Postoperative UFT-/Tegafur-based Chemotherapy Versus Postoperative Radiotherapy for Early-stage Non-small Cell Lung Cancer:A Systematic Review and Network Meta-analysis

Background:Both of UFT-/Tegafur-based postoperative chemotherapy and postoperative radiotherapy have made large progress in treatment of early-stage non-small cell lung cancer.While it is unclear that,whether UFT-/Tegafur-based postoperative chemotherapy is superior to postoperative radiotherapy for early-stage non-small cell lung cancer with no direct evidence.Methods:Electronic databases(Pubmed,embase,cochrane library and clinicaltrials.gov)were searched to obtain relevant studies.This systematic review and meta-analysis is reported in accordance with the Preferred Items for Systematic Reviews and Meta-analysis(PRISMA)Statement and was registered at International Prospective Register of Systematic Reviews(number CRD42018095979).Sensitive analysis was conducted by excluding overweight studies.Funnel plot and egger’s test were performed to conduct publication bias.Results:Twenty-one randomized control trials were included.Our results suggested UFT-/Tegafur-based postoperative chemotherapy could improve overall survival over postoperative radiotherapy[HR=0.69(0.59-0.80),p=0.000].But subgroup analysis about stage showed there was no significant difference between them,no matter of stage I,II and III.As to chemotherapy regime,both UFT-/Tegafur+platinum+vinca alkaloid[HR=0.68(0.56-0.82),p=0.000]and UFT-/Tegafur only[HR=0.66(0.54-0.79),p=0.000]were superior to radiotherapy.Subgroup analysis about radiotherapy delivery method and dose showed,significant improvement of chemotherapy over radiotherapy for Cobalt-60 only[HR=0.54(0.39-0.75),p=0.000],Cobalt-60 and linac[HR=0.69(0.59-0.81),p=0.000]and≥45 Gy[HR=0.64(0.54-0.75),p=0.000],but not for linac only[HR=0.78(0.60-1.03),p=0.081]and≥45 Gy[HR=0.86(0.67-1.11),p=0.241].Conclusion:UFT-/Tegafur-based postoperative chemotherapy was superior to postoperative radiotherapy for improving overall survival of early-stage non-small cell lung cancer,but it is not always so under certain circumstance,such as RT delivery method and radiation dose.Of course,it is imperative to further explore differences in specific stage,such as I A and I B.

Efficacy of Oncoxin-Viusid on the Reduction of Adverse Reactions to Chemotherapy and Radiotherapy in Patients Diagnosed with Cervical Cancer and Endometrial Adenocarcinoma

Introduction: Oncoxin-Viusid (OV) has shown antioxidant, immunomodulatory and anti-tumour capabilities in experimental studies on humans and animal subjects. Acute toxicity of Radiation Therapy (RT) and Chemotherapy (CT) in patients with cervical cancer and endometrial adenocarcinoma impact quality of life and, therefore, outcomes of these therapies. Objective: To identify Oncoxin-Viusid’s efficacy in reducing acute toxicity produced by onco-specific treatments in patients with cervical cancer and endometrial adenocarcinoma. Materials and Methods: A controlled, randomised double-blind phase II clinical trial was performed with a sample size of 63 patients distributed into 2 groups: one receiving the standard treatment plus the Oncoxin-Viusid nutritional supplement (OV group) and another receiving the standard treatment and placebo (P group). The primary efficacy variable is the proportion of secondary disruptions to acute adverse reactions produced by RT and CT. Results: The number of patients suffering adverse events from chemotherapy was 20.6% less in the OV group (70.0%) than in the placebo group (90.6%) (p = 0.04). We recorded consistently normal values of haemoglobin (-6.2 OV group vs -8.3 P group, p = 0.009), platelet count (-17.4 OV group vs -27.6 P group, p = 0.009) and leukocytes (-31.8 OV group vs -41.4 P group, p = 0.025) in the OV group, tolerating 4 more cytostatic doses on average than the placebo group. Significant increase in quality of life (QLQ-30) was registered in the OV group with a large effect size on such issues as emotional and social function (Cohen’s d = 0.9), as well as in the reduction of symptoms like dyspnea 60%, insomnia 15% and anorexia 30% (item CX-2), (Cohen’s d = 0.98), which were higher than the placebo group. Conclusions: OV administration reduces onco-specific adverse events and improves quality of life in patients diagnosed with cervical cancer and endometrial adenocarcinoma undergoing radiation therapy and chemotherapy.

