调强放疗结合腔内放疗同步化疗治疗中晚期宫颈癌的临床观察

目的 研究调强放疗、腔内治疗并同步化疗治疗中晚期(IIB-ⅢB)宫颈癌的疗效及毒副反应.方法 选择宫颈癌患者60例,随机分为调强组(调强放疗,腔内放疗结合同步化疗,30例),常规组(常规四野箱式外照射,腔内放疗结合同步化疗,30例).治疗方法:调强组给予56～60 Gy剂量,常规组予50～54 Gy盆腔照射.腔内放疗:A点给予5 Gy/次,2次/周,共6～8次.所有病人接受多西他赛和顺铂同步化疗,每3周一次,共3个疗程.比较临床疗效和急性、晚期毒副反应.结果 两组病人资料类似.中位随访时间是47个月.调强组与常规组的1,2,3年生存率分别为90.0%,86.7%,80.0%以及86.7%,70.0%,60.0%;两组比较差异没有显著性(P>0.05).调强组中有7例(23.33%)患者复发,常规组有17例(56.67%)复发,两组比较差异有统计学意义(P＜0.05).常规组中3,4级急性和晚期消化道反应和泌尿道反应的发生率比调强组高,差异有统计学意义(P＜0.05).血液骨髓毒副反应的比较,两组结果相似.结论 调强放疗结合腔内放疗并同步多西他赛、顺铂化疗,是治疗局部晚期宫颈癌有效的方法.     

食管癌后程三维适形放疗的临床疗效评价

Objective:The aim of our study was to evaluate the clinical results and acute side effects of late course three-dimensional conformal radiotherapy (3DCRT) for esophageal carcinoma.Methods:From January 2004 to October 2006,70 patients with esophageal carcinoma received late course 3DCRT.Their clinical data were analyzed retrospectively.The short-term clinical results,acute side effects,local control rates and survival rates were evaluated.Results:The complete response rate was 62.9%,partial response rate was 35.7%,and the overall response rate was 98.6%.The 1-,2- and 3-year local control rates were 77.1%,51.4% and 45.7%,respectively.The 1-,2- and 3-year overall survival rates were 75.7%,54.3% and 38.6%,respectively.The median survival time was 26 months.Conclusion:The technique of late course 3DCRT is an effective treatment for esophageal carcinoma and tend to improve the overall survival rate.     

食管癌全程三维适形放疗后程加速超分割的疗效观察

Objective:The aim of the study was to evaluate the therapeutic effect and safety of whole-course three-dimen-sional conformal radiotherapy (3DCRT) combined with late-course accelerated hyperfractionated radiotherapy (LCAFR) on patients with esophageal carcinoma.Methods:one hundred and one patients with esophageal carcinoma were divided into two groups.Observing group (49 cases) were treated by whole-course 3DCRT.Patients in control group (52 cases) were treated by conventional radiotherapy.Clinical efficiencies and radiation toxicities were compared between two groups.Re-sults:The side effects including radiation esophagitis (63.2%) and tracheitis (49.0%) decreased in observing group,but there was no significant difference between two groups (69.2% and 55.7% in controls).The 1-,2- and 3-year tumor local control rates and overall survival rates in the observing group were significantly improved compared with the control group,being respectively 87.8%,75.5%,63.3% vs 71.2%,55.8%,42.3% and 85.7%,71.4%,46.7% vs 69.2%,51.9%,26.9% (all P < 0.05).Conclusion:The therapeutic effect of whole-course 3DCRT combined with LCAFR for esophageal carcinomas is superior to conventional radiotherapy.     

局部植入缓释氟尿嘧啶配合热放疗治疗宫颈癌临床初步研究

目的:探讨局部植入缓释氟尿嘧啶配合射频深部热疗加常规放疗宫颈癌的临床疗效.方法:宫颈肿瘤局部植入缓释氟尿嘧啶配合射频深部热疗加常规放疗30例Ⅱb期-Ⅲb期宫颈癌(联合组),同期进行射频深部热疗加常规放疗35例作为对照组,比较2组的近期疗效和毒副作用.联合组采用15MV-X线盆腔外照射50Gy/25次/5周(其中全盆25-30Gy),192Ir后装腔内放疗A点剂量30-35Gy(5Gy/次,6-7次,2次/周).放疗期间配合射频深部热疗8-10次,2次/周;并在放疗期间直视下宫颈肿物植入缓释氟尿嘧啶200-600mg.对照组盆腔外照射、射频深部热疗和腔内后装治疗剂量同联合组.结果:联合组和对照组的肿瘤完全缓解率分别为93.3%(28/30)和74.3%(26/35)(X2＝4.169,P＝0.041).有52例随访满3年,3年局控率分别为92%和70.4%(X2＝4.001,P＝0.045),3年总生存率分别为84%和70.4%(X2＝1.387,P＝0.239).两组直肠和膀胱近期反应、骨髓抑制无明显差异.结论:局部植入缓释氟尿嘧啶热化放疗可以提高宫颈癌的缓解率、局控率和生存率,不明显增加毒副作用.     

