放化综合治疗在脑转移癌治疗中的临床应用研究

目的:观察放化综合治疗脑转移癌的近期疗效与安全性。方法:62例脑转移癌患者随机分为放化疗组与单纯放疗组。其中化疗联合组31例,非小细胞肺癌脑转移患者入组替莫唑胺联合放疗组、乳腺癌脑转移患者入组卡培他滨联合放疗组;31例为单纯放疗组。替莫唑胺联合放疗组给予替莫唑胺[75mg/(m2·d)]至放疗结束,卡培他滨组给予[625mg/(m2·d),2次/d,连用4周]。两组均联合2周三维适形头部放疗,总剂量42Gy(3Gy,5f/w),其中全脑30Gy/10f,病灶区补量12Gy/4f;单纯放疗组仅予42Gy三维适形头部放疗,其中全脑30 Gy,病灶区补量12 Gy。联合放化疗组放疗结束后继续给予2个周期替莫唑胺[每周期150mg/(m2·d)],连续服用5d,28d为1个周期;卡培他滨组给予[每周期825mg/(m2·d),2f/d,d1-14],连续服用14d,28d为1个周期。结果:联合放疗组与单纯放疗组的客观有效率分别为80.63%、64.5%,差异无统计学意义(P>0.05);骨髓抑制发生率分别为70.96%、54.84%,胃肠道毒副反应发生率分别为61.29%、41.94%,差异均无统计学意义(P>0.05)。结论:替莫唑胺联合放疗以及卡培他滨联合放疗治疗非小细胞肺癌及乳腺癌脑转移安全、有效,但是近期疗效对比单纯放疗差异不显著。     

放疗同步口服替莫唑胺治疗颅内转移瘤疗效评价

目的评价X线立体定向放射治疗同步口服替莫唑胺化疗对脑转移瘤的疗效及毒副反应。方法回顾性分析脑转移瘤单纯颅脑放疗(全脑放疗WBI X线立体定向放射治疗SRT)16例和放疗同步口服替莫唑胺化疗(WBI SRT TMZ)26例的疗效及毒副反应。2组患者放射治疗的方法相同,采用6MVX线,全脑照射2.0Gy/次,TD30~40Gy/3~4周,全脑放疗后行立体定向放射治疗局部加量,SRT每次处方剂量5~8Gy,每周3次,病灶局部总剂量TD55~72Gy;同步化疗组化疗方案为:口服替莫唑胺100mg,每日1次,周1至周5服用,连服2周,间隔1周重复上述剂量治疗,直至放疗结束后再服2周,随访3~25个月。结果单纯放疗组病灶完全消失(CR)占56.25%(9/16),部分消失(PR)占37.50%(6/16),无变化(NC)占6.25%(1/16),总缓解率为93.75%;同步化疗组分别为CR80.80%(21/26)、PR19.20%(5/26),总缓解率为100.00%,2组总缓解率比较,无显著性差异(χ2=3.09,P>0.05)。单纯放疗组肿瘤局部复发率、中位复发时间、中位生存时间,分别为37.5%(6/16)、9.8个月、11.5个月,同步化疗组分别为11.5%(3/26)、12个月、13.2个月,2组比较肿瘤局部复发率无显著性差异(χ2=2.57P>0.05),中位复发时间、中位生存时间有统计学差异(t=6.56,P<0.05,t=5.02P<0.05)。出现Ⅲ度以上白细胞计数减少单纯放疗组发生率为12.5%(2/16),同步化疗组为34.6%(9/26),2组比较差异无显著性(χ2=1.83,P>0.05)。结论放疗同步口服替莫唑胺治疗脑转移瘤安全、有效,能达到延缓中位复发时间、延长中位生存期的目的,不良反应无明显增加。     

