癌症化疗病人自我感受负担体验的质性研究

癌症是严重威胁人类生命健康的三大疾病之一，化疗是癌症的主要治疗手段。病人在化疗救治过程中，主要依靠家人及朋友提供照护支持，由于经济、照护、情绪等原因，普遍存在担心拖累家人思想，形成负担的心理，称为自我感受负担（SPB）。为了解癌症化疗病人自我感受负担真实情况，本研究对18例癌症化疗病人进行质性研究。

实施家属健康教育对癌症化疗病人生活质量的影响

目的探讨对家属实施健康教育对癌症化疗病人生活质量的影响。方法将58例癌症化疗病人随机分为两组,对照组29例,实验组29例,两组病人均按常规在入院时及住院期间接受健康教育,实验组病人家属同步接受健康教育。在病人入院及化疗结束后2周,用中国癌症患者化学生物治疗生活质量表分别对两组病人进行问卷调查并分析。结果入院时,两组病人总体生活质量无明显差异(p>0.05);化疗2周后,实验组病人总体生活质量明显高于对照组(p<0.05)。结论对癌症化疗病人家属同步实施健康教育,可明显提高病人的生活质量。

癌症病人化疗期间胃肠道反应及饮食指导

目的:了解癌症病人化疗期间胃肠道反应的临床表现,并进行针对性饮食指导,以提高食欲,增强抵抗力。方法:选择62例癌症化疗病人进行临床观察。结果:发现常见的胃肠道反应有:食欲不振、恶心呕吐、口腔溃疡、口干、腹泻、便秘。结论:合理改善饮食方式,能够缓解患者许多消化系统症状,增强机体免疫力,提高治疗的有效反应,让患者有足够的体力去面对长期的化疗。

Clinical significance of miRNA-106a in non-small cell lung cancer patients who received cisplatin combined with gemcitabine chemotherapy

Objective：Research has demonstrated that microRNA（miR）-106a is related to cisplatin resistance.We investigated the expression of miR-106a in the serum of patients with non-small cell lung cancer（NSCLC）and their sensitivity to chemotherapy by cisplatin combined with gemcitabine.Methods：Eighty-five NSCLC patients,who completed four cycles of gemcitabine and cisplatin chemotherapy,volunteered for this study and their serum samples were collected.Serum samples from 60 healthy subjects were used as controls.Real-time quantitative polymerase chain reaction（real-time q PCR）was used to quantify the level of miR-106a in the serum.Demographic and survival data of these patients were collected for the analysis.Results：The expression of miR-106a in the serum of NSCLC patients was significantly higher than that of healthy subjects（P＆lt;0.001）.The expression of miR-106a was not correlated with patients＇gender,age,tumor size,lymphatic metastasis,and pathological types;but was correlated with patients＇tumor staging（P=0.003）.After chemotherapy,serum miR-106a expression decreased in patients.The decrease in miR-106a expression in the chemotherapy-sensitive group was much higher than that in the chemotherapy-resistant group.Survival analysis shows that NSCLC patients with high expression of miR-106a have a poorer prognosis.The overall survival of NSCLC patients in the chemotherapy-sensitive group was significantly higher than that in the chemotherapy-resistant group.Conclusions：High expression of miR-106a may be involved in the development of NSCLC.Mi R-106a has significance in the prognosis of NSCLC.The level of miR-106a in the serum can be a useful parameter in screening for drug resistance during cisplatin-based chemotherapy.

Postoperative sequential chemotherapy and radiotherapy for locally advanced gastric cancer

Objective The aim of the study was to evaluate the role of postoperative sequential chemotherapy and radiotherapy in patients with locally advanced gastric cancer.Methods From January 2003 to December 2010, 146 gastric cancer patients at our institution(Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China) received postoperative sequential chemotherapy and radiotherapy after radical surgery. Radiotherapy was administered as a dose of 4500 cGy in 25 fractions. For patients with positive margins, the dose was raised to 5040 cGy in 28 fractions. Three cycles of m FOLFOX or PF(cisplatin, 5-fluorouracil) chemotherapy regimen were applied before and after radiotherapy. Three-and 5-year survival rates were analyzed; any adverse effects with respect to hematology, hepatic and renal function, or the gastrointestinal tract that occurred during the treatment were evaluated.Results This cohort consisted of non-metastatic patients: 104 men and 42 women with a median age of 51.0 years. The full course of sequential chemotherapy and radiotherapy(4500–5040 cGy) was completed by 129 patients(88.4%). Seventeen regional relapses(9.8%) and 46 distant relapses(23.8%) were recorded. Fifty patients(34.2%) died during follow-up. The 3-and 5-year overall survival rates(OS) were 60% and 54%, and disease-free survival rates(DFS) were 53% and 47%, respectively. There were no significant differences in survival rate with respect to age, sex, histopathology, N stage, site of the tumor, or margin status. Multivariate analysis showed that only the depth of tumor invasion(T stage) was an independent prognostic factor for OS(P = 0.009) and DFS(P = 0.006). The rates of grades 3 and 4 neutropenia and vomiting were 9.6% and 3.4%, respectively, during the treatment.Conclusion Postoperative sequential chemotherapy with an m FOLFOX or PF regimen and radiotherapy were found to be an effective means of treating advanced gastric cancer patients with T3–T4 disease. The adverse effects of this treatment were tolerable.

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.