Objective: To discuss the therapeutic effect of preoperative interventional chemotherapy on cervical cancer. Methods: Preoperative interventional chemotherapy by femoral intubation was performed in 25 patients with ...Objective: To discuss the therapeutic effect of preoperative interventional chemotherapy on cervical cancer. Methods: Preoperative interventional chemotherapy by femoral intubation was performed in 25 patients with bulky cervical cancer. The patients received bleomycin 45 mg and cisplatin or oxaliplatin 80 mg/m^2. Results: 25 cases (including 8 cases with stage I and 17 cases with stage II) received one or two courses of preoperative interventional chemotherapy. The size of the focal lesions was decreased greatly and radical hysterectomy and lymphadenectomy were performed successfully in all the patients. All of the specimens were sent for pathological examination. Lymphocyte infiltration was found more obvious in the cancer tissues as compared with their counterpart before treatment. As a result, relevant vaginal bleeding was stopped completely shortly after the treatment. Conclusion: Arterial interventional chemotherapy was proved to reduce the local size of cervical cancer and thus control the hemorrhage efficiently. The patients with cervical cancer can receive radical hysterectomy therapy after the interventional chemotherapy.展开更多
Objective:To investigate the effect of arterial interventional chemotherapy before radical operation for gastric cancer on serum tumor markers and cell growth in the lesion.Methods:90 patients with primary gastric can...Objective:To investigate the effect of arterial interventional chemotherapy before radical operation for gastric cancer on serum tumor markers and cell growth in the lesion.Methods:90 patients with primary gastric cancer who underwent radical operation for gastric cancer in our hospital were chosen as the research subjects and divided into the control group (n=48) (did not receive preoperative arterial interventional chemotherapy) and the arterial interventional chemotherapy group (n=42) (received preoperative arterial interventional chemotherapy). The differences in tumor markers in serum as well as proliferation and apoptosis gene expression in gastric cancer tissues were compared.Results: Before surgery started, serum CA199, CA153, CA724 and AFP levels of arterial interventional chemotherapy group were significantly lower than those immediately after admission whereas serum CA199, CA153, CA724 and AFP levels of control group were not significantly different from those immediately after admission. After surgery, proliferation genes CUL4A and NTSR1 mRNA expression in gastric cancer tissues of arterial interventional chemotherapy group were lower than those of control group whereas DADS and FAM96B mRNA expression were higher than those of control group;apoptosis genes Livin and Bcl-2 mRNA expression were lower than those of control group whereas p53, p21 and Bax mRNA expression were higher than those of control group.Conclusion:Preoperative arterial interventional chemotherapy combined with radical operation for gastric cancer can more effectively inhibit the malignant degree of tumor and delay the growth of cancer cells.展开更多
Objective To study the therapeutic efficacy of combined interventional chemotherapy and intravesical instillation of mitomycin on preventing bladder cancers from recurring after local ablation. Methods 28 patients wit...Objective To study the therapeutic efficacy of combined interventional chemotherapy and intravesical instillation of mitomycin on preventing bladder cancers from recurring after local ablation. Methods 28 patients with superficial bladder cancers were randomized into combined interventional chemotherapy and intravesical instillation of mitomycin or intravesical instillation of mitomycin alone for preventing recurrence after local ablation. The result was assessed by x2 test. Results The patients have been followed up for 12-26 months (mean 21 months). 1 case has had tumor recurrence in the combined modality therapy group and 4 in the intravesical instillation alone group, the tumor recurrence rate being 7% (1/14) and 29% (4/14) respectively (P【0.05). Conclusion Combined use of interventional chemotherapy and intravesical instillation of mitomycin is effective in preventing superficial bladder cancer from recurring after local ablation with fewer adverse effects. The ragimen is not only reliable but展开更多
BACKGROUND With the rapid progress of systematic therapy for hepatocellular carcinoma(HCC),therapeutic strategies combining hepatic arterial infusion chemotherapy(HAIC)with systematic therapy arised increasing concent...BACKGROUND With the rapid progress of systematic therapy for hepatocellular carcinoma(HCC),therapeutic strategies combining hepatic arterial infusion chemotherapy(HAIC)with systematic therapy arised increasing concentrations.However,there have been no systematic review comparing HAIC and its combination strategies in the first-line treatment for advanced HCC.AIM To investigate the efficacy and safety of HAIC and its combination therapies for advanced HCC.METHODS A network meta-analysis was performed by including 9 randomized controlled trails and 35 cohort studies to carry out our study.The outcomes of interest comprised overall survival(OS),progression-free survival(PFS),tumor response and adverse events.Hazard ratios(HR)and odds ratios(OR)with a 95% confidence interval(CI)were calculated and agents were ranked based on their ranking