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近年来,食管癌的治疗越来越倾向于多学科的综合治疗。多项研究已证明在手术的基础上加入放疗、化疗或免疫治疗可提高食管癌的生存获益。对于局部晚期食管癌患者,新辅助联合手术治疗效果明显,新辅助放化疗以及新辅助化疗均能够提高生存获益,但目前这两种治疗模式孰优孰劣尚存在争议。随着诱导化疗和新辅助免疫的加入,新辅助治疗模式更加多样化,进一步提高了病理完全缓解率,为局晚期食管癌患者的治疗提供了新思路。因此,本文旨在对近年来局晚期食管癌的新辅助治疗模式进行探讨,为进一步优化综合治疗策略提供参考。 相似文献
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胆管癌(cholangiocarcinoma,CCA)是胆管上皮来源的一种恶性肿瘤,恶性程度高,预后差。手术切除是唯一治愈手段,但早期症状隐匿,缺乏有效的筛查手段,只有少数患者可完成根治性切除。大多数CCA患者确诊时已处于晚期,全身治疗仍然是CCA主要治疗手段,化疗带来的生存获益有限,晚期CCA预后很差。对于局部晚期的患者,新辅助治疗的应用越来越广泛,通过新辅助治疗缩瘤完成二次切除使得患者获得了更长的生存期。随着靶向治疗及免疫治疗的到来,为晚期CCA的治疗带来更多的希望。本文系统回顾了晚期CCA的全身治疗及最新进展,包括术后辅助治疗、晚期化疗治疗、局部晚期新辅助治疗、靶向治疗和免疫治疗。 相似文献
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Ang KK 《The oncologist》2008,13(8):899-910
The management of locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN) is highly complex. Data from recent clinical trials have altered the treatment landscape by refining the use of existing therapies, such as radiation therapy and chemotherapy, and providing new treatment options, such as cetuximab. Selecting the most appropriate treatment for an individual patient requires a multidisciplinary approach and careful assessment of the relative advantages and disadvantages of each treatment approach. Surgery is highly effective but can have debilitating long-term consequences. Chemoradiation and altered fractionation radiation therapy are more effective than conventional radiation therapy, but also more toxic; as a consequence of toxicity, suboptimal delivery of radiation may diminish, in practice, the efficacy observed in clinical trials of these strategies. Cetuximab plus radiation therapy is more effective than radiation alone and does not substantially increase radiation-related toxicity, or affect the delivery of planned radiotherapy. However, whether cetuximab plus radiation therapy is similar in efficacy to chemoradiation is unknown at this time. Ideally, multidisciplinary teams weigh all these factors when making individual treatment decisions. Data from current trials will help further optimize multimodality treatment for LA-SCCHN. 相似文献
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目的骨转移为乳腺癌的常见转移部位,其最大危害是骨痛,应采用一系列方法减轻骨痛,努力提高患者的生存质量。方法70例乳腺癌骨转移患者采用化疗、放疗、内分泌、同位素和综合治疗,分单一方法治疗组和综合方法治疗组,观察治疗后疼痛缓解和功能障碍恢复情况,经t检验得出结论。结果单一方法治疗中,内分泌和同位素治疗有效率高于单纯化疗和放疗;单一方法治疗有效率为56.4%,综合治疗有效率为90%,经统计学处理,P<0.01。结论单纯内分泌和同位素治疗优于单纯化疗和放疗,乳腺癌骨转移患者雌孕激素受体多为阳性,更适于内分泌治疗;综合治疗明显优于单一治疗,综合治疗中大剂量化疗加内分泌治疗效果最佳。 相似文献
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Radiation therapy continues to be one of the more popular treatment options for localized prostate cancer. One major obstacle
to radiation therapy is that there is a limit to the amount of radiation that can be safely delivered to the target organ.
Emerging evidence suggests that therapeutic agents targeting specific molecules might be combined with radiation therapy for
more effective treatment of tumors. Recent studies suggest that modulation of these molecules by a variety of mechanisms (e.g.,
gene therapy, antisense oligonucleotides, small interfering RNA) may enhance the efficacy of radiation therapy by modifying
the activity of key cell proliferation and survival pathways such as those controlled by Bcl-2, p53, Akt/PTEN and cyclooxygenase-2.
In this article, we summarize the findings of recent investigations of radiosensitizing agents in the treatment of prostate
cancer. 相似文献