目的探讨术前改良短程放疗联合卡培他滨对腹腔镜直肠癌低位前切除术患者近远期疗效和安全性的影响。方法选取2017年1月至2018年5月重庆市人民医院收治的70例拟择期行腹腔镜下直肠癌低位前切除术和术前新辅助治疗的患者为研究对象。根据...目的探讨术前改良短程放疗联合卡培他滨对腹腔镜直肠癌低位前切除术患者近远期疗效和安全性的影响。方法选取2017年1月至2018年5月重庆市人民医院收治的70例拟择期行腹腔镜下直肠癌低位前切除术和术前新辅助治疗的患者为研究对象。根据随机数字表法将入选患者分为观察组和对照组,每组各35例。观察组患者实施术前改良短程放疗联合卡培他滨的新辅助治疗方案,对照组患者实施术前标准长程放疗联合卡培他滨的新辅助治疗方案。比较两组患者围手术期资料、术前生存质量、新辅助放化疗与手术的安全性和近远期预后。结果两组患者均顺利实施腹腔镜直肠癌前切除术,无一例中转开腹。两组Ⅱ期、Ⅲ期患者的降期率比较差异均无统计学意义(均P>0.05)。两组患者病理完全缓解率、保肛率、肿瘤R0切除率、手术时间、术中出血量、术后住院天数、新辅助放化疗前世界卫生组织生存质量测定量表简表(World Health Organization quality of life BREF,WHOQOL-BREF)各维度评分和总分、新辅助放化疗和手术并发症发生率、术后1年和3年内局部复发率、远处转移率和死亡率比较差异均无统计学意义(均P>0.05)。观察组患者手术前WHOQOL-BREF生理领域、心理领域评分和总分均显著高于本组新辅助放化疗前(均P<0.05),且以上指标均显著高于同期对照组(均P<0.05),手术前治疗总费用显著低于对照组(P<0.05)。结论术前改良短程放疗联合卡培他滨对腹腔镜下直肠癌低位前切除术患者的近远期疗效、安全性与常规长程放化疗基本相当,并在术前治疗总费用和生存质量方面均具有一定优势。展开更多
直肠癌是较为常见的消化系统恶性肿瘤,患者5年生存率极低,尽管外科技术较成熟,但5年生存率仍在50%左右[1]。根据美国国立综合癌症网络(National Comprehensive Cancer Network,NCCN)报道,临床分期超出T2分期且可切除性直肠癌应采用术前...直肠癌是较为常见的消化系统恶性肿瘤,患者5年生存率极低,尽管外科技术较成熟,但5年生存率仍在50%左右[1]。根据美国国立综合癌症网络(National Comprehensive Cancer Network,NCCN)报道,临床分期超出T2分期且可切除性直肠癌应采用术前新辅助放化疗,常规分割治疗,但随着研究的进展,最近英国医学研究理事会CR07多中心临床试验结果显示。展开更多
Purpose: To evaluate observed and relative survival rates, enucleation rates, and visual outcome after ruthenium 106 brachytherapy for uveal melanoma. Design: Retrospective cases series from the Swedish national refer...Purpose: To evaluate observed and relative survival rates, enucleation rates, and visual outcome after ruthenium 106 brachytherapy for uveal melanoma. Design: Retrospective cases series from the Swedish national referral center. Participants: Five hundred seventy-nine patients (579 eyes) with choroidal or ciliary body melanomas, including 55 tumors more than 7 mm in height, treated with ruthenium episcleral plaques from January, 1979, through April, 2003. Methods: Clinical and radiotherapy data were extracted from a dedicated database, and survival status was determined through population registries. Tumor size was classified according to the Collaborative Ocular Melanoma Study criteria. The 5-and 10-year relative survival rates were estimated, and univariate and multivariate regression models were constructed for predictive factors on observed survival, enucleation, and visual deterioration. Main Outcome Measures: Observed and relative survival rate, proportion of secondary enucleation, deterioration of visual acuity to less than 0.5, respectively, to 0.1 or worse. Results: Tumors were classified as small in 10.5%, medium in 78.4%, and large in 9.2%of patients. The 5-and 10-year observed overall survival rates were 83.3%and 71.5%, respectively, and the corresponding relative rates were 95.5%and 94%, respectively. Factors predicting survival were tumor diameter, patient age, and secondary enucleation. One hundred six patients (18%) underwent enucleation up to 14 years after plaque treatment. The only predictive factor for enucleation was tumor size. At 5 years, 31%of the patients retained 0.5 visual acuity or better, and 49%retained better than 0.1 visual acuity. Predictive factors for visual deterioration were visual acuity and distance from posterior tumor border to the foveola. Conclusions: After ruthenium brachytherapy for uveal melanoma, the survival rates and visual outcomes in this populationbased investigationwere similar to previously published results. The eye was retained in 81.7%of patients. Careful patient selection (presently we only treat melanomas 7 mm or smaller in height) and life-long monitoring for recurrences is warranted.展开更多