probability.RESULTS HAIC outperformed Sorafenib(HR=0.55,95%CI:0.42-0.72;HR=0.51,95%CI:0.33-0.78;OR=2.86,95%CI:1.37-5.98;OR=5.45,95%CI:3.57-8.30;OR=7.15,95%CI:4.06-12.58;OR=2.89,95%CI:1.99-4.19;OR=0.48,95%CI:0.25-0.92,respectively)and transarterial chemoembolization(TACE)(HR=0.50,95%CI:0.33-0.75;HR=0.62,95%CI:0.39-0.98;OR=3.08,95%CI:1.36-6.98;OR=2.07,95%CI:1.54-2.80;OR=3.16,95%CI:1.71-5.85;OR=2.67,95%CI:1.59-4.50;OR=0.16,95%CI:0.05-0.54,respectively)in terms of efficacy and safety.HAIC+lenvatinib+ablation,HAIC+ablation,HAIC+anti-programmed cell death 1(PD-1),and HAIC+radiotherapy had the higher likelihood of providing better OS and PFS outcomes compared to HAIC alone.HAIC+TACE+S-1,HAIC+lenvatinib,HAIC+PD-1,HAIC+TACE,and HAIC+sorafenib had the higher likelihood of providing better partial response and objective response rate outcomes compared to HAIC.HAIC+PD-1,HAIC+TACE+S-1 and HAIC+TACE had the higher likelihood of providing better complete response and disease control rate outcomes compared to HAIC alone.CONCLUSION HAIC proved more effective and safer than sorafenib and TACE.Furthermore,combined with other interventions,HAIC showed improved efficacy over HAIC monotherapy according to the treatment ranking analysis.展开更多
Objective: To study the use of interventional chemotherapy in comprehensive treatment for advanced nasopharyngeal carcinoma. Methods: Interventional chemotherapy with multi-drugs including cisplatin (DDP) 100 mg, 5-fl...Objective: To study the use of interventional chemotherapy in comprehensive treatment for advanced nasopharyngeal carcinoma. Methods: Interventional chemotherapy with multi-drugs including cisplatin (DDP) 100 mg, 5-fluorouracil (5-FU) 1000 mg and bleomycin (BLM) 16 mg was used to treat 30 cases with advanced nasopharyngeal carcinoma before radiotherapy. 50 cases that received radiotherapy alone were used as a control group. The methods, time and dose schedule of radiotherapy were similar in the two groups. Results: The primary lesions in 16 cases and the cervical lymph nodes in 12 cases were reduced hi size after interventional chemotherapy. Radiation doses of those in complete response in their primary lesion and cervical lymph nodes were lower than that of the control group (P<0.05). The complete response rate of study group was 83.3% and that of control group was 72.0% (P<0.05). Conclusion: Interventional chemotherapy plus radiotherapy is a valuable treatment method in advanced nasopharyngeal carcinoma.展开更多
Objectives:To explore the clinical effect of psychological intervention and nursing during the chemotherapy of gynecological malignant tumor.Methods:120 patients with gynecologic malignancies were selected as subjects...Objectives:To explore the clinical effect of psychological intervention and nursing during the chemotherapy of gynecological malignant tumor.Methods:120 patients with gynecologic malignancies were selected as subjects.According to the nursing method,these patients were divided into intervention group and control group,with 60 cases in each group.The patients in the control group were given routine care,and the patients in the observation group were given psychological intervention care on the basis of routine nursing.Before and after treatment,the anxiety and depression of the two groups were compared using the Self-rating Anxiety Scale(SAS)and the Self-rating Depression Scale(SDS).The satisfaction and adverse reactions of the two groups were compared.The results were statistically analyzed.Results:After nursing intervention,the anxiety and depression scores of the intervention group were lower than those of the control group(P<0.05).The incidence of nausea,vomiting and fatigue in the intervention group was significantly lower than that in the control group(P<0.01).There was no significant difference in the symptoms of diarrhea between the two groups(P>0.05).After the treatment,the satisfaction of the intervention group was significantly higher than that of the control group(P<0.05).Conclusions:During the chemotherapy of gynecological malignant tumor patients,psychological intervention nursing can alleviate the anxiety and depression of patients,improve the complications,and improve the satisfaction of patients.It is worthy of clinical application.展开更多
Objective:To explore the effect of neoadjuvant chemotherapy + nutritional intervention on the nutritional status and tumor load in colon cancer patients with incomplete ileus.Methods:A total of 90 patients with middle...Objective:To explore the effect of neoadjuvant chemotherapy + nutritional intervention on the nutritional status and tumor load in colon cancer patients with incomplete ileus.Methods:A total of 90 patients with middle and advanced colon cancer who were treated in the hospital between April 2014 and October 2016 were divided into control group and observation group by random number table, each with 45 cases. Control group received routine neoadjuvant chemotherapy + surgical treatment, and the observation group received nutritional intervention on this basis. The differences in nutritional status and tumor load were between the two groups before neoadjuvant chemotherapy (T0), after neoadjuvant chemotherapy (T1) and 3 d after opeartion (T2).Results:At T0, the differences in the contents of nutrition indexes in peripheral blood as well as the contents of specific tumor markers and angiogenesis indexes were not statistically significant between the two groups. At T1 and T2, peripheral blood nutrition indicators TB, Alb and Hb contents of observation group were higher than those of control group;serum specific tumor markers PTN and CCSA-1 contents were lower than those of control group;serum angiogenesis indexes VEGF and Ang-2 contents were lower than those of control group.Conclusion: Neoadjuvant chemotherapy + nutrition intervention can effectively improve the nutritional status of colon cancer patients with incomplete ileus, and help to further reduce the tumor load.展开更多
