Significance of 125I radioactive seed implantation on growth differentiation factor and programmed death receptor-1 during treatment of oral cancer

BACKGROUND Oral cancer(OC)is the most common malignant tumor in the oral cavity,and is mainly seen in middle-aged and elderly men.At present,OC is mainly treated clinically by surgery or combined with radiotherapy and chemotherapy;but recently,more and more studies have shown that the stress trauma caused by surgery and the side effects of radiotherapy and chemotherapy seriously affect the prognosis of patients.AIM To determine the significance of 125I radioactive seed implantation on growth differentiation factor 11(GDF11)and programmed death receptor-1(PD-1)during treatment of OC.METHODS A total of 184 OC patients admitted to The Second Affiliated Hospital of Jiamusi University from May 2015 to May 2017 were selected as the research subjects for prospective analysis.Of these patients,89 who received 125I radioactive seed implantation therapy were regarded as the research group(RG)and 95 patients who received surgical treatment were regarded as the control group(CG).The clinical efficacy,incidence of adverse reactions and changes in GDF11 and PD-1 before treatment(T0),2 wk after treatment(T1),4 wk after treatment(T2)and 6 wk after treatment(T3)were compared between the two groups.RESULTS The efficacy and recurrence rate in the RG were better than those in the CG(P<0.05),while the incidence of adverse reactions and survival rate were not different.There was no difference in GDF11 and PD-1 between the two groups at T0 and T1,but these factors were lower in the RG than in the CG at T2 and T3(P<0.05).Using receiver operating characteristic(ROC)curve analysis,GDF11 and PD-1 had good predictive value for efficacy and recurrence(P<0.001).CONCLUSION 125I radioactive seed implantation has clinical efficacy and can reduce the recurrence rate in patients with OC.This therapy has marked potential in clinical application.The detection of GDF11 and PD-1 in patients during treatment showed good predictive value for treatment efficacy and recurrence in OC patients,and may be potential targets for future OC treatment.     

Clinical evaluation of endoscopic resection for treatment of large gastric stromal tumors

BACKGROUND Gastric stromal tumor is a digestive tract mesenchymal tumor with malignant potential, and endoscopic techniques have been widely used in the treatment of gastric stromal tumors, but there is still controversy over their use for large gastric stromal tumors(≥ 3 cm).AIM To evaluate the clinical long-term efficacy and safety of endoscopic resection for large(≥ 3 cm) gastric stromal tumors.METHODS All patients who underwent endoscopic resection or surgery at our hospital from 2012 to 2017 for pathologically confirmed gastric stromal tumor with a maximum diameter of ≥ 3 cm were collected. The clinical data, histopathologic characteristics of the tumors, and long-term outcomes were recorded.RESULTS A total of 261 patients were included, including 37 patients in the endoscopy group and 224 patients in the surgical group. In the endoscopy group, the maximum tumor diameter was 3-8 cm; the male: Female ratio was 21/16; 34 cases had low-risk tumors, 3 had intermediate-risk, and 0 had high-risk; the mean follow-up time was 30.29 ± 19.67 mo, no patient was lost to follow-up, and no patient received chemotherapy after operation; two patients with recurrence had low-risk stromal tumors, and neither had complete resection under endoscopy. In the surgical group, the maximum tumor diameter was 3-22 cm; the male: Female ratio was 121/103; 103 cases had low-risk tumors, 75 had intermediate-risk, and 46 had high-risk; the average follow-up time was 38.83 ± 21.50 mo, 53 patients were lost to follow-up, and 8 patients had recurrence after operation(6 cases had high-risk tumors, 1 had intermediate-risk, and 1 had low-risk). The average tumor volume of the endoscopy group was 26.67 ± 26.22 cm^3(3.75-120), all of which were less than 125 cm^3. The average volume of the surgical group was 273.03 ± 609.74 cm^3(7-4114). Among all patients with a tumor volume < 125 cm^3,7 with high-risk stromal tumors in the surgical group(37.625 cm^3 to 115.2 cm^3)accounted for 3.8%(7/183); of those with a tumor volume < 125 cm^3, high-risk patients accounted for 50%(39/78). We found that 57.1%(12/22) of patients with high-risk stromal tumors also had endoscopic surface ulcer bleeding and tumor liquefaction on ultrasound or abdominal computed tomography; the ratio of tumors positive for both in high-risk stromal tumors with a volume < 125 cm^3 was 60%(3/5).CONCLUSION Endoscopic treatment is safe for 95.5% of patients with gastric stromal tumors with a tumor diameter ≥ 3 cm and a volume of < 125 cm^3 without endoscopic surface ulcer bleeding or CT liquefaction.     

晚期恶性肿瘤早期心理干预的疗效观察

Objectvie To observe the effect of early psychological intervention on patients with advanced tumors.Methods 81 tumor patients were randomly divided into treatemnt group(group I) and control group(group II).Patients in group I recieved early psychological intervention and assistive chemotherapy and supportive therapy.Patients in group II recieved chemotherapy and supportive therapy.Age,sex,and Karnofsky score in two groups showed significant similarity.Results Quality of life,Karnofsky score and curative effect of patients in group I were significantly superior to those of patients in group II.Conclusion Psychological intervention improves curative effect,quality of life and general conditons of patients with advanced tumors.     

