.05）。结论：玉肤解毒膏治疗结直肠癌患者卡培他滨化疗所致手足综合征的临床疗效确切,可有效降低患者临床分级,降低中医证候积分、缓解疼痛症状,改善患者生活质量及焦虑状况,具有一定的临床应用价值。     

卡培他滨联合参芪扶正注射液对食管癌术后VEGF表达及生活质量的影响

目的:探讨卡培他滨联合参芪扶正注射液对食管癌术后患者VEGF表达及不良反应发生率和生活质量的影响。方法:选取我院收治的食管癌术后患者90例,根据治疗方案不同分为对照组及实验组,对照组以常规化疗,实验组化疗联合参芪扶正注射液治疗。比较各组患者治疗前后生活质量及血管内皮生长因子VEGF表达水平,治疗后副反应发生率、肝肾功损害变化情况。结果:与治疗前比较,治疗后两组躯体、社会及QOL评分、疲乏评分及睡眠水平均降低(P0.05),QOL评分、尿素氮及肌酐均升高(P0.05),治疗后与对照组比较,实验组躯体、社会、睡眠及疲乏评分、生活质量、血象较高(P0.05),实验组消化道反应、脱发时间较短,肌酐及尿素氮水平及VEGF水平较低(P0.05)。结论:卡培他滨联合参芪扶正注射液可减轻化疗对患者体质、睡眠、社会功能、生活质量等水平的影响,保护肝肾功能,减轻脱发、恶心呕吐等副反应症状,降低VEGF水平,临床疗效优于传统方案,可作为临床有效治疗方案。     

替吉奥联合顺铂治疗晚期胃癌临床疗效研究

目的:研究替吉奥联合顺铂治疗晚期胃癌的疗效和安全性.方法:42例晚期胃腺癌患者随机分为观察组(21例)与对照组(21例)两组,观察组采用替吉奥联合顺铂,对照组采用卡培他滨联合顺铂.结果:两组患者疗效间差异无统计学意义(P＞0.05).两组的不良反应主要为骨髓抑制、消化道反应和乏力,观察组Ⅲ～Ⅳ度血小板减少发生率显著低于对照组(P＜0.05),Ⅲ～Ⅳ度手足综合征的发生率亦显著低于对照组(P＜0.05).结论:替吉奥联合顺铂治疗晚期胃癌疗效与卡培他滨联合顺铂相当,但其患者耐受性更好,值得临床进一步研究推广使用.     

卡培他滨联合奥沙利铂治疗晚期结直肠癌的疗效及对生活质量的影响

目的:探讨卡培他滨联合奥沙利铂治疗晚期结直肠癌患者的临床疗效及对患者生活质量的影响。方法:选取我院2013年3月-2015年12月收治的40例晚期结直肠癌患者,按乱数表法分为观察组和对照组各20例。对照组给予卡培他滨治疗,观察组给予卡培他滨联合奥沙利铂治疗,两组均治疗3周期。对比两组患者治疗后4周的客观缓解率和临床受益率,对比两组患者治疗前、治疗后4周的功能状态评分(KPS)和体力状况评分(ZPS),对比两组患者6个月、1年生存率以及并发症发生率。结果:治疗后4周观察组临床受益率和客观缓解率显著高于对照组,差异有统计学意义(P0.05);与治疗前相比,治疗后4周两组KPS评分显著升高,ZPS评分显著降低,差异均有统计学意义(P0.05);与对照组相比,治疗后4周观察组KPS评分显著升高,ZPS评分显著降低,差异均有统计学意义(P0.05);两组患者在治疗过程中恶心呕吐、口腔黏膜炎、贫血、血小板减少、白细胞减少、腹泻等并发症发生率比较差异均无统计学意义(P0.05);观察组1年生存率显著高于对照组,差异有统计学意义(P0.05)。结论:卡培他滨联合奥沙利铂治疗晚期结直肠癌患者疗效较好,能提高患者的客观缓解率、临床受益率、生活质量和1年生存率,较单用卡培他滨治疗优势明显,值得临床推广。     

紫杉醇联合卡培他滨治疗Ⅳ期肺腺癌临床疗效及毒理研究

目的:探究紫杉醇联合卡培他滨方案治疗Ⅳ期肺腺癌的临床疗效及毒理研究。方法:选取我院肿瘤科收治的Ⅳ期肺腺癌患者62例,随机分为两组,其中对照组30例,给予卡培他滨口服常规治疗;实验组32例,在常规治疗的基础上加用紫杉醇治疗。对比两组有效率(RR)、疾病控制率(DCR)、中位进展时间(TTP)、中位生存期(MST)、血细胞分析情况、毒副作用发生率。结果:1实验组DCR高于对照组,差异具有统计学意义(P0.05);2实验组TTP、MST明显优于对照组,结果有统计学意义(P0.05);3两组患者血细胞各项指标无明显差异(P0.05);两组患者脱发、肝损害、恶心呕吐的发生率无明显差异(P0.05)。结论:紫杉醇联合卡培他滨方案可明显改善Ⅳ期肺腺癌患者的临床症状,延长患者的生存期,且毒副作用与单药治疗相比无差异,对临床具有指导意义,值得临床推广。     

