目的探讨二次尿道膀胱肿瘤电切术(re-transurethral resection of bladder tumor,Re-TUBRT)对于预防非肌层浸润膀胱尿路上皮癌患者肿瘤复发的效果。方法将178例行尿道膀胱肿瘤电切术(transurethral resection of bladder tumor,TUBRT)...目的探讨二次尿道膀胱肿瘤电切术(re-transurethral resection of bladder tumor,Re-TUBRT)对于预防非肌层浸润膀胱尿路上皮癌患者肿瘤复发的效果。方法将178例行尿道膀胱肿瘤电切术(transurethral resection of bladder tumor,TUBRT)的非肌层浸润膀胱尿路上皮癌患者,按治疗方案分为实验组(经TUBRT后4~6周行Re-TURBT治疗,93例)和对照组(只行TURBT手术治疗,85例)。对2组患者进行术后随访并对其基线资料、治疗后肿瘤复发或进展情况进行统计分析。结果实验组93例患者中,肿瘤复发14例(15.1%),进展肌层浸润性肿瘤率为6.5%,相较对照组(肿瘤复发率为34.1%,进展肌层浸润性肿瘤率为22.4%),差异具有统计学意义(P=0.003,P<0.001)。结论 Re-TURBT对于预防非肌层浸润膀胱尿路上皮癌患者肿瘤复发的效果显著,能够有效降低肿瘤复发率,并延缓肿瘤的进展过程。展开更多
Chronic hepatitis C virus (HCV) infection is the leading cause of death from liver disease and the leading indication for liver transplantation (LT) in the United States and Western Europe. LT represents the best ther...Chronic hepatitis C virus (HCV) infection is the leading cause of death from liver disease and the leading indication for liver transplantation (LT) in the United States and Western Europe. LT represents the best therapeutic alternative for patients with advanced chronic liver disease caused by HCV or those who develop hepatocarcinoma. Reinfection by HCV of the graft is universal and occurs in 95% of transplant patients. This reinfection can compromise graft function and patient survival. In a few cases, the histological recurrence is minimal and non-progressive; however, in most patients it follows a more rapid course than in immunocompetent persons, and frequently evolves into cirrhosis with graft loss. In fact, the five-year and ten-year survival of patients transplanted because of HCV are 75% and 68%, respectively, compared with 85% and 78% in patients transplanted for other reasons. There is also a pattern of recurrence that is very severe, but rare (< 10%), called fibrosing cholestatic hepatitis, which often involves rapid graft loss. Patients who present a negative HCV viremia after antiviral treatment have better survival. Many studies published over recent years have shown that antiviral treatment of post-transplant HCV hepatitis carried out during the late phase is the best option for improving the prognosis of these patients. Until 2011, PEGylated interferon plus ribavirin was the standard of care, resulting in a sustained virological response in around 30% of recipients. The addition of protease inhibitors, such as boceprevir or telaprevir, to the standard of care, or the use of other direct-acting antiviral drugs may involve therapeutic changes in the context of HCV recurrence. This may result a better prognosis for these patients, particularly those with severe recurrence or factors predicting rapid progression of fibrosis. However, the use of these agents in LT still requires clarification in terms of safety and efficacy.展开更多
【目的】探讨多西他赛加顺铂动脉灌注化疗配合放疗对食管癌术后复发转移的近期疗效以及毒副反应。【方法】收集2010年1月至2013年1月本院收治的食管癌术后复发转移患者62例，患者随机分为观察组与对照组，每组31例。对照组行单纯放疗，...【目的】探讨多西他赛加顺铂动脉灌注化疗配合放疗对食管癌术后复发转移的近期疗效以及毒副反应。【方法】收集2010年1月至2013年1月本院收治的食管癌术后复发转移患者62例，患者随机分为观察组与对照组，每组31例。对照组行单纯放疗，观察组则予以多西他赛加顺铂动脉灌注化疗配合放疗，比较两组的近期疗效与毒副反应。【结果】观察组的总有效率为77．42％（24／31），显著高于对照组的54．84％（17／31），且两组相比较差异有显著性（ P ＜0．05）；观察组的6个月及1年生存率分别为87．10％、77．42％，显著高于对照组的70．97％、58．06％（ P ＜0．05）；两组的放射性食管炎发生率及程度相比较差异无显著性（ P ＞ 0．05）；观察组的骨髓抑制、胃肠道反应以及脱发发生率均高于对照组（ P ＜0．05），但主要为Ⅰ-Ⅱ级。【结论】多西他赛加顺铂动脉灌注化疗配合放疗对食管癌术后复发转移具有显著疗效，且毒副反应较轻，患者能够耐受，值得推广应用。展开更多
