恶性滋养细胞肿瘤的化疗要点及心理护理

化疗是妇科滋养细胞肿瘤的主要和最有效的治疗手段。同时抗肿瘤药物普遍存在较严重的毒副作用,通过了解病人的联合用药方案及各种药物的作用原理、用法和毒性反应,按时准确安全给药,给予精心细致的心理护理,使化疗顺利完成,从而提高化疗期间患者的生活质量。     

妇科恶性肿瘤化疗患者的心理干预与护理

目的探讨妇科恶性肿瘤化疗患者的心理干预与护理。方法观察心理护理对其情绪的影响及其护理,记录妇科恶性肿瘤病人进行护理干预前后焦虑自评量。结果心理护理干预后优于护理前,比较差异具有统计学意义。结论加强护理干预能有效降低妇科恶性肿瘤化疗患者的焦虑程度,使患者能积极配合治疗。     

肿瘤患者的化疗护理及饮食

放射治疗(放疗)、化学药物治疗(化疗)是当前治疗恶性肿瘤的两大治疗手段,其所引起的毒副反应,尤其是以恶心、呕吐为主要表现的胃肠道反应,往往使患者营养物质摄入不足。导致体质下降,直接影响下周期的治疗计划及生存质量。饮食方式不仅对一般人很重要,对肿瘤患者尤其重要。据有关报道,患者在良好的营养状况和饮食方式下较能承受肿瘤及其治疗对身体所产生的种种压力,同时患者接受手术、化疗效果也会更好。     

人文关怀在肿瘤患者护理中的应用

实施对肿瘤患者的人文关怀护理过程中,不但要改善患者的身心状态,而且要提高患者应对治疗的能力,从而提高患者及家属的治疗信心和生活质量,同时也使护患关系更加和谐。     

肿瘤微环境响应性抗肿瘤前药研究进展

恶性肿瘤是影响人类生命健康的重大疾病,传统的化疗药在临床中有着广泛的应用,但是化疗药物通常缺乏靶向性,对于正常组织也有较大的毒性。研究发现肿瘤组织具有不同于正常组织的特定微环境,包括肿瘤组织微酸性环境、还原环境等。针对肿瘤组织这些特定的微环境,利用前药策略可以实现对化疗药物靶向性、溶解性、毒性的改善,目前已有多种肿瘤微环境响应的抗肿瘤前药已经处于临床研究阶段。主要对近年来肿瘤微环境响应的抗肿瘤前药的研究进展进行综述。     

持续热灌注腹腔化疗在胃肠肿瘤治疗中的作用研究

目的比较持续热灌注腹腔化疗 静脉化疗(HIPC IVC)、常规腹腔化疗 静脉化疗(IPC IVC)和单纯静脉化疗(SIVC)对于进展期胃肠肿瘤患者的疗效。方法将2003年1月～2007年2月间住院转移性胃癌患者53例随机分成3组。14位患者接受HIPC IVC,18位患者接受IPC IVC,21位患者接受SIVC,化疗毒副反应对症处理。2个周期以上评价疗效及毒副反应。结果HIPC IVC与IPC IVC或SIVC相比,缓解率、总体疗效有明显差异,HIPC在治疗转移性腹水方面有明显的优势。引起全身副作用比SIVC组小,而且多属于I～II级。结论HIPC IVC治疗方法对机体的免疫打击小,患者生活质量改善明显,临床受益率高。     

热疗联合胸腔灌注化疗药物治疗恶性胸腔积液临床观察

近年来,热疗成为恶性胸腔积液治疗的重要手段。热疗产生的热效应使肿瘤组织局部增温,能在相对较短的时间内杀灭癌细胞,同时使细胞膜通透性增加,更有利于化疗药物的渗透吸收。本研究通过热疗联合胸腔灌注化疗药物治疗恶性胸腔积液,以期减轻患者临床症状,提高患者生存质量。     

护理干预对腹腔肿瘤患者手术前后焦虑的影响

目的通对腹腔肿瘤患者手术前后焦虑进行有针对性的护理干预,以观察焦虑效果。方法采用Zung氏焦虑自评量表(SAS)对60例腹腔肿瘤患者分别于干预前后进行量表测定,以观察效果。结果手术后患者焦虑程度较术前有明显改善,差异具有显著性(P<0.05)。结论通对腹腔肿瘤患者进行护理干预,明显改善手术前后焦虑程度,提高手术疗效,改善生活质量。     

