Objective:To explore the influence on liver function of hepatic artery interventional chemoembolization combined reduced glutathione therapy for elderly patients with advanced liver cancer.Methods:A total of 120 cases...Objective:To explore the influence on liver function of hepatic artery interventional chemoembolization combined reduced glutathione therapy for elderly patients with advanced liver cancer.Methods:A total of 120 cases of elderly patients with advanced liver cancer from digestive surgery in-patient department of our hospital during the period of January 2014 and January 2016 were selected as the research object, the patients were divided into two groups by using the random number table method,each for 60 cases.The control group were given conventional drugs chemotherapy, the study group were given hepatic artery interventional chemoembolization combined reduced glutathione therapy, serum liver function indexes of Direct Bilirubin(DBil), Total Bilirubin(TBil), Aspartate Transaminase(AST) and Alanineamino Transferase (ALT)were detected by using automatic biochemical analyzer. Results: The clinical remission rate of study group was significantly higher than the control group, the recurrence rate was obviously lower than the control group,compared between the two groups with statistically significant differences. The average survival time of study group (29.36±6.25) months, was significantly longer than the control group (18.02±4.16) months .Before the treatment, serum DBil, TBil, AST and ALT levels compared between the two groups with no statistically significant differences,after the treatment,the indexes of study group was significantly lower than the control group. The indexes levels compared between pre-therapy and post-therapy in study group with no statistically significant differences, while the indexes levels of post-therapy in the control group were significantly higher than those pre-therapy. Before the treatment, the life quality score compared between the two groups with no statistically significant differences, after treatment,the score of all patients were significantly higher than those pre-therapywhich the score of study group was significantly higher than the control group.The incidence rate of drug adverse reactions compared between the two groups with no statistically significant differences.Conclusion: The clinical efficacy of hepatic artery interventional chemoembolization combined reduced glutathione therapy for elderly patients with advanced liver cancer is satisfying, and helps to significantly improve liver function, improve life quality, it is worth popularization and application in the clinical practice.展开更多
Purpose: This study aims to understand how elderly patients with advanced cancer and their families make a decision for a place of death for the patient. Methods: Semi-structured interviews were conducted with 17 pair...Purpose: This study aims to understand how elderly patients with advanced cancer and their families make a decision for a place of death for the patient. Methods: Semi-structured interviews were conducted with 17 pairs of elderly patients and members of their family. The patients had finished anticancer treatment and made some decision about the preferred place of death. A modified grounded-theory approach was used for the data analysis. Results: Making a “tentative” decision for the place of death of the elderly patients is a process with the core category [carefully choosing the final place for self-fulfillment]. The patients were “conducting a comprehensive review of the place of death” and “embracing the wishes for a way of life without difficulty”. Involving the family in making a “tentative” decision about the place of death of the elderly patients is the process with the core category [realizing the wish of patients in the terminal condition for the way for death]. The families were “examining the place of death from different aspects” and “respecting the patient’s intention as far as possible”. Conclusions: When the patients [carefully choosing the final place for self-fulfillment], it was important to reconcile their wishes with the burden on the families. When the families were trying to [realize the wish of patients in the terminal condition for the way for dying], it was important to balance the respect for the patient intentions and homecare they can provide for the patient. For the patients and their families, it is essential to mutually understand the intentions and wishes of the other party in decision making about the place of death.展开更多
