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1.
目的:观察恩度联合新辅助化疗DIA方案治疗骨肉瘤的临床效果和安全性.方法:对2011年1月至2012年8月期间在我院肿瘤骨科接受治疗的48例患者随机分成两组,治疗组接受恩度联合新辅助化疗DIA方案治疗,然后手术,对照组先手术后接收DIA方案治疗.结果:治疗组疾病的总缓解率为75%,对照组疾病总缓解率为50%,两组疾病总缓解率相互比较有统计学意义(P<0.05);两组患者术后肿瘤复发率及生存率比较无明显差异(P>0.05);治疗组患者肿瘤细胞的坏死率明显低于对照组,二者组间差异有统计学意义(P<0.05);两组患者肝肾功能损害相互比较有统计学差异(P<0.05);两组患者口腔黏膜炎、骨髓抑制、胃肠道反应相互比较差异均无统计学意义(P>0.05).结论:恩度联合新辅助化疗DIA方案能提高骨肉瘤的治疗效果,减轻肝肾功能损害,值得在临床推广应用.  相似文献   

2.
目的:评价新辅助化疗联合人工膝关节置换治疗膝关节附近骨肉瘤的临床疗效。方法:38例膝关节附近骨肉瘤采用新辅助化疗和人工膝关节置换,所有病例均进行肿瘤细胞坏死率、5年内肿瘤局部复发率、5年生存率和膝关节功能评估。结果:38例患者新辅助化疗后肿瘤细胞坏死率平均95.8%;随访6-9年,38例患者中5年内肿瘤局部复发12例(31.6%),5年后生存31例(81.6%),膝关节功能优良率92.1%。结论:新辅助化疗联合人工膝关节置换治疗膝关节附近骨肉瘤可有效提高骨肉瘤5年生存率,保存患肢功能,是骨肉瘤保肢治疗的一种较好的方法。  相似文献   

3.
韦宝堂  马善新 《蛇志》2013,(4):387-389
目的探讨膝关节周围骨肉瘤患者施行保肢手术方案的优越性。方法 2001年1月~2009年12月我院收治并经病理活检确诊为膝关节周围骨肉瘤患者37例,其中24例行保肢治疗,13例截肢治疗,所有患者术前均行新辅助化疗2个疗程后行手术治疗,术后规律化疗6~12个疗程。随访患者术后生存率、局部复发、关节功能及并发症。结果 37例患者均获得随访,随访时间保肢组为16~163个月,截肢组为21~148个月。其中保肢组与截肢组5年生存率分别为58%和64%。术后局部复发保肢组为4例,占16.7%;截肢组为1例,占7.7%。保肢组的MSTS功能评分平均为81%(61%~88%)高于截肢组的72%(25%~91%)。术后并发症发生率两组相类似。结论膝关节周围骨肉瘤行保肢治疗的患者术后获得更好的肢体功能,术前、术后规律化疗和完整干净的肿瘤切除是获得较高生存率及较低局部复发的保证,术后并发症较常见。  相似文献   

4.
目的:对直肠癌患者进行联合贝伐单抗新辅助化疗的临床病理进行评估,研究贝伐单抗对肿瘤组织微血管的影响。方法:回 顾性分析在我院普外科治疗的47 例直肠癌患者进行联合或不联合贝伐单抗(Bev)的新辅助化疗(NAC)治疗,用最大肿瘤直径评 估肿瘤客观反应,用肿瘤消退分级评估肿瘤病理反应。结果:有31 例(66%)患者进行联合贝伐单抗(Bev)的新辅助化疗治疗(联合 Bev组)和其他16 例患者进行不联合Bev的新辅助化疗治疗(不联合Bev 组)。联合Bev组的肿瘤客观反应率明显高于不联合 Bev组(64.5 vs. 25.0 %,P=0.015)。联合Bev组(41.9 %)的病理反应率高于不联合Bev 组(41.9%vs. 12.5 %,p=0.052),但并没有明 显差异。联合Bev 组的微血管密度(MVD)低于不联合Bev 组。结论:联合Bev的新辅助化疗治疗患者的靶向和病理反应好于不 联合Bev 新辅助化疗的患者。联合Bev治疗患者的肿瘤组织的(MVD)受到抑制。  相似文献   

