艾迪注射液减轻胃肠癌化疗毒副作用的临床观察

目的:探讨艾迪注射液对胃肠癌术后化疗毒副作用的影响。方法:胃肠癌患者82例,分成治疗组4 8例,对照组34例,两组均用HCPT、DDP、5Fu -CF方案,对照组加艾迪注射,对两组出现的毒副反应进行分析。结果:艾迪实验组胃肠反应发生率为4 5 .3% ,白细胞下降发生率为2 7.6 % ;血小板下降率为13.1% ;而单纯化疗组胃肠反应分别为:胃肠反应发生率为6 8.1% ,白细胞下降率为82 % ,血小板下降发生率为38.6 % ,两组各项配对t检验,P<0 .0 1,差异均有显著性。

帕洛诺司琼在胃肠癌化疗过程中止吐的疗效探析

目的研究并探析帕洛诺司琼在胃肠癌化疗过程中止吐的临床疗效。方法选取2011年2月至2012年2月本院收治的90例胃肠癌化疗患者进行分析,在治疗观察的过程中,将所有患者分为观察组和对照组,进行不同的药物治疗。对不同的药物进行对比分析,最终得出帕洛诺司琼的治疗效果。通过两组的分析,将所有的资料进行对比分析,了解帕洛诺司琼在胃肠癌化疗过程中的临床止吐效果。结果在急性呕吐中,观察组和对照组的临床治疗效果没有明显的差异。在延发性呕吐的临床治疗过程中,有一些区别。其中在对照组的观察中,帕洛诺司琼和恩丹西酮治疗以及格拉司琼组也有区别。结论通过临床分析,在观察组和对照组的治疗过程中,帕洛诺司琼对于治疗胃肠癌患者的止吐效果比较明显。在化疗的过程中,持续的时间比较长,效果快,无论是急性呕吐还是延发性的呕吐,效果都十分的明显。

胃肠癌化疗患者的营养状况评估基础上饮食干预的效果分析

探究胃肠癌化疗患者的营养状况评估基础上饮食干预的效果分析。方法 从本院2019年1月~2021年1月期间收治的胃肠癌化疗患者抽取86例,按照时间段2019年1月~2020年12月为对照组(n=43),2020年1月~2021年12月为试验组(n=43),对照组为常规护理措施,试验组使用营养状况评估联合饮食干预,比较两组护理干预后生活质量、心理状态、营养状态、营养物质吸收情况和护理满意度。结果 试验组生活质量、心理状态、营养状态、营养物质吸收情况更好,分析两组干预后的护理满意度指标,试验组比对照组更好,具有统计学差异(P<0.05)。结论 在胃肠癌化疗患者中应用营养状况评估联合饮食干预措施效果显著。

斑点追踪技术联合血清高敏肌钙蛋白测定评价胃肠癌化疗患者心脏功能的改变

目的应用斑点追踪技术联合血清高敏肌钙蛋白测定评价胃肠癌患者应用FOLFOX(5-氟尿嘧啶+奥沙利铂+亚叶酸钙)化疗前后的心脏功能损伤情况。方法选取30例健康志愿者为正常组,另选择2020年1月至2021年3月我院收治的采用FOLFOX方案进行化疗的38例胃肠癌患者作为研究对象,采用自身对照的方式进行研究,于化疗前、化疗第2、4、6个周期结束后用斑点追踪评价患者的左心室纵向心肌应变,并于化疗前、化疗第2、4、6个周期结束后(24~48 h内)分别进行高敏肌钙蛋白的测定。结果化疗开始后,患者LVEDV在第4、6周期结束后有明显降低,分别为(92.45±10.11)ml、(74.86±10.07)ml;LVEF在第4、6周期结束后有明显降低,分别为(61.50±1.14)%、(58.36±1.08)%,较化疗前有统计学意义(P<0.05);LVFS在第4、6周期结束后有明显降低,分别为(37.50±2.25)%、(36.19±2.16)%,较化疗前有统计学意义(P<0.05);而其他常规左室超声心动图参数变化不明显;患者左室收缩期纵向应变在化疗前、化疗2周期、4周期、6周期后分别为(21.42±1.63)%、(19.76±1.41)%、(18.31±1.27)%、(17.69±1.09)%,随着化疗周期的增加纵向应变降低幅度更加明显(P<0.05);化疗第2、4、6个周期结束后患者高敏肌钙蛋白依次升高,分别为(4.04±0.77)pg/ml、(5.73±0.83)pg/ml、(7.69±0.89)pg/ml,较化疗前(2.67±0.64)pg/ml比较有统计学意义(P<0.05)。肌钙蛋白与左心室整体纵向应变呈负相关(r=-0.535,P<0.05)。结论斑点追踪技术联合血清高敏肌钙蛋白测定能够在胃肠癌化疗患者EF出现改变前预测患者心肌功能受损情况,并且血清高敏肌钙蛋白随着左心室整体纵向应变的降低而升高,对临床有一定的指导意义。

胃、结直肠癌肝转移的介入治疗(附55例报告)

