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.

Efficacy and safety of short duration radiotherapy combined with chemotherapy for advanced rectal cancer

BACKGROUND Radiotherapy or chemoradiotherapy is widely used for the treatment of rectal cancer preoperatively.Although the combination of radiotherapy and chemotherapy as an established preoperative neoadjuvant therapy shows high efficacy in the treatment of rectal cancer,some patients experience a response of poor tolerance and outcomes due to the long duration radiotherapy.The study compared short duration radiotherapy plus chemotherapy vs long duration radiotherapy plus chemotherapy for rectal cancer to determine whether short duration radiation treatment should be considered to diminish complications,reduce risk of recurrence and improve survival in patients with rectal cancer.AIM To evaluate the efficacy and safety of short duration radiotherapy combined with chemotherapy for the treatment of advanced rectal cancer.METHODS One hundred patients with stage IIIB or higher severe rectal cancer were selected as the study subjects at The First Affiliated Hospital of Hebei North University between December 2018 and December 2019.The patients were assigned to different groups based on the treatment regimens.Fifty patients who received preoperative short durations of radiotherapy plus chemotherapy were enrolled in an observation group and fifty patients who received conventional radiotherapy and chemotherapy were enrolled in a control group.Colonoscopic biopsy was performed for all patients with pathological diagnosis of rectal cancer.The expression of tumor-related factors such as RUNX3 and Ki-67 was quantitatively analyzed using immunohistochemistry in the tissues of the patients before and after treatment.Moreover,the duration of procedure,the amount of bleeding during the operation,the anus-conserving rate,the incidence of postoperative complications(wound infection,anastomotic leakage,postoperative intestinal obstruction,etc.)and postoperative pathology were compared between the two groups.The overall survival rate,recurrence rate and distant metastasis rate were also compared through postoperative reexamination and regular follow-up.RESULTS There was no significant difference in the positive expression rate of RUNX3 and Ki-67 between the two groups before the treatment(P>0.05).Compared with the pretreatment value,the positive rate of RUNX3 was increased and the positive rate of Ki-67 was decreased in both groups after the treatment(all P<0.05).The incidence of leukopenia,thrombocytopenia,neutropenia and diarrhea were higher in the observation group than in the control group(all P<0.05).There was no significant difference in the incidence of anemia,fatigue,neurotoxicity and nausea and vomiting between the two groups(all P>0.05).No significant difference was observed in the duration of procedure,intraoperative bleeding,the anus-conserving rate and the incidence of postoperative complications between the two groups(P>0.05).After 1 year of follow-up,the 1-yr survival rate was 80.0%in the observation group and 68.0%in the control group,the recurrence rate was 8.0%in the observation group and 10.0%in the control group,the distant metastasis rate was 6.0%in the observation group and 8.0%in the control group difference(all P<0.05).CONCLUSION Short duration radiotherapy combined with chemotherapy can improve the cure rate,prolong the survival time and reduce the incidence of complications in patients with advanced rectal cancer.

Optimal combination of radiofrequency ablation with chemoradiotherapy for locally advanced pancreatic cancer

Problems have been reported in the treatment of pancreatic cancer with radiofrequency ablation(RFA), such as the friability of the organ itself. This report presents possible solutions to such problems. Although our patient suffered from locally advanced unresectable pancreatic cancer, she remained well at 18 mo after RFA with no evidence of recurrence. To ameliorate the side effects of RFA, after a palliative bypass procedure, the subject was treated with combined radiotherapy and chemotherapy. After this regimen had been administered, a contrast-enhanced computed tomography scan confirmed that RFA is a viable approach to the treatment of pancreatic cancer as the chemoradiotherapy had resulted in marked tumor shrinkage and pancreatic fibrosis; i.e., sufficient tumor ablation was achieved without serious RFA-related complications, such as pancreatitis or pancreatic fistulae. The present case suggests that RFA combined with preceding chemoradiotherapy is safe and effective for the palliative treatment of locally advanced pancreatic cancer.

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 phase III trials 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 thus may represent a suitable companion in the neoadjuvant treatment of LARC. Preliminary results of phase&#x02005;I-II clinical 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.