Objective: To investigate the effect of the integrated nursing model in the prevention of chemotherapy-induced peripheral injury. Methods: A total of 60 tumor patients receiving oxaliplatin for 1 - 6 cycles of chemoth...Objective: To investigate the effect of the integrated nursing model in the prevention of chemotherapy-induced peripheral injury. Methods: A total of 60 tumor patients receiving oxaliplatin for 1 - 6 cycles of chemotherapy from January to September 2023 were selected. 30 patients were selected from January to March and divided into the control group, and 30 patients were selected from July to 9 as the experimental group. The control group received conventional chemotherapy nursing, while the experimental group received integrated nursing. Anxiety, peripheral nerve toxicity stage and quality of life score were compared between the two groups before and after intervention. Results: After intervention, the scores of the self-rating Anxiety Scale (SAS) and the total scores of the oxaliplatin Levi specific sensory neurotoxicity scale in the experimental group were significantly lower than those in the control group, and the differences were statistically significant (P< 0.05);The Quality of Life Scale (FACT-G) score of cancer patients was higher than that of control group, and the difference was statistically significant (P< 0.05). Conclusion: The integrated nursing model can effectively reduce the anxiety of patients, reduce the incidence of peripheral nerve injury and improve the quality of life of patients.展开更多
BACKGROUND Obstruction or fullness after feeding is common in gastric cancer(GC)patients,affecting their nutritional status and quality of life.Patients with digestive obstruction are generally in a more advanced stag...BACKGROUND Obstruction or fullness after feeding is common in gastric cancer(GC)patients,affecting their nutritional status and quality of life.Patients with digestive obstruction are generally in a more advanced stage.Existing methods,including palliative gastrectomy,gastrojejunostomy,endoluminal stent,jejunal nutrition tube and intravenous chemotherapy,have limitations in treating these symptoms.AIM To analyze the efficacy of continuous gastric artery infusion chemotherapy(cGAIC)in relieving digestive obstruction in patients with advanced GC.METHODS This study was a retrospective study.Twenty-nine patients with digestive obstruction of advanced GC who underwent at least one cycle of treatment were reviewed at The Second Affiliated Hospital of Zhejiang University School of Medicine.The oxaliplatin-based intra-arterial infusion regimen was applied in all patients.Mild systemic chemotherapy was used in combination with local treatment.The clinical response was evaluated by contrast-enhanced computed tomography using Response Evaluation Criteria In Solid Tumors(RECIST)criteria.Digestive tract symptoms and toxic effects were analyzed regularly.A comparison of the Karnofsky Performance Status(KPS)score and Stooler’s Dysphagia Score before and after therapy was made.Univariate survival analysis and multivariate survival analysis were also performed to explore the key factors affecting patient survival.RESULTS All patients finished cGAIC successfully without microcatheter displacement,as confirmed by arteriography.The median follow-up time was 24 mo(95%CI:20.24-27.76 mo).The overall response rate was 89.7%after cGAIC according to the RECIST criteria.The postoperative Stooler’s Dysphagia Score was significantly improved.Twentytwo(75.9%)of the 29 patients experienced relief of digestive obstruction after the first two cycles,and 13(44.8%)initially unresectable patients were then considered radically resectable.The median overall survival time(mOS)was 16 mo(95%CI:9.32-22.68 mo).Patients who received radical surgery had a significantly longer mOS than other patients(P value<0.001).Multivariate Cox regression analysis indicated that radical resection after cGAIC,intravenous chemotherapy after cGAIC,and immunotherapy after cGAIC were independent predictors of mOS.None of the patients stopped treatment because of adverse events.CONCLUSION cGAIC was effective and safe in relieving digestive obstruction in advanced GC,and it could improve surgical conversion possibility and survival time.展开更多
Objective:To study the effects of different administration routes of neoadjuvant chemotherapy on cancer cell growth signal pathway function in cervical cancer.Methods: Patients with cervical cancer who received neoadj...Objective:To study the effects of different administration routes of neoadjuvant chemotherapy on cancer cell growth signal pathway function in cervical cancer.Methods: Patients with cervical cancer who received neoadjuvant chemotherapy in Fufeng People's Hospital between July 2008 and July 2016 were selected as the research subjects and randomly divided into intervention group and intravenous group who accepted the neoadjuvant interventional arterial chemotherapy and neoadjuvant intravenous chemotherapy respectively. After surgical resection, the contents of PI3K/AKT/mTOR, Wnt/β-catenin and MEK/ERK signaling pathway in cervical cancer lesions were determined.Results:p-PI3K, p-AKT, mTOR, MMP2, VEGF,β-catenin, CyclinD1, Twist, Slug, Snail, MEK1, MEK2, ERK1/2 and Bcl-2 protein levels in cervical cancer lesion of intervention group were significantly lower than those of intravenous group whereas E-cadherin and Bax protein levels were significantly higher than those of intravenous group.Conclusion: Neoadjuvant interventional arterial chemotherapy can be more effective than neoadjuvant intravenous chemotherapy to inhibit the cancer cell growth mediated by PI3K/AKT/mTOR, Wnt/β-catenin and MEK/ERK signaling pathway in cervical cancer.展开更多