5.
目的:探讨新辅助化疗联合手术治疗较传统手术治疗Ib2、IIa2局部晚期宫颈癌的临床疗效。方法:选取2008年6月~2011年12月在黑龙江省哈尔滨医科大学附属第三医院初治宫颈癌患者120例,临床分期为Ib2期、IIa2期,术前均经病理证实为宫颈鳞癌,将其分为两组:研究组(新辅助化疗联合手术治疗组);对照组(单纯手术治疗组)。研究组给予1~2个疗程的新辅助化疗后评估其化疗疗效,有效者化疗结束后行广泛性子宫切除+盆腔淋巴结清扫术;对照组直接行手术治疗。结果:新辅助化疗能够使肿瘤体积较化疗前缩小或消失,临床有效率高达81.43%,从而降低了宫颈癌的临床分期,提高手术的切除率,扩大手术适应征,降低术后病理高危因素,同时手术治疗能保留卵巢功能,提高年轻宫颈癌患者生活质量。结论:术前新辅助化疗可以提高手术治疗局部晚期宫颈癌的临床疗效。  相似文献   

6.
目的:探讨微波灭活与射频消融技术联合应用治疗骨肉瘤的临床疗效。方法:回顾性分析我院自2007年至2012年间手术治疗的具有完整临床资料的骨肉瘤患者29例,其中发生于肱骨上端9例,股骨远端12例,胫骨上段5例,盆腔3例,并经TNM分期。术前采取动脉植入式化疗泵化疗2疗程,并于术中给以微波灭活与射频消融方法联合灭火肿瘤瘤体,刮除肿瘤后行骨水泥填充。术后随访8-60个月,平均50±2月。结果:29例患者中死亡1例,局部复发3例,远端转移2例。结论:微波灭活与射频消融术中联合应用于恶性骨肿瘤术中瘤体灭活,可以达到良好的肿瘤灭活效果,减少术中出血,大大提高患者生存率及降低复发率。  相似文献   

7.
目的:观察新辅助化疗配合手术治疗中晚期乳腺癌的临床效果,为临床研究提供参考。方法:选取我院2009年5月-2011年4月收治的中晚期乳腺癌患者107例,根据治疗方法的不同,将患者分为新辅助化疗组和对照组。新辅助化疗组采取术前辅助化疗,而对照组术前不接受化疗。观察新辅助化疗组患者的近期临床疗效、毒副反应发生率;比较两组患者的手术时间、术中出血量等;术后随访三年,记录两组患者的肿瘤局部复发率及远处转移率。结果:新辅助化疗组患者治疗的总有效率为79.66%,毒副反应的发生率为33.89%;新辅助化疗组的平均手术时间、术中出血量均低于对照组,差异具有统计学意义(P0.05)。新辅助化疗组患者的局部复发率为5.08%,远处转移率为6.78%;对照组患者局部复发率为12.50%,远处转移率为18.75%。新辅助化疗组患者的肿瘤复发转移率低于对照组,差异具有统计学意义(P0.05)。结论:在中晚期乳腺癌的临床治疗中,术前对患者实施新辅助化疗具有明显的效果,患者近期疗效良好,毒副反应可耐受,且手术后的复发转移率相对较低,值得推广应用。  相似文献   

8.
目的:探讨重组人血管内皮抑制素(恩度)联合肝动脉栓塞化疗术(TACE)治疗中晚期肝癌的临床疗效,为中晚期肝癌的临床治疗提供参考依据。方法:选择我院2012年6月至2013年7月收治的中晚期肝癌患者82例,根据治疗方法随机分为观察组(43例)和对照组(39例),对照组给予TACE治疗;观察组在给予TACE治疗的基础上,联合恩度治疗。治疗结束后,观察和评价两组患者的临床疗效和不良反应的发生情况。结果:治疗后,观察组的有效率为46.51%(20/43),显著高于对照组30.77%(12/39)(P0.05);观察组的AFP水平为(412.58±10.66)μg/m L,明显低于对照组(445.27±11.39)μg/m L(P0.05);两组并发症的发生率比较,差异无统计学意义(P0.05)。结论:恩度联合TACE治疗可以有效提高中晚期肝癌的临床疗效,且不增加不良反应。  相似文献   