同期推量调强放疗联合替莫唑胺治疗脑转移瘤的疗效观察

摘 要：［目的］ 评价同期推量调强放疗（SIB-IMRT）联合替莫唑胺（TMZ）治疗脑转移瘤的临床有效性和安全性。［方法］ 采用同期推量调强放疗联合替莫唑胺治疗经原发灶病理诊断的脑转移瘤患者83例。全脑放疗30Gy/10F,同期脑转移灶推量调强放疗50Gy/10F,放疗第一天开始口服替莫唑胺75mg/(m2·d),连续14天,放疗结束后1个月继续予6个周期替莫唑胺辅助化疗,150mg/(m2·d),连用5天,28天为1个周期。［结果］ 近期有效缓解率（RR）为91.56%,中位生存期为14.38个月,1年总生存率为63.85%。对预后因素行单因素和多因素分析显示KPS评分及脑转移个数对总生存有影响（P<0.05）。Ⅰ度和Ⅱ度中性粒细胞下降的比例为56.63%,Ⅰ度血小板下降的比例为24.1%,Ⅰ度和Ⅱ度恶心呕吐的比例为72.29%,Ⅰ度和Ⅱ度头痛的比例为62.66%,无Ⅳ度不良反应。［结论］ 同期推量调强放疗联合替莫唑胺治疗脑转移瘤可延长生存时间,不良反应轻。但是,同期推量调强放疗联合替莫唑胺治疗脑转移瘤的治疗是否可以成为脑转移治疗的一种有效方法,还需进一步的临床随机对照试验证实。     

颅脑放疗联合替莫唑胺治疗非小细胞肺癌脑转移30例

摘 要：［目的］ 观察全脑放疗与全脑放疗联合替莫唑胺治疗非小细胞肺癌(non-small cell lung cancer,NSCLC)脑转移的疗效、生存时间及不良反应。［方法］ 60例NSCLC伴脑转移患者随机分为放射治疗组(放疗组30例)和放射治疗联合化疗组(联合组30例)。放疗组：全脑放疗剂量DT 40Gy/20F/4W。联合组：放疗方法与放疗组相同,放疗同步替莫唑胺治疗剂量为75mg/（m2·d）,d1~28。［结果］ 放疗组和联合组总有效率分别为43.3％(13/30)、63.3％(19/30) (P=0.07);中位生存时间放疗组为4.3个月,联合组为8.5个月(P<0.01)。联合组骨髓抑制和胃肠反应高于放疗组（P＞0.05）。［结论］ 全脑放疗联合替莫唑胺可以作为NSCLC脑转移患者的治疗选择,治疗不良反应可耐受。     

全脑放疗联合尼莫司汀同步化疗治疗实体肿瘤脑转移的临床观察

目的：观察全脑放疗联合尼莫司汀同步化疗治疗实体肿瘤伴多发脑转移的疗效及不良反应。方法：对39例实体肿瘤脑转移患者分别采用全脑放疗联合尼莫司汀同步化疗和单纯全脑放疗方案治疗。同步放化疗组：全脑照射（WBRT）为DT2Gy/次,5次/周,总剂量40Gy。放疗开始的第1天同时给予尼莫司汀（ACNU）,2mg/kg,d1,每4-6周重复,共使用2-4个疗程。单纯放疗组：全脑照射（WBRT）为DT 2Gy/次,5次/周,总剂量40Gy。放疗结束后3个月评价疗效。结果：同步放化疗组总有效率65.0%（13/20）高于单纯放疗组（42.1%,8/19）;神经系统症状改善情况,同步放化疗组优于单纯放疗组;不良反应以放疗脑充血水肿及尼莫司汀引起的骨髓抑制和胃肠道反应为主。结论：全脑放疗联合尼莫司汀同步化疗治疗实体肿瘤脑转移的近期疗效、神经系统症状改善情况优于单纯放疗,不良反应可耐受,可作为实体肿瘤脑转移患者的解救方案。     

