Efficacy of capecitabine and oxaliplatin regimen for extrahepatic metastasis of hepatocellular carcinoma following local treatments

AIM: To investigate the efficacy and safety of capecitabine and oxaliplatin (CapeOx) for extrahepatic metastasis after local treatment of hepatocellular carcinoma (HCC). METHODS: Thirty-two patients with extrahepatic metastasis of HCC after local treatment were prospectively enrolled. The CapeOx regimen consisted of capecitabine 1000 mg/m 2 taken orally twice daily on days 1-14, and oxaliplatin was administered at a total dose of 100 mg/m 2 on day 1. The treatment was repeated every 3 wk until disease progression or unaccetablle toxicity. Efficacy and safety were assessable for all enrolled patients. The primary objective of this study was to assess the overall response rate. The secondary objectives were to evaluate the overall survival (OS), the time to tumor progression (TTP) and the toxicity profile of the combined strategy. TTP and OS were assessed by the Kaplan-Meier method and differences between the curves were analyzed using the log-rank test. The statistical software SPSS version 15.0 for Windows (SPSS Inc., Chicago, IL, United States) was used for statistical analysis. All P values were 2-tailed, with statistical significance defined byP ≤ 0.05. RESULTS: Thirty-two patients were assessable for efficacy and toxicity. The median follow-up duration was 15 mo (range, 12-20 mo). At the cut-off date of March 31, 2012, 27 patients died due to tumor progression and one patient died of myocardial infarction. Four patients were still alive (three patients with disease progression). OR was 21.9% (n = 7), the stabilization rate was 40.6% (n = 13), and the disease control rate was 62.5%. The responses lasted from 4 to 19 mo (median, 6 mo). Median TTP was 4.2 mo (95%CI: 2.5-7.4), and the median OS time was 9.2 mo (95%CI: 6.5-17.8). The 1-year survival rate was 43.6% (95%CI: 29.0-66.0). In a multivariate analysis, OS was significantly longer in patients with a Child-Pugh class A compared with class B patients (P = 0.014), with a median OS of 10.1 mo vs 5.4 mo, and there were trends towards longer OS (P = 0.065) in patients without portal vein tumor thrombosis. There were no significant effects of age, gender, performance status, cirrhosis, metastatic sites, and level of alpha fetoprotein (AFP) or hepatitis B virus-DNA on OS. Among the 22 patients with elevated AFP levels at baseline (≥ 400 ng/mL), the level fell by more than 50% during treatment in 6 patients (27.3%). The most frequent treatment-related grade 3 to 4 toxicities included leucopenia/neutropenia, transient elevation of aminotransferases, handfoot syndrome and fatigue. CONCLUSION: CapeOx showed modest anti-tumor activity in metastatic HCC. However, the manageable toxicity profile and the encouraging disease control rate deserve further study for these patients.

Outcomes of palliative local treatment in metastatic colorectal cancer patients receiving chemotherapy plus bevacizumab

Objective The aim of this study was to assess the value of palliative local treatment of incurable metastatic lesions in colorectal cancer(CRC) patients receiving chemotherapy plus bevacizumab.Methods Data of 105 patients with histologically confirmed synchronous or metachronous metastatic CRC who received bevacizumab treatment from January 1, 2011 to January 31, 2017 were retrospectively reviewed. Sixteen(15%) patients who were treated with bevacizumab for less than 4 cycles were excluded, and finally, 89(85%) patients were enrolled. Among them, 33(37%) patients who received palliative local treatment were categorized into the palliative local treatment group, and the remaining 56(63%) patients were categorized into the chemotherapy plus bevacizumab group. The primary endpoint was overall survival(OS), which was calculated using Kaplan-Meier survival analyses. Factors possibly influencing survival were evaluated by univariate and multivariate analyses. Adverse events(AEs) were graded according to Common Terminology Criteria for Adverse Events, version 4.0. Grades 1–2 and 3–4 AEs of the two groups were compared and analyzed using the Fisher's exact test and χ~2 analysis.Results The median follow-up period was 20.4 months, ranging from 1 to 60 months. The median OS in the palliative local treatment group was 36.3 months(95% CI, 33.5–39.2), and that in the chemotherapy plus bevacizumab group was 20.5 months(95% CI, 17.6–23.4). Both the univariate(HR 0.13, 95% CI, 0.05–0.30, P < 0.001) and multivariate(HR 0.16, 95% CI, 0.07–0.39, P < 0.001) analyses showed that the addition of palliative local treatment could prolong survival compared with chemotherapy plus bevacizumab alone. There were no significant differences in the rates of common chemotherapy-or bevacizumab-related AEs between the two groups.Conclusion These findings suggest palliative local treatment is an effective and safe method for treating patients with incurable metastatic CRC receiving chemotherapy plus bevacizumab.