OBJECTIVES: To understand the characteristics of primary, liver camcer (PLC) in the elderly and summarize the experience in treatment of such patients. METHODS: The clinical data of PLC in the elderly group (≥60 year...OBJECTIVES: To understand the characteristics of primary, liver camcer (PLC) in the elderly and summarize the experience in treatment of such patients. METHODS: The clinical data of PLC in the elderly group (≥60 years, 125 patients) and the young group (≤59 years, 295 patients) were analyzed retrospectively. RESULTS: In the elderly group, 64 patients were found HBsAg positive, 39 patients small PLC, 24 large PLC, 15 tumor emboli in the portal vein, 86 AFP positive, and 34 hepatectomy performed. In the young group, 205 patients were found HBsAg positive, 79 patients small PLC, 97 large PLC, 96 tumor emboli in the portal vein, 200 AFP positive, and 126 hepatectomy performed. The median survival was 44 and 25 months respectively, and no significant difference was observed in the mortality between the two groups (P>0.05). CONCLUSIONS: Hepatectomy is a choice of treatment for PLC in the elderly based on their liver function. AFP and B-ultrasonography are important methods for the diagnosis of PLC in the elderly.展开更多
Objective:The aim of our study was to evaluate the clinical efficacy and side effects of docetaxel as single chemotherapy for elderly patients with advanced non-small-cell lung cancer (NSCLC). Methods: Forty-two elder...Objective:The aim of our study was to evaluate the clinical efficacy and side effects of docetaxel as single chemotherapy for elderly patients with advanced non-small-cell lung cancer (NSCLC). Methods: Forty-two elderly patients with advanced NSCLC who were chemotherapy-naive were enrolled in this study. Docetaxel at the doses of 70 mg/m2 was administrated intravenously every 21 days as a cycle, each patient received 2-4 cycles. All patients were followed up until disease progressed or patients died. Results: Among 42 patients, 40 could be evaluated, 1 complete response (CR), 9 partial response (PR), 13 stable disease (SD), 17 progress disease (PD). The overall response rate (CR+PR) was 35% and disease control rate (CR+PR+SD) was 57.5%. The median time to progress (TTP) was 4.2 months, median survival time was 6.1 months and 1-year survival rate was 35.8%. The main toxicity was myelosuppression and decreasing platelet. Conclusion: Single agent docetaxel for elderly patients with advanced NSCLC is an efficient and well-tolerated chemotherapeutic approach with a low toxicity level.展开更多
Objective:To investigate the effect of Kanglaite injection combined with docetaxel in advanced esophageal cancer on tumor markers, angiogenesis and immune function in elderly patients.Method:A total of 130 patients wi...Objective:To investigate the effect of Kanglaite injection combined with docetaxel in advanced esophageal cancer on tumor markers, angiogenesis and immune function in elderly patients.Method:A total of 130 patients with advanced esophageal cancer admitted in our hospital from October 2014 to July 2017were selected and divided into two groups according to the time of admission, 65 cases in each group, set as observation group and control group, all patients were treated with conventional radiotherapy (cisplatin combined with 5-fluorouracil), the observation group was given Kanglaite injection combined with docetaxel on the basis of this, while the control group only was given docetaxel treatment, the treatment period was 6 weeks, tumor markers, VEGF and immune function of both group after treatment were compared.Result: After treatment, the levels of carbohydrate antigen 125 (CA125), carbohydrate antigen 19-9 (CA19-9) and carcino-embryonic antigen (CEA) in the observation group were lower than those in the control group, the difference was statistically significant;VEGF level in the observation group after treatment was lower than the control group, the difference was statistically significant;After treatment, the levels of CD3+, CD4+ and CD4+/CD8+ in the observation group were higher than those in the control group, while the levels of CD8+ in the observation group was lower than those in the control group, the difference was statistically significant.Conclusion: Kanglaite injection combined with docetaxel in the treatment of elderly patients with advanced esophageal cancer is better, effectively reducing the level of tumor markers and vascular endothelial growth factor, improve immune function, it isworthy of clinical application.展开更多
Enhanced recovery after surgery (ERAS) has been used in various surgical professions in recent years and is widely accepted by doctors. This concept not only helps patients speed up postoperative recovery, reduce the ...Enhanced recovery after surgery (ERAS) has been used in various surgical professions in recent years and is widely accepted by doctors. This concept not only helps patients speed up postoperative recovery, reduce the incidence of related complications and shorten hospital stays, but also has been proved to be effective and safe in the perioperative application of gastric cancer. This article reviews the clinical application and research progress of enhanced recovery after surgery in the perioperative period of advanced gastric cancer in the elderly.展开更多