文摘目的探讨二次尿道膀胱肿瘤电切术(re-transurethral resection of bladder tumor,Re-TUBRT)对于预防非肌层浸润膀胱尿路上皮癌患者肿瘤复发的效果。方法将178例行尿道膀胱肿瘤电切术(transurethral resection of bladder tumor,TUBRT)的非肌层浸润膀胱尿路上皮癌患者,按治疗方案分为实验组(经TUBRT后4~6周行Re-TURBT治疗,93例)和对照组(只行TURBT手术治疗,85例)。对2组患者进行术后随访并对其基线资料、治疗后肿瘤复发或进展情况进行统计分析。结果实验组93例患者中,肿瘤复发14例(15.1%),进展肌层浸润性肿瘤率为6.5%,相较对照组(肿瘤复发率为34.1%,进展肌层浸润性肿瘤率为22.4%),差异具有统计学意义(P=0.003,P<0.001)。结论 Re-TURBT对于预防非肌层浸润膀胱尿路上皮癌患者肿瘤复发的效果显著,能够有效降低肿瘤复发率,并延缓肿瘤的进展过程。
文摘Chronic hepatitis C virus (HCV) infection is the leading cause of death from liver disease and the leading indication for liver transplantation (LT) in the United States and Western Europe. LT represents the best therapeutic alternative for patients with advanced chronic liver disease caused by HCV or those who develop hepatocarcinoma. Reinfection by HCV of the graft is universal and occurs in 95% of transplant patients. This reinfection can compromise graft function and patient survival. In a few cases, the histological recurrence is minimal and non-progressive; however, in most patients it follows a more rapid course than in immunocompetent persons, and frequently evolves into cirrhosis with graft loss. In fact, the five-year and ten-year survival of patients transplanted because of HCV are 75% and 68%, respectively, compared with 85% and 78% in patients transplanted for other reasons. There is also a pattern of recurrence that is very severe, but rare (< 10%), called fibrosing cholestatic hepatitis, which often involves rapid graft loss. Patients who present a negative HCV viremia after antiviral treatment have better survival. Many studies published over recent years have shown that antiviral treatment of post-transplant HCV hepatitis carried out during the late phase is the best option for improving the prognosis of these patients. Until 2011, PEGylated interferon plus ribavirin was the standard of care, resulting in a sustained virological response in around 30% of recipients. The addition of protease inhibitors, such as boceprevir or telaprevir, to the standard of care, or the use of other direct-acting antiviral drugs may involve therapeutic changes in the context of HCV recurrence. This may result a better prognosis for these patients, particularly those with severe recurrence or factors predicting rapid progression of fibrosis. However, the use of these agents in LT still requires clarification in terms of safety and efficacy.
文摘【目的】探讨多西他赛加顺铂动脉灌注化疗配合放疗对食管癌术后复发转移的近期疗效以及毒副反应。【方法】收集2010年1月至2013年1月本院收治的食管癌术后复发转移患者62例，患者随机分为观察组与对照组，每组31例。对照组行单纯放疗，观察组则予以多西他赛加顺铂动脉灌注化疗配合放疗，比较两组的近期疗效与毒副反应。【结果】观察组的总有效率为77．42％（24／31），显著高于对照组的54．84％（17／31），且两组相比较差异有显著性（ P ＜0．05）；观察组的6个月及1年生存率分别为87．10％、77．42％，显著高于对照组的70．97％、58．06％（ P ＜0．05）；两组的放射性食管炎发生率及程度相比较差异无显著性（ P ＞ 0．05）；观察组的骨髓抑制、胃肠道反应以及脱发发生率均高于对照组（ P ＜0．05），但主要为Ⅰ-Ⅱ级。【结论】多西他赛加顺铂动脉灌注化疗配合放疗对食管癌术后复发转移具有显著疗效，且毒副反应较轻，患者能够耐受，值得推广应用。