9.
目的:通过对接受新辅助化疗的局部晚期宫颈癌患者术后病理显示明显缓解的临床特征及随访资料进行回顾性分析,初步探讨病理明显缓解患者的预后及术后治疗。方法:选择2013年1月至2015年12月新疆医科大学附属肿瘤医院妇科收治的局部晚期宫颈癌患者共计413例,其中278例术前接受了以铂类为基础的新辅助化疗2-3程,对术后病理提示90%缓解的25例患者的病例资料进行回顾性分析。结果:(1)25例患者中,宫颈鳞状细胞癌24例,宫颈腺癌1例,中分化者18例,高分化2例,低分化者5例;术后病理显示脉管内癌栓者一例;IB2期患者的发病年龄为(37.33±2.08)岁,低于Ⅱa2/Ⅱb期患者。(2)25例患者术后均接受同手术前的化疗方案4程,随访至2017年6月,随访时间21~60个月,无一例复发或死亡,2年生存率为100%。253例病理未明显缓解患者2年生存率为82.2%,比较两组的2年生存率,其差异有统计学意义(P0.05)。结论:宫颈癌手术前新辅助化疗如果能达到病理明显缓解,提示死亡风险下降。局部晚期宫颈癌患者对新辅助化疗的病理学反应可能可作为评估其预后的指标之一。  相似文献   

10.
目的:探讨吉西他滨联合卡铂化疗方案治疗局部浸润性膀胱癌的临床疗效及毒副作用.方法:56例局部浸润性膀胱癌患者,其中28例术前接受GC化疗方案,即吉西他滨1000 mg/m2,静脉滴注,第1、8天;顺铂25 mg/m2,静脉滴注,第2~4天,21d为1周期治疗;28例术前接受GCa化疗方案,即吉西他滨1000mg/m2,静脉滴注,第1、8天;卡铂400 mg/m2,静脉滴注,第2天,21d为1周期治疗.所有病例均完成2~3周期化疗,观察疗效及不良反应.结果:肿瘤分期降至pT1或更低分期的比率,GC组为61%,GCa组为53%(P=0.616).从确诊开始24个月无复发生存率,GC组为88%,GCa组为86%(P=0.833).化疗过程中监测了血液系统的不良反应,主要有3~4度的中性粒细胞减少症、贫血和血小板减少,在GC组发生率分别为14%,14%和0%,GCa组发生率分别为53%,22%和50%.非血液系统的不良反应主要是消化道症状,恶心、呕吐的发生率GC组为25%,GCa组则为0%.化疗过程中最低中位肾小球滤过率估算值(eGFR),GC组和GCa组分别为54.9和69.6 mL/min/1.73 m2(p=0.002).结论:吉西他滨联合卡铂的辅助化疗方案治疗局部浸润性膀胱癌与顺铂为主的化疗方案疗效相当,在非血液系统毒性方面优于顺铂为主的化疗方案,尤其GCa方案具有更小的肾毒性.  相似文献   

11.
The purpose of this study was to investigate the efficacy of Endostar combined with chemotherapy on human esophageal squamous cell carcinoma Eca-109 in mice. The tumor xenograft models were established and randomly assigned to 4 groups: control group, Endostar group (1.5?mg/kg?day, once daily for 3?weeks), chemotherapy group (Paclitaxel 10?mg/kg?day, Cisplatin 5?mg/kg?day, for 1, 7, 14, 21?days), and chemotherapy?+?Endostar group (combination). The length and width of tumor were measured and the tumor volumes (cm3) were calculated every other day. Three weeks later, the mice were executed, and the tumor tissues were collected to weigh and analyse the histopathology and proliferation for tumor xenograft. The results demonstrated that the tumor volumes and weight in chemotherapy?+?Endostar group were significantly lower than that in other three groups. Meanwhile, the cell proliferation of tumor xenograft in combined treatment group was significantly lower than that in other three groups. It was concluded that Endostar combined with chemotherapy could obviously enhance the inhibitory effect on esophageal squamous cell carcinoma Eca-109 in mice.  相似文献   