Bone marrow-sparing intensity-modulated radiotherapy for postoperative treatment of cervical cancer

Objective： The aim of this study was to compare bone marrow-sparing intensity-modulated radiotherapy （IMRT） with IMRT without entering pelvic bone marrow as a planning constraint in the treatment of cervical cancer after hysterectomy. Methods： For a cohort of 10 patients, bone marrow-sparing IMRT and routine IMRT planning were designed. The prescribed dose was 45 Gy/1.8 Gy/25f, 95% of the planning target volume received this dose. Doses were computed with a commercially available treatment planning system （TPS） using convolution/superimposition （CS） algorithm. Plans were compared according to dose-volume histogram （DVH） analysis in terms of planning target volume （PTV） homogeneity and conformity indices （HI and CI） as well as organs at risk （OARs） dose and volume parameters. Results： Bone marrow-sparing IMRT had an vantages over routine IMRT in terms of CI, but inferior to the latter for HI. Compared with routine IMRT, V5, Vl0, V20, V30, V40 of pelvic bone marrow of bone marrow-sparing IMRT reduced by 1.81%, 8.61%, 31.81%, 29.50%, 28.29%, respectively. No statistically significant differences were observed between bone marrow-sparing IMRT and routine IMRT in terms of small bowel, bladder and rectum. Conclusion： For patients with cervical cancer after hysterectomy, bone marrowsparing IMRT reduced the pelvic bone marrow volume irradiated at all dose levels and might be conducive to preventing the occurrence of acute bone marrow toxicity.

Clinical observation of three-dimensional conformal radiotherapy(3D-CRT) with concurrent chemotherapy in treatment of recurrent cervical cancers

Objective： The aim of the study was to explore the efficacy of three-dimensional conformal radiotherapy （3D- CRT） combined with TP concurrent chemotherapy in treatment of recurrent cervical cancers. Methods： From May 2005 to May 2009, 36 patients with recurrent cervical cancer were treated by 3D-CRT of 60-66 Gy and TP （docetaxel 70 mg/m^2, d1; cisplatin 20 mg/m^2, dl-d3; 21 days per cycle, totally 2 cycles） concurrent chemotherapy. Results： All of the patients had finished the 3D-CRT, the total response rate, complete response rate and partial response rate were 80.0% （28/35）, 45.7% （16/35）, and 34.3% （12/35）, respectively. The pain-alleviation rate was 91.4% （32/35）. The hemorrhage control rate was 94.3% （33/35）. The median overall survival was 21.2 months. The 1-, 2- and 3-year survival rates were 54.3%, 37.1% and 22.8%, respectively. The life qualities of the patients were improved, without any treatment related death. Conclusion： Radiotherapy is effective and well-tolerated for recurrent cervical cancers, and it can promote regional control of the disease and prolong survival time.

Treatment Results of Adjuvant Chemotherapy after Radical Hysterectomy for Intermediate-Risk Stage IB-IIB Cervical Cancer

Objective: The objective is to evaluate the effectiveness of chemotherapy as postoperative adjuvant therapy for stage IB-IIB cervical cancer with intermediate-risk factors. Methods: We retrospectively reviewed the medical records of 119 cervical cancer patients with intermediate-risk factors treated with radical hysterectomy and pelvic lymphadenectomy from December 1997 to September 2010. The intermediate-risk factors included bulky tumor (≥4 cm), lymphovascular space invasion, and deep stromal invasion. Sixteen patients did not receive adjuvant therapy (observation group);73 were treated with chemotherapy (CT group);30 were treated with adjuvant radiation therapy (RT group). The significance of the clinical parameters, 3- and 5-year overall survival (OS) rates of each group, was analyzed. Results: The 3- and 5-year OS rates between the observation group and adjuvant therapy group (CT plus RT groups) were not statistically different (3-year OS: 100% and 94.4%, respectively;5-year OS: 100% and 92.3%, respectively;p > 0.05). The 3- and 5-year OS rates between the CT group and RT group were also not statistically different (3-year OS: 93.6% and 96.4%, respectively;5-year OS: 80.7% and 96.4%, respectively;p < 0.05). Univariate and multivariate analysis of survival indicated that different adjuvant therapies were not independent prognostic indicators for IB-IIB cervical cancer patients with intermediate-risk factors. Conclusions: CT may have equivalent therapeutic effect as RT for stage IB-IIB cervical cancer patients with intermediate-risk factors after radical surgery, and prospective randomized trial is needed to study the effect of CT in these patients.