Advances in translational therapy for locally advanced gastric cancer

Translational therapy refers to a combination of chemotherapy,radiotherapy,targeted therapy,and immunotherapy for patients with advanced gastric cancer who are initially unable to undergo R0 resection.This treatment can achieve partial or complete remission of the unresectable tumors to meet the criteria for R0 resection,thus enabling the patients to prolong their survival time and improve their quality of life.In gastric cancer,translational therapy has been tried and improved.At present,there are a large number of patients with locally advanced gastric cancer in China,and the selection of suitable patients for transla-tional therapy to prolong objective survival and improve survival quality is one of the hot spots in the field of gastric cancer research.

Treatment strategy for colorectal cancer with resectable synchronous liver metastases:Is any evidence-based strategy possible?

Fifteen percent to twenty-five percent of patients affected by colorectal cancer presents with liver metastases at diagnosis. In resectable cases, surgery is the only potentially curative treatment and achieves survival rates up to 50% at 5 years. Management is complex, as colorectal resection, liver resection, chemotherapy, and, in locally advanced mid/low rectal tumors, radiotherapy have to be integrated. Modern medical practice usually relies on evidence-based protocols. Levels of evidence for synchronous metastases are poor:published studies include few recent prospective series and several retrospective analyses collecting a limited number of patients across long periods of time. Data are difficult to be generalized and are mainly representative of single centre's experience, biased by local recruitment, indications and surgical technique. In this context, surgeons have to renounce to "evidence-based medicine" and to adopt a sort of "experience-based medicine". Anyway, some suggestions are possible. Simultaneous colorectal and liver resection can be safely performed whenever minor hepatectomies are planned, while a case-by-case evaluation is mandatory in case of more complex procedures. Neoadjuvant chemotherapy is preferentially scheduled for patients with advanced metastatic tumors to assess disease biology and to control lesions. It can be safely performed with primarytumor in situ , even planning simultaneous resection at its end. Locally advanced mid/low rectal tumor represents a further indication to neoadjuvant therapies, even if treatment's schedule is not yet standardized. In summary, several issues have to be solved, but every single HPB centre should define its proper strategy to optimize patient's selection, disease control and safety and completeness of surgery.

Role of taxanes in pancreatic cancer

Pancreatic cancer is one of the most deadly cancers and is characterized by a poor prognosis. Single agent gemcitabine, despite its limited activity and modest impact on disease outcome, is considered as the standard therapy in pancreatic cancer. Most of the combination regimens used in the treatment of this disease, also including the targeted agents, did not improve the outcome of patients. Also, taxanes have been tested as single agent and in combination chemotherapy, both in first line and as salvage chemotherapy, as another possible option for treating pancreatic cancer. The inclusion of taxanes in combination with gemcitabine as upfront therapy obtained promising results. Accordingly, taxanes, and above all, new generation taxanes, appear to be suitable candidates for further testing to assess their role against pancreatic cancer in various clinical settings.

新辅助抗PD-1免疫治疗联合放化疗治疗局部晚期非小细胞肺癌的临床疗效

目的研究新辅助抗PD-1免疫疗法与化疗结合放疗序贯治疗方案治疗局部晚期非小细胞肺癌的临床疗效与安全性。方法回顾性选取2021年3月至2022年3月江苏省肿瘤医院治疗的非小细胞肺癌患者80例。依据治疗方案不同分为研究组和对照组,每组各40例。研究组接受含新辅助抗PD-1疗法的综合放化疗,对照组仅接受标准放化疗。比较两组患者的实体瘤治疗客观缓解率、细胞免疫功能、血清肿瘤因子[癌胚抗原(CEA)、糖类抗原(CA)125、CA199]以及不良反应。结果研究组患者治疗后的客观缓解率为7.00%,明显高于对照组(52.50%),差异有统计学意义(P<0.05)。治疗后,研究组患者的CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)均较治疗前升高,对照组患者的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均较治疗前降低,且研究组患者的CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)分别为(64.33±5.16)%、(43.71±4.53)%、(32.54±3.91)%、1.34±0.26,均明显高于对照组[(55.25±5.63)%、(31.87±3.16)%、(28.24±3.89)%、1.13±0.31],差异均有统计学意义(P<0.05)。治疗后,两组患者的血清CEA、CA125、CA199水平均较治疗前降低,且研究组患者的血清CEA、CA125、CA199水平分别为(12.25±4.15)ng/mL、(31.55±5.78)U/mL、(56.62±8.52)U/mL,均明显低于对照组[(18.97±4.36)ng/mL、(38.17±5.81)U/mL、(65.20±8.79)U/mL],差异均有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论新辅助抗PD-1免疫治疗联合放化疗相比单纯放化疗对局部晚期非小细胞肺癌有更加明显的优势,能够提高放化疗过程中的机体免疫功能,减少血清肿瘤相关因子,同时没有增加明显的不良反应,可以作为非小细胞肺癌提升疗效的方案在临床中推广应用。