Miramistinum and metronidazole in the local treatment of the experimental purulent wounds

Objective To study the wound-healting ability of immobilized forms of miramistinum and metronidazole,based on a sodium salt of carboxymethylcellulose.Methods The research was made on an experimental model of a purulent wound and levomecol was used for comparison.Results During the experiment antimicrobial activity of made drugs was evaluated and the planimetric assessment of the process of epithelialization of the wound’s surface,bacterial load,morphometric examination of histological drugs for wounds and were made.ConclusionThe benefits of combination miramistinum and metronidazole,immobilized on a sodium salt of carboxymethylcellulose,compared with the drug levomecol.

Local treatment of osteoporosis with alendronate-loaded calcium phosphate cement

Background A new treatment strategy is to target specific areas of the skeletal system that are prone to clinically significant osteoporotic fractures.We term this strategy as the ＂local treatment of osteoporosis＂.The study was performed to investigate the effect of alendronate-loaded calcium phosphate cement （CPC） as a novel drug delivery system for local treatment of osteoorosis.Methods An in vitro study was performed using CPC fabricated with different concentrations of alendronate （ALE,0,2,5,10 weight percent （wt％））.The microstructure,setting time,infrared spectrum,biomechanics,drug release,and biocompatibility of the composite were measured in order to detect changes when mixing CPC with ALE.An in vivo study was also performed using 30 Sprague-Dawley rats randomly divided into six groups：normal,Sham （ovariectomized （OVX） ＋ Sham）,CPC with 2％ ALE,5％ALE,and 10％ ALE groups.At 4 months after the implantation of the composite,animals were sacrificed and the caudal vertebrae （levels 4-7） were harvested for micro-CT examination and biomechanical testing.Results The setting time and strength of CPC was significantly faster and greater than the other groups.The ALE release was sustained over 21 days,and the composite showed good biocompatibility.In micro-CT analysis,compared with the Sham group,there was a significant increase with regard to volumetric bone mineral density （BMD） and trabecular number （Tb.N） in the treated groups （P ＜0.05）.Trabecular spacing （Tb.Sp） showed a significant increase in the Sham group compared to other groups （P ＜0.01）.However,trabecular thickness （Tb.Th） showed no significant difference among the groups.In biomechanical testing,the maximum compression strength and stiffness of trabecular bone in the Sham group were lower than those in the experimental groups.Conclusions The ALE-loaded CPC displayed satisfactory properties in vitro,which can reverse the OVX rat vertebral trabecular bone microarchitecture and biomechanical properties in vivo.

Therapeutic response and safety of different treatments for cutaneous leishmaniasis in patients: A retrospective cross-sectional study

Objective:To analyze the therapeutic response and safety of different treatments for cutaneous leishmaniasis,received by patients in the Program for the Study and Control of Tropical Diseases-PECET-Medellín-Colombia.Methods:This is a retrospective cross-sectional study of patients attended at PECET Research Center during 2016-2021.Relevant information regarding sociodemographic characteristics,history of leishmaniasis,characterization of current infection,treatment received,follow-up of therapeutic response and safety was collected from the medical records.Data were analyzed with Pearson's Chi-square association tests and Mann-Whitney U test using statistical software.Results:A total of 486 clinical records of patients were analyzed,and 356 received treatment.Eight different therapeutic alternatives(systemic,local and in combination)were analyzed.The therapeutic response of the different alternatives used(except thermotherapy)was higher than 50%.Most frequent adverse events were myalgias,arthralgias and headache,and vesicles for systemic and local treatment,respectively.Conclusions:Safety profile and performance of local therapeutic alternatives and combined schemes for the treatment of uncomplicated cutaneous leishmaniasis are an interesting option for the management of the disease.