中成药结合5-FU、奥沙利铂辅助治疗大肠癌术后的疗效观察

目的比较中成药康艾注射液联合5-FU、奥沙利铂与单用化疗对大肠癌术后的临床疗效。方法大肠癌术后患者,随机分组为治疗组(中成药 化疗)和对照组(化疗)。各组均治疗4-6个疗程,观察生活质量和毒副反应的同时,比较复发时间、复发率、1-3年生存率和中位生存期。结果治疗组在改善临床症状和毒副反应明显优于对照组(P<0.05),但在1￣2年生存期比较差异无意义(P>0.05),而在累计死亡率、3年生存期、中位生存期以及复发率等方面差异均有显著性意义(P<0.05)。结论中成药康艾注射液可明显改善大肠癌患者生活质量和减少化疗药物毒副反应,并对术后患者可延长生命和减少复发,可见选择中成药配合化疗是很有意义的临床治疗方案。     

128例肝癌患者介入治疗的护理体会

目的探讨经肝动脉化疗栓塞治疗肝癌的护理措施。方法对128例肝癌介入治疗的患者给予心理护理。结果效果明显,患者的生活质量和生存质量都有提高,同时患者也十分满意。结论运用科学的方法对患者进行有效的护理是十分必要的。     

Probiotics, prebiotics infant formula use in preterm or low birth weight infants: a systematic review

Malnutrition is a significant factor in predicting cancer patients?? quality of life (QoL). We systematically reviewed the literature on the role of nutritional status in predicting QoL in cancer. We searched MEDLINE database using the terms ??nutritional status?? in combination with ??quality of life?? together with ??cancer??. Human studies published in English, having nutritional status as one of the predictor variables, and QoL as one of the outcome measures were included. Of the 26 included studies, 6 investigated head and neck cancer, 8 gastrointestinal, 1 lung, 1 gynecologic and 10 heterogeneous cancers. 24 studies concluded that better nutritional status was associated with better QoL, 1 study showed that better nutritional status was associated with better QoL only in high-risk patients, while 1 study concluded that there was no association between nutritional status and QoL. Nutritional status is a strong predictor of QoL in cancer patients. We recommend that more providers implement the American Society of Parenteral and Enteral Nutrition (ASPEN) guidelines for oncology patients, which includes nutritional screening, nutritional assessment and intervention as appropriate. Correcting malnutrition may improve QoL in cancer patients, an important outcome of interest to cancer patients, their caregivers, and families.     

Precision Oncology via NMR-Based Metabolomics: A Review on Breast Cancer

Precision oncology is an emerging approach in cancer care. It aims at selecting the optimal therapy for the right patient by considering each patient’s unique disease and individual health status. In the last years, it has become evident that breast cancer is an extremely heterogeneous disease, and therefore, patients need to be appropriately stratified to maximize survival and quality of life. Gene-expression tools have already positively assisted clinical decision making by estimating the risk of recurrence and the potential benefit from adjuvant chemotherapy. However, these approaches need refinement to further reduce the proportion of patients potentially exposed to unnecessary chemotherapy. Nuclear magnetic resonance (NMR) metabolomics has demonstrated to be an optimal approach for cancer research and has provided significant results in BC, in particular for prognostic and stratification purposes. In this review, we give an update on the status of NMR-based metabolomic studies for the biochemical characterization and stratification of breast cancer patients using different biospecimens (breast tissue, blood serum/plasma, and urine).     

Micronutrient Food Supplements in Patients with Gastro-Intestinal and Hepatic Cancers

Colorectal carcinogenesis is the second most common cause of mortality across all types of malignancies, followed by hepatic and stomach cancers. Chemotherapy and radiotherapy are key approaches to treating cancer patients, but these carry major concerns, such as a high risk of side effects, poor accessibility, and the non-selective nature of chemotherapeutics. A number of natural products have been identified as countering various forms of cancer with fewer side effects. The potential impact of vitamins and minerals on long-term health, cognition, healthy development, bone formation, and aging has been supported by experimental and epidemiological studies. Successful treatment may thus be highly influenced by the nutritional status of patients. An insufficient diet could lead to detrimental effects on immune status and tolerance to treatment, affecting the ability of chemotherapy to destroy cancerous cells. In recent decades, most cancer patients have been taking vitamins and minerals to improve standard therapy and/or to decrease the undesirable side effects of the treatment together with the underlying disease. On the other hand, taking dietary supplements during cancer therapy may affect the effectiveness of chemotherapy. Thus, micronutrients in complementary oncology must be selected appropriately and should be taken at the right time. Here, the potential impact of micronutrients on gastro-intestinal and hepatic cancers is explored and their molecular targets are laid down.     