全脑放疗联合尼莫司汀同步化疗治疗实体肿瘤脑转移的临床观察

目的:观察全脑放疗联合尼莫司汀同步化疗治疗实体肿瘤伴多发脑转移的疗效及不良反应。方法:对39例实体肿瘤脑转移患者分别采用全脑放疗联合尼莫司汀同步化疗和单纯全脑放疗方案治疗。同步放化疗组:全脑照射(WBRT)为DT2Gy/次,5次/周,总剂量40Gy。放疗开始的第1天同时给予尼莫司汀(ACNU),2mg/kg,d1,每4-6周重复,共使用2-4个疗程。单纯放疗组:全脑照射(WBRT)为DT 2Gy/次,5次/周,总剂量40Gy。放疗结束后3个月评价疗效。结果:同步放化疗组总有效率65.0%(13/20)高于单纯放疗组(42.1%,8/19);神经系统症状改善情况,同步放化疗组优于单纯放疗组;不良反应以放疗脑充血水肿及尼莫司汀引起的骨髓抑制和胃肠道反应为主。结论:全脑放疗联合尼莫司汀同步化疗治疗实体肿瘤脑转移的近期疗效、神经系统症状改善情况优于单纯放疗,不良反应可耐受,可作为实体肿瘤脑转移患者的解救方案。     

替莫唑胺联合放疗治疗18例初诊高级别脑胶质瘤患者的临床观察

背景与目的:高级别脑胶质瘤(HGG)病程发展快,死亡率高,寻找新的治疗方法和开发新的化疗药物成为目前这种疾病研究的热点.本研究通过观察替莫唑胺同步放疗加单药辅助化疗治疗初诊高级别脑胶质瘤的疗效和安全性,对替莫唑胺一线治疗脑胶质瘤的临床获益性进行探讨.方法:采用60Co对18例HGG患者进行全脑(DT 40 Gy/20 f)加局部小野(DT 20 Gy/10 f)照射DT 60 Gy/30 f×6周,放疗期间每日口服替莫唑胺75 mg/m2,放疗结束后4周,继续给予替莫唑胺标准5 d方案辅助化疗6个周期,每一周期28 d.第1周期用量150 mg/m2,连用5 d,无明显血液毒性后,从第2周期起剂量增至200 mg/m2.结果:18例高级别脑胶质瘤患者中位随访12.5个月,11例出现复发或进展,5例死亡.中位疾病无进展生存期为9.8个月(95%CI,6.1～9.8个月),中位总生存时间为14个月(95%CI,8.5～19.5个月),1年总生存率为55.6%,6个月疾病无进展生存率为81.8%.替莫唑胺不良反应发生率低,以轻度血液毒性为主.结论:替莫唑胺联合同步放疗加后续单药辅助化疗治疗初诊高级别脑胶质瘤有较好的临床疗效,本疗法安全性好,患者能够从中受益.     

大分割放疗联合替莫唑胺治疗大体积脑转移瘤的效果观察

目的 观察大分割放疗联合替莫唑胺治疗大体积脑转移瘤的临床疗效.方法 选取90例大体积脑转移瘤患者为研究对象,随机将患者分为对照组和实验组,每组45例.对照组患者给予大分割放疗治疗,实验组患者在大分割放疗的基础上每日加服1次替莫唑胺150 mg/m2,连续口服28天即1个放疗周期结束后,每个放疗周期的前5天给予每天1次口服替莫唑胺200 mg/m2辅助治疗.治疗6个疗程后观察2组的临床疗效及不良反应,并分析患者1年随访记录.结果 实验组患者的临床治疗有效率为75.56%,明显高于对照组的48.89%(P<0.05).实验组患者半年及1年生存率高于对照组,复发率低于对照组(P<0.05).2组患者均有放射性脑水肿、放射性脑坏死、脑神经损伤、恶心呕吐及发热等不良反应,实验组患者临床还表现出骨髓抑制及贫血等不良反应,但均可耐受.结论 大分割放疗联合替莫唑胺对临床治疗大体积脑转移瘤安全有效,患者临床症状可得到明显改善,临床不良反应较轻,值得推广应用.     