Purpose: Iris neovascularization (INV) and anterior chamber angle neovascularization after radiotherapy for uveal melanoma may lead to neovascular glaucoma and enucleation. However, neovascularization of the anterior ...Purpose: Iris neovascularization (INV) and anterior chamber angle neovascularization after radiotherapy for uveal melanoma may lead to neovascular glaucoma and enucleation. However, neovascularization of the anterior ocular segment may respond favorably to treatment with panretinal photocoagulation. The purpose of this study was to evaluate the frequency, interval to development, and predisposing factors of anterior ocular segment neovascularization following iodine 125 (I125)- brachytherapy for uveal melanoma. Design: Retrospective, interventional, consecutive case series. Participants: Sixty- five patients (65 eyes), consecutively treated with I125 brachytherapy for uveal melanoma from 1995 through 2000 and followed up after radiation therapy for 24 months or more. Methods: Clinical findings and ultrasonography characteristics as well as treatment parameters were analyzed. Main Outcome Measures: The frequency of INV was determined and the interval to development of INV as well as the predisposing factors were analyzed statistically. Results: In 15 of 65 eyes (23% ), INV was detected after I125 brachytherapy at a mean± standard deviation of 26.66± 11.63 months (median, 24 months; range, 9- 48 months). Risk factors displaying the stronger correlation with INV were greater maximal tumor height (P< 0.01), greater tumor vascularity (P< 0.01), and disinsertion of horizontal rectus muscles (P=0.01). Conclusions: After I125 brachytherapy for choroidal melanoma, INV developed in 23% of eyes and was correlated with larger tumor size, greater tumor vascularity, and disinsertion of a horizontal rectus muscle.展开更多
文摘目的探讨术前改良短程放疗联合卡培他滨对腹腔镜直肠癌低位前切除术患者近远期疗效和安全性的影响。方法选取2017年1月至2018年5月重庆市人民医院收治的70例拟择期行腹腔镜下直肠癌低位前切除术和术前新辅助治疗的患者为研究对象。根据随机数字表法将入选患者分为观察组和对照组,每组各35例。观察组患者实施术前改良短程放疗联合卡培他滨的新辅助治疗方案,对照组患者实施术前标准长程放疗联合卡培他滨的新辅助治疗方案。比较两组患者围手术期资料、术前生存质量、新辅助放化疗与手术的安全性和近远期预后。结果两组患者均顺利实施腹腔镜直肠癌前切除术,无一例中转开腹。两组Ⅱ期、Ⅲ期患者的降期率比较差异均无统计学意义(均P>0.05)。两组患者病理完全缓解率、保肛率、肿瘤R0切除率、手术时间、术中出血量、术后住院天数、新辅助放化疗前世界卫生组织生存质量测定量表简表(World Health Organization quality of life BREF,WHOQOL-BREF)各维度评分和总分、新辅助放化疗和手术并发症发生率、术后1年和3年内局部复发率、远处转移率和死亡率比较差异均无统计学意义(均P>0.05)。观察组患者手术前WHOQOL-BREF生理领域、心理领域评分和总分均显著高于本组新辅助放化疗前(均P<0.05),且以上指标均显著高于同期对照组(均P<0.05),手术前治疗总费用显著低于对照组(P<0.05)。结论术前改良短程放疗联合卡培他滨对腹腔镜下直肠癌低位前切除术患者的近远期疗效、安全性与常规长程放化疗基本相当,并在术前治疗总费用和生存质量方面均具有一定优势。
文摘直肠癌是较为常见的消化系统恶性肿瘤,患者5年生存率极低,尽管外科技术较成熟,但5年生存率仍在50%左右[1]。根据美国国立综合癌症网络(National Comprehensive Cancer Network,NCCN)报道,临床分期超出T2分期且可切除性直肠癌应采用术前新辅助放化疗,常规分割治疗,但随着研究的进展,最近英国医学研究理事会CR07多中心临床试验结果显示。