Metastatic Voyage of Ovarian Cancer Cells in Ascites with the Assistance of Various Cellular Components

Epithelial ovarian cancer (EOC) is the most lethal gynecologic malignancy and has a unique metastatic route using ascites, known as the transcoelomic root. However, studies on ascites and contained cellular components have not yet been sufficiently clarified. In this review, we focus on the significance of accumulating ascites, contained EOC cells in the form of spheroids, and interaction with non-malignant host cells. To become resistant against anoikis, EOC cells form spheroids in ascites, where epithelial-to-mesenchymal transition stimulated by transforming growth factor-β can be a key pathway. As spheroids form, EOC cells are also gaining the ability to attach and invade the peritoneum to induce intraperitoneal metastasis, as well as resistance to conventional chemotherapy. Recently, accumulating evidence suggests that EOC spheroids in ascites are composed of not only cancer cells, but also non-malignant cells existing with higher abundance than EOC cells in ascites, including macrophages, mesothelial cells, and lymphocytes. Moreover, hetero-cellular spheroids are demonstrated to form more aggregated spheroids and have higher adhesion ability for the mesothelial layer. To improve the poor prognosis, we need to elucidate the mechanisms of spheroid formation and interactions with non-malignant cells in ascites that are a unique tumor microenvironment for EOC.     

Exosomes and Brain Metastases: A Review on Their Role and Potential Applications

Brain metastases (BM) are a frequent complication in patients with advanced stages of cancer, associated with impairment of the neurological function, quality of life, prognosis, and survival. BM treatment consists of a combination of the available cancer therapies, such as surgery, radiotherapy, chemotherapy, immunotherapy and targeted therapies. Even so, cancer patients with BM are still linked to poor prognosis, with overall survival being reported as 12 months or less. Intercellular communication has a pivotal role in the development of metastases, therefore, it has been extensively studied not only to better understand the metastization process, but also to further develop new therapeutic strategies. Exosomes have emerged as key players in intercellular communication being potential therapeutic targets, drug delivery systems (DDS) or biomarkers. In this Review, we focus on the role of these extracellular vesicles (EVs) in BM formation and their promising application in the development of new BM therapeutic strategies.     

Vincristine-Induced Peripheral Neuropathy (VIPN) in Pediatric Tumors: Mechanisms,Risk Factors,Strategies of Prevention and Treatment

Vincristine-induced peripheral neurotoxicity (VIPN) is a very common side effect of vincristine chemotherapy among pediatric patients with cancer. Neuropathy may be sensory, motor and/or autonomic, with consequent reduction, delay or discontinuation of vincristine-chemotherapy, but also pain, disability, reduced quality of life of patients and an increase in medical costs. Vincristine acts out its antineoplastic function by altering the normal assembly and disassembly of microtubules, with their consequent mitosis block and death. Vincristine leads to VIPN through a complex mechanism of damage, which occurs not only on the microtubules, but also on the endothelium and the mitochondria of nerve cells. Furthermore, both patient-related risk factors (age, race, ethnicity and genetic polymorphisms) and treatment-related risk factors (dose, time of infusion and drug–drug interactions) are involved in the pathogenesis of VIPN. There is a lack of consensus about the prophylaxis and treatment of VIPN among pediatric oncologic patients, despite several molecules (such as gabapentin, pyridoxine and pyridostigmine, glutamic acid and glutamine) having been already investigated in clinical trials. This review describes the molecular mechanisms of VIPN and analyzes the risk factors and the principal drugs adopted for the prophylaxis and treatment of VIPN in pediatric patients with cancer.     