无化疗放射治疗联合免疫检查点抑制剂治疗局部晚期非小细胞肺癌的研究进展

对不可切除的局部晚期非小细胞肺癌(LA-NSCLC)患者,同步放化疗后维持免疫检查点抑制剂治疗仍是标准的治疗方案。部分LA-NSCLC患者因各种原因不适合化疗,表现在治疗方案选择中对无化疗方案的需求。近期研究表明,放射治疗联合免疫检查点抑制剂的治疗策略有良好协同效应和潜在治疗价值。本文主要对无化疗放射治疗联合免疫检查点抑制剂治疗不可切除的LA-NSCLC进行系统总结,有助于更好地了解该治疗模式的机制、优势和局限性,为临床实践提供更有针对性的指导。

立体定向放疗联合TP方案及免疫治疗对晚期寡转移食管癌的疗效及安全性分析

目的评估立体定向放疗(SBRT)联合TP化疗方案(紫杉醇和顺铂)及免疫治疗对晚期寡转移食管癌的疗效和安全性。方法前瞻性选取2016年3月—2020年3月在苏州市立医院确诊的120例晚期寡转移食管癌患者。通过随机数字表法将患者分为治疗组和对照组,每组60例。治疗组接受SBRT联合TP化疗方案和免疫治疗;对照组仅接受TP化疗方案和免疫治疗。随访期3年。主要观察指标包括临床疗效、肿瘤标志物水平、免疫相关指标、总生存期、无进展生存期,次要观察指标为远处转移、局部复发和不良反应。结果治疗组总有效率为95%,高于对照组的58.33%(P<0.05)。治疗组治疗前后肿瘤标志物癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、细胞角蛋白片段21-1(CYFRA21-1)的差值均高于对照组(P<0.05),免疫功能指标CD4^(+)/CD8^(+)、程序性死亡受体(PD-1)、程序性死亡受体-配体1(PD-L1)的差值均高于对照组(P<0.05)。治疗组的无进展生存期和总生存期分别为(24.17±3.14)和(35.68±5.36)个月,均高于对照组(P<0.05)。治疗组的远处转移率为8.33%,低于对照组的26.67%(P<0.05),两组局部复发率、总不良反应发生率比较,差异均无统计学意义(P>0.05)。结论对于晚期寡转移食管癌患者,SBRT联合TP化疗方案及免疫治疗能显著改善临床疗效,提高总体生存期和无进展生存期,同时保持可接受的安全性。

局部晚期宫颈癌预后影响因素的研究进展

宫颈癌是全球女性生殖系统最常见的恶性肿瘤,严重危害女性健康。由于子宫颈癌筛查覆盖面有限,我国相当一部分患者就诊时已是局部晚期。局部晚期宫颈癌的首选治疗方案是以铂类为主的同步放化疗,大量研究显示,其近期疗效尚可,但易出现复发和转移,远期预后差,整体预后欠佳。目前宫颈癌的预后评估主要依据FIGO分期,然而患者年龄、肿瘤大小、病理类型、淋巴结转移情况、分子生物学指标以及治疗方案等因素均会影响宫颈癌患者预后。全面评估患者,筛选出影响患者预后的高危素对指导治疗、判断预后、提高患者生存率具有重要意义。本文从临床病理因素、分子生物学指标以及治疗方案等多个方面对局部晚期宫颈癌患者预后影响因素的临床研究进展进行概述。