12.
Peng F  Xu Z  Wang J  Chen Y  Li Q  Zuo Y  Chen J  Hu X  Zhou Q  Wang Y  Ma H  Bao Y  Chen M 《PloS one》2012,7(4):e34646

Background

Hypoxic tumor cells can reduce the efficacy of radiation. Antiangiogenic therapy may transiently “normalize” the tumor vasculature to make it more efficient for oxygen delivery. The aim of this study is to investigate whether the recombinant human endostatin (endostar) can create a “vascular normalization window” to alleviate hypoxia and enhance the inhibitory effects of radiation therapy in human nasopharyngeal carcinoma (NPC) in mice.

Methodology/Principal Findings

Transient changes in morphology of tumor vasculature and hypoxic tumor cell fraction in response to endostar were detected in mice bearing CNE-2 and 5–8F human NPC xenografts. Various treatment schedules were tested to assess the influence of endostar on the effect of radiation therapy. Several important factors relevant to the angiogenesis were identified through immunohistochemical staining. During endostar treatment, tumor vascularity decreased, while the basement membrane and pericyte coverage associated with endothelial cells increased, which supported the idea of vessel normalization. Hypoxic tumor cell fraction also decreased after the treatment. The transient modulation of tumor physiology caused by endostar improved the effect of radiation treatment compared with other treatment schedules. The expressions of vascular endothelial growth factor (VEGF), matrix metalloproteinase-2 (MMP-2), MMP-9, and MMP-14 decreased, while the level of pigment epithelium-derived factor (PEDF) increased.

Conclusions

Endostar normalized tumor vasculature, which alleviated hypoxia and significantly sensitized the function of radiation in anti-tumor in human NPC. The results provide an important experimental basis for combining endostar with radiation therapy in human NPC.  相似文献   

13.
目的:评估人重组内皮抑素(endostar,ES)辅助化疗药物治疗食管癌的临床效果。方法:研究共入组128例食管癌患者,根据化疗方案将患者分为试验组与对照组,试验组患者(n=60)进行5个疗程ES联合化疗,每个化疗疗程持续3周,静脉注射ES 15mg/d。对照组患者(n=68)未使用ES化疗。化疗2个疗程后,手术切除肿瘤,分析肿瘤对化疗的反应。检测血管内皮生长因子(vascular endothelial growth factor,VEGF)和血小板-内皮细胞粘附分子(Platelet endothelial cell adhesion molecule-1,CD31)的表达。结果:同治疗前比较,化疗明显促进了食管癌肿瘤组织中的VEGF的表达和组织中血管的再生。两组相比,试验组患者的生存率明显提高,转移率明显降低,通过重组内皮抑素治疗显著抑制了化疗引起的VEGF的表达和微血管的生成。结论:联合重组内皮抑素化疗能够显著改善食管癌患者的临床结局。  相似文献   

14.

Background

Malignant pleural effusion (MPE) is a common complication of lung cancer. One widely used treatment for MPE is Endostar, a recombined humanized endostatin based treatment. However, the mechanism of this treatment is still unclear. The aim of this study was to investigate the effects of Endostar in mice with MPE.

Methods and Materials

Lewis lung carcinoma (LLC) cell line expressing enhanced green fluorescent protein (EGFP) was injected into pleural cavity to establish MPE mice model. Mice were randomly divided into four groups. High dose of Endostar (30 mg/kg), low dose of Endostar (8 mg/kg), normal saline, or Bevacizumab (5 mg/kg) was respectively injected into pleural cavity three times with 3-day interval in each group. Transverse computed tomography (CT) was performed to observe pleural fluid formation 14 days after LLC cells injection. Mice were anesthetized and sacrificed 3 days after final administration. The volume of pleural effusion n was measured using 1 ml syringe. Micro blood vessel density (MVD), Lymphatic micro vessel density (LMVD), the expression level of vascular endothelial growth factor A (VEGF-A) and VEGF-C were observed by immunohistochemistry (IHC) staining.

Results

The volume of pleural effusion as well as the number of pleural tumor foci, MVD and the expression of VEGF-A were significantly reduced in high dose of Endostar treat group. More importantly, LMVD and the expression of VEGF-C were markedly lower in treat group than those in the other three control groups.