Effects of Electron Beam Local Postweld Heat Treatment on Microstructure and Properties of 30CrMnSiNi2A Steel Welded Joints

To improve the microstructure and properties of the electron beam welded joints, the vacuum or furnace whole post weld heat treatment (FWPWHT) usually should be done on it. The electron beam local post weld heat treatment (EBLPWHT) is a rather new heat treatment procedure that provides the advantages of high precision, flexibility and efficiency, energy saving and higher productivity. In this paper, the microstructure, mechanical properties, fracture toughness and fatigue properties of electron beam welded joints of 30CrMnSiNi2A steel in as-welded (AW) and EBLPWHT conditions have been investigated respectively. The results show that the microstructures of different zones of joints in as-welded condition are changed by EBLPWHT procedure, in which the welds from coarse needle martensite into lath-shaped martensite; the main structures of heat affected zones (HAZ) from lath-shaped martensite into lower bainite. The properties of welded joints can be improved by the EBLPWHT in some extent, especially the fracture toughness of the welds and the fatigue crack resistance of welded joints can be sufficiently improved. However, more appropriate heat treatment parameters of the EBLPWHT have to be studied in order to increase the mechanical properties of base metal near by the HAZ.

Temperature field analysis of main steam pipe under local post weld heat treatment

In local post weld heat treatment, the temperature difference is the criterion of the process. The temperature field in the main stream pipe under local post weld heat treatment is simulated by finite element method. A close-loop control program is designed to simulate the temperature field of two different pipes. Both the skin effect of induction heating and electro-thermal coupled effect are considered in the heating model. The local heat treatment temperature difference at the inner and outer side of the pipe is analyzed and the different convection conditions are also considered. The simulation results show that in appropriate induction heating process, the temperature difference in the pipe can be controlled within 30 ℃.

Bevacizumab in the pre-operative treatment of locally advanced rectal cancer: A systematic review

Despite advances in the management of patients with locally advanced,non-metastatic rectal adenocarcinoma(LARC),prognosis remains largely unsatisfactory due to a high rate of distant relapse.In fact,currently available neoadjuvant protocols,represented by fluoropyrimidine-based chemo-radiotherapy(CT-RT)or short-course RT,together with improved surgical techniques,have largely reduced the risk of local relapse,with limited impact on distant recurrence.Available results of phaseⅢtrials with additional cytotoxic agents combined with standard CT-RT are disappointing,as no significant reduction in the risk of recurrence has been demonstrated.In order to improve the control of micrometastatic disease,integrating targeted agents into neoadjuvant treatment protocols thus offers a rational approach.In particular,the antiangiogenic agent bevacizumab has demonstrated synergistic activity with both CT and RT in pre-clinical and clinical models,and thusmay represent a suitable companion in the neoadjuvant treatment of LARC.Preliminary results of phase?Ⅰ-Ⅱclinical studies are promising and suggest potential clinical parameters and molecular predictive biomarkers useful for patient selection:treatment personalization is indeed the key in order to maximize the benefit while reducing the risk of more complex neoadjuvant treatment schedules.

NUMERICAL ANALYSIS OF RESIDUAL STRESSES IN TITANIUM ALLOY DURING ELECTRON BEAM LOCAL POST-WELD HEAT TREATMENT

The distributions of temperature and residual stresses in thin plates of BT20titanium alloy are numerically analyzed by three-dimensional finite element software duringelectron beam welding and electron beam local post-weld heat treatment (EBLPWHT). Combined withnumerical calculating results, the effects of different EBLPWHT mode and parameters, including heattreating position, heating width and heating time, on the distribution of welding residual stressesare analyzed. The results show that, the residual tensile stresses in weld center can be largelydecreased when the weld is heat treated at back preface of the plate. The numerical results alsoindicated that the magnitude of the residual longitudinal stresses of the weld and the zone vicinityof the weld is decreased, and the range of the residual longitudinal stresses is increased alongwith the increase of heating width and heating time.