目的评价胃、结直肠癌肝转移瘤介入治疗效果及影响因素。方法采用Seldinger法经股动脉插管,治疗胃癌、结直肠癌肝转移21例、34例。化疗药物选择5-Fu、PDD、ADM或ADM与碘化油乳剂作栓塞治疗。结果1胃、结直肠癌肝转移瘤总有效率CR+PR为64%;234例转移瘤碘化油沉积CT分为四型:均匀型占20%,非均匀型占39%,环型占9%,无碘油沉积型占32%;3转移瘤疗效最好者为单发、多血供病灶及均匀碘化油蓄积者;464%病例治疗后出现肝外转移。结论介入化疗栓塞治疗为胃、结直肠癌肝转移有效的姑息治疗手段。

Effects of nutritional and psychological status in gastrointestinal cancer patients on tolerance of treatment

AIM: To assess the effects of poor nutritional and psychological status on tolerance of cancer treatment and the recovery of physical performance status in patients with gastrointestinal cancer. METHODS: An epidemiological survey with respect to nutritional and psychological status in patients with gastrointestinal cancer was conducted among 182 operated patients in four provincial-level hospitals from December 2005 to June 2006. The food frequency survey method, state-trait anxiety inventory (STAI) and depression status inventory (DSI) were used to obtain information about the diet and psychological status in the patients. Nutritional status in the participants was reflected by serum albumin (Alb), hemoglobin (HB) and body mass index (BMI). RESULTS: Alb, protein intake and anxiety were associated with the severity of side effects of treatment. The adjusted relative risk (RR) for Alb, protein intake and anxiety was 3.30 (95% CI: 1.08, 10.10, P = 0.03), 3.25 (95% CI: 1.06, 9.90, P = 0.04) and 1.48 (95% CI: 1.29, 1.70, P < 0.0001), respectively. Moreover, calorie intake, HB and depression were associated with the recovery of physical performance status in the patients. Adjusted relative risk was 2.12 (95% CI: 1.09, 4.03, P = 0.028), 2.05 (95% CI: 1.08, 3.88, P =0.026) and 1.07 (95% CI: 1.02, 1.12, P = 0.007), respectively. CONCLUSION: Both poor nutrition status and psychological status are independent risk factors for severe side effects of cancer treatment, and have impact on the recovery of physical performance status in patients after treatment.

Hyperthermic intraperitoneal chemotherapy for gastric and colorectal cancer in China's Mainland

AIM:To investigate the current status of peritoneal carcinomatosis(PC) management,as well as the usage of cytoreductive surgery(CRS) and hyperthermic intraperitoneal chemotherapy(HIPEC) in China's Mainland.METHODS:A potentially curative therapeutic strategy for selecting patients with PC,known as "Techniques",consists of CRS in combination with HIPEC.A systemic search of published works and clinical trials was performed.Additional papers were retrieved by crosschecking references and obtaining information from Chinese oncologists and relevant conferences.One hundred and one papers and one registered clinical trial on HIPEC were included.RESULTS:A literature review identified 86 hospitals in 25 out of all 31 areas of China's Mainland that perform HIPEC.The earliest report included in our survey was published in 1993.Different approaches to HIPEC have been utilized,i.e.palliative,prophylactic,and possiblycurative treatment.Only one center has consistently performed HIPEC according to the "Sugarbaker Protocol",which involves evaluating the extent of PC with peritoneal cancer index and the results of CRS with the completeness of cytoreduction.Positive preliminary results were reported:7 of 21 patients with PC survived,free of tumors,during an 8-43-mo follow-up period.Hyperthermic strategies that include HIPEC have been practiced for a long time in China's Mainland,whereas the "Sugarbaker Protocol/Techniques" has been only rarely implemented in China.The Peritoneal Surface Oncology Group International hosts a biannual workshop with the intent to train more specialists in this field and provide support for the construction of quality treatment centers,especially in developing countries like China,whose population is huge and has a dramatically increased incidence of cancer.CONCLUSION:To popularize Sugarbaker Protocol/Techniques in China's Mainland in PC management arising from gastric cancer or colorectal cancer will be the responsibility of the upcoming Chinese Peritoneal Surface Oncology Group.

Effect of Fuzheng Yiliu decoction combined with chemotherapy on patients with intermediate and late stage gastrointestinal cancer

