三维适形放疗联合多烯紫杉醇治疗局部晚期非小细胞肺癌近期疗效观察

目的 探讨和分析三维适形放疗联合多烯杉醇治疗局部晚期非小细胞肺癌患者的近期疗效.方法 选取接受治疗的局部晚期非小细胞肺癌患者90例,按照随机数字表的方法分为观察组(n=45)和对照组(n=45),观察组患者采用三维适形放疗联合多烯紫杉醇的治疗方法,对照组患者仅采用紫杉醇化疗的方案进行治疗.比较两组患者的治疗总有效率,两组患者的不良反应发生率,两组患者治疗后的生活质量良好率.结果 观察组患者的治疗总有效率高于对照组,差异具有统计学意义(P<0.05);观察组与对照组不良反应发生率比较差异无统计学意义(P>0.05);治疗后,观察组患者的生活质量良好率显著高于对照组(P<0.05).结论 三维适形放疗联合多烯紫杉醇对局部晚期非小细胞肺癌患者的效果显著,提高患者生存质量,值得推广应用.     

三维适形放疗联合替吉奥治疗晚期非小细胞肺癌的临床研究

目的：观察替吉奥胶囊联合三维适形放疗对晚期非小细胞肺癌患者的疗效及毒副反应.方法：56例经病理组织学确诊为晚期非小细胞肺癌的患者随机分为治疗组（替吉奥＋放疗,n =28）和对照组（单纯放疗,n =28）.两组患者均接受三维适形放疗;治疗组在放疗同期行替吉奥单药化疗,80mg/（m2·d）,2次/天,服两周停一周,3周为一周期,至放疗结束.结果：所有56例患者均可评价疗效.治疗组有效率为82.1％,明显高于对照组64.3％（P＜0.05）.治疗组骨髓抑制和胃肠道反应高于对照组（P＜0.05）,放射性食管炎和放射性肺炎发生率与对照组相比,无统计学意义（P＞0.05）.结论：替吉奥胶囊联合三维适形放疗治疗晚期非小细胞肺癌疗效明确,毒副反应较轻,耐受性较好,作为晚期非小细胞肺癌的辅助治疗药物值得临床推广.     

三维适形放疗联合多西紫杉醇同期化疗治疗老年局部晚期非小细胞肺癌临床研究

目的:研究三维适形放射治疗联合多西紫杉醇同期化疗治疗老年局部晚期非小细胞肺癌疗效和不良反应.方法:84例局部晚期非小细胞肺癌患者随机分成A组和B组,A组40例采用三维适形放射治疗,总剂量66-70Gy/33-35次,6-7周完成.B组44例采用三维适形放射治疗联合多西紫杉醇同期化疗.结果:两组患者的总有效率分别为57.9%和80.5%,其中CR率分别为7.9%和29.3%,P＜0.05.两组1、2年生存率分别65.7% vs 80.5%和 39.5% vs 53.7%( P＞0.05).A组患者中位生存期为10.5个月,B组患者为19.5个月.两组患者早期放射反应主要为I-II级放射性食道炎和骨髓抑制,后期放射反应主要为I-II级放射性肺炎,发生率两组接近.结论:三维适形放射治疗联合多西紫杉醇同期化疗治疗局部晚期非小细胞肺癌疗效优于单纯三维适形放射治疗.     

注射用黄芪多糖联合三维适形放疗治疗老年肺癌临床观察

目的:观察注射用黄芪多糖(APS)联合三维适形放射治疗(3D-CRT)对老年非小细胞肺癌的疗效.方法:将80例确诊的Ⅰ～Ⅳ期老年非小细胞肺癌患者,随机分为中药联合放疗治疗(治疗组,40例)和单纯放疗治疗(对照组,40例).放疗采用三维适形放射治疗,治疗总剂量50～70Gy,2Cy/次,每日1次,每周5次.中药选用注射用黄芪多糖250mg加入5%葡萄糖或生理盐水500ml中静滴,放疗当日开始给药,每天1次,直至放疗结束后停药,疗程与放疗同步.比较两组的近期疗效、外周血象、免疫功能及生活质量.结果:治疗组近期有效率87.5%,对照组有效率72.5%,两组间比较无明显差异(P＞0.05).治疗组患者的外周血白细胞计数治疗后下降不明显、而对照组下降明显,治疗组治疗前后比较无显著性差异,而对照组治疗前后比较有显著性差异(P＜0.05),对照组治疗后白细胞数较治疗组有显著性差异(P＜0.05);治疗组患者治疗后T淋巴细胞亚群CD8、CD4/CD8较治疗前好转,差异显著(P＜O.05),对照组放疗前后比较差异无显著性(P＞0.05),两组间治疗后差异有显著性(P＜0.05).结论:注射用黄芪多糖联合3D-CRT可以降低老年非小细胞肺癌患者的放射副反应,提高机体免疫水平.     

