Objective: To compare the efficacy and safety of hepatic arterial infusion chemotherapy (HAIC) with transarterial chemoembolization (TACE) for the treatment of high-risk hepatocellular carcinoma (hHCC) patients. Methods: Between January 2014 and August 2022, a total of 1765 consecutive patients with hHCC who underwent initial intraarterial therapies were reviewed and divided into a TACE group (n, 507) and a HAIC group (n, 426). The study used propensity score matching (PSM) to reduce selectivity bias. Overall survival (OS) and progression-free survival (PFS) were compared using Kaplan- Meier curves with the Log rank test. The objective response rate (ORR), conversion surgery rate (CSR) adverse event (AE) comparison and subgroup analysis were performed between the two groups. Results: After PSM 1:1, 444 patients were divided into two groups. The patients with hHCC who received HAIC had higher median PFS (6.1 vs 3.3 months, P < 0.001) and OS (10.3 vs 8.2 months, P=0.303) than TACE. Higher ORR (24.8% vs 11.7%) and CSR (15.5% vs 8.9%) were found in the HAIC group than in the TACE group (both P < 0.05). The incidence of grade 3/4 AE was 23.9% and 8.1% in the TACE and HAIC groups, respectively. The subgroup analysis suggest that HAIC appeared to particularly benefit patients with tumor diameter of more than 10 centimeters (hazard ratio [HR], 0.6; 95% CI, 0.47-0.77; p, 0.00) and PVTT Vp4 (HR, 0.56; 95% CI, 0.39-0.8; P, 0.01) for PFS outperforming TACE. Conclusion: HAIC can provide better disease control for hHCC than cTACE, with a comparable long-term OS and safety.

目的 观察肝动脉栓塞化疗(TACE)联合索拉非尼在原发性肝癌治疗中的应用效果,以及其对患者免疫功能相关指标的影响.方法 回顾性分析首都医科大学附属北京潞河医院自2018年1月至2020年2月收治的84例原发性肝癌患者的临床资料.将患者随机分入TACE组和联合组,每组各42例.TACE组采用TACE方式进行治疗,联合组在TACE基础上联合索拉非尼进行治疗.比较两组的临床治疗有效率,治疗前后的免疫功能指标,以及不良反应发生率.结果 联合组临床治疗有效率高于TACE组,差异有统计学意义(P<0.05).治疗后,TACE组和联合组CD3+、CD4+、CD4/CD8水平均较治疗前升高,且联合组高于TACE组,差异有统计学意义(P<0.05);同时,CD8+水平较治疗前降低,且联合组低于TACE组,差异有统计学意义(P<0.05).联合组不良反应发生率低于TACE组,差异有统计学意义(P<0.05).结论 TACE联合索拉非尼治疗原发性肝癌安全有效,可增强患者免疫功能.

目的 探究肺癌组织中P65、细胞角质蛋白19片段抗原21-1(CYFRA21-1)、波形蛋白(vimentin)的表达情况及与肺癌患者临床特征的关系.方法 选取60例肺癌患者的肺癌组织及对应的癌旁组织,采用免疫组织化学法检测肺癌组织和癌旁组织中P65、CYFRA21-1、vimentin蛋白的表达情况,并对其与肺癌患者临床特征的关系进行分析.结果 肺癌组织中P65、CYFRA21-1、vimentin蛋白的阳性表达率均明显高于癌旁组织(P﹤0.01);临床分期为Ⅲ～Ⅳ期肺癌患者肺癌组织中P65、CYFRA21-1、vimentin蛋白的阳性表达率均明显高于临床分期为Ⅰ～Ⅱ期的患者(P﹤0.01).有淋巴结转移的肺癌患者肺癌组织中P65和vimentin蛋白的阳性表达率均高于无淋巴结转移的患者(P﹤0.05);不同淋巴结转移情况肺癌患者肺癌组织中CYFRA21-1蛋白的阳性表达率比较,差异无统计学意义(P﹥0.05).结论 肺癌患者肺癌组织中P65、CYFRA21-1、vimentin蛋白的阳性表达率较癌旁组织增高,P65、CYFRA21-1、vimentin蛋白的表达与肺癌患者的临床分期和淋巴结转移情况有一定关联.

