伽玛刀治疗无功能型垂体腺瘤的临床疗效观察

目的:评价伽玛刀治疗无功能型垂体腺瘤(NFA)的中长期效应。方法:随访193例伽玛刀治疗后的NFA,分成单纯伽玛刀治疗组与外科手术后加伽玛刀治疗组,平均随访时间46.2个月(36～90个月)。单纯伽玛刀治疗组68例,手术加伽玛刀治疗组125例,平均周边剂量14.5Gy。结果:单纯伽玛刀治疗的68例NFA患者中,肿瘤缩小46例(67.6%),肿瘤大小无变化19例(27.9%),瘤体增大3例(4.4%),肿瘤控制率95.6%(65/68)。伽玛刀治疗后出现垂体功能低下2例(2.9%),视力视野障碍加重2例(2.9%)。术后肿瘤残留或复发加伽玛刀治疗的125例NFA患者中,肿瘤缩小81例(64.9%),肿瘤大小无变化35例(28.0%),肿瘤增大9例(7.2%),肿瘤控制率92.8%(116/125)。新发垂体功能低下者7例(5.6%),未发现有视力受损。随访193例患者肿瘤总控制率93.7%(181/193),出现新的垂体功能低下9例(4.6%)。结论:伽玛刀治疗NFA是有效和安全的。     

18F-FDG PET对非小细胞肺癌预后预测价值的研究进展

目的:探讨18F-FDG PET对非小细胞肺癌预后的研究进展,指导临床中PET的应用.方法:应用计算机在PUBMED数据库检索2002～2007年有关18F-FDG PET对非小细胞肺癌预后的文章,并限定文献语种为英文,检索词fluorodeoxyglucose (FDG)、positron emmition tomography (PET)和non-small cell lung cancer和prognosis.同时,计算机检索中国期刊全文数据库2002～2007年的相关文章,检索词为PET和肺肿瘤,限定文章语言种类为中文.对选择的资料进行初审,选取和PDGPET以及与其非小细胞肺癌预后相关的文献,然后查找全文.排除标准:1)重复研究;2)个案报道.共收集到相关文献59篇,排除重复或类似的同一研究,最终纳入30篇符合标准的文献.结果:大部分研究证明,肺癌原发灶的18F-氟脱氧葡萄糖(18F-FDG)标准摄取值(standardized uptake value, SUV)与患者的预后相关,治疗前后SUV值高的患者预后相对SUV值低的患者对放化疗敏感性差;进一步的研究显示,其复发的概率相对高,预后较差.但是放疗前后SUV变化能否作为独立的预后因素尚存在争议.结论:PET在非小细胞肺癌的预后判断方面有重要意义.不仅可以广泛用于放化疗疗效评价,也可用于预测肺癌治疗后复发以及对患者生存期的预测.     

Enhanced CD3~+/CD4~+ T Cell Activities and Modulation of Th1/Th2 Lineage Development in Irradiated Rats Due to Treatment with the Male Zooid of Antheraea Pernyi Extracts

Objective:Cancer patients undergoing large dose radiotherapy exhibit multifaceted defects in their immune capacity that are likely to contribute to an increased susceptibility to infections and disease progression.The immune impairment may also constitute a barrier to effective immunotherapeutic interventions.Here,we evaluate whether supplementation with the male zooid of Antheraea pernyi extracts could enhance immune function in irradiated rats.Methods:Fifty male Wistar rats were randomly divided into a...     

Enhanced CD3+/CD4+ T cell activities and modulation of Th1/Th2 lineage development in irradiated rats due to treatment with the male zooid of antheraea pernyi extracts

Objective  Cancer patients undergoing large dose radiotherapy exhibit multifaceted defects in their immune capacity that are likely to contribute to an increased susceptibility to infections and disease progression. The immune impairment may also constitute a barrier to effective immunotherapeutic interventions. Here, we evaluate whether supplementation with the male zooid of Antheraea pernyi extracts could enhance immune function in irradiated rats. Methods  Fifty male Wistar rats were randomly divided into a control group, a simple radiation group and a treatment group. The mice in the simple irradiation and treatment groups were given whole-chest irradiation with 6Gy. In the treatment group, the male zooid of Antheraea pernyi extracts was gavaged at the doses of 16.53mg/kg (large dose group), 2.62mg/kg (medium dose group), and 0.564mg/kg (small dose group) once a day for 14 days. The thymus and spleen indices were calculated. T cell subsets in peripheral blood were determined by flow cytometry and the expressions of IL-2, IFN-γ, IL-4 and IL-10 in sera were determined by ELISA on the 15th day. Results  The thymus index and spleen index of the high dose treatment group were statistically lower than that of the control group and higher than that of the radiation group (P<0.01). CD3+ and CD4+ T cells in the peripheral blood were increased in the high dose treatment group and decreased in the radiation group (P<0.01). Expression of IL-2 and INF-γ in the radiation group was lower than that in control, and significantly increased during therapy. The production of IL-4 and IL-10 could be induced by radiation and was inhibited in the high dose treatment group (P<0.01). Conclusion  Our data indicate that the male zooid of Antheraea pernyi extracts may be administrated to improve immune function in irradiated rats and reverse the radial immune inhibition of rats by stimulating the proliferation of Th cells and inducing the differentiation of Th2 to Th1. This work was supported by the grants from the National Natural Science foundation of China (No. 30472260), the Administration of Traditional Chinese Medicine of Shandong Province, China(No. 2005-109),, and the Health Protection Committee of Shandong Province, China(No. 2006059).     