Although it is assumed that the combination of chemotherapy and radical surgery should be indicated in all newly diagnosed advanced-stage ovarian cancer patients, one of the main raised questions is how to select the ...Although it is assumed that the combination of chemotherapy and radical surgery should be indicated in all newly diagnosed advanced-stage ovarian cancer patients, one of the main raised questions is how to select the best strategy of initial treatment in this group of patients, neoadjuvant chemotherapy followed by interval debulking surgery or primary debulking surgery followed by adjuvant chemotherapy. The selection criteria to offer one strategy over the other as well as a stepwise patient selection for initial treatment are described. Selecting the best strategy of treatment in newly diagnosed advanced stage ovarian cancer patients is a multifactorial and multidisciplinary decision. Several factors should be taken into consideration:(1) the disease factor, related to the extension and localization of the disease as well as tumor biology;(2) the patient factor, associated with patient age, poor performance status, and co-morbidities; and(3) institutional infrastructure factor, related to the lack of prolonged operative time, an appropriate surgical armamentarium, as well as well-equipped intensive care units with well-trained personnel.展开更多
Laparoscopy-assisted distal gastrectomy(LDG)combined with D2 lymphadenectomy may be safely performed in patients with advanced gastric cancer(AGC)by experienced surgeons at specialized high-volume institutions as show...Laparoscopy-assisted distal gastrectomy(LDG)combined with D2 lymphadenectomy may be safely performed in patients with advanced gastric cancer(AGC)by experienced surgeons at specialized high-volume institutions as shown in the Chinese Laparoscopic Gastrointestinal Surgery Study(CLASS)-01.However,studies focusing on the use of LDG in patients with gastric cancer older than 65 years are rare.This study was designed to investigate the morbidity and mortality of elderly patients with gastric cancer who underwent laparoscopic-assisted or open distal gastrectomy(ODG).In this prospective,randomized,open,parallel controlled trial,patients older than 65 years with tumor located at the middle or lower part of the stomach will be enrolled in this study.Patients will be randomly divided into a laparoscopic group and an open surgery group.The early post-operative complications,intra-operative complications and post-operative recovery will be compared between the two groups.This trial will provide valuable clinical evidence for the objective assessment of the feasibility,short-term safety,and potential benefits of LDG compared with ODG for gastric cancer in the elderly patients.This trial has been registered on ClinicalTrials.gov.(Identifier:NCT02246153.)in September 22,2014.展开更多
Bevacizumab,an anti-VEGF monoclonal antibody,has significantly improved the clinical outcomes of patients with advanced non-squamous NSCLC(ns-NSCLC).However,the safety and efficacy of bevacizumab for elderly patients ...Bevacizumab,an anti-VEGF monoclonal antibody,has significantly improved the clinical outcomes of patients with advanced non-squamous NSCLC(ns-NSCLC).However,the safety and efficacy of bevacizumab for elderly patients with advanced NSCLC require further investigation.Thus,59 patients were included in the present retrospective study,22 patients in the bevacizumab plus pemetrexed and platinum(B+PP)group,and 37 patients in the pemetrexed and platinum(PP)group.For the entire cohort of patients,the median OS was 33.3 months,and the 1-year and 2-year overall survival rates were 88.5%and 67.8%,respectively.The median OS and 1-year and 2-year OS rates were 20.5 months,70.3%and 0%,respectively,in the B+PP group and 33.4 months,97.0%and 89.4%,respectively,in the PP group(P<0.001).The incidence of grade≥3 adverse events was higher in the B+PP group than in the PP group(27.3%vs.10.8%,respectively;P=0.204).Univariate and multivariate analyses suggested that the receipt of≥5 cycles of first-line chemotherapy was an independent favorable prognostic factor for OS,whereas the addition of bevacizumab was an unfavorable prognostic factor.With increased toxicities,the addition of bevacizumab to PP does not improve the overall survival of elderly patients with advanced ns-NSCLC.展开更多
Lung cancer is the leading cause of cancerrelated mortality in China.(1'2) Meanwhile, the average life expectancy in the aging population has increased from 46 years in 1950 to 75 years in 2010.