宫颈癌术后骨髓保护调强放疗研究

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. Theproscribed 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,V10, 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.     

立体适形放疗与常规放疗对老年非小细胞肺癌的疗效比较

比较立体适形放疗与常规放疗对老年非小细胞肺癌的疗效,结果表明:立体适形放疗的治疗效果更有优势。     

三氧化二砷治疗血液病后合并带状疱疹的临床研究

目的 分析三氧化二砷(ATO)治疗血液病后合并带状疱疹感染患者的临床特征及其可能的发生机制.方法 将研究对象分为研究组(应用ATO)和对照组(未应用ATO),观察两组带状疱疹发病率,以及研究组中发生带状疱疹和未发生带状疱疹患者的平均化疗次数.结果 研究组带状疱疹发病率为23.95%(23/96),发生带状疱疹者平均化疗7.60次,未发生带状疱疹者平均化疗7.72次(Z=0.976,P=0.296);对照组带状疱疹发病率7.89%(3/38),两组间带状疱疹发病率差异有统计学意义(χ2=4.492,P=0.034).结论 ATO治疗血液疾病可以增加带状疱疹的发病率,可能与其激活水痘-带状疱疹病毒有关.     

缪刺配合关节活动治疗粘连期肩周炎的临床研究

目的:观察缪刺配合关节活动治疗粘连期肩周炎的临床疗效及相对普通针刺治疗的优势.方法:将60例粘连期肩周炎患者随机分为2组,实验组采用缪刺疗法配合关节活动治疗,对照组予普通针刺治疗,隔日治疗1次,15次为1个疗程.结果:治疗组疗效明显优于对照组,差异有统计学意义(P<0.05).结论:与普通针刺相比,缪刺配合关节活动的临床疗效更佳,即刻镇痛效应尤其显著.     

电针配合面肌功能训练治疗面神经炎的临床研究

目的:试图探索中西结合治疗面神经炎的最佳康复方案.方法:把385例患者随机纳入观察组198例,采用一般治疗加电针、理疗、面肌功能训练;对照组187例,采用一般治疗加理疗,在疗程结束时及6个月后随访,以House-Brachmann面神经功能分级标准进行分析.结果:两组比较,痊愈率、愈显率在疗程结束时有极显著差异(P＜0.01),6个月后随访也有显著差异(P＜0.05).结论:面神经炎的康复,选择中西结合康复治疗其疗效明显优于纯西医的治疗,本方案可能是一套比较好的中西结合综合治疗面神经炎的康复方案.     

A pilot study of intracavitary hyperthermia combined with radiation in the treatment of oesophageal carcinoma

The possibility that the experiences of the "hidden" child survivors of the Holocaust (those who survived outside of the concentration camps during the Nazi occupation) had a pathological effect on their offspring was examined by comparing volunteer, matched samples of adult children of "hidden" child survivors of the Holocaust with adult children of nontraumatized U.S.-born Jewish parents on personality variables measured by the Sixteen Personality Factor Questionnaire (Cattell, Eber, & Tatsuoka, 1970). The MANOVA results indicated that there were no differences in the personality characteristics of the two groups.     

Comparing two theories of health behavior: A prospective study of noncompletion of treatment following cervical cancer screening.

Some women receiving abnormal cervical screening tests do not complete recommended treatment. A prospective study (N = 660) investigated the value of conceptualizing attendance at colposcopy for treatment as either (a) an active problem-solving response to a health threat, motivated by attitudes toward an abnormal result, as implied by self-regulation theory (H. Leventhal, D. Meyer, & D. Nerenz, 1980); or (b) as a behavior motivated by attitudes toward clinic attendance, as implied by the theory of planned behavior (TPB; I. Ajzen, 1985). Responses to questionnaires containing variables specified by these models were used to predict women's subsequent attendance or nonattendance for treatment over the following 15 months. Although the TPB offered superior prediction of intentions and completion of treatment, discriminant function analyses showed that consideration of both models was important in distinguishing between those who attended all their appointments as scheduled, attended after being prompted, or ceased attending. Implications for measurement and theory in health protection are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

