目的 探讨重组人白细胞介素2(rhIL-2)联合重组人粒细胞-巨噬细胞刺激因子(rhGM-CSF)治疗食管癌放疗后放射性食管炎的临床效果.方法 选择食管癌放疗后放射性食管炎患者106例,随机分为观察组、对照组各53例.对照组予rhIL-2100万U静脉滴注,每天1次;观察组在对照组基础上予rhGM-CSF 100μg皮下注射,每周3次.两组均连续治疗14 d.比较两组治疗前后放射性食管炎分级、外周血T淋巴细胞亚群(CD3+、CD4+、CD8+T细胞及CD4+/CD8+)和自然杀伤细胞(CD16+CD56+NK细胞)以及生活质量核心问卷-30(QLQ-C30)评分(包括躯体功能、角色功能、情绪功能、认知功能和社会功能五个维度).结果 观察组治疗后放射性食管炎分级0、Ⅰ级占比显著高于本组治疗前和对照组治疗后,而放射性食管炎分级Ⅱ～Ⅳ级占比显著低于本组治疗前和对照组治疗后(P均<0.05).两组治疗后CD3+、CD4+T细胞及CD4+/CD8+和CD16+CD56+NK细胞均高于治疗前,而CD8+T细胞均低于治疗前,以观察组治疗后上述指标变化更明显(P均<0.05).两组治疗后躯体功能、角色功能、情绪功能、认知功能和社会功能评分均高于治疗前,以观察组治疗后上述评分变化更明显(P均<0.05).结论 rhIL-2联合rhGM-CSF能够降低食管癌放疗后放射性食管炎严重程度,提高机体免疫功能,改善患者生活质量.

Objective To investigate the effect of platelet (PLT) count and their change on the prognosis of colorectal cancer patients before and after surgery. Methods Retrospective analysis of clinical data of 260 colorectal cancer patients undergoing radical resection by our surgical oncology were done. All cases were divided into normal platelet group (PLT<300 ×109/L) and high platelet group (PLT≥300 ×109/L) according to the platelet counts before and after surgery, and all cases were also divided into postoperative platelet elevated group and reduced group according to changes in perioperative platelet counts. The overall survival rates were analyzed by univariate analysis and COX regression model. Results Univariate survival analysis demonstrates that survival in preoperative normal platelet group is better than high platelet group, while the result is opposite in postoperative cases. Further analysis shows that survival in postoperative platelet elevated group is better than platelet reduced group. Though differences between these groups were not statistically significant, but the two survival curves had a tendency to further separation. Multivariate analysis showed PLT≥300 ×109/L before surgery (RR:0.553;95%CI:0.318~0.962;P=0.036) and PLT<300 ×109/L after surgery (RR:1.824;95%CI:1.006~3.308;P=0.048) were both independent risk factors affecting the prognosis of colorectal cancer. Conclusion Abnormal rise of platelet counts before and after surgery have opposite effect in colorectal cancer prognosis. The mechanism may be that part of colorectal cancer cells have the ability of secreting factor to promote platelet growth, whereas having the secretory function is associated with a poor prognosis.

目的探讨后程加速超分割适形放疗治疗鼻咽癌的临床效果。方法对2008年收治的25例确诊的鼻咽癌患者进行放疗治疗,使用WD-6 mvX线照射,采用后程加速超分割适形放疗技术,对鼻咽及上颈部的靶区完成40Gy剂量后,改为由1.5 Gy/次、2次/d、1周5次的剂量依次递增照射,两次照射的间隔时间在4～6 h以上,40～45 d为1个疗程,随访1年。按照急性放射反应评分标准(RTOG/EORTC标准)评价毒副作用。结果鼻咽原发灶治疗后总有效率为88.0%,且毒副反应发生率经过治疗或调理后均好转。结论后程加速超分割适形放疗治疗鼻咽癌能够显著提高局部的控制率,且安全有效,应作为放疗首选积极推广于临床。

Objective:To observe the comparative analysis of conventional radiotherapy and hyperfractionated accelerated radiotherapy in advanced non-small cell lung cancer.Methods:The hospital admitted to reject surgery or surgery does not meet the conditions of advanced non-small cell lung cancer in 60 patients.Randomly divided into control group and observation group and control group with conventional fractionated radiation therapy in the observation group accelerated hyperfractionated radiation method,the two groups of treatment were analyzed.Results:1 year after radiotherapy review,observation group was(83.33%) was significantly higher(53.33%),the difference was statistically significant(P<0.01).Conclusion:The accelerated hyperfractionated radiotherapy in the treatment of advanced non-small cell lung cancer significantly better short-term effect on the conventional fractionated radiation therapy in clinical practice should be widely used.

骨骼是许多恶性肿瘤常见的转移部位,随着抗癌疗法的不断改进,晚期癌症患者生存时间不断延长,其出现骨转移的风险明显增加.2007～2009年,我们采用放疗+唑来磷酸治疗肿瘤骨转移患者90例,疗效较好.现报告如下.

目的观察草酸铂联合氟脲嘧啶及醛氢叶酸同步放化疗治疗局部晚期鼻咽癌的疗效及毒副反应,探讨该方案的临床可行性。方法36例T3～4N2～3MO局部晚期鼻咽癌患者进入综合治疗组,分别在放疗第1、22、43天接受草酸铂130mg/m2+5-氟脲嘧啶3.75mg/m2+醛氢叶酸100mg/m2同步化疗。选取32例单纯放疗者为对照组。结果所有患者如期完成治疗。结论草酸铂联合氟脲嘧啶及醛氢叶酸同步化放疗,可明显提高晚期鼻咽癌患者颈淋巴结转灶局控率,对鼻咽原发灶的控制也有一定帮助;对其毒性反应患者可耐受,未影响放疗的顺利完成。