目的 探讨在老年中度癌痛患者中,羟考酮与曲马多作为初始止痛治疗方案的疗效.方法 96例老年中度癌痛患者,按治疗方式不同分为观察组(n=49)和对照组(n=47).观察组患者初始治疗直接采用盐酸羟考酮缓释片10 mg q12 h口服;对照组先采用盐酸曲马多缓释片100 mg q12 h口服,根据疼痛控制情况逐渐加量改用盐酸羟考酮缓释片20 mg q12 h继续止痛治疗,两组患者观察时间为14天.分别采用数字评分法(NRS)、卡氏功能状态(KPS)评分、汉密尔顿抑郁量表(HAMD)、生活质量评分量表对患者的疼痛情况、功能状态、抑郁情况、生活质量进行评估.结果 治疗前两组患者NRS、HAMD及KPS评分比较,差异均无统计学意义(P﹥0.05);治疗后两组患者NRS、HAMD评分均下降,与治疗前比较,差异均有统计学意义(P﹤0.05),且观察组患者NRS、HAMD评分均明显低于对照组,差异均有统计学意义(P﹤0.01);治疗后两组患者KPS评分均提高,与治疗前比较,差异均有统计学意义(P﹤0.05),且观察组患者KPS评分明显高于对照组,差异有统计学意义(P﹤0.01).观察组患者疼痛缓解总有效率为95.9％(47/49),明显高于对照组患者的72.3％(34/47),差异有统计学意义(P﹤0.01).治疗后观察组患者生活质量优于对照组,差异有统计学意义(P﹤0.05).治疗过程中,观察组患者便秘发生率明显高于对照组,差异有统计学意义(P﹤0.01);而两组患者其他不良反应发生率比较,差异均无统计学意义(P﹥0.05).结论 以羟考酮作为老年中度癌痛患者的初治用药,与曲马多比较,能明显减轻患者的痛苦,改善患者体力,有效消除患者负面情绪,降低患者的心理困扰程度,改善患者的生活质量,提高癌痛治疗效果,对老年肿瘤患者的中度癌痛初始治疗选择策略具有重要意义.

Received: 18 July 2017 Revised: 5 August 2017 Accepted: 25 August 2017 Objective Colorectal cancer (CRC) is a heterogeneous disease in which both epigenetic alterations and gene mutations transform normal cells into cancer cells. Apart from a variety of standard treatments, there are few options available to improve a CRC patient’s overall survival (OS) and quality of a life. The objective of the present retrospective study was to analyze the response and toxicity associated with apatinib in patients with metastatic CRC (mCRC). Method Data on the use of apatinib as salvage therapy were collected from patients diagnosed with mCRC, Eastern Cooperative Oncology Group (ECOG) performance status ≤ 3, from the Luhe Hospital. A total of 17 patients with stage IV unresectable mCRC, who received at least one cycle of apatinib, between October 2015 and February 2017, were involved in this study. Our primary endpoints were the overall response rate (ORR) and disease control rate (DCR), and the secondary objectives were progression-free survival (PFS), OS and safety. Result Seventeen patients with a median age of 62 years (34–83 years) were enrolled. Twelve patients were male, and the location of the primary tumor was in the colon and the rectum in 9 and 8 patients, respectively. Liver metastasis was observed in 9 patients and lung metastasis in 5. The ECOG performance status was 0 to 2 in 13 patients. The ORR at the first evaluation was 17.6 % (3/17). The DCR was 82.4% (14/17). The median PFS was 3.0 months (95% confidence interval (CI): 1.924–4.076 months) and the median OS was 5.4 months (95% CI: 3.383–7.417 months). Grade 1–2 adverse events included hypertension (52.9%), fatigue (64.7%), anorexia (29.4%), hoarseness (23.5%), proteinuria (23.5%), and development of rashes (17.6%). Grade 3 adverse events included thrombocytopenia (5.9%) and proteinuria (5.9%). There were no Grade 4 adverse events in our analysis. Conclusions Apatinib was found to be both safe and effective in the treatment of advanced mCRC, and its associated toxicities were acceptable and manageable. However, further studies are required to validate these findings.

