该化疗时就化疗

化学药物治疗(简称化疗),在临床上我们常看到有患者迷信它,为了放心每年都做一次化疗,而有些患者因恐惧化疗的毒副反应而又排斥它.     

走近化疗

化疗即用化学药物治疗肿瘤。化疗是肿瘤最重要的治疗手段之一,也是肿瘤综合治疗的关键组成部分。其历史可以追溯到20世纪40年代,高速发展于最近二十多年。时至今日,虽然靶向治疗已经成为目前研究和讨论的热点,化疗依然是肿瘤最常用的全身治疗手段。     

化疗及化疗患者的家庭护理

目前,治疗肿瘤的方法有多种,其中化疗是治疗肿瘤的重要方法.所谓化疗,简单的说就是使用化学药物去治疗肿瘤,它作用于全身,对原发及转移性肿瘤的细胞都具有杀伤作用.     

化疗脑

在临床工作中,常被患者问及化疗是否会使脑受损？化疗后记忆力明显下降,能否恢复？需多久才能恢复？遗憾的是由于以往对此研究甚少,文献中涉及的不多,我也知之不详,只能笼统答日：“可能会有影响,但影响的大小因人而异。”这种似是而非、模棱两可的解答,其实是无奈状况下的一时搪塞,自己也不满意,何况患者？如被进一步追问,是何种不良反应？其严重程度受何影响？能否加以预防或治疗？就无言以对了。所幸病友常是“点到为止”,给我留有余地,不再发问,我也就侥幸得以渡此困境。不过,此一疑问如鲠在喉,尤其在面对众多接受化疗的乳腺癌患者,总有内疚之感。     

新辅助化疗——乳腺癌化疗新选择

医生建议我先行＂新辅助化疗＂,什么是新辅助化疗？几乎所有的乳腺癌患者都经历过以下过程,在最早发现时,往往会经历一系列的心理变化过程,从最初的怀疑诊断,到逐步相信诊断,到心情烦躁、情绪低落,但是一旦看到带有＂癌＂这个字眼的报告单时,相信所有的患者除了情绪低落与悲观以外,脑子里随即浮现出来的一个念头就是：我要尽快手术!然而有时医生反而不主张尽早手术,建议在手术前先做化疗,尤其是在一些医疗条件较好,学术水平较高的医院,这让很多病人感到疑惑、焦急,甚至抵制。     

化疗的起源

第一次世界大战后,人们发现芥子气可以杀死一般的白细胞,就认为芥子气也可以杀死导致白血病的变异白细胞,于是芥子气就作为杀死变异白细胞及其它癌细胞的“良药”。虽然人们发现这些经过化疗的病人出现像那些在芥子气中幸存的士兵有非常相似的症状,可人们还继续使用化疗。     

黑色素瘤化疗进展

黑色素瘤是所有恶性肿瘤中发病率增长最快的肿瘤,年增长率约3％～5％。中国和日本等亚洲国家发病率低,但是增长迅猛。北京市统计资料显示,2000年黑色素瘤发病率为0．2／10万。     

化疗药膳良方

化疗是目前治疗肿瘤的重要手段之一,但在治疗同时,化疗药物常损伤人体正气,产生诸多毒副作用。最常见的如造血功能障碍、消化道反应、肝功能受损、头发脱落等,使患者深受其扰,甚至不能耐受后续治疗。我国自古以来就有"药食同源"之说,运用具有药疗作用的食物调理,能有效减轻化疗阶段的不良反应。     

卵巢癌化疗研究进展

化疗是治疗卵巢癌的重要手段.对于早期卵巢癌,腹腔和全身化疗可以防止复发,提高治愈率;对于晚期卵巢癌,化疗可以缓解症状,延长患者生存期.现综述近年有关卵巢癌化疗方面的研究进展.     

胰腺癌化疗现状

胰腺癌是一种临床发病隐匿,发展迅速,预后极差的肿瘤。据统计,2009年美国新增胰腺癌病人42,470例,其中将有83%的患者于1年内死亡。胰腺癌仅占患癌症总人数的2%-3%,但却已成为因癌症导致患者死亡原因的第4位。     

The future of chemotherapy at home--from outpatient chemotherapy to chemotherapy at home

Chemotherapy for colorectal cancer has changed greatly. A continuous systemic chemotherapy like FOLFOX or FOLFIRI became a standard. It is necessary to get sufficient knowledge and technique of chemotherapy for an infusion port system and a portable pump system. The risk management aspect is very important. Both strict and steady drug mixing and an administration system are necessary. It is also important to make a 24-hour surveillance system for any unusual conditions. The hospital as a whole must come to grips with these problems. The chemotherapy at an outpatient clinic or home will become a standard in the near future because it preserves the patients' QOL.     