158例Ⅱ和Ⅲ期直肠癌根治术后不同治疗方法 疗效分析

手术是直肠癌治疗的主要手段,尽管肿瘤外科技术的长足进步,直肠癌单纯手术的5年生存率仍在50%左右[1].失败主要原因是局部复发,复发率约为20%-40%[2].术后联合放化疗可提高局部控制率,降低复发率,对提高生活质量和延长生存率具有重要意义.笔者回顾分析了1998年1月至2004年1月收治的158例Ⅱ～Ⅲ期直肠癌根治术后病例资料,观察术后放化疗对直肠癌术后局部复发率和生存率的影响.     

氟脱氧葡萄糖PET-CT确定食管癌淋巴结放疗靶区的可行性研究

目的分析~(18)FDG PET-CT诊断食管癌淋巴结转移的优势及确定淋巴结放疗靶区的可行性。方法回顾性分析30例食管癌患者的临床病理资料,分析PET-CT在诊断淋巴结转移方面的优势,基于CT和PET-CT确定淋巴结大体肿瘤靶区(GTVN)和临床靶区(CTVN),根据术后病理分析PET-CT在确定淋巴结放疗靶区中的价值。结果13例由CT确定的GTVN(GTVN-CT)与病理一致,19例基于PET-CT的GTVN(GTVN-PET-CT)与病理相符。对照淋巴结病理结果,PET-CT改变了15例由CT确定的GTVN和其中10例的CTVN。PET-CT导致GTV缩小(GTVN-PET-CTGTVN- CT的12例共涉及22组淋巴结,其中9例CTVN亦扩大。GTVN-PET-CT>GTVN-CT的亚组分析显示,PET-CT确定的淋巴结GTV准确率高于CT(67%:25%,P=0.041)。结论PET-CT在诊断淋巴结转移中的优势使之可作为优化和确定食管癌淋巴结放疗靶区的有用工具。     

99mTc-HL91人肺腺癌乏氧显像的体内外实验研究

~(99m)Tc-HL91(~(99m)Tc-4,9-二氮-2,3,10,10-四甲基十二烷- 2,11-二酮肟),是一种良好的乏氧组织显像剂,具有合成简单,容易标记,标记率高,不具细胞毒性,使用安全,体外稳定的优点。笔者以肿瘤乏氧及照射中乏氧的变化为切入点,观察SPCA-1人肺腺癌细胞及裸鼠移植瘤模型接受不同剂量X线照射后对~(99m)Tc-HL91的摄取变化。     

立体定向放射结合介入治疗腹膜后转移癌

随着晚期肿瘤患者的增加 ,临床工作中可遇到许多腹膜后转移的恶性肿瘤 (主要是腹膜后淋巴结转移癌 )。以往这部分患者的治疗主要是全身化疗 ,肿瘤缓解期短 ,缓解率低 ,严重影响患者的生存质量和生存期 ,它是肿瘤医生积极探讨的重点。笔者从 1997年 8月至 1999年 10月 ,共收治各类腹膜后转移癌 31例 ,用立体定向放射治疗加介入治疗 ,取得了较好的效果 ,现报道如下。1　材料与方法1.1　一般临床资料 :31例患者中男性 2 4例 ,女性 7例 ,年龄32～ 6 9岁 ,中位年龄 47.9岁。其中胃腺癌术后转移 13例 ,胃未分化癌术后转移 7例 ,结肠腺癌术后转移 6…     

158例Ⅱ和Ⅲ期直肠癌根治术后不同治疗方法 疗效分析

手术是直肠癌治疗的主要手段,尽管肿瘤外科技术的长足进步,直肠癌单纯手术的5年生存率仍在50%左右[1].失败主要原因是局部复发,复发率约为20%-40%[2].术后联合放化疗可提高局部控制率,降低复发率,对提高生活质量和延长生存率具有重要意义.笔者回顾分析了1998年1月至2004年1月收治的158例Ⅱ～Ⅲ期直肠癌根治术后病例资料,观察术后放化疗对直肠癌术后局部复发率和生存率的影响.     

调强放疗技术研究进展

调强放疗是一新兴的正在发展中的放疗技术,综述了调强放疗技术研究进展,着重介绍了调强放疗的优势,实现方式,射野数及强度水平数,时间剂量分割策略及调强放疗实施方面的进展,并展望了调强放疗的未来发展方向,。