新辅助化疗联合放疗治疗中晚期鼻咽癌的疗效观察

目的研究新辅助化疗在治疗中晚期鼻咽癌(NPC)中的疗效。方法63例中晚期NPC病人随机分为单纯放疗组30例、新辅助化疗联合放疗组33例。化疗方案PFL方案(DDP80mg/m2~100mg/m2,d1;5-FU3.5/m248h;CF0.3,d1),共2~3疗程;化疗后2周常规放射治疗鼻咽癌原发灶DT68.0Gy/7周,颈转移灶DT65.0Gy/6周,颈预防剂量55.0Gy。结果新辅助化疗联合放疗组原发灶及颈转移灶完全缓解率优于单纯放疗组,毒性反应与单纯放疗组相比无明显差异。结论新辅助化疗联合放疗可提高中晚期NPC患者近期肿瘤缓解率,毒性反应可耐受,但远期生存率需进一步观察。     

序贯化疗联合脑放射治疗非小细胞肺癌脑转移

背景与目的脑放疗是非小细胞肺癌脑转移的传统治疗,化疗与脑放疗的联合是近年的研究方向。鉴于序贯/维持化疗近年来在晚期非小细胞肺癌显示较好前景,我们对非小细胞肺癌脑转移患者进行序贯化疗联合脑放射的治疗探索。方法对确诊的非小细胞肺癌脑转移患者采用TP-NP-GP三个方案序贯化疗联合同期的脑放射进行治疗。TP方案:TXT175mg/m2d1,DDP20mg/m2d1-5,每3周重复;NP方案:NVB25mg/m2d1、8,DDP20mg/m2d1-5,每3周重复;GP方案:GEM1g/m2d1、8,DDP20mg/m2d1-5,每3周重复。每个化疗方案至少使用2疗程,有效的患者继续原方案至4疗程后行下一个方案的序贯化疗。结果51例患者使用TP-NP-GP方案序贯化疗在外周病灶的有效率分别为41.2%、35.6%及27.8%,联合同期的脑放射治疗在脑转移灶的有效率达到60.8%。中位生存期14.7个月。1年、2年及3年生存率分别为67.8%、20.6%及1.3%。结论第三代新药方案序贯化疗联合脑放射治疗非小细胞肺癌脑转移可以取得较好疗效,总体耐受性良好。     

恶性脑胶质瘤术后三维适形放疗联合三苯氧胺治疗的临床观察

目的:观察恶性脑胶质瘤术后三维适形放疗联合三苯氧胺治疗的疗效及不良反应。方法:60例恶性脑胶质瘤术后患者随机分为三维适形放疗联合三苯氧胺（治疗组）和三维适形放疗联合替莫唑胺（对照组）各30例。放疗采用6MV X线三维适形放射治疗,2.0Gy/次,1次/d,5次/周,DT 56~60Gy。治疗组与对照组分别于放疗第一天开始口服三苯氧胺60mg/m2每日3次或替莫唑胺75mg/m2每日1次,至放疗结束。结果:治疗组与对照组1、2、3年生存率分别为63.3%、30.0%、23.0%和70.0%、33.3%、26.7%（χ2=0.01、0.23、0.09, P＞0.05）,无统计学差异。三苯氧胺主要不良反应为血栓栓塞,发生率为6.7%。结论:三维适形放疗联合三苯氧胺术后患者生存率较好,且价格便宜,并未增加不良反应,适合临床推广应用。     