Objective:By comparing the efficacy of different frequency application of polyethylene glycol recombinant human granulocyte stimulating factor in the prevention of neutropenia after chemotherapy with dose-intensive re...Objective:By comparing the efficacy of different frequency application of polyethylene glycol recombinant human granulocyte stimulating factor in the prevention of neutropenia after chemotherapy with dose-intensive regimen in breast cancer, the more optimized administration scheme of polyethylene glycol recombinant human granulocyte stimulating factor in the prevention of neutropenia after chemotherapy in breast cancer was further explored.Methods:From June 2017 to May 2019, 64 patients with breast cancer who had received dose-intensive chemotherapy from June 2017 to May 2019 were randomly divided into two groups: control group (n=31) and observation group (n=33). Control group: after dose-intensive chemotherapy, PEG-rhG-CSF was injected subcutaneously with 100μg/kg, and given 24 hours after chemotherapy. Observation group: after dose-intensive chemotherapy, PEG-rhG-CSF: 50μg/kg, was injected subcutaneously and given 24 hours and 72 hours after chemotherapy. With PEG-rhG-CSF on the number of neutrophils in the two groups and the incidence, duration, fever incidence and duration of neutropenia in the two groups were observed. The curative effect was evaluated after 2 cycles of treatment.Results: There was no significant difference in the number of neutrophils between the two groups before chemotherapy in the first cycle and the second cycle (P>0.05), but the neutrophils in the observation group decreased slowly on the 3rd day, 5th day, 10th day and 5th day and 10th day after the first cycle of chemotherapy, and there was significant difference between the two groups (P<0.001). In the second cycle, there was no significant difference in neutrophils between the two groups on the third day after chemotherapy (P<0.05). In the control group, 7 patients were delayed by the second week because the neutrophil value was less than 2.0109/ L. The time of chemotherapy was delayed in 5 patients in the observation group. The incidence of neutropenia in the control group and the observation group was 41.9% VS 12.1%, and the duration of neutropenia in the observation group was significantly shorter than that in the control group (3.25 ±0.84d VS 5.12 ±1.24d), and the incidence of neutropenia in the observation group was 41.9% VS 12.1%, the duration of neutropenia in the observation group was significantly shorter than that in the control group (3.25 ±0.84d VS 5.12 ±1.24d). The number of patients with fever in the control group and the observation group were 10 cases of VS, the incidence rate was 32.2% VS 12.1%, compared with the control group and the observation group, the incidence of febrile fever was 32.2% and 12.1%, respectively. The duration of fever in the observation group was significantly shorter than that in the control group (2.46 ±1.24 d VS 4.05 ±1.01).Conclusions: Low dose of PEG-rhG-CSF can increase the absolute value of neutrophils after multiple administration, and its curative effect is better than that of single administration in dose-intensive chemotherapy, and the incidence of neutropenia and associated fever is lower, which is worthy of further clinical study and promotion.展开更多
Objective:To study and compare the clinical effects of the combination of different interventional embolization chemotherapy and radiofrequency ablation in patients with primary liver cancer.Methods:In this paper,base...Objective:To study and compare the clinical effects of the combination of different interventional embolization chemotherapy and radiofrequency ablation in patients with primary liver cancer.Methods:In this paper,based on the target data validation of those 60 patients with primary liver cancer treated in the hospital during the period from May 2017 to May 2018,the double-blind method was used for the comparison between groups.Patients in the reference group were treated with the combination of cisplatinum interventional chemoembolization regimen and radiofrequency ablation,while those in the experimental group were treated with the combination of lobaplatin interventional chemoembolization regimen and radiofrequency ablation.Then,the efficacy of both groups was compared.Results:After the treatment,the clinically effective total value,the calculation value of adverse reactions,and the value of IgA,IgM,IgG and AFP of the experimental group were compared with those of the reference group.In addition,the value of IgA,IgM,IgG and AFP of both groups after and before the treatment were compared.The experimental results showed that the data was statistically significant(P<0.05).Conclusion:The combination of lobaplatin and cisplatin interventional embolization chemotherapy and radiofrequency ablation has some effects in patients with primary liver cancer,but the former one showed more significant effects.展开更多