With the increasing incidence of malignant tumor, different patients may see their doctor in different clinical departments due to their symptoms. The clinicians should master the basic knowledge of common tumors and the treatment principle, so that more patients with malignant tumor can be timely diagnosis and treatment, reduce the incidence of missed diagnosis and misdiagnosis. Currently, more and more standardized training of residents rotate in department of oncology. Under integrative medicine mode, our hospital carry out the multidisciplinary collaboration mode and strengthen the close cooperation between departments, and we choose different diseases in clinical teaching. Each of specialized subject works together. We wish it can makes students learn more about tumor specialized knowledge and makes their clinical thinking expanded and makes their interest in learning increased and makes the quality of teaching improved.

Objective:To observe the analgesic effect and adverse effect of oral administration Oxycontin (Oxycodone Hydrochloride Controlled- release Tablets) before and after Transcatheter arterial chemoembolization (TACE) treatment of hepatic carcinoma,discuss the reasonable and feasible pain control method for TACE.Methods:90 patients were given 10mg Oxycontin 1h before the interventional therapy,and after operation 10mg for every 12h for 3 days.The efficacy and side effects were observed and recorded. Results:12 and 24 hours after interventional therapy,the incidences of pain were respectively 32.2% and 8.9%.48h after TACE,the incidences of pain were remained around 3.3%.Among all patients,incidence of severe pain is zero.Conclusion:Oral treatment of Oxycontin can be effective in controlling pain of interventional therapy in hepatic carcinoma,less adverse reactions and take safety.

Objective To investigate the effect of thromboelastography(TEG) in combination with routine haemostatic assays and ultrasonic doppler examination in deep veins of lower limbs in diagnosis of hypercoagulability of malignant tumor.Methods One hundred and sixty-two malignant tumor patients were examined by TEG,routine haemostatic assays and deep venous ultrasonic examination in lower limbs.According to the results,the patients were classified into deep venous thrombosis group(group A,n=12),erythrocyte aggregation group(group B,n=23) and non-thrombus and erythrocyte aggregation group(group C,n=127).The relationships between reaction time(R value),maximum amplitude value(MA),α angle,D-Dimer,fibrinogen(FIB),fibrinogen degradation products(FDP) and platelet count of three groups were compared.Results There was no statistical significance in each parameter between groups A and B.The R values in groups A and B were significantly lower than that in group C,and the rest of the parameters were significantly higher than that in group C.Conclusion TEG combined with routine haemostatic assays and ultrasonic doppler examination in deep veins of lower limbs can assess the coagulant state in patients with tumor,predict occurred risk of deep venous thrombosis.It can be used to judge whether the patients need anticoagulation,and is one method of reducing the risk of thrombus.

目的 观察康艾注射液联合化疗治疗晚期消化道肿瘤的临床效果及其减毒增效作用.方法 将90例明确诊断的胃癌、食管癌、结直肠癌的患者按随机数字表法分为两组,治疗组(46例)采用化疗加康艾注射液,对照组(44例)单用化疗.观察两组近期疗效、化疗不良反应及生活质量改善情况.结果 治疗组与对照组近期疗效有效率分别为43.5％(20/46)和43.2％(19/44),两组比较差异无统计学意义(P＞0.05);治疗组生活质量改善率为82.6％(38/46),明显高于对照组的59.1％(26/44),差异有统计学意义(P＜0.05);治疗组Ⅲ～Ⅳ级白细胞减少、恶心呕吐发生率分别为6.52％(3/46)、8.70％(4/46),对照组分别为34.09％ (15/44)、38.64％(17/44),两组比较差异有统计学意义(P＜0.05).结论 康艾注射液对消化道肿瘤可协助化疗抗癌,改善患者生活质量,降低化疗不良反应.