全脑放疗联合替莫唑胺治疗肺癌脑转移疗效观察

目的:探讨全脑放疗（WBRT）联合替莫唑胺（TMZ）治疗非小细胞肺癌（NSCLC）脑转移的疗效。方法:回顾分析本院2010年-2014年收治的37例接受WBRT联合TMZ同步治疗及TMZ辅助治疗的NSCLC脑转移患者疗效。WBRT剂量30Gy,TMZ放疗同步口服75mg/(m2·d),序贯给予TMZ 150~200mg/(m2·d),连续5天,28天为1周期,3~6周期。结果:完全缓解10.8%(4/37),部分缓解40.5%(15/37)。中位无进展生存时间和中位生存时间分别为8和10个月。最常见不良反应恶心、呕吐,中性粒细胞减少和血小板减少的发生率分别为59.5%（22/37）,32.4%（12/37）,35.1%（13/37）。结论:WBRT联合TMZ同步治疗及TMZ辅助化疗治疗NSCLC脑转移癌安全有效,耐受性良好,不良反应轻,可作为脑转移癌放化疗综合治疗模式之一进行深入研究。     

奈达铂与顺铂对食管癌同步放化疗治疗的不良反应比较

目的对比分析含奈达铂（捷佰舒、NDP）的方案和含顺铂（诺欣、DDP）的方案在同步放化疗治疗食管癌的不良反应。方法我科2007年12月-2009年3月收治的食管癌患者52例,随机分为两组,NF组（NDP＋5-Fu＋放疗）24例,DF组（DDP＋5-Fu＋放疗）28例。两组均常规分割放疗,2.0Gy／次,术后患者总剂量50Gy／25次／35天,未手术的患者64Gy／320／44天,化疗在放疗的第一天开始,NF组为NDP60mg／m^2·d1、2＋5-Fu500mg／m^2·d1-5;DF组为25mg／m^2·d1-4＋5-Fu500mg／m^1·d1-5。两组均28天为一个疗程,共2个疗程。结果NF组的主要不良反应,如恶心呕吐、肾功能损害发生率明显低于DF组（P〈0．05）,白细胞下降无显著性差异（P〉0．05）,血小板下降NF组高于DF组（P〈0．05）。结论NDP＋5-Fu联合放疗治疗食管癌术后患者是安全的,不良反应易于耐受,特别适合老年人使用,疗效比较有待进一步随访。     

Clinical Observation of Three Dimensional Conformal Radiotherapy with Tamoxifen in Treatment of Postoperative Malignant Glioma

Objective: To evaluate the efficacy and adverse effects of three dimensional conformal radiotherapy (3D-CRT)with tamoxifen in treating patients with postoperative malignant glioma. Patients and Methods: 60 patients ofpostoperative malignant glioma were randomly assigned into two groups, 30 patients were treated with 3D-CRTplus tamoxifen (treatment group), and the other 30 patients with 3D-CRT plus temozolomide (control group).All patients were radiated by 6MV X-ray, 2.0Gy per fraction, once daily, with a total dose (DT) of 56~60Gy.Tamoxifen was delivered at 60mg /m2/d, temozolomide was given at 75mg/m2/d. All patients were treated withconcurrent radiotherapy. Results: One, 2, 3 year survival rates of treatment and control group were 63.3%,30.0%, 23.0% and 70.0%, 33.3%, 26.7%, respectively (χ2=0.01, 0.23, 0.09, P>0.05). The rate of thromboembolismin treatment group was 6.7%. Conclusion: Therapeutic efficacy of two groups was similar, but it was more costeffectivein treatment group, and toxicity did not increase.     

Phase II randomized trial of temozolomide and concurrent radiotherapy in patients with brain metastases.