目的评估新辅助动脉介入化疗(NAIC)和新辅助全身静脉化疗(NIVC)治疗局部晚期宫颈癌(LACC)的有效性与安全性。方法通过检索PubMed、Web of Science、Embase、中国知网、万方数据库获取符合主题的随机对照试验(RCT),经文献质量评估和数据...目的评估新辅助动脉介入化疗(NAIC)和新辅助全身静脉化疗(NIVC)治疗局部晚期宫颈癌(LACC)的有效性与安全性。方法通过检索PubMed、Web of Science、Embase、中国知网、万方数据库获取符合主题的随机对照试验(RCT),经文献质量评估和数据提取后使用Stata 17.0进行统计学分析,使用GRADE质量评价系统对结局进行质量评估。结果共纳入14项RCT,合计1063例LACC患者。Meta分析结果表明,NAIC和NIVC在有效性指标方面:完全缓解(CR)[RR=1.23,95%CI(0.91,1.67),P=0.174]、部分缓解(PR)[RR=1.10,95%CI(0.86,1.20),P=0.874]、总缓解(TR)[RR=1.10,95%CI(0.95,1.25),P=0.212]、无变化(NC)[RR=0.62,95%CI(0.33,1.16),P=0.137]和进展(PD)[RR=1.43,95%CI(0.41,4.99),P=0.574]间的差异无统计学意义;在安全性指标方面:胃肠道反应[RR=0.96,95%CI(0.76,1.23),P=0.755]、肝肾功能损害[RR=0.71,95%CI(0.41,1.23),P=0.226]差异无统计学意义,而在骨髓抑制[RR=0.62,95%CI(0.45,0.86),P=0.04]的发生率方面,NAIC较NIVC更优。此外,GRADE评分结果显示CR、PR、TR、NC为高质量证据。结论对于LACC患者,NAIC在治疗后骨髓抑制的发生率较NIVC更低、更安全,在其他有效性与安全性指标上两者并未发现显著差异。临床医师根据患者的实际情况综合评估,选择适宜新辅助化疗方案。展开更多
文摘Objective: To discuss the therapeutic effect of preoperative interventional chemotherapy on cervical cancer. Methods: Preoperative interventional chemotherapy by femoral intubation was performed in 25 patients with bulky cervical cancer. The patients received bleomycin 45 mg and cisplatin or oxaliplatin 80 mg/m^2. Results: 25 cases (including 8 cases with stage I and 17 cases with stage II) received one or two courses of preoperative interventional chemotherapy. The size of the focal lesions was decreased greatly and radical hysterectomy and lymphadenectomy were performed successfully in all the patients. All of the specimens were sent for pathological examination. Lymphocyte infiltration was found more obvious in the cancer tissues as compared with their counterpart before treatment. As a result, relevant vaginal bleeding was stopped completely shortly after the treatment. Conclusion: Arterial interventional chemotherapy was proved to reduce the local size of cervical cancer and thus control the hemorrhage efficiently. The patients with cervical cancer can receive radical hysterectomy therapy after the interventional chemotherapy.
文摘Objective:To investigate the effect of arterial interventional chemotherapy before radical operation for gastric cancer on serum tumor markers and cell growth in the lesion.Methods:90 patients with primary gastric cancer who underwent radical operation for gastric cancer in our hospital were chosen as the research subjects and divided into the control group (n=48) (did not receive preoperative arterial interventional chemotherapy) and the arterial interventional chemotherapy group (n=42) (received preoperative arterial interventional chemotherapy). The differences in tumor markers in serum as well as proliferation and apoptosis gene expression in gastric cancer tissues were compared.Results: Before surgery started, serum CA199, CA153, CA724 and AFP levels of arterial interventional chemotherapy group were significantly lower than those immediately after admission whereas serum CA199, CA153, CA724 and AFP levels of control group were not significantly different from those immediately after admission. After surgery, proliferation genes CUL4A and NTSR1 mRNA expression in gastric cancer tissues of arterial interventional chemotherapy group were lower than those of control group whereas DADS and FAM96B mRNA expression were higher than those of control group;apoptosis genes Livin and Bcl-2 mRNA expression were lower than those of control group whereas p53, p21 and Bax mRNA expression were higher than those of control group.Conclusion:Preoperative arterial interventional chemotherapy combined with radical operation for gastric cancer can more effectively inhibit the malignant degree of tumor and delay the growth of cancer cells.
文摘Objective To study the therapeutic efficacy of combined interventional chemotherapy and intravesical instillation of mitomycin on preventing bladder cancers from recurring after local ablation. Methods 28 patients with superficial bladder cancers were randomized into combined interventional chemotherapy and intravesical instillation of mitomycin or intravesical instillation of mitomycin alone for preventing recurrence after local ablation. The result was assessed by x2 test. Results The patients have been followed up for 12-26 months (mean 21 months). 1 case has had tumor recurrence in the combined modality therapy group and 4 in the intravesical instillation alone group, the tumor recurrence rate being 7% (1/14) and 29% (4/14) respectively (P【0.05). Conclusion Combined use of interventional chemotherapy and intravesical instillation of mitomycin is effective in preventing superficial bladder cancer from recurring after local ablation with fewer adverse effects. The ragimen is not only reliable but