EXPERIMENTAL AND CLINICAL STUDY OF CONCOMITANT RADIATION THERAPY AND CHEMOTHERAPY FORCERVICAL CARCINOMA

The results of in vitro Hela cell experiment and human cervical cancer in nude mice therapeutic trial skowed that combined anticancer drugrs and radiation bad more marked anticancer effect than radiation alone.On the bases of experiment,25 patients with carcinoma of uterine cervix,FIGO stage Ib-IV,were chosen for our study.A weskly 60Co intracavitacy irradliatiou plus cisplatin(30 mg/M2) and bleomycin(15 mg/M2) were glven to 11/25 cases,while the remaining 14,radiotherapy alone.The former group sbowed a superior response in tumor regression and histological improvement than the later one.The toxic side effect was acceptable.The results indicate that concomitant radiation therapy and chemotherapy may be benefit for treating cervicai carcinoma.

Clinical study of three dimensional conformal radiotherapy combined with intracavitary brachytherapy in the treatment of cervical cancer

Objective: The aim of our study was to evaluate the outcome and complications of cervical cancer patients undergoing conventional intracavitary brachytherapy (ICBT) treated with 3D-conformal radiotherapy (3DCRT). Methods: Sixty cervical cancer patients were divided randomly into the conformal group and the conventional group. Thirty patients treated with 3D-conformal radiotherapy in the 3DCRT group, when the whole pelvic received DT 40 Gy, a planning CT scan of each patient was obtained and the second 3DCRT therapy plan was taken. Then, continued to irradiate to 50 Gy. At last, 3DCRT was boosted at local involved volumes to the total dose of 60 Gy. When 3DCRT was combined with intracavitary brachytherapy, the dose of brachytherapy to point A was 30 Gy/5 fractions. In the conventional group, after a total tumor dose of 40 Gy was delivered by the whole pelvic irradiation, the four-field technique was used to irradiate the total pelvic and regional nodes (median dose of 10 Gy), and the involved volumes were boosted to 60 Gy and the dose of brachytherapy to point A was 30 Gy-36 Gy/5-6 fractions. Moreover, both groups were combined with intracavitary brachytherapy respectively. Results: The 1, 2, 3-year survival rates for the 3DCRT group and the conventional group were 96.7%, 93.3%, 90.0% and 86.6%, 76.7%, 70% respectively (P = 0.04, P = 0.02 and P = 0.02). There was a statistically significant difference between the two groups. Compared to the two groups each other in toxic effects, except for the I-II grade rectal and bladder reaction and pelvic fibrosis which was lower in the 3DCRT group (P = 0. 007, P = 0. 006 and P = 0. 015), the side effects were similar and well tolerated in two groups. Conclusion: The all-course 3DCRT combined with intracavitary brachytherapy can be considered as an effective and feasible approach to cervical cancer and may significantly improve the survival rate and reduce the late toxicity. This new role for 3DCRT merits need further evaluation with large patient numbers and longer follows up.

Extent of lymphadenectomy and perioperative therapies:two open issues in gastric cancer

Gastric cancer is one of the leading causes of death for cancer worldwide,although geographical variations in incidence exist.Over the last decades,its incidence and mortality have gradually decreased in Western countries,while these have increased,or remained stable,in the other world regions.Gastric cancer is often diagnosed at an advanced stage,with the only notable exception of Japan,where nationwide screening programs are enforced,due to local high incidence.Curativeintent surgery(i.e.,gastrectomy,total or partial,and lymphadenectomy)remains the cornerstone of treatment of gastric cancer.Much has been debated about the extent of lymph node dissection and,although it is a valuable contribution to staging and cure,operative treatment only represents one aspect of overall effective management,as the risk of both locoregional and distant recurrences are high,and bear a poor prognosis.As a matter of fact,surgery,as a single modality treatment,has probably achieved its maximum efficacy for local control and survival,while other accompanying nonsurgical treatment modalities have to be taken into account,although their role is still the subject of considerable debate.The authors in this review present an update on the outcome of treatment of gastric cancer in relation to the extent of lymphadenectomy and of various nonsurgical preoperative,intraoperative,and postoperative strategies.