The treatment of metastatic colorectal cancer(mCRC)has evolved considerably in the last decade,currently allowing most mCRC patients to live more than two years.Monoclonal antibodies targeting the epidermal growth fac...The treatment of metastatic colorectal cancer(mCRC)has evolved considerably in the last decade,currently allowing most mCRC patients to live more than two years.Monoclonal antibodies targeting the epidermal growth factor receptor(EGFR)and vascular endothelial growth factor play an important role in the current treatment of these patients.However,only antibodies directed against EGFR have a predictive marker of response,which is the mutation status of v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog(KRAS).Cetuximab has been shown to be effective in patients with KRAS wild-type mCRC.The CRYSTAL study showed that adding cetuximab to FOLFIRI(regimen of irinotecan,infusional fluorouracil and leucovorin)significantly improved results in the first-line treatment of KRAS wildtype mCRC.However,results that evaluate the efficacy of cetuximab in combination with oxaliplatin-based chemotherapy in this setting are contradictory.On the other hand,recent advances in the management of colorectal liver metastases have improved survival in these patients.Adding cetuximab to standard chemotherapy increases the response rate in patients with wild-type KRAS and can thus increase the resectability rate of liver metastases in this group of patients.In this paper we review the different studies assessing the efficacy of cetuximab in the first-line treatment of mCRC.展开更多
文摘Objective:To explore the influence on liver function of hepatic artery interventional chemoembolization combined reduced glutathione therapy for elderly patients with advanced liver cancer.Methods:A total of 120 cases of elderly patients with advanced liver cancer from digestive surgery in-patient department of our hospital during the period of January 2014 and January 2016 were selected as the research object, the patients were divided into two groups by using the random number table method,each for 60 cases.The control group were given conventional drugs chemotherapy, the study group were given hepatic artery interventional chemoembolization combined reduced glutathione therapy, serum liver function indexes of Direct Bilirubin(DBil), Total Bilirubin(TBil), Aspartate Transaminase(AST) and Alanineamino Transferase (ALT)were detected by using automatic biochemical analyzer. Results: The clinical remission rate of study group was significantly higher than the control group, the recurrence rate was obviously lower than the control group,compared between the two groups with statistically significant differences. The average survival time of study group (29.36±6.25) months, was significantly longer than the control group (18.02±4.16) months .Before the treatment, serum DBil, TBil, AST and ALT levels compared between the two groups with no statistically significant differences,after the treatment,the indexes of study group was significantly lower than the control group. The indexes levels compared between pre-therapy and post-therapy in study group with no statistically significant differences, while the indexes levels of post-therapy in the control group were significantly higher than those pre-therapy. Before the treatment, the life quality score compared between the two groups with no statistically significant differences, after treatment,the score of all patients were significantly higher than those pre-therapywhich the score of study group was significantly higher than the control group.The incidence rate of drug adverse reactions compared between the two groups with no statistically significant differences.Conclusion: The clinical efficacy of hepatic artery interventional chemoembolization combined reduced glutathione therapy for elderly patients with advanced liver cancer is satisfying, and helps to significantly improve liver function, improve life quality, it is worth popularization and application in the clinical practice.
文摘Purpose: This study aims to understand how elderly patients with advanced cancer and their families make a decision for a place of death for the patient. Methods: Semi-structured interviews were conducted with 17 pairs of elderly patients and members of their family. The patients had finished anticancer treatment and made some decision about the preferred place of death. A modified grounded-theory approach was used for the data analysis. Results: Making a “tentative” decision for the place of death of the elderly patients is a process with the core category [carefully choosing the final place for self-fulfillment]. The patients were “conducting a comprehensive review of the place of death” and “embracing the wishes for a way of life without difficulty”. Involving the family in making a “tentative” decision about the place of death of the elderly patients is the process with the core category [realizing the wish of patients in the terminal condition for the way for death]. The families were “examining the place of death from different aspects” and “respecting the patient’s intention as far as possible”. Conclusions: When the patients [carefully choosing the final place for self-fulfillment], it was important to reconcile their wishes with the burden on the families. When the families were trying to [realize the wish of patients in the terminal condition for the way for dying], it was important to balance the respect for the patient intentions and homecare they can provide for the patient. For the patients and their families, it is essential to mutually understand the intentions and wishes of the other party in decision making about the place of death.