Conclusion

Our work demonstrated that Endostar played an efficient anti-cancer role in MPE through its suppressive effect on angiogenesis and lymphangiogenesis, which provided a certain theoretical basis for the effectiveness of Endostar on the MPE treatment.  相似文献   

15.
Molecular imaging enables non-invasive monitoring of tumor growth, progression, and drug treatment response, and it has become an important tool to promote biological studies in recent years. In this study, we comprehensively evaluated the in vivo anti-angiogenic and anti-neoplastic effects of Endostar on liver cancer based on the optical molecular imaging systems including micro-computer tomography (Micro-CT), bioluminescence molecular imaging (BLI) and fluorescence molecular tomography (FMT). Firefly luciferase (fLuc) and green fluorescent protein (GFP) dual labeled human hepatocellular carcinoma cells (HCC-LM3-fLuc-GFP cells) were used to establish the subcutaneous and orthotopic liver tumor model. After the tumor cells were implanted 14∼18 days, Endostar (5 mg/kg/day) was administered through an intravenous tail vein injection for continuous 14 days. The computer tomography angiography (CTA) and BLI were carried out for the subcutaneous tumor model. FMT was executed for the orthotopic tumor model. The CTA data showed that tumor vessel formation and the peritumoral vasculature of subcutaneous tumor in the Endostar treatment group was significantly inhibited compared to the control group. The BLI data exhibited the obvious tumor inhibition day 8 post-treatment. The FMT detected the tumor suppression effects of Endostar as early as day 4 post-treatment and measured the tumor location. The above data confirmed the effects of Endostar on anti-angiogenesis and tumor suppression on liver cancer. Our system combined CTA, BLI, and FMT to offer more comprehensive information about the effects of Endostar on the suppression of vessel and tumor formation. Optical molecular imaging system enabled the non-invasive and reliable assessment of anti-tumor drug efficacy on liver cancer.  相似文献   

16.
目的:探究急性白血病患者给予沙利度胺配合化疗在抗血管生长方面的临床成效。方法:选取我院2009年3月-2014年1月收治的86例急性白血病患者,随机分为研究组和对照组,每组43例。对照组患者给予常规化疗方案,研究组在对照组基础上给予沙利度胺配合化疗。观察两组患者治疗前后血浆VEGF,VEGFR,b FGF及MVD的水平变化。比较两组患者的临床疗效及不良反应发生率。结果:治疗前,两组患者VEGF、VEGFR、b FGF及MVD水平无显著差异(P0.05);治疗后,研究组患者VEGF、VEGFR、b FGF及MVD水平均低于对照组,差异有统计学意义(P0.05)。研究组患者治疗的有效率为88.4%,对照组为76.7%,研究组显著优于对照组,差异具有统计学意义(P0.05)。研究组不良反应发生率为79.1%,对照组为81.4%,差异无统计学意义(P0.05)。结论:沙利度胺配合化疗治疗急性白血病能调控促血管生长因子水平,提高疗效,不良反应可耐受。  相似文献   

17.
OBJECTIVE: A previous phase-2 trial to assess the addition of Endostar to gemcitabine and cisplatin (GC) chemotherapy showed that it improves prognosis in metastatic nasopharyngeal carcinoma (M-NPC) but the study cohort was small. We wished to update that phase-2 trial by enrolling an additional 44 patients and to assess the benefit of Endostar+GC chemotherapy. METHODS: An analysis of 72 M-NPC patients treated between July 2010 and November 2016 was done. The treatment regimen was a combination of gemcitabine (1,000 mg/m2) on days 1 and 8, cisplatin (80 mg/m2) on day 1, and Endostar (15 mg/day) from day 1 to day 14 of a 21-day cycle for ≥2 cycles. The acute toxic effects and therapeutic efficacy were analyzed. RESULTS: The response rate was 77.8%. The median progression-free and overall survivals were 12 and 19.5 months, respectively. A total of 329 cycles of GC and 288 cycles of Endostar were delivered to 72 patients, with the median number of four (range, 2–10) cycles administered per patient. The main grade-3/4 hematologic toxicities were leukopenia (54.1%) and neutropenia (59.8%). The number of non-hematologic adverse events was minimal. The regimen was well-tolerated. CONCLUSIONS: Endostar+GC chemotherapy is an effective, well-tolerated regimen for M-NPC.  相似文献   