PURPOSE: To determine the efficacy, tolerability, and safety of concurrent temozolomide and radiotherapy in patients with previously untreated brain metastases. PATIENTS AND METHODS: Fifty-two patients with brain metastases from solid tumors were randomized to oral temozolomide (75 mg/m(2)/d) concurrent with 40-Gy fractionated conventional external-beam radiotherapy (2 Gy, 5 d/wk) for 4 weeks versus 40-Gy radiotherapy alone. The group receiving temozolomide and radiotherapy continued temozolomide therapy (200 mg/m(2)/d) for 5 days every 28 days for an additional six cycles. The primary end points were radiologic response and neurologic symptom evaluation. RESULTS: The objective response rate was significantly (P =.017) improved in patients receiving temozolomide and radiotherapy versus radiotherapy alone. Among 24 patients assessable for response in the temozolomide group, 23 (96%) of 24 responded, including nine (38%) patients with a complete response and 14 (58%) patients with a partial response. With radiotherapy alone, 14 (67%) of 21 assessable patients responded, including seven (33%) complete responses and seven (33%) partial responses. There was marked neurologic improvement in the group receiving temozolomide, and the proportion of patients requiring corticosteroids 2 months after treatment was lower in the temozolomide group compared with radiotherapy alone (67% v 91%, respectively). Daily temozolomide concurrent with radiotherapy was generally well tolerated; however, grade >or= 2 nausea (48% v 13%, P =.13) and vomiting (32% v 0%, P =.004) were significantly increased in the temozolomide group. Hematologic toxicity was predictable and reversible. CONCLUSION: Temozolomide is safe, and a significant improvement in response rate was observed when administered in combination with radiotherapy in patients with previously untreated brain metastases. A larger randomized trial is warranted to verify these results.     

COAPC方案联合脑部放射治疗非小细胞肺癌脑转移

背景与目的：放射治疗具有治疗脑转移癌的主要手段。而到目前为止化疗与放疗联合治疗脑转移癌的研究较少,本研究旨在观察COAPC方案化疗与脑部放射同时治疗非小细胞肺癌（non-small cell lung cancer,NSCLC)脑转移患者疗效,不良反应及生存率。方法：45例NSCLC脑转移患者接受COAPC方案化疗,环磷酰胺0．3g/m^2第1天静推,长春新碱1．4mg/m^2第1天静推,阿霉素50mg/m^2第1天静推,顺铂20mg/m^2第1－5天静滴,司莫司汀80mg/m2第1天口服,每3－4周为1疗程,脑部放射治疗于化疗第1疗程的第6天开始,每次2Gy,每天1次,每周5天,脑转移灶1－3个者,全脑放疗40Gy后,缩野放疗至总量60Gy,脑转移灶＞3个者,全脑放疗至总量40Gy.结果：治疗后80％患者神经系统症状改善,对脑转移灶的客观有效率为64．4％,对肺原发灶的有效率为40％,治疗的主要不良反应为骨髓抑制(Ⅲ-Ⅳ度占35％）,中位生存期10个月,1年生存率44．1％,5年生存率6．7％,单纯脑转移患者的中位生存期14个月,高于多发远处转移患者的9个月（P＝0．012）。结论：化疗联合脑部放射治疗NSCLC脑转移患者有效率与生存率较高,且患者耐受性较好。     

Phase I study of hypofractionated dose-escalated thoracic radiotherapy for limited-stage small-cell lung cancer

PURPOSE: To determine the maximal tolerated dose of hypofractionated thoracic radiotherapy with concurrent chemotherapy for limited-stage small-cell lung cancer patients. METHODS AND MATERIALS: Three radiotherapy regimens were used. Radiotherapy was given in two phases: patients initially received 20 Gy in 10 fractions to gross tumor plus uninvolved mediastinal nodes, followed by a boost to gross disease of 30, 38, or 42 Gy in 15 fractions. Radiotherapy was planned with conformal techniques. All patients received four cycles of cisplatin (25 mg/m2) and etoposide (100 mg/m2) chemotherapy. Radiotherapy commenced with Day 1 of Cycle 2 of chemotherapy. All complete/near-complete responders were offered prophylactic cranial irradiation. The maximal tolerated dose of radiotherapy was based on the dose that caused unacceptably high rates of radiotherapy-related toxicity. RESULTS: Thirteen patients were accrued. All patients who commenced radiotherapy received all prescribed chemo- and radiotherapy. There were no treatment-related deaths. There was one Grade 3 acute nonhematologic toxicity in the 50-Gy group. Of the 6 patients given 58 Gy, 3 experienced acute Grade 3 esophagitis. With a median follow-up of 7 months, median overall survival was 9.5 months. CONCLUSIONS: The maximal tolerated dose of thoracic radiotherapy with concurrent chemotherapy on this trial was 50 Gy in 25 daily fractions.     