TREATMENT OF LOCAL RECURRENCE OF NASOPHARYN-GEAL CARCINOMA WITH REIRRADIATION

From 1975 to 1987, 112 patients with loco-regional recurrence of nasopharyngeal carcinoma (N P C) were treated again with radiation at our hospital. All cases were proven histologically by biopsy. Of these patients, 92 had their recurrence in the nasopharynx only, 13 had additional involvement of the base of the skull, and 7 had tumor recurrences simultaneously in the nasopharynx as well as the cervical lymph nodes. Radiotherapy adopted in this series was 60Co external irradiation (X R Te) and/ or betatron in 96 patients, X R Te plus intracavitary 60Co irradiation (X R Ti) in 12 patients and X R Ti alone in the other 4 patients. The 1-, 3-, and 5-year survival rates were 86.3%, 45.8% and 30.2% respectively after the start of recurrence retreatment. The 63 patients who survived for 5 years or more were analyzed. The prognosis of the patient was related to the histological type, clinical stage, modality of treatment, and disease interval to recurrence and site of recurrence. No serious complications occurred. It is suggested that re-irradiation is appropriate in the treatment of loco-regional recurrent N P C.

Magnetic resonance imaging for diagnosis and neoadjuvant treatment evaluation in locally advanced rectal cancer:A pictorial review

High-resolution pelvic magnetic resonance imaging(MRI) is the primary method for staging rectal cancer.MRI is highly accurate in the primary staging of rectal cancer;however,it has not proven to be effective in restaging,especially in complete response evaluation after neoadjuvant therapy.Neoadjuvant chemoradiotherapy produces many changes in rectal tumors and on adjacent area,as a result,local tumor extent may not be accurately determined.However,adding diffusion-weighted sequences to the standard approach can improve diagnostic accuracy.In this pictorial review,an overview of the situation of MRI in the staging and re-staging of rectal cancer is exhibited as a pictorial assay.An experience-and literature-based discussion of limitations and difficulties in interpretation are also presented.

Salvage Photodynamic Therapy Is an Effective and Safe Treatment for Patients with Local Failure after Definitive Chemoradiotherapy for Esophageal Squamous Cell Carcinoma

Although chemoradiotherapy (CRT) is one curative treatment option for patients with esophageal squamous cell carcinoma (ESCC), local failure after CRT remains a major problem for patients’ curability. The aim of this study was to evaluate the efficacy and safety of photodynamic therapy (PDT) as a salvage treatment for local failure. From August 2007 to March 2012, 193 consecutive ESCC patients were treated with definitive CRT in Kyoto University Hospital. Eighteen of the patients with T2 or earlier T-stage local failure after CRT underwent salvage PDT. After the salvage PDT, 11 patients (61.1%) achieved a complete response at the primary site. Over a median follow-up period of 28.3 months, the 1-year survival and progression-free survival rates were 77.8% and 38.9%, respectively;and the 2-year survival and progression-free survival rates were 60.6% and 33.3%, respectively. Adverse events were mild esophageal stricture in seven (38.9%), esophageal obstruction because of necrotic tissue in nine (50.0%), and photosensitivity in three (16.7%) patients. There were no severe complications or treatment-related deaths. Salvage PDT may be a promising treatment option for the patients with a local residual or recurrent tumor after CRT for ESCC when the lesion is suspected to be in T2 or earlier.

Local metothrexate treatment of cesarean scar ectopic pregnancy

Myometrial pregnancy developing in a previous caesarean section scar is the rarest of all ectopic pregnancies (EP) and probably one of the most dangerous of all because of the risk of rupture and hemorrhage. The recent recognition of this problem means that diagnosis and management are still in their infancy, and there is no consensus regarding the best management of CSP. Methotrexate (MTX) can be administered systemically or locally, or in both ways, with the aid of ultrasound. Patients diagnosed with caesarean scar pregnancies (CSP) in our clinic underwent transvaginal treatment of ectopic pregnancy. Safe and short treatment under transvaginal ultrasonographic (USG) guidance was performed uneventfully in all cases. The operating time ranged from 5 to 10 minutes with no blood loss. Serum β-hCG (β-subunit of human chorionic gonadotrophin) levels declined to normal levels within a month, and patients were discharged without further complications in two or three hours after the procedure. Our cases show that this treatment is effective, safe, and minimally invasive for patients diagnosed with CSP.