18.
吴碧川  曾虎  张杰军  朱晋峰 《生物磁学》2011,(16):3095-3097
目的:探讨索拉非尼和沙利度胺这两种不同的化疗药物,对肝癌患者血清中VEGF-C、VEGF—D及微血管密度的影响。方法:将患者分成3组,每纽16例。对照组采用常规治疗并服用安慰剂;索拉非尼和沙利度胺这两个组患者中,前者服用索拉非尼400mg/次,2次/d,治疗6个月;后者服用沙利度胺每日服200mg,每周增加200mg/d,直至最大剂量每日600mg,至少服用4月。ELISA检测患者血清中VEGF-C、VEGF-D;免疫组织化学检测肝癌组织中微血管密度。结果:对照组患者血清中VEGF-C的水平为210ng/ml,索拉非尼组患者血清中VEGF—C的水平为132ng/ml,而沙利度胺组患者血清中VEGF—C的水平为186ng/ml。与对照组相比,索拉非尼组和沙利度胺组患者血清中VEGF—C的水平均降低。对照组患者血清中VEGF—D的水平为322ng/ml,索拉非尼组患者血清中VEGF—D的水平为217ng/ml,而沙利度胺组患者血清中VEGF—D的水平为256ng/ml。与对照组相比,索拉非尼组和沙利度胺组患者血清中VEGF—D的水平均降低。索拉非尼组患者血清中VEGF—D的水平明显低于沙利度胺高(P〈0.05)。对照组肝癌组织MVD为(44.32±5.16)个,索拉非尼组患者肝癌组织MVD为(21.75±1.49)个,而沙利度胺组患者肝癌组织MVD为(34.78±2.31)个。结论:多靶点化疗药物索拉非尼对肝癌患者血清中VEGF—C、VEGF—D及微血管密度的影响最大,深入探讨其作用机制.可为其肝癌患者提供新的化疗方案。  相似文献   

19.
Endostar, a novel recombinant human endostatin expressed and purified in Escherichia coli with an additional nine-amino acid sequence forming another his-tag structure, was approved by the State Food and Drug Administration of China (SFDA) in 2005 for the treatment of non-small-cell lung cancer. However, the molecular mechanism of its potent anticancer activity remains poorly understood and warrants further investigations. In this study, we examined the anti-invasive activities of endostar in vitro. The results showed that endostar suppressed MDA-MB-435 cell adhesion to the fibronectin-coated substrate in a concentration-dependent manner. It could inhibit the wound healing migration of MDA-MB-435 cells and invasion of MDA-MB-435 cells through reconstituted ECM (matrigel). Zymography revealed that endostar decreased the secretion of MMP-2 and MMP-9. Endostar could also inhibit the expressions of MMP-2 and MMP-9 in MDA-MB-435 cells. Additionally, endostar exerted an inhibitory effect on the phosphorylation of ERK1/2. Collectively, these data provided a molecular basis for the anti-invasive effects of endostar.  相似文献   

20.
目的:探讨骨肉瘤新辅助化疗结合保肢手术的临床疗效。方法:收集我院就诊或住院治疗的50例骨肉瘤患者,随机分为实验组和对照组,每组25例。对照组患者采用囊外彻底切除,对瘤体以及周围正常组织5 cm以上进行根治性切除术;实验组患者行保肢手术术前以及术后行新辅助化疗。治疗过程中对患者的不良反应进行及时治疗。治疗结束后,对患者肿瘤复发率、转移率、生存状况、肢体功能以及患者临床疗效进行评价。结果:与对照组相比,实验组患者术后的复发率、转移率较低(P0.05),3年生存率以及肢体功能的优良率较高(P0.05),临床治疗有效率较高(P0.05)。结论:新辅助化疗结合保肢手术能够降低骨肉瘤患者的术后复发率和转移率、改善患者的生存状况、肢体功能,临床疗效较好,对临床有指导意义。  相似文献   

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