Different strategies of treatment for uterine cervical carcinoma stage ⅠB2-ⅡB

Uterine cervical cancer is the second most common gynecological malignancy. It is estimated that over 35% of tumors are diagnosed at locally advanced disease, stage ⅠB2-ⅡB with an estimated 5-year overall survival of 60%. During the last decades, the initial treatment for these women has been debated and largely varies through different countries. Thus, radical concurrent chemoradiation is the standard of care in United Sated and Canada, and neoadjuvant chemotherapy followed by radical surgery is the first line of treatment in some institutions of Europe, Asia and Latin America. Until today, there is no evidence of which strategy is better over the other. This article describe the evidence as well as the advantages and disadvantages of the main strategies of treatment for women affected by uterine cervical cancer stage ⅠB2-ⅡB.

节约体能法对宫颈癌同步放化疗病人癌因性疲乏的干预效果

目的:探讨节约体能法对宫颈癌同步放化疗病人癌因性疲乏(CRF)的干预效果。方法:采用方便抽样法,选取2018年4月—12月在西安交通大学第一附属医院放疗病区住院治疗的108例宫颈癌病人作为研究对象,按入院时间分为对照组和干预组,每组54例。对照组给予放疗科常规护理,干预组在放疗科常规护理基础上给予节约体能法的干预。于治疗开始前、放疗5次结束、放疗10次结束、放疗15次结束、放疗20次结束及放疗25次结束后采用中文版Piper疲乏修订量表(RPFS)对病人CRF严重程度进行评价。结果:干预期间对照组流失3例病人,干预组流失4例病人,最终对照组51例病人完成研究,干预组50例病人完成研究。中文版RPFS总分及行为疲乏、情感疲乏、感知疲乏、认知疲乏维度得分的干预主效应、时间主效应均有统计学意义(P<0.05)。在治疗开始前和放疗5次结束2个时间点,对照组与干预组的中文版RPFS总分及各维度得分差异无统计学意义(P>0.05)。在放疗10次结束、放疗15次结束、放疗20次结束及放疗25次结束4个时间点,对照组与干预组的中文版RPFS总分及各维度得分差异有统计学意义(P<0.05)。结论:宫颈癌同步放化疗病人CRF水平在治疗期间升高,节约体能法可有效降低各时间点宫颈癌同步放化疗病人的CRF水平。

宫颈癌同步放化疗患者线粒体相关基因表达变化与癌因性疲乏的关系

目的探讨宫颈癌同步放化疗患者癌因性疲乏的动态变化趋势及其与线粒体相关基因的关系。方法采用前瞻性纵向研究设计,选取2021年5月至2022年10月于四川大学华西第二医院行宫颈癌同步放化疗的84例患者,观察组和对照组各42例,收集观察组患者的癌因性疲乏得分和抑郁得分以及6次(治疗前、第1~5次同步放化疗后)外周全血样本并将与对照组基线数据进行比较。采用重复测量、线粒体PCR阵列、混合线性模型来分析治疗不同时间点癌因性疲乏的变化趋势、线粒体相关基因差异性表达情况以及与癌因性疲乏的关系。结果与基线相比,随着放化疗次数的增加,癌因性疲乏逐渐加重(F=8.254,P=0.036)。有8个线粒体基因(EHD1、FIS1、SORL1、CXCR1、GAPDH、RAC2、ACTB和BCL2L1)上调超过3倍,5个线粒体基因(MTOR、PDK3、NSD1、MIPEP和MSTO1)下调超过5倍。9个线粒体基因(CXCR1、GAPDH、SORL1、MTOR、FIS1、EHD1、PDK3、NSD1和MIPEP)表达与癌因性疲乏密切相关。结论本研究初步证实了9个线粒体基因与癌因性疲乏有关,为临床研制治疗癌因性疲乏的靶向药物或制定针对性的护理干预措施提供参考。