AIM: To investigate the therapeutic effects of Fuzheng Yiliu (strengthening the body resistance to inhibit tumor) decoction combined with chemotherapy on the patients with intermediate and late stage gastrointestinal cancer. METHODS: Sixty patients were randomly divided into treatment group (chemotherapy combined with Fuzheng Yiliu decoction) and control group (chemotherapy alone). Four indexes, including the tumor recent remission rate (RR), the change of main symptoms, the toxic and side effects caused by chemotherapy and the change of performance status, were observed in the patients. Peripheral blood contents of CD3+, CD4+, CD8+ cells, CD4+/CD8+ and soluble interleukin-2 receptor (sIL-2R) were tested before and after treatment and the values were compared with those of healthy peoples. RESULTS: The improving rate of main symptoms (69.6%) and performance status (56.7%) were significantly higher in the treatment group than in the control group (34.8%, 26.7%, P<0.05). The occurrence rates of grade II toxic and side-effects on both bone marrow (13.3%) and digestive tract (30%) were lower in the treatment group compared to the control group (36.7%, 63.3%, P<0.05). Before treatment, the proportion of CD3+, CD4+ and CD4+/CD8+ decreased and the proportion of CD8+ and SIL-2R raised markedly both in the control group and treatment group as compared to the healttiy people. After treatment, that increased of CD3+, CD4+, CD4+/CD8+ increased (62.25±10.01% vs 68.31±9.72%, 36.83±10.44% vs 42.6±9.62%, 1.24±0.65 vs l.66±0.85, P<0.05) and the values of CD8+ and sIL-2R decreased obviously (33.06±7.69% vs 29.24±6.25%, 588.23±216.86 U/mL vs 475.87±211.36 U/mL,P<0.05) in the treatment group, whereas these values were opposite in the control group (64.22±6.91% vs60.63±5.75%,35.62±7.49% vs31.53±5.53%, 32.95±8.28% vs 37.14±7.48%, 1.17±0.43 vs 0.94±0.43, 573.63±214.32 U/mL vs 692.17?21.33 U/mL, P<0.05). CONCLUSION: Fuzheng Yiliu decoction can enhance therapeutic effects of chemotherapy on malignant gastrointestinal tumor, and also reduce the toxic and side effects on bone marrow and digestive tract, thereby improving the quality of life and cellular immunity in patients with malignant gastrointestinal tumor.

Systemic therapy of non-colorectal gastrointestinal malignancies in the elderly

In the coming years life expectancy is expected to increase and with this the percentage of the population above age 65 will grow. Patients above 65 make up more than two thirds of those currently diagnosed with gastrointestinal malignancies. Available evidence based medicine does not focus on the average patient, above the age 70, encountered in every day practice. Most guidelines and clinical trials are not designed to take into account the special considerations needed when treating the elderly such as functional status, comorbidities, polypharmacy, life expectancy, and social support. The majority of available data is based on retrospective reviews or subset analyses of larger studies where the elderly represent a fraction of the studied population. This review focuses on the toxicities and tolerability of current standard therapies for noncolorectal gastrointestinal malignancies, including gastroesophageal, pancreatic, bile duct and hepatocellular cancers in the elderly. With careful patient selection and geriatric assessment the elderly can safely benefit from standard therapies offered to younger patients.

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.

Short-term efficacy of Cetuximab-contained regimen on patients with advanced gastrointestinal (noncolorectal) cancer: Experiences of 16 patients in single institute

Objective： Cetuximab is an effective medicine for colorectal cancer bearing wild type Kras. However, few studies of cetuximab on patients with noncolorectal gastrointestinal cancer were available now. The aim of this study was to summarize the efficacy and safety profiles base-on the experiences of 16 patients with noncolorectal gastrointestinal cancer accepted cetuximab-contained regimens treatment. Methods： The clinical data of all patients with noncolorectal gastrointestinal cancer treated by cetuximab combined with chemotherapy and/or radiotherapy from October 1st 2006 to Jun 30th 2009 in Sun Yat-sen University Cancer Center were collected. Results： （1） A total of 16 patients enrolled, including gastric cancer, esophageal carcinoma, pancreatic cancer and cholangiocarcinoma （8, 6, 1 and 1, respectively）. The cetuximab was administered 92 cycles totally with median cycle of 4. （2） PR, SD and PD obtained in 4, 3 and 2 patients respectively in cetuximab ＋ chemotherapy group. The disease control rate, median l-rP and median OS were 77.8% （7/9）, 3.5 months and 3.5 months, respectively. （3） Both of patients in cetuximab ＋ radiotherapy group achieved PR with median TTP of 4 months and 7 months, with median OS of 14 and 28 months, respectively. （4） in evaluable patients, 3 PR obtained in first-line setting, 1 PD and 1 SD achieved in second-line setting, 2 SD and 1 PD appeared in third-line and more than third-line setting. （5） The commonly side effect was neutropenia, however, rash and hypomagnesemia were the common side effects related to cetuximab. Conclusion： Cetuximab-contained regimens show a promising disease control rate, especially in first-line setting, in patients with noncolorectal gastrointestinal cancer, and the side effects both related to cytotoxic agents and related to cetuximab itself is tolerable and manageable. Of course, more phase Ⅲ clinical trails are needed urgently.

Fulminant amoebic colitis during chemotherapy for advanced gastric cancer

A 52-year-old man had bloody stools during chemo-therapy for gastric cancer. A colonoscopy revealed necrotizing ulcer-like changes. A biopsy confirmed the presence of amoebic trophozoites. Subsequently, peritonitis with intestinal perforation developed, and emergency peritoneal lavage and colostomy were performed. After surgery, endotoxin adsorption therapy was performed and metronidazole was given. Symptoms of peritonitis and colonitis resolved. However, the patient's general condition worsened with the progression of gastric cancer. The patient died 50 d after surgery. Fulminant amoebic colitis is very rarely associated with chemotherapy. Amoebic colitis should be considered in the differential diagnosis of patients who have bloody stools during chemotherapy.