目的:探讨新辅助化疗在中晚期乳腺癌保乳手术治疗中的作用及临床疗效.方法:选择我院2013年09月至2015年03月收治的中晚期乳腺癌保乳手术患者76例,采用计算机随机分组法,分成观察组和对照组,每组各38例.对照组患者术前不进行化疗、观察组患者术前进行新辅助化疗,对比两组的客观缓解率、不良反应率及中位无进展生存期.结果:观察组患者的不良反应率为(2.63%)明显低于对照组患者(26.32%),且观察组的客观缓解率、中位无进展生存期均优于对照组(P<0.05).结论:针对中晚期乳腺癌保乳手术患者,使用新辅助化疗治疗的效果较为明显,不良反应少,值得在临床上推广.

目的探讨腹膜转移癌腹腔灌注后微波治疗的近期疗效及免疫学改变机制。方法选择吉林省肿瘤医院2010年1月至2011年12月既往经过手术及放化疗的胃癌、胰头癌、卵巢癌、大肠癌等晚期腹腔恶性肿瘤恶性腹水患者共40例,随机分为腹腔灌注化疗组(单纯组)和腹腔灌注后微波治疗组(治疗组)。结果治疗组的近期总有效率(65.02%)明显优于对照组(40.03%)(P<0.005)。治疗组治疗后KPS评分(73.08±4.58)与单纯组(69.16±2.14)比较具有显著性差异(P<0.05)。两组患者治疗期间不良反应轻微,主要表现为恶心、呕吐及骨髓抑制,给予对症处理后完全消失,无相关死亡,两组比较未见统计学差异(P>0.05)。腹腔热灌注化疗后外周血CD3+CD4+、CD3+CD56+、CD3-CD56+细胞数目较化疗前明显上升,差异有统计学意义;CD3+CD8+在热灌注化疗前后无明显变化,CD3+CD4+/CD3+CD8+(免疫状态)明显改善。结论顺铂腹腔灌注化疗后微波治疗具有独特的抗肿瘤优势,适应、可操作性良好,不良反应小,骨髓抑制轻,患者基本耐受。腹腔灌注化疗后微波治疗可以使恶性腹盆腔肿瘤患者的免疫抑制解除,机体免疫功能增强,机体对肿瘤的免疫应答加强。

Objective To evaluate the efficacy and safety of gemcitabine combined with capecit-abine in treatment of patients with tripe-negative advanced breast carcinoma( TNABC) who had been treated with chemotherapy. Methods Fourteen patients with immunohistochemically proved TNABC were enrolled. The patients received treatment with 28 days per cycle of capecitabine 2500 mg/m2 po on d1-14 and gemcitabine 800 mg/m2 iv gtt on d1,d8 and d15. Results A total of 58 cycles were given to 14 patients( median 4 /patient; range 2-6 cycles) . The treatment response was evaluable in all patients. Of the 14 patients,no one showed complete remission( CR) ,4 partial remission( PR) ,6 stable disease( SD) and 4 progression of dis-ease( PD) . Response rate( CR + PR) was 28. 6% . The median time to progress( mTTP) was 6 months( 95% CI: 4-8) . The median survival time was 16 months( 95% CI: 6-32) . The 1-year survival rate was 64. 4% . The 3-year survival rate was 14. 3% . The major toxic reactions were Ⅰ-Ⅲ degree of bone marrow suppression, gastrointestinal reactions,hand-foot syndrome,peripheral nerve toxicity,flu-like symptoms,mild liver damage. Conclusion The combination of gemcitabine and capecitabine is an effective and well tolerated regi-men for the patients with TNABC.

Objective To observe the curative effect of thalidomide combined with dexamethasone(Thal-Dex) in treatment of refractory or relapsing multiple myeloma.Methods Twelve patients with advanced and refractory relapsing multiple myeloma were treated with Thal-Dex.All of the patients were given thalidomide at the starting dose of 100 mg/d,increasing by 100 mg/d every week till 400 mg/d;dexamethasone 40 mg/d,d1-4,d9-12,d17-20 in each cycle,repeated monthly.Results Two of 12 patients had complete remission(CR,16.7%),6 of them got partial remission(PR,50.0%),2 of them showed minimal response(MR,16.7%) and 2 had no response(NR,16.7%),with a total efficacy rate of 66.7%(CR+PR).Conclusion Thalidomide combined with dexamethasone in the treatment of refractory or relapsing multiple myeloma might be effective.

在恶性肿瘤的化疗中我们发现随着治疗周期的延长有越来越多的患者出现空腹血糖增高,其中部分病人诊断为糖尿病.为进一步探讨化疗药物能否诱发糖尿病,我们对我科近2年收治的735例恶性肿瘤患者化疗后血糖水平及相关资料进行分析,现报道如下.

目的:观察紫杉醇与顺铂联合化疗对晚期卵巢上皮性癌近期疗效及毒副反应。方法:晚期卵巢上皮性癌36例,采用PT案化疗,紫杉醇135 mg/m2,顺铂70 mg/m2全身化疗,3周为1疗程,至少完成4个疗程观察疗效。结果:Ⅲ期有效率为71.42%;Ⅳ期有效率为50.00%。毒副反应主要为骨髓抑制,发生率72.22%(26/36),但61.11%(22/36)均为Ⅰ~Ⅱ度。胃肠道反应发生率55.56%(20/36),所有患者均未因毒副作用中断或退出治疗。结论:PT方案联合化疗效果较好,毒副反应小。

原发性肝癌是我国常见的恶性肿瘤之一,恶性程度高,起病隐匿,复发率高,能够接受手术切除治疗的肝癌患者仅占20%左右[1].故临床上大多数肝癌仍需采用非手术疗法.肝癌主要治疗手段有手术、放疗、化疗、介入治疗等.对于病变范围小、孤立、数目少的可以手术或放疗;对于病变大又有包膜的可以介入栓塞治疗.但原发性肝癌往往当发现时,已是晚期,病变较大或弥散,手术、介入栓塞难以起作用.晚期肝癌多数伴有不同程度的肝硬化及肝功失代偿,化疗效果不佳.不断探索和研究新的治疗方法,显得十分重要.随着高热治疗癌的进展,大量的临床实践及生物实验表明热疗联合化疗有明显的互补与增敏效果.我科自2003年11月～2004年11月采用局部热疗联合化疗治疗63例晚期原发性肝癌患者,取得满意疗效,现报告如下:

目的 比较全身化疗加局部热疗及单纯化疗治疗中晚期非小细胞肺癌的疗效和副反应差异.方法 47例中晚期非小细胞肺癌病人随机分为两组.A组(化疗热疗组)23例,B组(单纯化疗组)24例,热疗化疗组采用局部热疗联合NP方案化疗,单纯化疗组单纯采用NP方案化疗,对比分析两组疗效及毒副反应.结果 A组总有效率52.2%,B组总有效率45.8%.两组有显著性的差异(P＜0.05).两组毒副反应发生率无显著性差异.局部热疗联合化疗不失为治疗中晚期非小细胞肺癌的有效综合治疗方法.结论局部热疗联合全身化疗可提高单纯化疗治疗中晚期非小细胞肺癌的疗效,副作用增加不明显.