甲磺酸阿帕替尼在晚期难治性骨与软组织肉瘤治疗中的临床应用观察

目的:观察甲磺酸阿帕替尼治疗晚期难治性骨与软组织肉瘤的有效性及安全性,同时分析影响患者无进展生存期(progression free survival,PFS)的可能相关因素。方法:选取云南省肿瘤医院2017年6月至2018年9月收治的21例晚期难治性骨与软组织肉瘤患者,予以甲磺酸阿帕替尼片,主要疗效指标为PFS,次要疗效指标为总生存时间(overall survival,OS)。根据实体瘤疗效评定标准RECIST 1.1评价临床疗效,包括总缓解率(overall response rate,ORR)、疾病控制率(disease control rate,DCR),同时根据美国国家癌症研究所(National Cancer Institute,NCI)4.0标准随访观察安全性。结果:21例患者均获得随访,截至最后1次随访时间2019年3月31日,无完全缓解(complete response,CR),部分缓解(partial response,PR)患者有2例(9.5%),疾病稳定(stable disease,SD)患者7例(33.3%),疾病进展(progressive disease,PD)患者12例(57.1%),ORR为9.5%,DCR为(42.8%),中位无进展生存期(median progression free survival,mPFS)为8个月,中位总生存时间(median overall survival,mOS)为14个月。患者的性别、年龄、ECOG评分、组织来源、是否手术、是否化疗对患者PFS的影响差异无统计学意义(P>0.05),只有服用阿帕替尼前是否有放疗史这一因素对患者PFS的影响差异均具有统计学意义(P<0.05),有放疗史患者的PFS低于无放疗史患者。Ⅲ级及以上不良反应依次为手足综合征(14.3%)、气胸(14.3%)和贫血(4.8%)。结论:甲磺酸阿帕替尼在治疗晚期难治性骨与软组织肉瘤中显现出一定的疗效,不良反应总体来说是可预见、可控制和可逆转的,对于治疗依从性良好、无其他治疗方法可选择的晚期难治性骨与软组织肉瘤的患者可以尝试。

Simulation of structural design with high coupling efficiency in external cavity semiconductor laser

For external cavity semiconductor lasers(ECSLs),high coupling efficiency is critical to reducing the linewidth.In this paper,the coupling efficiency between the laser diode and the waveguide grating has been improved,with proposals for its improvement presented,including adding spot-size conversion(SSC)and using a silicon-on-insulator(SOI)waveguide.The results indicate an increase of coupling efficiency from 41.5%to 93.1%,which exhibits an improvement of approximately 51.6%over conventional schemes.The relationship between coupling efficiency and SOI waveguide structures is mainly concerned in this article.These findings provide a new way for the future research of the narrow linewidth of ECSL.