文摘OBJECTIVES: To understand the characteristics of primary, liver camcer (PLC) in the elderly and summarize the experience in treatment of such patients. METHODS: The clinical data of PLC in the elderly group (≥60 years, 125 patients) and the young group (≤59 years, 295 patients) were analyzed retrospectively. RESULTS: In the elderly group, 64 patients were found HBsAg positive, 39 patients small PLC, 24 large PLC, 15 tumor emboli in the portal vein, 86 AFP positive, and 34 hepatectomy performed. In the young group, 205 patients were found HBsAg positive, 79 patients small PLC, 97 large PLC, 96 tumor emboli in the portal vein, 200 AFP positive, and 126 hepatectomy performed. The median survival was 44 and 25 months respectively, and no significant difference was observed in the mortality between the two groups (P>0.05). CONCLUSIONS: Hepatectomy is a choice of treatment for PLC in the elderly based on their liver function. AFP and B-ultrasonography are important methods for the diagnosis of PLC in the elderly.
文摘Objective:The aim of our study was to evaluate the clinical efficacy and side effects of docetaxel as single chemotherapy for elderly patients with advanced non-small-cell lung cancer (NSCLC). Methods: Forty-two elderly patients with advanced NSCLC who were chemotherapy-naive were enrolled in this study. Docetaxel at the doses of 70 mg/m2 was administrated intravenously every 21 days as a cycle, each patient received 2-4 cycles. All patients were followed up until disease progressed or patients died. Results: Among 42 patients, 40 could be evaluated, 1 complete response (CR), 9 partial response (PR), 13 stable disease (SD), 17 progress disease (PD). The overall response rate (CR+PR) was 35% and disease control rate (CR+PR+SD) was 57.5%. The median time to progress (TTP) was 4.2 months, median survival time was 6.1 months and 1-year survival rate was 35.8%. The main toxicity was myelosuppression and decreasing platelet. Conclusion: Single agent docetaxel for elderly patients with advanced NSCLC is an efficient and well-tolerated chemotherapeutic approach with a low toxicity level.
文摘Objective:To investigate the effect of Kanglaite injection combined with docetaxel in advanced esophageal cancer on tumor markers, angiogenesis and immune function in elderly patients.Method:A total of 130 patients with advanced esophageal cancer admitted in our hospital from October 2014 to July 2017were selected and divided into two groups according to the time of admission, 65 cases in each group, set as observation group and control group, all patients were treated with conventional radiotherapy (cisplatin combined with 5-fluorouracil), the observation group was given Kanglaite injection combined with docetaxel on the basis of this, while the control group only was given docetaxel treatment, the treatment period was 6 weeks, tumor markers, VEGF and immune function of both group after treatment were compared.Result: After treatment, the levels of carbohydrate antigen 125 (CA125), carbohydrate antigen 19-9 (CA19-9) and carcino-embryonic antigen (CEA) in the observation group were lower than those in the control group, the difference was statistically significant;VEGF level in the observation group after treatment was lower than the control group, the difference was statistically significant;After treatment, the levels of CD3+, CD4+ and CD4+/CD8+ in the observation group were higher than those in the control group, while the levels of CD8+ in the observation group was lower than those in the control group, the difference was statistically significant.Conclusion: Kanglaite injection combined with docetaxel in the treatment of elderly patients with advanced esophageal cancer is better, effectively reducing the level of tumor markers and vascular endothelial growth factor, improve immune function, it isworthy of clinical application.
文摘Enhanced recovery after surgery (ERAS) has been used in various surgical professions in recent years and is widely accepted by doctors. This concept not only helps patients speed up postoperative recovery, reduce the incidence of related complications and shorten hospital stays, but also has been proved to be effective and safe in the perioperative application of gastric cancer. This article reviews the clinical application and research progress of enhanced recovery after surgery in the perioperative period of advanced gastric cancer in the elderly.
文摘Although it is assumed that the combination of chemotherapy and radical surgery should be indicated in all newly diagnosed advanced-stage ovarian cancer patients, one of the main raised questions is how to select the best strategy of initial treatment in this group of patients, neoadjuvant chemotherapy followed by interval debulking surgery or primary debulking surgery followed by adjuvant chemotherapy. The selection criteria to offer one strategy over the other as well as a stepwise patient selection for initial treatment are described. Selecting the best strategy of treatment in newly diagnosed advanced stage ovarian cancer patients is a multifactorial and multidisciplinary decision. Several factors should be taken into consideration:(1) the disease factor, related to the extension and localization of the disease as well as tumor biology;(2) the patient factor, associated with patient age, poor performance status, and co-morbidities; and(3) institutional infrastructure factor, related to the lack of prolonged operative time, an appropriate surgical armamentarium, as well as well-equipped intensive care units with well-trained personnel.
