特罗凯+反应停效果如何

jimmy112199

Patient Stories: Erik - Lung Cancer

In the spring of 2001, I started having symptoms of what we thought was pneumonia. After several rounds of antibiotics, things didn’t clear up, so my general practitioner suggested I see a pulmonary specialist.

In October 2001, they did a CAT scan done and a bronchoscope. Then I got the call that you never forget. “We ran through all the tests, and you’ve got lung cancer.’” The non-small cell lung cancer was already at stage four. It was quite a shock.

I knew I needed to see an oncologist quickly, and the Duke oncologist who was recommended to us had a full schedule, so they suggested I see a new physician on the staff, Dr. Dunphy. We went to see him, and he was very good.

He did the obligatory run through the statistics. He was very up front and said that most patients with the kind of lung cancer that I had didn’t survive more than a year.

But, he said, there are lots of things that we can do. He ran me through a PET scan and bone scan, and we discovered that, in addition to the tumors in my lung, there were a couple of tumors in the vertebrae in my back.

We immediately started a chemo regimen of Taxol® and Carboplatin, and I tolerated the first chemo treatment pretty well. Then, when they hooked me up for the second treatment, I went into anaphylactic shock.

After that episode we switched to a different set of chemo drugs and things went a little smoother. I also got radiation treatment for the tumors on my vertebrae.

Working as a Team

My wife, Pat, was trained as a nurse, and she came with me to all of the doctor’s appointments and was very involved. She and I and Dr. Dunphy and Karen Dukelow had many, many discussions about what the next steps should be.

Often, Dr. Dunphy would have a suggestion, and Pat would throw something into the mix, and between all four of us we’d come up with a plan to move forward. We really worked together as a team.

We had talked several times with Dr. Dunphy about the pros and cons of removing the bad lung. He made us aware that this was not the standard treatment for someone in my condition, however, based on my general state of health and the fact that my other lung was completely normal we felt I might benefit from this procedure.

So after lots of discussion, I went ahead and had my right lung removed. Dr. Dunphy suggested that we then go ahead with some additional chemotherapy, which we did, and things looked pretty good. But we still needed a longer-term plan to try to prevent further tumor development.

All this time I was getting scans about every three to four months to check progress. I had had my fill of chemo, so we started looking for alternative treatments. Dr. Dunphy recommended trying Iressa, a daily pill. I got into a clinical trial and started that last April.

But a few months later, I started having some pain in the lower part of my right leg which turned out to be cancer. Then some additional tumors appeared in my lower spine. Since these tumors arose while I was still on Iressa, we figured the drug wasn’t working for me, so we stopped that and I got radiation treatment for those spots instead.

Dr. Dunphy then switched me over to Thalidomide, also a daily pill, which I’m on now. Since I’ve been on it, we haven’t picked up anything new. I’ve been back at work on a full-time basis for quite some time now.

I think the combination of having good medical advice and a lot of prayer support has been helpful.

Dr. Dunphy has looked at me as an individual, not as just a statistic. He’s not afraid to try new things. Obviously when you get into a situation like this you try to learn as much as you can, and he always listens to what we have to say and works with us.

In addition, Pat and I have a lot of faith, and there have been a lot of folks who have prayed for us. I’m a positive person, and I generally have a pretty good attitude and sense of humor, and I think that helps.

Going through a life-threatening experience puts things into a different perspective. Most people sort of take life for granted, then something like this happens and you realize what a thin thread we all are hanging on. It caused me to stop and think about not taking anything for granted, taking every day as it comes. It’s an eye opener.

jimmy112199

Phase II study of carboplatin, irinotecan, and thalidomide in patients with advanced non-small cell lung cancer (NSCLC).

Sub-category: Non-Small Cell Lung Cancer Category: Lung Cancer Meeting: 2004 ASCO Annual Meeting

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Abstract No:	7132
Citation:	Journal of Clinical Oncology, 2004 ASCO Annual Meeting Proceedings (Post-Meeting Edition). Vol 22, No 14S (July 15 Supplement), 2004: 7132
Author(s):	A. A. Miller, D. Case, J. Atkins, J. Giguere, for the Comprehensive Cancer Center of Wake Forest University (cccwfu) Ccop Research Base; CCCWFU, Winston-Salem, NC
Abstract:	Background: We hypothesized that thalidomide improves the response and toxicity profile of chemotherapy with carboplatin and irinotecan because of its novel mechanism of action (anti-angiogenic, anti-neoplastic, anti-inflammatory) which is different from classic chemotherapy and because it causes constipation which may counteract diarrhea of irinotecan. Methods: Treatment consists of carboplatin AUC = 5 iv over 30 min day 1 and irinotecan 50 mg/m2 iv over 90 min day 1 and 8 q 21 days. Thalidomide is given continuously po qhs starting on day 1 until progressive disease; the starting dose is 200 mg/d which is escalated by 100 mg per week if tolerated (max. 1,000 mg/d). The objectives are to determine the response rate, time to progression, overall survival, and toxicity profile. Key eligibility criteria: NSCLC stage IIIB (malignant pleural effusion) and IV; measurable disease; no prior chemotherapy; prior radiation only allowed for brain metastasis, neurologically stable; performance status (PS) 0-1; adequate hematologic, hepatic and renal function. Results: So far, 36 patients have been entered, but 2 never received protocol treatment; characteristics of 34 treated patients: median age 65 (47-79); female/male 8/26; black/white 2/32; PS 0/1 in 10/24; stage 3/4 in 6/28. 23 patients are evaluable for response: partial 5 (22%), stable 12 (52%). The median time to progression is 3.6 months (95% CI, 2.3-4.9). 19 of 34 patients have died. The median survival time is 7.3 months (95% CI, 3.4-14.2). Frequent toxicities are neutropenia (grade 3/4 in 20%/8%), fatigue/malaise (grade 3/4 in 16%/4%), and nausea/vomiting (grade 3/4 in 20%/0%). Diarrhea grade 3/4 occurred in 4%/4%. No patient had lethal toxicity. Conclusions: Treatment with carboplatin, irinotecan, and thalidomide on this regimen is tolerable with reversible neutropenia as the major toxicity. Accrual to this study continues to more firmly establish the objective response rate and survival time. *Supported by NCI grant U10CA81851-04

amei

非常感谢jimmy提供了国外的资料。

另外，听说反应停可以有效抑制血管生成，不知道吃了之后是不是就不可以停了呢，就像易瑞沙一样，吃到无效为止。另外不知道反应停和特罗凯连用是否会加大脑出血的风险。请坛里用过反应停的病友，和专业人士帮帮忙，能给解答一下么？