三维适形放疗同步吉西他滨联合氟脲嘧啶+阿霉素+ 丝裂霉素化疗方案治疗晚期胰腺癌患者的临床研究

目的探讨三维适形放疗同步吉西他滨联合氟脲嘧啶+阿霉素+丝裂霉素(FAM)化疗方案治疗晚期胰腺癌的效果。方法选取2019年1月至2022年6月日照市中心医院收治的78例晚期胰腺癌患者作为研究对象,按照随机数字表法分为对照组与观察组,每组39例。两组均行三维适形放疗,对照组同步FAM化疗方案,观察组在对照组基础上加用吉西他滨治疗。比较两组临床疗效、肿瘤标志物水平、生命质量及不良反应发生情况。结果观察组治疗总有效率、疾病控制率均高于对照组(58.97%vs.35.90%、87.18%vs.66.67%),差异有统计学意义(P<0.05)。治疗2个周期后,观察组糖类抗原125(CA125)、癌胚抗原(CEA)、糖类抗原19-9(CA19-9)水平分别为(50.41±5.38)μg/L、(4.53±1.02)μg/L、(45.63±4.15)U/L,均低于对照组的(56.74±5.45)μg/L、(6.05±1.14)μg/L、(51.37±4.28)U/L,差异有统计学意义(P<0.05)。治疗2个周期后,观察组生理、心理、社会及环境评分分别为(84.56±6.62)、(85.44±6.43)、(90.33±4.41)、(90.52±4.13)分,均高于对照组的(75.43±6.41)、(80.14±6.35)、(83.69±6.17)、(84.46±6.59)分,差异有统计学意义(P<0.05)。两组恶心呕吐、血小板减少、白细胞下降发生率比较差异无统计学意义。结论三维适形放疗同步吉西他滨联合FAM化疗方案可增强高晚期胰腺癌治疗效果,降低肿瘤标志物水平,提高患者生命质量,且安全性尚可。

新辅助化疗联合局部热疗在局部晚期宫颈癌治疗中的疗效

目的:探讨新辅助化疗联合局部热疗在局部晚期宫颈癌治疗中的临床疗效、放疗总时间、加速器机器跳数及不良反应。方法:选取2019年9月~2022年9月桂林市人民医院40例局部晚期宫颈癌接受新辅助化疗联合局部热疗的患者作为观察组,对本组宫颈癌患者给予2个疗程TPF方案新辅助化疗,每周期给予盆腔局部深部热疗2次;同时选取单独同期放化疗40例作为对照组;分析观察组新辅助化疗联合局部热疗的疗效、两组放射治疗总时间、加速器机器跳数及两组患者的不良反应发生情况。结果:观察组新辅助化疗联合局部热疗的客观缓解率(ORR)为87.5%(35/40),其中完全缓解(CR)为30%(12/40),部分缓解(PR)为57.5%(23/40),疾病稳定(SD)为12.5%(5/40);观察组新辅助化疗联合热疗前后肿瘤最大径分别为(5.31±1.72)cm、(2.12±1.35)cm,差异有统计学意义(t=9.401,P<0.01);观察组和对照组放射治疗时间分别为(42.15±2.75)d、(53.41±6.18)d,两组比较,差异有统计学意义(t=12.398,P<0.01);观察组和对照组外照射时单次外照射加速器机器跳数分别为(1347±129.14)MU、(1556±128.61)MU两组比较,差异有统计学意义(t=3.782,P<0.01)。结论:局部晚期宫颈癌新辅助化疗联合局部热疗患者临床治疗效果显著,新辅助化疗联合热疗后腔内后装放疗能与调强外照射放疗同时进行,缩短放疗时间,单次外照射加速器机器跳数明显减少,缩短单次治疗时间,减少加速器磨损。