基金supported by the Research Fund of Public Welfare in Health Industry,National Health and Family Planning Commission of China(No.201402015).
文摘Laparoscopy-assisted distal gastrectomy(LDG)combined with D2 lymphadenectomy may be safely performed in patients with advanced gastric cancer(AGC)by experienced surgeons at specialized high-volume institutions as shown in the Chinese Laparoscopic Gastrointestinal Surgery Study(CLASS)-01.However,studies focusing on the use of LDG in patients with gastric cancer older than 65 years are rare.This study was designed to investigate the morbidity and mortality of elderly patients with gastric cancer who underwent laparoscopic-assisted or open distal gastrectomy(ODG).In this prospective,randomized,open,parallel controlled trial,patients older than 65 years with tumor located at the middle or lower part of the stomach will be enrolled in this study.Patients will be randomly divided into a laparoscopic group and an open surgery group.The early post-operative complications,intra-operative complications and post-operative recovery will be compared between the two groups.This trial will provide valuable clinical evidence for the objective assessment of the feasibility,short-term safety,and potential benefits of LDG compared with ODG for gastric cancer in the elderly patients.This trial has been registered on ClinicalTrials.gov.(Identifier:NCT02246153.)in September 22,2014.
基金supported by the National Key R&D Program of China(No.2018YFC1313201)the Innovation Project of Shandong Academy of Medical Sciences(No.2019-04)the Academic Promotion Program of Shandong First Medical University(No.2019ZL002).
文摘Bevacizumab,an anti-VEGF monoclonal antibody,has significantly improved the clinical outcomes of patients with advanced non-squamous NSCLC(ns-NSCLC).However,the safety and efficacy of bevacizumab for elderly patients with advanced NSCLC require further investigation.Thus,59 patients were included in the present retrospective study,22 patients in the bevacizumab plus pemetrexed and platinum(B+PP)group,and 37 patients in the pemetrexed and platinum(PP)group.For the entire cohort of patients,the median OS was 33.3 months,and the 1-year and 2-year overall survival rates were 88.5%and 67.8%,respectively.The median OS and 1-year and 2-year OS rates were 20.5 months,70.3%and 0%,respectively,in the B+PP group and 33.4 months,97.0%and 89.4%,respectively,in the PP group(P<0.001).The incidence of grade≥3 adverse events was higher in the B+PP group than in the PP group(27.3%vs.10.8%,respectively;P=0.204).Univariate and multivariate analyses suggested that the receipt of≥5 cycles of first-line chemotherapy was an independent favorable prognostic factor for OS,whereas the addition of bevacizumab was an unfavorable prognostic factor.With increased toxicities,the addition of bevacizumab to PP does not improve the overall survival of elderly patients with advanced ns-NSCLC.
基金Supported by the National Natural Science Foundation of China(No.81273718 and No.81102719)
文摘Lung cancer is the leading cause of cancerrelated mortality in China.(1'2) Meanwhile, the average life expectancy in the aging population has increased from 46 years in 1950 to 75 years in 2010.
文摘The treatment of metastatic colorectal cancer(mCRC)has evolved considerably in the last decade,currently allowing most mCRC patients to live more than two years.Monoclonal antibodies targeting the epidermal growth factor receptor(EGFR)and vascular endothelial growth factor play an important role in the current treatment of these patients.However,only antibodies directed against EGFR have a predictive marker of response,which is the mutation status of v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog(KRAS).Cetuximab has been shown to be effective in patients with KRAS wild-type mCRC.The CRYSTAL study showed that adding cetuximab to FOLFIRI(regimen of irinotecan,infusional fluorouracil and leucovorin)significantly improved results in the first-line treatment of KRAS wildtype mCRC.However,results that evaluate the efficacy of cetuximab in combination with oxaliplatin-based chemotherapy in this setting are contradictory.On the other hand,recent advances in the management of colorectal liver metastases have improved survival in these patients.Adding cetuximab to standard chemotherapy increases the response rate in patients with wild-type KRAS and can thus increase the resectability rate of liver metastases in this group of patients.In this paper we review the different studies assessing the efficacy of cetuximab in the first-line treatment of mCRC.