合併 Gemcitabine 與docetaxel 對攝護腺癌病人並無好處 !!

Cancer. 2010 Oct 4. [Epub ahead of print]

Gemcitabine and docetaxel in metastatic, castrate-resistant prostate cancer: results from a phase 2 trial.

Garcia JA, Hutson TE, Shepard D, Elson P, Dreicer R.

Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio.

Abstract

BACKGROUND: Docetaxel is the standard of care for patients with metastatic, castrate-resistant prostate cancer (CRPC). Gemcitabine is a nucleoside analogue with broad antitumor activity. In a phase 2 study of combined docetaxel and gemcitabine, the authors assessed its safety and activity in patients with chemotherapy-naive, metastatic CRPC.

METHODS: Eligible patients had untreated, metastatic CRPC with radiologic and/or biochemical evidence of progression after antiandrogen withdrawal with castrate testosterone levels, an Eastern Cooperative Oncology performance status (ECOG PS) of 0 to 2, and adequate organ function; no previous chemotherapy was permitted. Patients received gemcitabine (800 mg/m(2)) Days 1 and 8 and docetaxel (75 mg/m(2)) on Day 8 every 21 days for a maximum of 6 cycles. Response was evaluated using Response Evaluation Criteria in Solid Tumors (RECIST) for measurable disease. A prostate-specific antigen (PSA) response was defined as a decline ≥50% in baseline PSA level.

RESULTS: Thirty-five patients with chemotherapy-naive, metastatic CRPC were enrolled. The median age was 67 years, and 60% of patients had an ECOG PS of 0. PSA responses were observed in 49% of patients. Among the patients who had measurable disease (n = 25), 3 patients (12%) had a confirmed, RECIST-defined partial response (PR); 4 patients (16%) had an unconfirmed PR; and 15 patients (60%) achieved stable disease. The most common adverse events included grade 1 and 2 fatigue (69%), alopecia (80%), and nausea/vomiting (54%). No treatment-related deaths were noted, but an unusually high incidence of grade 3 and 4 neutropenia was observed.

CONCLUSIONS: The efficacy of combined gemcitabine and docetaxel in metastatic CRPC was similar to that observed with single-agent docetaxel. In contrast to single-agent docetaxel, the combination was moderately toxic and had an impact primarily on bone marrow reserve. Cancer 2010. © 2010 American Cancer Society.

如內視鏡處理_心臟病可免開刀 !!

香港中大治心房中隔缺損成效佳
2010/10/05 17:03:05
（中央社記者王曼娜香港5日電）香港中文大學醫學院利用新療法，替心房中隔缺損的病人進行手術，減少創傷及加快康復速度，成功率達98%。 中大治療心房中隔缺損的技術，主要是在患者大腿的靜脈置入「間隔堵塞器」，再利用導管將堵塞器引入心房，填補缺損部分，病人只需局部麻醉，無需用傳統開胸的方法，大大減少創傷，避免造成永久傷痕，患者一般只需住院2天，手術費用約港幣5萬元。 中大醫學院心腦血管醫學研究所主任余卓文今天在記者會表示，由2005年至今年9月，中大已為76名心房中隔缺損患者置入堵塞器，患者年齡介於14歲至85歲，女性占71%，其中75名患者治療成功，沒有死亡個案，成功率高達98.7%。 他說，有93%的病人在手術半年後右心房恢復正常，91%患者症狀得到改善。 余卓文強調，這項技術為心房中隔缺損患者提供了低創傷、安全而有效的治療方案，更可避免外科手術帶來的風險及心房中隔缺損併發症。991005

肺結核變肺癌_台灣研究發現, 搶先世界

Cancer. 2010 Sep 30. [Epub ahead of print]

Pulmonary tuberculosis increases the risk of lung cancer: a population-based cohort study.

Wu CY, Hu HY, Pu CY, Huang N, Shen HC, Li CP, Chou YJ.

Division of Dermatology, Taipei County Hospital, Taipei County, Taiwan.

Abstract

BACKGROUND: The possible effect of pulmonary tuberculosis (TB) on subsequent lung cancer development has been suspected, but the evidence remains inconsistent. The purpose of this study was to perform a nationwide population-based cohort study to investigate the risk of lung cancer after pulmonary TB infection.

METHODS: This nationwide population-based cohort study was based on data obtained from the Taiwan National Health Insurance Database. In total, 5657 TB patients and 23,984 controls matched for age and sex were recruited for the study from 1997 to 2008.

RESULTS: The incidence rate of lung cancer (269 of 100,000 person-years) was significantly higher in the pulmonary TB patients than that in controls (153 of 100,000 person-years) (incidence rate ratio [IRR], 1.76; 95% confidence interval [CI], 1.33-2.32; P < .001). Compared with the controls, the IRRs of lung cancer in the TB cohort were 1.98 at 2 to 4 years, 1.42 at 5 to 7 years, and 1.59 at 8 to 12 years after TB infections. The multivariate Cox proportional hazards model revealed pulmonary TB infections (hazard ratio [HR], 1.64; 95% CI, 1.24-2.15; P < .001) and chronic obstructive pulmonary disease (HR, 1.09; 95% CI, 1.03-1.14; P = .002) to be independent risk factors for lung cancer.

CONCLUSIONS: Pulmonary infection with TB is associated with an increased risk of lung cancer. Cancer 2010. © 2010 American Cancer Society.

MedWatch: The FDA Safety Information and Adverse Event Reporting Program

MedWatch: The FDA Safety Information and Adverse Event Reporting Program