情绪调节策略在宫颈癌同步放化疗病人恐惧疾病进展与自杀意念间的中介效应

目的:探讨情绪调节策略在宫颈癌同步放化疗病人恐惧疾病进展与自杀意念间的中介效应。方法:采用便利抽样法选取厦门大学附属东南医院收治的216例宫颈癌同步放化疗病人为研究对象,采用一般调查问卷、恐惧疾病进展量表、自杀意念自评量表、情绪调节策略问卷对病人进行调查,并构建结构方程模型。结果:宫颈癌同步放化疗病人恐惧疾病进展量表评分为(28.26±5.41)分,情绪调节策略问卷评分为(39.47±10.45)分,其中表达抑制策略评分[(4.57±1.42)分]高于认知重评策略评分[(3.53±1.17)分],自杀意念评分为(13.78±3.25)分。恐惧疾病进展评分与自杀意念评分、表达抑制策略评分呈正相关,与认知重评策略评分呈负相关;表达抑制策略评分与自杀意念评分呈正相关,与认知重评策略评分呈负相关;自杀意念评分与认知重评策略评分呈负相关,表达抑制策略和认知重评策略在恐惧疾病进展与自杀意念间起到一定中介效应,效应值分别为0.164、0.072,占比分别为29.39%、12.90%;总中介效应为0.236,占总效应43.29%。结论:宫颈癌同步放化疗病人自杀意念评分偏高,情绪调节策略在恐惧疾病进展与自杀意念间起一定中介作用。

利益相关者视角下放化疗宫颈癌患者病痛体验的质性研究

目的基于利益相关者理论探讨放化疗宫颈癌患者的病痛体验。方法采用描述性现象学研究方法对15例宫颈癌放化疗患者以及12名妇科肿瘤科医护人员进行叙事访谈以及半结构式访谈,运用Colaizzi七步分析法分析资料。结果提炼出3个主题及10个亚主题:身体完整性遭破坏(消化系统损伤、泌尿生殖系统改变、皮肤改变),身份序列被打乱(社会角色转变、家庭角色调整、自我认同危机),新的康复断裂与冲击(医疗照护服务断裂、饮食习惯改变、社会再融入障碍、癌症复发恐惧)。结论放化疗宫颈癌患者病痛体验复杂多样,医护人员应及时评估患者病情和感受,制定针对性的干预措施,缓解患者身心痛苦。

中性粒细胞减少、NLR指标及TNF-α、IL-8水平对早期宫颈癌放化疗的预后作用研究

目的探讨中性粒细胞减少、NLR指标及TNF-α、IL-8水平在早期宫颈癌放化疗中的预后作用分析。方法选取2020年6月至2022年1月于我院就诊的宫颈鳞状细胞癌患者115例,对患者的基本资料、临床分期、病理结果等信息进行回顾性分析。患者均行根治性子宫切除术伴淋巴结切除术,并行术后辅助CCRT。在辅助CCRT治疗期间,每周对患者行血细胞计数测定,每周进行血清炎性因子的检测。根据是否有中性粒细胞减少分为A(中性粒细胞减少)、B(中性粒细胞未减少)两组,对两组患者临床资料进行比较,采用Cox回归模型检验影响预后的独立因素,Kaplan-Meier法进行生存分析。结果A组患者发生深基质入侵比例显著低于B组,A组发生淋巴血管空间侵犯比例显著高于B组,A组血清炎性因子TNF-α、IL-8水平明显优于对照组患者,差异均有统计学意义(P<0.05)。Kaplan-Meier曲线分析结果显示具有淋巴结转移的患者中中性粒细胞减少患者的无病生存率(DFS)相较无中性粒细胞减少患者增加(P=0.033),具有淋巴结转移的患者群中,A组无病生存率较B组增加(P<0.05)。Cox比例风险模型分析结果显示中性粒细胞减少与TNF-α、IL-8水平为复发的预后因素,差异有统计学意义(P<0.05)。结论辅助CCRT引起的中性粒细胞减少可能是宫颈癌复发的一个预后因素,建议在宫颈癌的临床治疗中,在骨髓抑制的安全范围内给予患者个体化CCRT剂量方案,同时定期监测患者血清炎性因子TNF-α、IL-8水平。