三维适形放疗联合同期及序贯吉西他滨治疗老年Ⅲ期非小细胞肺癌的临床观察

目的:探讨三维适形放疗联合吉西他滨化疗治疗老年局部晚期非小细胞肺癌的临床研究.方法:85例Ⅲ期>65岁老年非小细胞肺癌(NSCLC)患者随机分为治疗组(43例,采用三维适形放疗)和对照组(42例,采用常规放疗).两组放射治疗均采用6/15 MV X射线,2 Gy/(次·d),5次/周,Dr60～70 Gy;放疗周期每周...     

三维适形放疗同步 TP 化疗联合细胞免疫对Ⅲ期非小细胞肺癌的临床治疗效果

目的：探讨三维适形放疗同步TP（紫杉醇＋顺铂）并联合细胞免疫治疗对Ⅲ期非小细胞肺癌的临床治疗效果。方法收集经病理诊断为Ⅲ期非小细胞肺癌的患者110例,随机分为对照组和实验组,对照组采用三维适形放疗同步TP化疗,实验组在此基础上联合细胞免疫治疗。结果对照组与实验组在白细胞降低、血小板减少、恶性呕吐、放射性肺炎以及食管炎的发生率上差异不具统计学意义（P＞0．05）;实验组与对照组发热以及外周血中CD阳性细胞降低等发生率上比较,差异具有统计学意义（P＜0．05）。2组患者接受治疗后的KPS评分除稳定者差异不具统计学意义外（P＞0．05）,其余评分差异具有统计学意义（P＜0．05）。2组患者临床治疗效果对比分析发现,实验组治疗后临床缓解率显著优于对照组,其总有效率为85．5％。结论三维适形放疗同步TP化疗联合细胞免疫治疗非小细胞肺癌具有良好的临床治疗效果,且未发现增加严重的毒副作用的风险,临床上可以推广使用。     

非小细胞肺癌再程放疗联合化疗的临床疗效观察

目的:比较三维适形放射治疗联合化疗和单纯三维适形放射治疗治疗复发的非小细胞肺癌的近期疗效及不良反应。方法:回顾性收集2011年6月至2017年10月入住我院的52例复发的非小细胞肺癌患者。治疗组:三维适形放射治疗+TP方案。对照组:三维适形放射治疗。结果:治疗组患者总有效率为50.00%（14/28）,对照组患者总有效率为20.83%（5/24）,两组患者近期总有效率比较差异有统计学意义（P＜0.05）。治疗组不良反应的发生率消化道反应最为明显,达到85.71%（24/28）,与对照组比较差异有显著统计学差异（P＜0.01）。骨髓抑制的发生率为53.57%（15/28）,与对照组比较差异有统计学意义（P＜0.05）。放射性肺炎、肝功能损害、放射性食管炎,皮肤反应两组均无明显差异（P＞0.05）。 结论:小细胞肺癌复发后,在身体条件允许的情况下,再程放疗联合化疗疗效比单纯放疗疗效高,不良反应可接受,值得临床进一步研究和推广。     

紫杉醇周方案与三维放疗同步治疗Ⅲ期非小细胞肺癌的临床观察

目的评估紫杉醇周方案与三维放疗同步治疗Ⅲ期非小细胞癌的疗效和毒副反应。方法 47例Ⅲ期非小细胞肺癌患者予三维放疗(三维适形或适形调强),同时予紫杉醇化疗(45 mg.m-2,每周1次,共6周)。结果全组有效率为70.2%,中位生存期15.5个月,1、2 a生存率分别为68.1%、36.2%。结论紫杉醇周方案与三维放疗同步治疗Ⅲ期非小细胞肺癌有较好的疗效,毒副反应可耐受。     

卡培他滨联合三维适形放疗治疗老年直肠癌临床疗效观察

目的 分析卡培他滨联合三维适形放疗治疗老年直肠癌的临床疗效.方法 50例老年晚期直肠癌患者,分为对照组和试验组2组,每组25例,对照组患者给予单纯三维适形放疗,试验组患者则给予卡培他滨联合三维适形放疗.结果 试验组总有效率、疾病控制率显著高于对照组,差异有统计学意义(P＜0.05);试验组局部复发率、远处转移率显著低于对照组,差异有统计学意义(P＜0.05).结论 在对老年直肠癌患者进行治疗时,卡培他滨联合三维适形放疗治疗安全有效,具有临床推广和应用价值.     