Palliative Treatment of Locally Advanced Non Metastatic Lung Cancer

Introduction: To determine the proportion and the reasons which lead to palliative treatment in patients initially a candidate for concomitant chemoradiotherapy (CCRT). Methods: A retrospective study including patients followed for locally advanced lung cancer newly diagnosed from April 1, 2016, to 12/31/2017 in the radiotherapy department of the National Oncology Institute who received palliative treatment. Results: We collected 52 patients out of a total of 225 stage III patients (23%) followed by lung cancer candidates for CCRT who had undergone palliative treatment. The mean age in our series was 61.23 years [22 - 81] with 86% male. The majority of patients (71%) had Performance Status (PS) ≤ 2. Histological confirmation was obtained by pathological examination in all our patients. It was an adenocarcinoma (ADK) in 54% of cases;squamous cell carcinoma in 46% of cases. The reasons for palliative treatment were mainly due to dosimetric constraints: large tumor volume 22/52 (42%);the tumor location close to the bone marrow in 15 of 52 (29%) patients;and general Performance Status impairment (29%) in 15 of 52 patients. Palliative treatment consisted of palliative chemotherapy in 37 of 52 patients (71%), among whom 19 (51%) were stable after 2 months of chemotherapy, in palliative dose chest radiotherapy on the pulmonary parenchyma and/or mediastinum in 10 of 52 (19%) patients, and supportive care in 5 (10 %) patients. We observed 40/52 (77%) cases of stationary course, 04/52 (8%) cases of progress to metastases, and 08/52 (15%) deaths before radiotherapy. Conclusion: A large proportion of patients followed for locally advanced non-metastatic lung cancer are not eligible for curative treatment. The reasons for the palliative treatment of patients followed for lung cancer candidates for CCRT are variable but for a large proportion of patients due to the deterioration of their state of health during their diagnostic journey. Hence, there is the need to improve the early diagnosis and early management of patients with lung cancer to avoid delayed care.

THE FACTORS AND TREATMENT OF LOCAL RECURRENCE AFTER RADICAL RESECTION RESERVING THE ANUS IN THE PATIENTS WITH RECTAL CANCER

Of seventy-one patients with rectal cancer after radical resection retaining the anus, 15 developed local recurrence with a recurrence rate of 21.1%. Local recurrence was correlated with improper safety margin from the lower edge of cancer to the anal end. There was statistical significant difference between 3 cm or more and 2 cm or less. The local recurrence was also related to the pathologic stage, histologic differentiation and implant of free cancer cells. It is suggested that the surgical indication of saving the anus be strict and without stretching, the safety margin from the lower edge of cancer to the anal end should not be less than 2 cm in early rectal cancer and not less than 4 cm in advanced lesions. During the operation, no touching tumor technique, thorough rinsing of the peritoneal cavity and pre- or post-operative radiotherapy are important for prevention of local recurrence. Early local recurrent rectal cancer can be detected by periodic examinations.

皮下免疫治疗对局部变应性鼻炎伴哮喘患者的疗效及安全性评价

目的探究皮下免疫治疗(subcutaneous immunotherapy,SCIT)对局部变应性鼻炎(local allergic rhinitis,LAR)伴哮喘患者的疗效,并评价其安全性。方法2019年6月~2022年6月间绵阳市中心医院收治的LAR伴哮喘患者,观察组36例,对照组35例,两组患者均接受哮喘规范化治疗,观察组另给予SCIT,对照组给予安慰剂。治疗12个月后评估患者临床疗效,评估患者症状评分、用药评分,检测并比较治疗前、后血清特异性IgG4(sIgG4)和特异性IgE(sIgE)水平,采用鼻结膜炎相关生活质量问卷(rhinoconjunctivitis quality of life questionnaire,RQLQ)评估患者生活质量,统计治疗期间不良事件发生情况。结果与治疗前比较,两组患者治疗12个月时哮喘症状总评分(total asthma symptom score,TASS)和鼻部症状总评分(total nasal symptom score,TNSS)均降低(P均<0.05),观察组TASS和TNSS均较对照组降低(P均<0.05);与治疗3个月比较,两组患者治疗12个月时用药积分(total medication score,TMS)均降低(P均<0.05),观察组TMS较对照组降低(P<0.05);两组患者治疗12个月时sIgG4水平升高(P<0.05),sIgE降低水平(P<0.05);观察组sIgG4水平较对照组升高(P<0.05),两组sIgE水平无显著差异(P>0.05);两组患者治疗12个月时RQLQ评分降低(P<0.05),观察组RQLQ评分较对照组降低(P<0.05);观察组和对照组治疗期间不良事件发生率分别为16.67%和8.57%,二者比较差异无显著性(P>0.05)。结论SCIT能够有效改善LAR伴哮喘患者的临床症状,减轻Ⅰ型变态反应,提高患者生活质量,安全性较高。

