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.
目的观察放射治疗配合紫杉醇化疗局部晚期非小细胞肺癌(NSCLC)的疗效及不良反应。方法将65例食管癌患者根据不同的治疗方法分为两组,单纯放射治疗组(治疗组)和放射治疗同步化疗组(放化疗组)。治疗组33例,采用常规放疗,DT65～70Gy;放化疗组CR、PR分别为18.2%和69.7%,而放疗组分别是6.3%和50.0%。两组CR、RR(CR+PR)差异有显著性意义(P<0.05)。放化疗组和放疗组1年、2年生存率分别是69.7%(23/33)、48.5%(16/33)和65.6%(21/32)、28.1%(9/32),两组的1年生存率无明显差异,2年生存率差异则有显著性(P<0.05)。放化疗组白细胞下降、恶心呕吐较放疗组明显(P<0.05)。结论同步放化疗优于单纯放射治疗,不良反应患者能耐受,安全可行,可明显局部晚期非小细胞肺癌(NSCLC)的疗效。
目的:观察希罗达治疗转移性或复发性乳腺癌的疗效及不良反应。方法:希罗达单药治疗52例晚期乳腺癌患者,每天用药2500mg/m2,早晚两次餐后口服,连用14天,间隔7天,21天为1周期。结果:52例均治疗1周期以上,总有效率(CR+PR)为23.1%(12/52),临床获益率(CR+PR+SD>6个月)为26.9%(14/52),疾病控制率(CR+PR+SD)为69.2%(36/52)。最常见的不良反应是手足综合征(HFS),发生率为38.5%(20/52),程度均为Ⅰ～Ⅱ度,无Ⅲ度HFS发生。结论:希罗达对经含蒽环类和(或)紫杉醇化疗方案治疗失败的患者仍有较好疗效,患者不良反应可耐受且可口服。
HER-2基因过表达与乳腺癌术后辅助内科治疗的疗效及预后密切相关。HER-2过表达患者在辅助化疗时,对烷化剂等化疗药物不敏感,而对蒽环类及紫杉醇敏感;在辅助内分泌治疗时,HER-2过表达通过各种信号转导通路,使乳腺癌细胞对以TAM为代表的内分泌治疗耐药,而对芳香化酶抑制剂敏感。赫赛汀联合化疗能明显提高晚期复发转移乳腺癌的疗效,可延长生存期,将其应用于辅助治疗中可能延长患者的无病生存。乳腺癌HER-2表达状态在指导临床医师选择治疗方案、判断预后方面有重要的参考价值。
Objective Clinical effect and side-effect of cryosurgery on advanced lung cancer were studied. Method 97 patients with unresectable advanced lung cancer or lung cancer of metastasis were treated. Results Operative complications including cough,chest pain ,hemoptysis,fever pneumothorax were slight,and they were improved after treatment .No operation-related death was observed. Conclusion Cryotherapy is an effective method for advanced lung cancer or lung cancer of metastasis.