临床药师参与宫颈癌根治性放化疗患者营养支持的效果分析

目的观察临床药师对改善宫颈癌同期放化疗患者的营养状况及放化疗耐受的效果。方法选取赣州市肿瘤医院2021年1月至2023年9月收治的初诊为宫颈癌且接受根治性放化疗的患者116例,对照组临床药师不参与营养监护,观察组均由临床药师对其全程营养监护,比较两组患者的营养相关指标的变化以及放化疗耐受情况。结果对照组较观察组中重度营养不良发生率更高,差异有统计学意义(P=0.006)。观察组有9例放疗中断,放疗完成49例(84.48%);对照组22例放疗中断,完成36例(62.07%),两组比较差异有统计学意义(t=7.44,P=0.006)。结论在宫颈癌同步放化疗期间临床药师给与全程营养监护能够改善患者的营养状况及提高患者对放化疗的耐受性。

新辅助化疗联合同步放化疗和后装治疗Ⅲ_(C)期宫颈癌的疗效观察

目的:观察新辅助化疗联合同步放化疗和后装治疗Ⅲ_(C)期宫颈癌的效果及安全性。方法:选取医院2020年01月至2022年12月收治的Ⅲ_(C)期宫颈癌患者100例,根据不同治疗方案分为观察组和对照组,每组各50例。观察组采用新辅助化疗联合同步放化疗和后装治疗,对照组采用同步放化疗联合后装治疗。比较两组近期和远期疗效,观察两种方案治疗Ⅲ_(C)期宫颈癌的安全性。结果:观察组总有效率为94.00%,高于对照组的80.00%,差异具有统计学意义(P<0.05)。观察组远处转移率低于对照组,差异具有统计学意义(P<0.05)。两组不良反应分级为1-2级,均未影响相关治疗。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:新辅助化疗联合同步放化疗和后装治疗Ⅲ_(C)期宫颈癌可获得较为理想的近期和远期效果,降低远处转移风险,且不良反应轻微,安全性较高,具有临床应用价值。

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。

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。

HIV合并宫颈癌患者采用单纯放疗和同步放化疗的疗效及毒副作用分析

目的探讨HIV合并宫颈癌患者采用单纯放疗和同步放化疗的疗效及毒副作用分析。方法将2018年1月—2022年12月在本院治疗的62例HIV合并宫颈癌患者随机分为两组,对照组使用单纯放疗,观察组使用同步放化疗,对比两组的近期疗效、毒副反应、肿瘤标志物、免疫功能指标。结果观察组治疗有效率、临床控制率明显高于对照组,组间差异有统计学意义(P<0.05)。观察组恶心呕吐、白细胞减少、血小板减少等毒副反应发生率高于对照组,组间差异有统计学意义(P<0.05);而两组肾功能损害、放射性膀胱炎、放射性肠炎发生率相当,差异无统计学意义(P>0.05)。观察组治疗后CEA、CA12-5、SCC-Ag水平均低于对照组,组间差异有统计学意义(P<0.05)。观察组治疗后CD3+、CD3+和CD4+、CD3+和CD8+、NK细胞均与对照组相当,差异无统计学意义(P>0.05)。结论HIV合并宫颈癌患者采用同步放化疗的疗效更好,能有效降低肿瘤标志物水平,对免疫功能影响小,胃肠道及骨髓抑制毒副反应发生率较高,但整体可耐受。

宫颈癌术后化疗护理中舒适护理的应用效果

目的分析宫颈癌术后化疗患者接受舒适护理的效果。方法选取44例宫颈癌术后化疗患者,采用随机数字表法分为对照组及观察组。对照组(22例)采用常规护理,观察组(22例)采用舒适护理。比较两组患者的不良心理状态、临床配合度及生活质量。结果护理后,观察组焦虑自评量表、抑郁自评量表评分均低于对照组(P<0.05)。观察组临床配合度为95.45%,高于对照组的68.18%(P<0.05)。护理后,观察组各项生活质量评分均高于对照组(P<0.05)。结论宫颈癌术后化疗患者接受舒适护理的应用效果良好,能有效改善其心理状态,提高临床配合度及生活质量,提升整体护理效率。