T4a期甲状腺癌外科治疗的临床经验报告

目的分析T4a期甲状腺癌的临床特点及外科治疗策略。方法回顾性纳入2004年1月至2021年5月间在四川省肿瘤医院头颈外科住院手术的甲状腺恶性肿瘤患者,共计纳入T4a的甲状腺癌病例303例,分析患者的病理分型、受侵器官、手术方式、生存时间等。分析患者的总生存率,使用Kaplan Meier法分析患者术后生存曲线。结果在入组的303例患者中,共计53例患者失访,1年总生存率为98.4%(246/250),3年总生存率为97.0%(224/231),5年总生存率为90.2%(92/102)。其中喉返神经单独受侵94例,失访13例,1年总生存率为100%(81/81),3年总生存率为98.7%(77/78),5年总生存率为97.4%(38/39)。喉返神经合并气管/喉/食道受侵151例,失访31例,1年总生存率为96.7%(116/120),3年总生存率为95.3%(101/106),5年总生存率为82.2%(37/45)。在生存曲线分析中,喉返神经单独受侵组较喉返神经合并气管、喉或食道等器官受侵组在总生存时间上存在优势。结论T4a期甲状腺癌如果有手术机会,应该首选手术切除,通过合理的手术策略,根治性手术的同时重视重要组织器官的一期修复重建,患者可获得较好的生活质量和预后。

混合型肝细胞癌-胆管癌的诊疗进展

混合型肝细胞癌-胆管癌(cHCC-CCA)是常见的原发性肝癌之一,其同时具有肝细胞癌(HCC)和肝内胆管癌(iCCA)的特征。在临床上,cHCC-CCA较HCC和iCCA更为少见。由于组织来源丰富以及缺乏特异性临床表现,cHCC-CCA的病理诊断和治疗方案选择往往难度加大。目前治疗cHCC-CCA的方法包括手术治疗、局部治疗、辅助治疗等,但不同治疗方法在cHCC-CCA中的应用价值仍有待探讨。随着cHCC-CCA的病理诊断及治疗方案的不断完善,明确其组织来源和表型将有助于进一步优化治疗方案,使患者得到更大获益。

高压液氨预热器管板环焊缝主副加热局部热处理

管板环焊缝局部热处理是影响高压液氨预热器服役安全的关键制造技术,传统局部热处理时温度分布不均匀、管板约束大,导致残余应力难以消除。对此,采用主副加热局部热处理方法,并验证该方法在高压液氨预热器局部热处理时的有效性。计算与测试结果表明,传统局部热处理仅可降低外表面的轴向和环向残余应力,而内表面轴向应力会略微增大,环向应力降幅较小;主副加热局部热处理使内表面轴向应力由283 MPa降低至100 MPa以下,降幅约64%,环向应力由324 MPa降低至206 MPa,降幅约37%,显著降低了设备内表面应力腐蚀开裂的敏感性。

肝内胆管癌的分型及综合治疗现状

肝内胆管癌(intrahepatic cholangiocarcinoma,ICC)是一种恶性程度较高的原发性肝癌,其发病率处于原发性肝癌的第2位,手术切除是目前唯一可能治愈ICC的治疗方式。由于ICC侵袭性强、预后差,大部分病人发现疾病时已经失去手术机会,且手术后仍有较高的复发风险。近年来,经动脉化疗栓塞、肝动脉灌注化疗、放疗等多种治疗方式均取得了不同程度的进展,在ICC治疗领域显示出良好的临床效果,肝移植也逐渐在ICC早期病人中进行了积极的探索与尝试。目前,靶向治疗、免疫治疗等新的治疗方式也逐渐崭露头角。形成了以手术治疗为基石,多种治疗方式相结合的综合个性化的治疗体系。同时,随着基因测序技术的进展和肿瘤微环境等研究的深入,分子分型也成为近年来的热点,对靶向治疗等治疗方案的选择具有重要的意义。然而,目前仍有部分治疗方式存在争议,需要大规模的临床研究进行验证,从而提高治疗水平,改善病人的预后。此文就目前ICC的分子分型、局部治疗、系统治疗的新进展及分子分型对于靶向治疗等的指导作用进行总结与阐述。