同步放化疗联合免疫治疗对局部晚期宫颈癌患者不良反应及效果的影响

目的探讨同步放化疗联合免疫治疗对局部晚期宫颈癌患者不良反应及效果的影响。方法非随机选取2020年1月—2023年8月在德州市第二人民医院接受治疗的96例局部晚期宫颈癌患者为研究对象,根据治疗方法不同分成两组,各48例,对照组应用同步放化疗,研究组联合应用同步放化疗、免疫治疗。对比两组疾病控制率、血清肿瘤标志物、癌因性疼痛评分、癌因性疲乏评分、生活质量评分、不良反应发生率。结果研究组疾病控制率为87.50%(42/48),高于对照组的68.75%(33/48),差异有统计学意义(χ^(2)=4.937,P<0.05)。治疗后,研究组中血清癌胚抗原、糖类抗原125、鳞状细胞抗原的水平均较对照组更低,研究组对癌因性疼痛、癌因性疲乏测评的分数均较对照组分数更低,研究组关于生活质量测评的四项分数均较对照组更高,差异有统计学意义(P均<0.05)。两组不良反应发生率对比,差异无统计学意义(P>0.05)。结论在局部晚期宫颈癌患者同步放化疗治疗的同时,联合应用免疫治疗,可增强患者的近期疗效,控制肿瘤进展,减轻癌因性症状,有利于提高其生活质量水平,且不良反应未增多,安全性可靠。

卡瑞利珠单抗联合放化疗在晚期宫颈癌患者中的应用效果

目的探讨卡瑞利珠单抗联合放化疗在晚期宫颈癌(CCA)患者中的应用效果。方法选取2021年11月至2022年10月菏泽市牡丹人民医院收治的102例晚期CCA患者作为研究对象,按照随机数字表法分为对照组(51例)与研究组(51例)。对照组接受常规放化疗治疗,研究组在对照组基础上采用卡瑞利珠单抗治疗。比较两组临床疗效、肿瘤标志物[癌抗原125(CA125)、癌胚抗原(CEA)、细胞角质蛋白19片段抗原21-1(CYFRA21-1)]、细胞免疫功能及不良反应发生情况。结果研究组治疗总有效率高于对照组(P<0.05)。治疗后,与对照组相比,研究组CA125、CEA、CYFRA21-1水平更低(P<0.05)。治疗后,研究组CD8^(+)水平低于对照组,CD4^(+)、CD3^(+)水平高于对照组(P<0.05)。两组放射性膀胱炎、发热、贫血、骨髓抑制、消化道反应、放射性直肠炎及肝、肾功能异常的发生率比较,差异无统计学意义(P>0.05)。结论卡瑞利珠单抗联合放化疗用于晚期CCA患者的临床疗效确切,可降低肿瘤标志物水平,调节细胞免疫功能,且不增加不良反应,具有临床推广价值。

调强放疗同步化疗对中晚期食管癌患者血清肿瘤标志物水平、生活质量的影响

目的探讨调强放疗同步化疗在中晚期食管癌患者中的应用效果。方法选取新泰市人民医院2020年6月—2023年6月收治的64例中晚期食管癌患者为研究对象,按随机数字表法将其分为对照组和观察组,每组32例。两组均行化疗,在此基础上,对照组进行常规放疗,观察组进行调强放疗。比较两组患者的临床效果及安全性。结果观察组的临床疗效为93.75%,高于对照组的75.00%,差异有统计学意义(P<0.05)。治疗后,观察组的癌胚抗原、细胞角化素蛋白片段19、鳞状上皮细胞癌相关抗原水平分别为(1.61±0.27)μg/mL、(1.42±0.25)ng/mL、(1.04±0.22)μg/mL,均低于对照组的(1.91±0.32)μg/mL、(1.78±0.28)ng/mL、(1.38±0.25)μg/mL,组间差异有统计学意义(P<0.05)。治疗后,观察组的世界卫生组织生活质量评定量表简表中的心理、生理、环境、社会关系领域评分分别为(86.41±6.12)分、(87.56±6.23)分、(89.47±5.81)分、(86.87±6.25)分,均高于对照组的(80.34±5.87)分、(80.87±6.11)分、(82.06±5.39)分、(80.76±6.14)分,组间差异有统计学意义(P<0.05)。两组的不良反应发生率比较,差异无统计学意义(P>0.05)。结论调强放疗同步化疗可提高中晚期食管癌的控制效果,降低患者血清肿瘤标志物水平,更好地改善其生活质量,安全可行。