EPOCH方案治疗老年人外周T细胞淋巴瘤的临床研究

目的 评价EPOCH方案治疗老年外周T细胞淋巴瘤( PTCL)患者的临床疗效和不良反应.方法 对经病理确诊为PTCL老年患者28例,采用EPOCH方案治疗:依托泊苷50 mg/m2、表柔比星12mg/m2、长春新碱0.4mg/m2溶解于0.9%NaCl溶液持续静脉滴注,第1天至第4天;环磷酰胺750 mg/m2静脉滴注,第5天;泼尼松60 mg/m2口服,第1天至第5天,每21 d为1个疗程.依据WHO标准进行疗效和安全性分析和评估.结果 28例患者共完成85个疗程EPOCH方案化疗,中位化疗2个疗程,完全缓解(CR)15例,部分缓解(PR)5例,总有效(OR)率71.4%(20/28),总体平均生存时间20个月.初治患者CR率64.7%(11/17),PR率23.5%(4/17),OR率88.2%(15/17),明显高于诱导化疗失败的难治性患者[分别为36.4%(4/11)、9.1%(1/11)和45.5%(5/11)].两组OR率比较差异有统计学意义(λ2=5.99,P＜0.05),且初治患者平均生存时间长于难治性患者(24个月与13个月).EPOCH方案化疗的主要毒副作用为骨髓抑制,其中Ⅲ～Ⅳ度粒细胞和血小板减少的发生率分别为53.6%(15/28)和50.0%(14/28),非血液毒性发生率较低,初治与难治性患者的不良反应发生率差异无统计学意义(P＞0.05).结论 EPOCH方案是治疗老年PTCL患者有效而且耐受性较好的化疗方案.     

Phase I study of suramin combined with doxorubicin in the treatment of androgen-independent prostate cancer

In this study, we determined the maximum tolerated plasma concentration of suramin (within the predetermined study target range) when combined with doxorubicin in the treatment of androgen-independent prostate cancer. Twenty-four patients received suramin dosages based on proportional adjustment of the steady-state plasma suramin concentration to achieve the targeted plasma concentrations of 50-100, 101-150, 151-200, or 201-250 microg/ml. Doxorubicin (20 mg/m2) was administered i.v. over 24 h at weekly intervals. Suramin was given i.v. over 2 h twice weekly. Patients received treatment until dose-limiting toxicity or disease progression. Side effects similar to those reported for suramin and doxorubicin administered as individual agents were observed. Dose-limiting motor neuropathy developed in three patients (13%). Twelve of 24 evaluable patients (50%; 95% confidence interval, 28-71%) and 6 of 10 evaluable patients (60%; 95% confidence interval, 26-88%) had a >50% decrease of prostate-specific antigen and measurable lesions, respectively. The maximum tolerated plasma level of suramin when combined with doxorubicin was 151-200 microg/ml. Future studies on suramin combined with doxorubicin or other agents could be performed using a fixed dosing scheme with a targeted suramin steady-state plasma concentration of 200 microg/ml.     

直肠癌患者血清白介素-8、TNA-α及T细胞亚群的临床研究

Objective:The aim of our study was to investigate the immune status of patients with rectal cancer and its relationship with clinicopathological features.Methods:The serum levels of interleukin-8(IL-8),tumor necrosis factor(TNF-a)and T-cell subgroup contents were measured using a double-antibody sandwich assay of ELISA in 43 patients with rectal cancer,and compared with the normal health adults.Results:In patients with rectal cancer,the serum levels of CD4,CD4/CD8of T-cell subgroup in peripheral blood were significantly lower than the control group(P<0.01),which gradually decreased with increase of Dukes stage;but the levels of CD8,IL-8 and TNF-a were higher than the control group,which gradually increased with increase of Dukes stage.Conclusion:The immunocompromice exists in patients with rectal cancer,there is a correlation between the contents of T-cell subgroup,IL-8 and TNF-a in serum and the Dukes stage of rectal cancer.Therefore immunotherapy can be used in patients with rectal cancer.     

多西他赛与吉西他滨分别顺泊治疗晚期非小细胞肺癌的临床研究

Objective: The aim of this study was to evaluate the clinical efficacy and side effects of docetaxel/cisplatin regiment and gemcitabine/cisplatin regiment in the patients with advanced non-small-cell lung cancer (NSCLC). Methods: Seventy six patients with advanced NSCLC who were chemotherapy-naive were enrolled in two groups. In docetaxel group (DP group) the patients received docetaxel 75 mg/m2 and cisplatin 60 mg/m2 on day 1. In gemcitabine group (GP group) the patients received gemcitabine 1000 mg/m2 on day 1 and day 8. The dosage of cisplatin was the same as DP group. The two regiments were 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: The overall response rates were 43.5% in DP group and 45.9% in GP group. The response rate was significantly different between the initial treated group and retreated group in both two groups (53.8% vs 23.0% in DP group and 56% vs 25% in GP group, P < 0.05, respectively). The main side effects were bone marrow suppression and thrombocytopenia. Conclusion: Docetaxel/cisplatin regiment and gemcitabine/cisplatin regiment for the patients with advanced NSCLC were efficient and well-tolerated chemotherapeutic approachs with low toxicity levels. The efficacy and major toxicity in two groups were similar.