文摘Purpose: To evaluate observed and relative survival rates, enucleation rates, and visual outcome after ruthenium 106 brachytherapy for uveal melanoma. Design: Retrospective cases series from the Swedish national referral center. Participants: Five hundred seventy-nine patients (579 eyes) with choroidal or ciliary body melanomas, including 55 tumors more than 7 mm in height, treated with ruthenium episcleral plaques from January, 1979, through April, 2003. Methods: Clinical and radiotherapy data were extracted from a dedicated database, and survival status was determined through population registries. Tumor size was classified according to the Collaborative Ocular Melanoma Study criteria. The 5-and 10-year relative survival rates were estimated, and univariate and multivariate regression models were constructed for predictive factors on observed survival, enucleation, and visual deterioration. Main Outcome Measures: Observed and relative survival rate, proportion of secondary enucleation, deterioration of visual acuity to less than 0.5, respectively, to 0.1 or worse. Results: Tumors were classified as small in 10.5%, medium in 78.4%, and large in 9.2%of patients. The 5-and 10-year observed overall survival rates were 83.3%and 71.5%, respectively, and the corresponding relative rates were 95.5%and 94%, respectively. Factors predicting survival were tumor diameter, patient age, and secondary enucleation. One hundred six patients (18%) underwent enucleation up to 14 years after plaque treatment. The only predictive factor for enucleation was tumor size. At 5 years, 31%of the patients retained 0.5 visual acuity or better, and 49%retained better than 0.1 visual acuity. Predictive factors for visual deterioration were visual acuity and distance from posterior tumor border to the foveola. Conclusions: After ruthenium brachytherapy for uveal melanoma, the survival rates and visual outcomes in this populationbased investigationwere similar to previously published results. The eye was retained in 81.7%of patients. Careful patient selection (presently we only treat melanomas 7 mm or smaller in height) and life-long monitoring for recurrences is warranted.
文摘Purpose: Iris neovascularization (INV) and anterior chamber angle neovascularization after radiotherapy for uveal melanoma may lead to neovascular glaucoma and enucleation. However, neovascularization of the anterior ocular segment may respond favorably to treatment with panretinal photocoagulation. The purpose of this study was to evaluate the frequency, interval to development, and predisposing factors of anterior ocular segment neovascularization following iodine 125 (I125)- brachytherapy for uveal melanoma. Design: Retrospective, interventional, consecutive case series. Participants: Sixty- five patients (65 eyes), consecutively treated with I125 brachytherapy for uveal melanoma from 1995 through 2000 and followed up after radiation therapy for 24 months or more. Methods: Clinical findings and ultrasonography characteristics as well as treatment parameters were analyzed. Main Outcome Measures: The frequency of INV was determined and the interval to development of INV as well as the predisposing factors were analyzed statistically. Results: In 15 of 65 eyes (23% ), INV was detected after I125 brachytherapy at a mean± standard deviation of 26.66± 11.63 months (median, 24 months; range, 9- 48 months). Risk factors displaying the stronger correlation with INV were greater maximal tumor height (P< 0.01), greater tumor vascularity (P< 0.01), and disinsertion of horizontal rectus muscles (P=0.01). Conclusions: After I125 brachytherapy for choroidal melanoma, INV developed in 23% of eyes and was correlated with larger tumor size, greater tumor vascularity, and disinsertion of a horizontal rectus muscle.