文摘BACKGROUND With the rapid progress of systematic therapy for hepatocellular carcinoma(HCC),therapeutic strategies combining hepatic arterial infusion chemotherapy(HAIC)with systematic therapy arised increasing concentrations.However,there have been no systematic review comparing HAIC and its combination strategies in the first-line treatment for advanced HCC.AIM To investigate the efficacy and safety of HAIC and its combination therapies for advanced HCC.METHODS A network meta-analysis was performed by including 9 randomized controlled trails and 35 cohort studies to carry out our study.The outcomes of interest comprised overall survival(OS),progression-free survival(PFS),tumor response and adverse events.Hazard ratios(HR)and odds ratios(OR)with a 95% confidence interval(CI)were calculated and agents were ranked based on their ranking probability.RESULTS HAIC outperformed Sorafenib(HR=0.55,95%CI:0.42-0.72;HR=0.51,95%CI:0.33-0.78;OR=2.86,95%CI:1.37-5.98;OR=5.45,95%CI:3.57-8.30;OR=7.15,95%CI:4.06-12.58;OR=2.89,95%CI:1.99-4.19;OR=0.48,95%CI:0.25-0.92,respectively)and transarterial chemoembolization(TACE)(HR=0.50,95%CI:0.33-0.75;HR=0.62,95%CI:0.39-0.98;OR=3.08,95%CI:1.36-6.98;OR=2.07,95%CI:1.54-2.80;OR=3.16,95%CI:1.71-5.85;OR=2.67,95%CI:1.59-4.50;OR=0.16,95%CI:0.05-0.54,respectively)in terms of efficacy and safety.HAIC+lenvatinib+ablation,HAIC+ablation,HAIC+anti-programmed cell death 1(PD-1),and HAIC+radiotherapy had the higher likelihood of providing better OS and PFS outcomes compared to HAIC alone.HAIC+TACE+S-1,HAIC+lenvatinib,HAIC+PD-1,HAIC+TACE,and HAIC+sorafenib had the higher likelihood of providing better partial response and objective response rate outcomes compared to HAIC.HAIC+PD-1,HAIC+TACE+S-1 and HAIC+TACE had the higher likelihood of providing better complete response and disease control rate outcomes compared to HAIC alone.CONCLUSION HAIC proved more effective and safer than sorafenib and TACE.Furthermore,combined with other interventions,HAIC showed improved efficacy over HAIC monotherapy according to the treatment ranking analysis.
基金a grant from the Science Foundation of the Health Department of Guangxi Province of China (No. Q9711).
文摘Objective: To study the use of interventional chemotherapy in comprehensive treatment for advanced nasopharyngeal carcinoma. Methods: Interventional chemotherapy with multi-drugs including cisplatin (DDP) 100 mg, 5-fluorouracil (5-FU) 1000 mg and bleomycin (BLM) 16 mg was used to treat 30 cases with advanced nasopharyngeal carcinoma before radiotherapy. 50 cases that received radiotherapy alone were used as a control group. The methods, time and dose schedule of radiotherapy were similar in the two groups. Results: The primary lesions in 16 cases and the cervical lymph nodes in 12 cases were reduced hi size after interventional chemotherapy. Radiation doses of those in complete response in their primary lesion and cervical lymph nodes were lower than that of the control group (P<0.05). The complete response rate of study group was 83.3% and that of control group was 72.0% (P<0.05). Conclusion: Interventional chemotherapy plus radiotherapy is a valuable treatment method in advanced nasopharyngeal carcinoma.
文摘Objectives:To explore the clinical effect of psychological intervention and nursing during the chemotherapy of gynecological malignant tumor.Methods:120 patients with gynecologic malignancies were selected as subjects.According to the nursing method,these patients were divided into intervention group and control group,with 60 cases in each group.The patients in the control group were given routine care,and the patients in the observation group were given psychological intervention care on the basis of routine nursing.Before and after treatment,the anxiety and depression of the two groups were compared using the Self-rating Anxiety Scale(SAS)and the Self-rating Depression Scale(SDS).The satisfaction and adverse reactions of the two groups were compared.The results were statistically analyzed.Results:After nursing intervention,the anxiety and depression scores of the intervention group were lower than those of the control group(P<0.05).The incidence of nausea,vomiting and fatigue in the intervention group was significantly lower than that in the control group(P<0.01).There was no significant difference in the symptoms of diarrhea between the two groups(P>0.05).After the treatment,the satisfaction of the intervention group was significantly higher than that of the control group(P<0.05).Conclusions:During the chemotherapy of gynecological malignant tumor patients,psychological intervention nursing can alleviate the anxiety and depression of patients,improve the complications,and improve the satisfaction of patients.It is worthy of clinical application.
文摘Objective:To explore the effect of neoadjuvant chemotherapy + nutritional intervention on the nutritional status and tumor load in colon cancer patients with incomplete ileus.Methods:A total of 90 patients with middle and advanced colon cancer who were treated in the hospital between April 2014 and October 2016 were divided into control group and observation group by random number table, each with 45 cases. Control group received routine neoadjuvant chemotherapy + surgical treatment, and the observation group received nutritional intervention on this basis. The differences in nutritional status and tumor load were between the two groups before neoadjuvant chemotherapy (T0), after neoadjuvant chemotherapy (T1) and 3 d after opeartion (T2).Results:At T0, the differences in the contents of nutrition indexes in peripheral blood as well as the contents of specific tumor markers and angiogenesis indexes were not statistically significant between the two groups. At T1 and T2, peripheral blood nutrition indicators TB, Alb and Hb contents of observation group were higher than those of control group;serum specific tumor markers PTN and CCSA-1 contents were lower than those of control group;serum angiogenesis indexes VEGF and Ang-2 contents were lower than those of control group.Conclusion: Neoadjuvant chemotherapy + nutrition intervention can effectively improve the nutritional status of colon cancer patients with incomplete ileus, and help to further reduce the tumor load.