<正>目前,对于胃癌的治疗采取以手术为主,多学科综合治疗手段。但是对于许多胃癌患者来说,因多种原因导致就诊晚,分期晚,一旦确诊失去手术机会,或因患者自身因素放弃手术治疗,在这类患者中,我们采取经导管动脉灌注化疗栓塞(transcatheter arterial chemoembolization,TACE),术后联合替吉奥胶囊口服[1~2],患者临床症状明显改善,生

Objective To investigate the clinical methods of venous thromboembolism(VTE) prevention for patients with malignant tumor.Methods Eighty hospitalized patients with malignant tumor were randomly divided into intervention group(n=60) and control group(n=20).The intervention group was intervened according to thrombelastogram and clotting results,whereas the control group was not intervened.According to different hypercoagulable factors,intervention group was further grouped into deep venous thrombosis(DVT) group(group A),erythrocyte aggregation group(group B) and erythrocyte aggregation group without thrombosis(group C),20 cases in each group.DVT in lower limbs,pulmonary thromboembolism(PTE) and occurrence of hemorrhagic events of patients in each group were observed.Results During hospitalization,both incidences of DVT and fatal PTE in the intervention group were significantly lower than those in the control group.Compared with hemorrhagic events in each group during hospitalization and follow-up visit,all the differences showed no statistical significance.Conclusion For patients with malignant tumor,understanding early clotting changes of thrombosis according to thrombelastogram and clotting presentation and taking positive interventions can effectively reduce the incidence rates of DVT and PTE.Seeking different causal factors based on different hypercoagulable states and applying individual treatment can ensure the efficiency and safety of treatment.

Objective To investigate the safety and effectiveness of S-1 capsule combined with oxaliplatin in the treatment of advanced gastric cancer.Methods Fifty-two patients with advanced gastric cancer were treated with the chemotherapy: composed of S-1 capsule 80 mg·m-2·d-1,twice daily,oral,d1-14;oxaliplatin 130 mg·m-2,intravenous drip,d1.One treatment cycle covered 3 weeks.The effects and toxicities were evaluated after 4 cycles.Results The effective rate was 44.2%(23/52).The clinical beneficial response was 76.9%(40/52).The main side effects included myelosuppressio,gastrointestinal reactions and neurotoxicity.ConclusionS-1 capsule combined with oxaliplatin is effective in the treatment of advanced gastric cancer,and the toxicities can be tolerated.These results indicate that further clinical study and application are warranted.

Objective: To investigate the value of kelp micro gelation (KMG) and lipiodol in transcatheter hepatic artery chemoembolization (TACE) for primary hepatocarcinoma. Methods: TACE was performed with KMG and lipiodol in 136 patients with primary hepatocarcinoma. Results: Complete response was found in 38 patients, tumor volume reduced greater than 50% in 65, 25%-50% in 25, while no change in 8 patients. After TACE with KMG and lipiodol, the incidence of abdominal pain was 47.79% (65/136), within which 80.00% was slight or moderate. The incidence of fever was 41.18% (56/136). The damage to liver function was slight, and no serious complications occurred. Conclusion: TACE with KMG and lipiodol is simple and easy, may overcome the loss of lipiodol, reinforce the effect of vascular embolism and improve curative effect.

Objective To evaluate the efficacy of superselective arterial embolization in treatment of liver hemangioma.Methods Forty-two cases of liver hemangioma treated with superselective arterial embolization were reviewed.The femoral artery puncture and catheter introduction with Seldinger′s approach were applied,then superselective hepatic artery or superior mesentery artery angiography followed by embolism with mixture of lipiodol + bleomycin + sodium alginate microball was performed.Results The symptoms disappeared or were alleviated in 40 patients treated once,and in 2 patients treated twice.Twelve months later,the CT image showed still presence of lipiodol in the focus.The hemangiomas disappeared in 10 patients,the size of hemangioma reduced in 30 patients,stabilized in 2 cases and no serious embolization syndrome occurred.The patients stayed in hospital for 3-5 days after arterial embolization.Conclusion The treatment of liver hemangioma with superselective arterial embolization has definite clinical efficacy,and has the advantages of minimally invasive,safe,rapid recovery and inexpensive.