Rationalization of adjuvant chemotherapy by induction chemotherapy

An induction chemotherapy, before any local treatment, allows to precise the chemosensitivity of the primary tumor. These data may help to improve indication and type of a further adjuvant chemotherapy. However there are many biological differences between different sites of the same tumor and along the time, without or after treatment. It is thus impossible to be sure that a chemotherapeutic regimen effective as first treatment on the primary will be equally active on micro-metastases some months later. Many questions in this field will be answered only by controlled studies and careful observations.     

Hepatotoxicity of chemotherapy

Patients who will receive chemotherapy require careful assessment of liver function prior to treatment to determine which drugs are not appropriate, and which drugs need dose modification. However, if the hepatic parenchymal abnormalities are caused by an underlying neoplasm and the neoplasm is sensitive to the drugs, it may not be necessary to reduce the dose. Clearly, this is an area where clinical judgment must be used to assess the risk/benefit ratio. Treatment of chronic hepatitis B virus (HBV) involves either the nucleoside analogue lamivudine or interferon alpha. The advantage of lamivudine includes limited adverse effects and the fact that histological improvement has been documented in the majority of patients. Primary prophylaxis with lamivudine may be a well tolerated and effective method to reduce the frequency of chemotherapy-induced HBV reactivation in chronic HbsAg carriers. HbsAg screening is necessary before beginning chemotherapy for non Hodgkin's lymphoma patients. However, the main problem with long-term lamivudine therapy is the emergence of genotypic resistance because of base pair substitution at specific sites within the YMDD locus of the DNA polymerase gene. Significant hepatic dysfunction is uncommon among hepatitis C virus (HCV) infected patients treated with chemotherapy for hematological malignancies. However, infection with elevated AST levels is a significant risk factor for veno-occlusive disease after hematopoietic stem cell transplantation. Clinical judgment and a high index of suspicion remain critical tools in preventing and treating hepatic manifestations of cancer chemotherapy.     

Hepatotoxicity of chemotherapy

After assessment of tumor histology, the next important factor to consider in the selection of a chemotherapy regime is organ function. Patients who are to receive chemotherapy require careful assessment of liver function prior to treatment to determine which drugs may not be appropriate, and which drug doses should be modified. Following therapy abnormalities of liver function tests may be due to the therapy rather than to progressive disease, and this distinction is of critical importance. Furthermore, not all abnormalities in liver function are due to the tumor or its treatment, and other processes, such as hepatitis, must be kept in mind. This article reviews the hepatic toxicity of chemotherapeutic agents, and suggests dose modifications based upon liver function abnormalities. Emphasis is placed on agents known to be hepatotoxic, and those agents with hepatic metabolism.     

Hepatotoxicity of chemotherapy

The selection of an antineoplastic regimen for an oncology patient is based first on the availability of effective drugs and then on a balancing of potential treatment-related toxicities with the patient's clinical condition and associated comorbidities. Liver function abnormalities are commonly observed in this patient population and identifying their etiology is often difficult. Immunosuppression, paraneoplastic phenomena, infectious diseases, metastases, and poly-pharmacy may cloud the picture. While criteria for standardizing liver injury have been established, dose modifications often rely on empiric clinical judgment. Therefore, a comprehensive understanding of hepatotoxic manifestations for the most common chemotherapeutic agents is essential. We herein review the hepatotoxicity of commonly used antineoplastic agents and regimens.     

Regional chemotherapy

Regional chemotherapy is an interesting treatment option in patients with advanced pancreatic cancer but cannot be considered standard treatment, and it should not be performed outside controlled clinical trials. The real value of regional chemotherapy must be evaluated in larger, randomized trials. New drug combinations may reduce the observed side effects and improve tumor response. Gene therapy with p53 and K-ras modulated herpesviruses may become a palliative treatment option and can be administered easily by regional chemotherapy techniques [23].     

诱导化疗联合同步放化疗治疗鼻咽癌的临床观察

目的探讨诱导化疗联合同步放化疗治疗鼻咽癌患者的近期、远期疗效和安全性。方法选取2010年1月至2012年1月间收治的54例中晚期鼻咽癌患者,按照就诊顺序编号随机分为观察组和对照组,每组各27例。观察组患者实施同步放化疗,对照组患者采用诱导化疗。治疗结束后,对近期、远期疗效和不良反应进行比较。结果入选患者均完成治疗,其中观察组患者治疗有效率为88.9%,对照组为85.2%,组间差异无统计学意义(P>0.05)。观察组患者3年总生存率、3年无瘤生存率与对照组比较,差异均有统计学意义(均P<0.05);局部复发率、远处转移率与对照组比较,差异均有统计学意义(均P<0.05)。观察组患者血小板减少和恶心呕吐发生率与对照组比较,差异均有统计学意义(均P<0.05);白细胞减少、放射性皮炎和口腔黏膜炎等发生率组间在两组间差异均无统计学意义(均P>0.05)。结论同步放化疗治疗鼻咽癌有效率与诱导化疗相当,且能改善患者生存情况,降低局部复发、远处转移率,安全性高,值得推广。