文摘Objective: To investigate the effect of the integrated nursing model in the prevention of chemotherapy-induced peripheral injury. Methods: A total of 60 tumor patients receiving oxaliplatin for 1 - 6 cycles of chemotherapy from January to September 2023 were selected. 30 patients were selected from January to March and divided into the control group, and 30 patients were selected from July to 9 as the experimental group. The control group received conventional chemotherapy nursing, while the experimental group received integrated nursing. Anxiety, peripheral nerve toxicity stage and quality of life score were compared between the two groups before and after intervention. Results: After intervention, the scores of the self-rating Anxiety Scale (SAS) and the total scores of the oxaliplatin Levi specific sensory neurotoxicity scale in the experimental group were significantly lower than those in the control group, and the differences were statistically significant (P< 0.05);The Quality of Life Scale (FACT-G) score of cancer patients was higher than that of control group, and the difference was statistically significant (P< 0.05). Conclusion: The integrated nursing model can effectively reduce the anxiety of patients, reduce the incidence of peripheral nerve injury and improve the quality of life of patients.
基金The study was reviewed and approved by the Ethics Committee of The Second Affiliated Hospital of Zhejiang University School of Medicine(Approval No.I2020001737).
文摘BACKGROUND Obstruction or fullness after feeding is common in gastric cancer(GC)patients,affecting their nutritional status and quality of life.Patients with digestive obstruction are generally in a more advanced stage.Existing methods,including palliative gastrectomy,gastrojejunostomy,endoluminal stent,jejunal nutrition tube and intravenous chemotherapy,have limitations in treating these symptoms.AIM To analyze the efficacy of continuous gastric artery infusion chemotherapy(cGAIC)in relieving digestive obstruction in patients with advanced GC.METHODS This study was a retrospective study.Twenty-nine patients with digestive obstruction of advanced GC who underwent at least one cycle of treatment were reviewed at The Second Affiliated Hospital of Zhejiang University School of Medicine.The oxaliplatin-based intra-arterial infusion regimen was applied in all patients.Mild systemic chemotherapy was used in combination with local treatment.The clinical response was evaluated by contrast-enhanced computed tomography using Response Evaluation Criteria In Solid Tumors(RECIST)criteria.Digestive tract symptoms and toxic effects were analyzed regularly.A comparison of the Karnofsky Performance Status(KPS)score and Stooler’s Dysphagia Score before and after therapy was made.Univariate survival analysis and multivariate survival analysis were also performed to explore the key factors affecting patient survival.RESULTS All patients finished cGAIC successfully without microcatheter displacement,as confirmed by arteriography.The median follow-up time was 24 mo(95%CI:20.24-27.76 mo).The overall response rate was 89.7%after cGAIC according to the RECIST criteria.The postoperative Stooler’s Dysphagia Score was significantly improved.Twentytwo(75.9%)of the 29 patients experienced relief of digestive obstruction after the first two cycles,and 13(44.8%)initially unresectable patients were then considered radically resectable.The median overall survival time(mOS)was 16 mo(95%CI:9.32-22.68 mo).Patients who received radical surgery had a significantly longer mOS than other patients(P value<0.001).Multivariate Cox regression analysis indicated that radical resection after cGAIC,intravenous chemotherapy after cGAIC,and immunotherapy after cGAIC were independent predictors of mOS.None of the patients stopped treatment because of adverse events.CONCLUSION cGAIC was effective and safe in relieving digestive obstruction in advanced GC,and it could improve surgical conversion possibility and survival time.
文摘Objective:To study the effects of different administration routes of neoadjuvant chemotherapy on cancer cell growth signal pathway function in cervical cancer.Methods: Patients with cervical cancer who received neoadjuvant chemotherapy in Fufeng People's Hospital between July 2008 and July 2016 were selected as the research subjects and randomly divided into intervention group and intravenous group who accepted the neoadjuvant interventional arterial chemotherapy and neoadjuvant intravenous chemotherapy respectively. After surgical resection, the contents of PI3K/AKT/mTOR, Wnt/β-catenin and MEK/ERK signaling pathway in cervical cancer lesions were determined.Results:p-PI3K, p-AKT, mTOR, MMP2, VEGF,β-catenin, CyclinD1, Twist, Slug, Snail, MEK1, MEK2, ERK1/2 and Bcl-2 protein levels in cervical cancer lesion of intervention group were significantly lower than those of intravenous group whereas E-cadherin and Bax protein levels were significantly higher than those of intravenous group.Conclusion: Neoadjuvant interventional arterial chemotherapy can be more effective than neoadjuvant intravenous chemotherapy to inhibit the cancer cell growth mediated by PI3K/AKT/mTOR, Wnt/β-catenin and MEK/ERK signaling pathway in cervical cancer.
基金Beijing Xisco Clinical Oncology Research Foundation Project No.:Y-HR2018-271.