紫杉醇联合三维适形放疗治疗局部晚期非小细胞肺癌的临床观察

目的探讨紫杉醇(TXT)联合三维适形放疗(3D-CRT)治疗局部晚期(Ⅲ期)非小细胞肺癌的疗效。方法选取2013年1月至2016年1月间武汉大学人民医院收治的160例非小细胞肺癌ⅢA~ⅢB期患者,采用随机数字表法分为观察组和对照组,每组80例。观察组患者予以TXT联合3D-CRT治疗,对照组患者予以紫杉醇联合卡铂(TP方案)化疗,治疗3个疗程后进行疗效评价,比较两组患者的疗效和不良反应发生情况。结果观察组患者部分缓解率(PR)高于对照组患者,两组比较差异有统计学意义(P<0.05),疾病进展率(PD)低于对照组患者,两组比较差异有统计学意义(P<0.01)。对照组患者胃肠道反应、骨髓抑制和肝功能损害发生率均高于观察组患者,两组比较差异均有统计学意义(均P<0.05)。结论紫杉醇联合三维适形放疗治疗局部晚期非小细胞肺癌具有较好的临床效果,提高了药物的抗肿瘤作用,降低了不良反应的发生。     

Compliance with guidelines and correlation with outcome in patients with advanced germ-cell tumours

PurposeTo evaluate prior compliance with guidelines in patients treated with salvage chemotherapy for advanced germ-cell tumours (GCT).Patients and methodsData concerning the initial management of patients requiring salvage chemotherapy for GCT at Institut Gustave Roussy between 2000 and 2010 were obtained and correlated with recommendations for treatment. Criteria of non-compliance were defined based on guidelines. Compliance with guidelines, predictive factors for non-compliance and the impact on outcome were analysed.ResultsAmong 82 patients treated in the salvage setting, guidelines to initial treatment were followed in only 41 cases (50%). The most common non-compliance criteria were non-adherence to the planned dose (16%), an inappropriate interval between first-line chemotherapy cycles (16%), the lack of post-chemotherapy surgery (16%) and a long interval to post-chemotherapy surgery (48%). Compliance with standard care was better in cancer centres than in other hospitals (private or public) (Odd Ratio (OR): 6.9, P = 0.001). A poor-risk status according to the International Germ Cell Cancer Collaborative Group (IGCCCG) was also predictive of compliance in univariate but not in multivariate analysis. No significant difference in outcome after salvage chemotherapy was observed. Patients relapsing after non-compliant first-line therapy tended to be more easily salvaged, which is consistent with the fact that their initial treatment was inadequate. Some of these relapses were therefore probably not due to true biologically refractory disease.ConclusionGuidelines for first-line treatment are adhered to in only half the patients requiring salvage chemotherapy. As the only predictive factor for non-compliance was the treating centre, centralisation of patients with GCT in well-trained hospitals should be recommended.     

Living with secondary breast cancer: coping with an uncertain future with unmet needs

JOHNSTON S.R.D. (2010) European Journal of Cancer Care 19 , 561–563 Living with secondary breast cancer: coping with an uncertain future with unmet needs     

Costs associated with complications are lower with capecitabine than with 5‐fluorouracil in patients with colorectal cancer

BACKGROUND:

Capecitabine, an oral alternative to 5‐fluorouracil (5‐FU) in patients with colorectal cancer (CRC), has equal clinical efficacy and a favorable safety profile; however, its use may be limited because of unit cost concerns. In this study, the authors measured the cost of chemotherapy‐related complications during treatment with capecitabine‐ and 5‐FU–based regimens.

METHODS:

Patients with CRC who received at least 1 administration of capecitabine or 5‐FU during 2004 and 2005 were identified from the Thomson MarketScan research databases. Monthly frequency and cost for 23 complications were recorded. Logistic regression was used to predict complication probability. General linear models were used to predict monthly complication cost and total monthly expenditure.

RESULTS:

In total, 4973 patients with CRC met the inclusion criteria for this analysis. Although the most frequently observed complications were the same between capecitabine and 5‐FU (nausea and vomiting, infection, anemia, neutropenia, diarrhea), each was observed with greater frequency in 5‐FU–based regimens. The mean predicted monthly complication cost was significantly higher (by 136%) with 5‐FU monotherapy than with capecitabine monotherapy (difference, $601; 95% confidence interval [95% CI], $469‐$737). In addition, the mean predicted monthly complication cost for 5‐FU+oxaliplatin was higher than the cost with capecitabine plus oxaliplatin (difference, $1165; 95% CI, $892‐$1595). When acquisition, administration, and complication costs were taken into consideration, there were no significant differences in the total cost between capecitabine regimens and 5‐FU regimens.

CONCLUSIONS:

Capecitabine compared well with 5‐FU–based therapy in patients with CRC and was associated with lower complication rates and associated costs. Cancer 2009. © 2009 American Cancer Society.     

Experience with Impedance Phlebography Compared with Venography

Venography is a particularly reliable method for the diagnosis of deep venous thrombosis but is not suitable as a screening test. Impedance phlebography represents another attempt to discover a simple, non-invasive and reliable method of detecting deep venous thrombosis. It does not, however, meet these criteria.     

Protothecosis successfully treated with amikacin combined with tetracyclines

Summary We report a case of protothecosis in an 18-year-old female student caused by Prototheca zopfii successfully treated with amikacin combined with tetracyclines. Zusammenfassung Es wird über eine Protothecose, verursacht durch Prototheca zopfii, bei einer 18-j?hrigen Studentin berichtet, die erfolgreich mit Amikacin in Kombination mit Tetracyclinen behandelt wurde.