三维适形放射治疗与同步化疗治疗晚期非小细胞肺癌效果比较

目的系统评价单纯三维适形放射治疗(放疗)与同步化学治疗(化疗)在局部晚期非小细胞肺癌治疗中的疗效与安全性。方法计算机检索Cochrane Database of Systematic Reviews、Medline、EMbase、OpenSIGLE、National Technical Information Service(NTIS)、中国知网(CNKI)、维普数据库(VIP)、万方数据库和CBM中关于三维适形放疗联合化疗治疗局部晚期非小细胞肺癌疗效评估的随机对照试验(RCT),同时追索纳入文献的参考文献。检索时限均从建库至2011年10月。由两名研究者对纳入研究的质量进行严格评价和资料提取,对符合质量标准的RCT进行Meta分析。统计学分析采用RevMan5.0.25软件。结果共纳入12个RCT,Meta分析5个主要结局指标的结果显示:单纯三维适形放疗与同步化疗比较,有效率和局部症状改善差异有统计学意义[分别为OR=2.52,95%CI(1.41,4.52)和OR=3.22,95%CI(1.32,7.83)],放射性食管炎、放射性肺炎和骨髓抑制程度差异无统计学意义。结论现有研究表明,三维适形放疗联合化疗可明显改善患者局部症状,提高治疗有效率,且大部分患者可耐受毒副作用,临床医师可将联合化疗作为强推荐。但鉴于纳入研究较少,样本量小,质量不高,仍需开展大样本、多中心、方法科学和规范的高质量RCT,以进一步验证二者的联合治疗效果。

局部晚期乳腺癌的治疗进展

新辅助化疗后再手术和(或)放疗已成为治疗局部晚期乳腺癌的治疗模式。本文综述新辅助化疗的依据、疗程方案、影响疗效及预后相关因素及其优缺点,同时介绍了局部晚期乳腺癌诊断,局部治疗及内分泌治疗等方面的进展。

益气活血中药在中晚期胰腺癌放化疗中的作用

目的 :探讨益气活血中药在中晚期胰腺癌放化疗中的作用。方法 :58例中晚期胰腺癌患者随机分成两组 ,2 8例行放疗和介入化疗 (A组 ) ,与 30例放疗、介入化疗及益气活血中药并用 (B组 )进行比较。结果 :A、B两组近期有效率为 53 6%、67 6% (P >0 0 5)。腹痛、黄疸症状缓解率A组分别为 57 1%、50 0 % ,B组分别为 83 3%、76 7% ,两组比较差异均有显著性 (P <0 0 5)。消化道反应B组 ( 4例 )明显轻于A组 ( 11例 ,P <0 0 5)。 1、2年生存率A组分别为 50 0 %、2 1 4 % ,B组分别为 80 0 %、4 6 6% ,两组比较差异有显著性 (P <0 0 5)。结论 :益气活血中药能减轻放化疗所致的消化道反应 ,提高临床症状有效率 ,延长 1。

16例局部晚期胃癌同步放化疗的疗效分析

目的:探讨不能手术或不愿手术的局部进展期胃癌行同步放化疗的疗效、不良反应。方法:选择不能手术或不愿手术的局部进展期胃癌患者16例,给予DLF方案化疗2周期,同步行病灶以及胃周淋巴结区域放疗DT 45-50.4Gy/1.8-2.0Gy。治疗期间评价不良反应,治疗结束后1个月开始评价疗效,每两个月随访一次。结果:16例患者全部完成治疗,客观缓解率为75%;患者梗阻、疼痛、出血的症状缓解率分别为:80.0%(12/15),83.3%(5/6),100%(1/1)。中位进展时间为6个月,中位生存期为7个月,生存期范围:5-18个月。不良反应主要为I-II级血液学和消化道反应。结论:局部进展期胃癌选用DLF方案同步放疗疗效较好,不良反应可以耐受,值得进一步推广。