Carbon nanotube/polyurethane modified hollow fiber‐pencil graphite electrode for in situ concentration and electrochemical quantification of anticancer drugs Capecitabine and Erlotinib

A sensitive electrochemical sensor has been designed for in situ preconcentration and determination of anticancer drugs Capecitabine (CPT) and Erlotinib hydrochloride (ETHC) based on a pencil graphite electrode modified with multivalued carbon nanotube—polyurethane (MWCNT‐PUFIX) nanocomposite that was supported with a piece of polypropylene hollow fiber (HF‐PGE). The electrochemical behavior of CPT and ETHC on the MWCNT‐PUFIX/HF‐PGE modified electrode was investigated by differential pulse voltammetry (DPV) techniques and the obtained results confirmed its efficiency for sensing of CPT and ETHC. The synthesized nanocomposite was characterized by infrared spectroscopy and scanning electron microscope. After optimization of some effective parameters on the method efficiency including pH, nanocomposite amount, the type of organic solvent, scan rate and the effect of some additives, the mentioned sensor presented suitable results for determination of CPT and ETHC with the linear ranges from 7.70 to 142.00 μM and 0.11 to 23.50 μM and detection limits of 0.11 and 0.02 μM, respectively. Also, the fabricated sensor has shown good performance in analysis of CPT and ETHC in biological samples.     

诺维本联合希罗达方案与紫杉醇、顺铂方案治疗晚期乳腺癌的疗效对比

目的:比较诺维本联合希罗达方案(NF方案)和紫杉醇联合顺铂方案(TP方案)治疗晚期乳腺癌的疗效及安全性。方法:将117例经病理证实的晚期乳腺癌患者随机分为两组,第一组66例采用紫杉醇135mg/m~2,第1天静点,顺铂20mg,第2-6天静点,21天为一个周期。第二组51例采用诺维本25mg/m~2,第1,8天静点,希罗达2500mg/m~2,每天2次,连服14天,21天为一个周期。两组均以三个周期为一个疗程,至少接受两个疗程化疗。结果:TP组总有效率为42-4%(28/66);NF组为60.8%(31/51),p<0.05。TP组中位无进展时间7.7个月,中位生存时间为16.6个月。NF组分别为10.3个月和22.1个月,p<0.05。恶心呕吐的发生率NF组明显低于TP组,p<0.05。其余不良反应发生率相近,p>0.05。所有不良反应均能耐受。结论:诺维本联合希罗迭方案疗效较好,可作为晚期乳腺癌首选治疗方案。     

Liquid chromatography-mass spectrometry method for the analysis of the anti-cancer agent capecitabine and its nucleoside metabolites in human plasma

A reversed-phase high-performance liquid chromatography method with electrospray ionization and mass spectral detection is described for the determination of capecitabine, 5'-deoxy-5-fluorocytidine and 5'-deoxy-5-fluorouridine in human plasma with 5-chloro-2'-deoxyuridine as the internal standard. An on-line sample clean-up procedure allows dilution of the plasma sample with the initial mobile phase. The linear dynamic range is 0.0500-10.0 microgram/ml for capecitabine, and 0.0500-25.0 microgram/ml for the metabolites, 5'-deoxy-5-fluorocytidine and 5'-deoxy-5-fluorouridine, respectively. This method has been used to analyze plasma samples from patients receiving capecitabine in combination with oxaliplatin.     

Probing the binding mechanism of capecitabine to human serum albumin using spectrometric methods,molecular modeling,and chemometrics approach

Capecitabine as a prodrug of 5-Fluorouracil plays an important role in the treatment of breast and gastrointestinal cancers. Herein, in view of the importance of this drug in chemotherapy, interaction mechanism between Capecitabine (CAP) and human serum albumin (HSA) as a major transport protein in the blood circulatory system has been investigated by using a combination of spectroscopic and molecular modeling methods. The fluorescence spectroscopic results revealed that capecitabine could effectively quench the intrinsic fluorescence of HSA through a static quenching mechanism. Evaluation of the thermodynamic parameters suggested that the binding process was spontaneous while hydrogen bonds and van der Waals forces played a major role in this interaction. The value of the binding constant (K_b = 1.820 × 10⁴) suggested a moderate binding affinity between CAP and HSA which implies its easy diffusion from the circulatory system to the target tissue. The efficiency of energy transfer and the binding distance between the donor (HSA) and acceptor (CAP) were determined according to forster theory of nonradiation energy transfer as 0.410 and 4.135 nm, respectively. Furthermore, UV–Vis spectroscopic results confirmed that the interaction was occurred between HSA and CAP and caused conformational and micro-environmental changes of HSA during the interaction. Multivariate curve resolution-alternating least square (MCR-ALS) methodology as an efficient chemometric tool was used to separate the overlapped spectra of the species. The MCR-ALS result was exploited to estimate the stoichiometry of interaction and to provide concentration and structural information about HSA-CAP interactions. Molecular docking studies suggested that CAP binds mainly to the subdomain IIA of HSA, which were compatible with those obtained by experimental data. Finally, molecular dynamics simulation (MD) was performed on the best docked complex by considering the permanence and flexibility of HSA-CAP complex in the binding site. MD result showed that CAP could steadily bind to HSA in the site I based on the formation of hydrogen bond and π-π stacking interaction in addition to hydrophobic force.