文摘Objective:By comparing the efficacy of different frequency application of polyethylene glycol recombinant human granulocyte stimulating factor in the prevention of neutropenia after chemotherapy with dose-intensive regimen in breast cancer, the more optimized administration scheme of polyethylene glycol recombinant human granulocyte stimulating factor in the prevention of neutropenia after chemotherapy in breast cancer was further explored.Methods:From June 2017 to May 2019, 64 patients with breast cancer who had received dose-intensive chemotherapy from June 2017 to May 2019 were randomly divided into two groups: control group (n=31) and observation group (n=33). Control group: after dose-intensive chemotherapy, PEG-rhG-CSF was injected subcutaneously with 100μg/kg, and given 24 hours after chemotherapy. Observation group: after dose-intensive chemotherapy, PEG-rhG-CSF: 50μg/kg, was injected subcutaneously and given 24 hours and 72 hours after chemotherapy. With PEG-rhG-CSF on the number of neutrophils in the two groups and the incidence, duration, fever incidence and duration of neutropenia in the two groups were observed. The curative effect was evaluated after 2 cycles of treatment.Results: There was no significant difference in the number of neutrophils between the two groups before chemotherapy in the first cycle and the second cycle (P>0.05), but the neutrophils in the observation group decreased slowly on the 3rd day, 5th day, 10th day and 5th day and 10th day after the first cycle of chemotherapy, and there was significant difference between the two groups (P<0.001). In the second cycle, there was no significant difference in neutrophils between the two groups on the third day after chemotherapy (P<0.05). In the control group, 7 patients were delayed by the second week because the neutrophil value was less than 2.0109/ L. The time of chemotherapy was delayed in 5 patients in the observation group. The incidence of neutropenia in the control group and the observation group was 41.9% VS 12.1%, and the duration of neutropenia in the observation group was significantly shorter than that in the control group (3.25 ±0.84d VS 5.12 ±1.24d), and the incidence of neutropenia in the observation group was 41.9% VS 12.1%, the duration of neutropenia in the observation group was significantly shorter than that in the control group (3.25 ±0.84d VS 5.12 ±1.24d). The number of patients with fever in the control group and the observation group were 10 cases of VS, the incidence rate was 32.2% VS 12.1%, compared with the control group and the observation group, the incidence of febrile fever was 32.2% and 12.1%, respectively. The duration of fever in the observation group was significantly shorter than that in the control group (2.46 ±1.24 d VS 4.05 ±1.01).Conclusions: Low dose of PEG-rhG-CSF can increase the absolute value of neutrophils after multiple administration, and its curative effect is better than that of single administration in dose-intensive chemotherapy, and the incidence of neutropenia and associated fever is lower, which is worthy of further clinical study and promotion.
文摘Objective:To study and compare the clinical effects of the combination of different interventional embolization chemotherapy and radiofrequency ablation in patients with primary liver cancer.Methods:In this paper,based on the target data validation of those 60 patients with primary liver cancer treated in the hospital during the period from May 2017 to May 2018,the double-blind method was used for the comparison between groups.Patients in the reference group were treated with the combination of cisplatinum interventional chemoembolization regimen and radiofrequency ablation,while those in the experimental group were treated with the combination of lobaplatin interventional chemoembolization regimen and radiofrequency ablation.Then,the efficacy of both groups was compared.Results:After the treatment,the clinically effective total value,the calculation value of adverse reactions,and the value of IgA,IgM,IgG and AFP of the experimental group were compared with those of the reference group.In addition,the value of IgA,IgM,IgG and AFP of both groups after and before the treatment were compared.The experimental results showed that the data was statistically significant(P<0.05).Conclusion:The combination of lobaplatin and cisplatin interventional embolization chemotherapy and radiofrequency ablation has some effects in patients with primary liver cancer,but the former one showed more significant effects.
文摘目的评估新辅助动脉介入化疗(NAIC)和新辅助全身静脉化疗(NIVC)治疗局部晚期宫颈癌(LACC)的有效性与安全性。方法通过检索PubMed、Web of Science、Embase、中国知网、万方数据库获取符合主题的随机对照试验(RCT),经文献质量评估和数据提取后使用Stata 17.0进行统计学分析,使用GRADE质量评价系统对结局进行质量评估。结果共纳入14项RCT,合计1063例LACC患者。Meta分析结果表明,NAIC和NIVC在有效性指标方面:完全缓解(CR)[RR=1.23,95%CI(0.91,1.67),P=0.174]、部分缓解(PR)[RR=1.10,95%CI(0.86,1.20),P=0.874]、总缓解(TR)[RR=1.10,95%CI(0.95,1.25),P=0.212]、无变化(NC)[RR=0.62,95%CI(0.33,1.16),P=0.137]和进展(PD)[RR=1.43,95%CI(0.41,4.99),P=0.574]间的差异无统计学意义;在安全性指标方面:胃肠道反应[RR=0.96,95%CI(0.76,1.23),P=0.755]、肝肾功能损害[RR=0.71,95%CI(0.41,1.23),P=0.226]差异无统计学意义,而在骨髓抑制[RR=0.62,95%CI(0.45,0.86),P=0.04]的发生率方面,NAIC较NIVC更优。此外,GRADE评分结果显示CR、PR、TR、NC为高质量证据。结论对于LACC患者,NAIC在治疗后骨髓抑制的发生率较NIVC更低、更安全,在其他有效性与安全性指标上两者并未发现显著差异。临床医师根据患者的实际情况综合评估,选择适宜新辅助化疗方案。