同步放疗加化疗综合治疗宫颈癌的临床研究

目的 探讨同步化疗加放射治疗宫颈癌的疗效和不良反应.方法 128例宫颈癌患者随机分为两组:同步放化疗和单纯放疗各64例.单纯放射治疗采用192Ir高剂量率腔内加体外放射治疗,开始体外全盆腔照射,5次/周,2 Gy/次,盆腔平面中心剂量26 Gy-40 Gy,2.5-4.0周完成;然后中间挡铅,4个野照射,4次/周,2 Gy/次,宫旁剂量20 Gy-25 Gy;同时腔内治疗,1次/周,66y/次,A点剂量为30 Gy-36 Gy.同步化疗加放疗组在放疗开始给予DF方案化疗即DDP50 mg/m2 dl 5-Fu 4.0/m2静注96 h,每4周重复,共3个周期.结果 两组3、5年生存率,A组分别为73.4﹪和59.4﹪,B组分别为51.6﹪和43.7﹪(P＜0.05).早期放射性直肠反应发生率A组为15.6﹪,B组为12.5﹪,膀胱反应发生率A组为6.3﹪,B组为4.7﹪.A组远处转移率明显低于B组,A组的骨髓抑制和消化的道反应明显低于B组,但患者经一般处理均能耐受.结论 同步化疗加放射治疗官颈癌能提高患者的生存率,降低远处转移率.     

Early change in glucose metabolic rate measured using FDG-PET in patients with high-grade glioma predicts response to temozolomide but not temozolomide plus radiotherapy

PURPOSE: To compare the ability of positron emission tomography (PET) to predict response to temozolomide vs. temozolomide plus radiotherapy. METHODS AND MATERIALS: Nineteen patients with high-grade glioma (HGG) were studied. Patients with recurrent glioma received temozolomide 75 mg/m2 daily for 7 weeks (n=8). Newly diagnosed patients received temozolomide 75 mg/m2 daily plus radiotherapy 60 Gy/30 fractions over 6 weeks, followed by six cycles of adjuvant temozolomide 200 mg/m2/day (Days 1-5 q28) starting 1 month after radiotherapy (n=11). [18F]Fluorodeoxyglucose ([18F]FDG) PET scan and magnetic resonance imaging (MRI) were performed at baseline, and 7 and 19 weeks after initiation of temozolomide administration. Changes in glucose metabolic rate (MRGlu) and MRI response were correlated with patient survival. RESULTS: In the temozolomide-alone group, patients who survived>26 vs. or=25%, survived longer than nonresponders with mean survival times of 75 weeks (95% CI, 34-115 vs. 20 weeks (95% CI, 14-26) (p=0.0067). In the small group of patients studied, there was no relationship between MRI response and survival (p=0.52). For patients receiving temozolomide plus radiotherapy, there was no difference in survival between PET responders and nonresponders (p=0.32). CONCLUSIONS: Early changes in MRGlu predict response to temozolomide, but not temozolomide plus radiotherapy.     

GP方案与放疗联合治疗食管癌纵隔淋巴结转移的临床观察

目的：探讨吉西他滨＋DDP联合放疗治疗食管癌纵隔淋巴结转移的疗效及不良反应。方法：收集43例以呼吸困难就诊的食管癌纵隔淋巴结转移患者,采用GP方案化疗（吉西他滨1．0g／m^2,d1,8;顺铂30mg／m^2,d2-4。每21—28天1个周期）。化疗1—2周期后开始行放疗,6MV—X线照射,DT2Gy／次,5次／周,总剂量DT 50Gy-68Gy。结果：本组病例总有效率73．9％。结论：吉西他滨＋顺铂联合放疗治疗食管癌纵隔淋巴结转移有明显疗效。