Bone Density as a Marker of Response to Radiotherapy in Bone Metastatic Lesions: A Review of the Published Data

Metastases to the bone are presenting in a great percentage of patients with cancer, causing a variety of symptoms, affecting the quality of life and survival of patients. A multidisciplinary approach from different health providers is required for treatment, including radiation oncologists, medical oncologists and surgeons. The role of radiotherapy in the management of bone metastases has long been established through multiple randomized trials. The estimation of response to the therapy is subjective and is based on the palliation of the symptoms that the patients report. However, a quantification of the tumor burden and response to the treatment with the use of an objective method to measure those parameters is a clinical expectation in oncology. The change in bone density in affected areas (mainly lytic) after local radiotherapy, representing the cellular changes that have occurred, is a promising marker of response to treatment.     

Chemotherapeutic engineering: Application and further development of chemical engineering principles for chemotherapy of cancer and other diseases

This review defines chemotherapeutic engineering as an engineering discipline that applies and further develops chemical engineering principles, techniques and devices for chemotherapy of cancer and other diseases. It provides new challenges as well as new opportunities for chemical engineering. Chemical engineering has substantially changed the human civilization through its services and products to improve the quality of life for human being. It is now time for chemical engineering to contribute to the most important aspect of the quality of life—human health care. Cancer and cardiovascular diseases are the leading causes for deaths. Chemotherapy is one of the most important treatments currently available for cancer and other diseases such as cardiovascular diseases. The present status of chemotherapy is far from being satisfactory. Its efficacy is limited and patients have to suffer from serious side effects, some of which are life-threatening. Chemotherapeutic engineering is emerging to help solving the problems in chemotherapy and to eventually develop an ideal way to conduct chemotherapy with the best efficacy and the least side effects. This review gives, from an engineering point of view, brief introductions to cancer and cancer treatment, chemotherapy and the problems involved in chemotherapy, and the possible roles of chemical engineering in solving the problems involved. Progress in developing various controlled and targeted drug delivery systems is reviewed with an emphasis on nanoparticles of biodegradable polymers and lipid bilayer vesicles (liposomes). Preparation, characterization, in vitro release, cell line experiments and animal testing of drug-loaded polymeric nanoparticles are described with paclitaxel as a prototype drug, which is one of the best anticancer drugs found in nature. A novel drug delivery system, liposomes-in-microspheres, is used as an example for possible combinations of the existing polymer- and lipid-based delivery systems. Research of molecular interactions between the drug and the cell membrane is also reviewed, with the lipid monolayer at the air-water or oil-water interface and bilayer vesicles as models for the cell membrane. Finally, mathematical modeling in chemotherapeutic engineering is discussed with typical examples in the literature. This review is a short introduction of chemotherapeutic engineering to chemical engineers, biomedical engineers, other engineers, clinical oncologists, and pharmaceutical scientists, who are interested in developing new dosage forms of drugs for chemotherapy of cancer and other diseases with the best efficacy and the least side effects.     

Nutrition support in cancer patients: a brief review and suggestion for standard indications criteria

The indications of nutrition support in cancer patients have been subject to controversy. Most studies address the effects of the method in increasing the survival or the tumor response rate. Few studies have focused on the effects in improving quality of life.After a brief review, we described the results of a study, which evaluated the effects of protein-caloric supplementation on the quality of life parameters in a group of head and neck cancer patients submitted to radiotherapy. The results support the suggestion of creating standard criteria to indicate nutrition support in cancer patients.Based on our findings, nutrition support should be indicated for cancer patients considering the potential effects to improve the quality of life.     

Mechanisms of Ovarian Cancer Metastasis: Biochemical Pathways

Ovarian cancer is the most lethal gynecologic malignancy. Despite advances in chemotherapy, the five-year survival rate of advanced ovarian cancer patients with peritoneal metastasis remains around 30%. The most significant prognostic factor is stage, and most patients present at an advanced stage with peritoneal dissemination. There is often no clearly identifiable precursor lesion; therefore, the events leading to metastatic disease are poorly understood. This article reviews metastatic suppressor genes, the epithelial-mesenchymal transition (EMT), and the tumor microenvironment as they relate to ovarian cancer metastasis. Additionally, novel chemotherapeutic agents targeting the metastasis-related biochemical pathways are discussed.