超声乳化联合复合式小梁切除术治疗青光眼合并白内障的临床研究

Objective To observe the clinical effects of phacomulsification. IOL implantation combined with trabeculectomy, MMC and transcornea adjustable suture in glaucoma. Methods 69 patients (72 eyes) were treated,mading conjunctive petal base in fornix madng scleral flap 5 mm × 4 mm, base in limbus corneae, setting 0.2 ～ 0.4 mg/ml MMC cotton disk under conjunctive petal and sclera petal, stopping 3 ～ 5 min,washing with normal saline then phacoemulsification. IOL trabeculectomy implantation trabeculectomy and transcornea adiustale suture. Results The mean followup time was 7.36±4.64 months. Best corrected visual acuity improved in 46 eyes(63.89%) of the patients,fixed in 9 eyes(26.39%),dropped in 7 eyes (9.72%).Preoperative IOP was 28.67±10.69 mm Hg. Final IOP of 66 eyes(91.67%) were controlled (＜21 mm Hg).The rate of functional fitering bled was 91.67%. unfunctional bleb was 8.33%, complication included correal edema shallow anterior chamber, effusion in anterior chamber in early postoperative days. Conclusion Phacoemulsification combined with trabeculectomy and adjustable suture in glaucoma patients was effective method to treat patients of glaucoma and cataract.     

超声乳化联合复合式小梁切除术治疗青光眼合并白内障的临床研究

Objective To observe the clinical effects of phacomulsification. IOL implantation combined with trabeculectomy, MMC and transcornea adjustable suture in glaucoma. Methods 69 patients (72 eyes) were treated,mading conjunctive petal base in fornix madng scleral flap 5 mm × 4 mm, base in limbus corneae, setting 0.2 ～ 0.4 mg/ml MMC cotton disk under conjunctive petal and sclera petal, stopping 3 ～ 5 min,washing with normal saline then phacoemulsification. IOL trabeculectomy implantation trabeculectomy and transcornea adiustale suture. Results The mean followup time was 7.36±4.64 months. Best corrected visual acuity improved in 46 eyes(63.89%) of the patients,fixed in 9 eyes(26.39%),dropped in 7 eyes (9.72%).Preoperative IOP was 28.67±10.69 mm Hg. Final IOP of 66 eyes(91.67%) were controlled (＜21 mm Hg).The rate of functional fitering bled was 91.67%. unfunctional bleb was 8.33%, complication included correal edema shallow anterior chamber, effusion in anterior chamber in early postoperative days. Conclusion Phacoemulsification combined with trabeculectomy and adjustable suture in glaucoma patients was effective method to treat patients of glaucoma and cataract.     

多西他赛或奥沙利铂联合卡培他滨治疗老年晚期胃癌疗效及并发症比较

Objective To compare the short-term efficacy and adverse effects of docetaxe or oxaliplatin combined with capecitabine in the treatment of late-staged gastric cancer in aged patients. Methods Eighty-two aged patients with late-staged gastric cancer were randomly divided into two groups,of which 38 patients were treated group) ,and 44 patients were treated with oxaliplatin (100 mg/m2 ivgtt on 1st day) and eapecitabine (2000 mg/1 cycle). Results There is no failure of follow-up. In the docetaxe group,the effective rate was 52.63% (20/38) and 54.55 % (24/44) for the docetaxe and oxaliplatin group,respectively (P>0.05). The median progression-free survival(PFS) in the docetaxe group (6.1 months) was similar to that in the oxaliplatin group (6.3 months) (P>0.05). Gastrointestinal response,myelosuppression and neurotoxicity (Ⅰ or Ⅱ level) were the most common ad-verse effects observed in both groups (P>0.05). No chemotherapy-related death was observed. Conclusions The short-term efficacy of decetaxe or oxaliplatin combined with capecitabine in the treatment of late-staged gastric cancer in aged patients is similar,and the adverse effects are all within tolerance limits.     

康复期癌症人的心理问题探讨

Background: The mental problems of the patients with malignant tumor are complex, and it is very important for rehabilitation of the patients to find the most common and prominent mental problems and perform effective mental care. Objective: To discuss the mental problems of the patients with malignant tumor in the recovery stage. Unit: the tumor department of Hospital of Heze City in Shandong Province. Subject: All cases in the research came from the patients with malignant tumor in our hospital durng the period of 1998～ 2000. We selected 100 cases who have reached fully clinical recovery or turned better and could take care of oneself by systemic therapy. In the group, there were 61 males and 39 females; 30 patients in 40～ 55 years old, 70 in 56～ 65; 39 cases who were illiterate, 36 who only accepted primary school education, 21 who accepted middle school education, 4 who reached the degree of university education; 63 farmers, 28 workers, 4 cadres, and 5 individual businessman. Intervention: During the days before leaving hospital, record the mental problems worried most of the patients by responsibility nurse' survey. In the course, only record whether there were the problems or not and the content of the problems, but never determine the degree of the problems. Result:(1) The problems most worried by 27 patients were there were no effective therapeutic methods (27％ ); (2) The problems most worried by 21 patients were the life would be terminal (21％ ); (3) The problems most worried by 12 patients were short of family income, decrease of labor ability and arrangement of the children (12％ ); (4) The problems most worried by 6 patients were unhappy relationship between man and wife (6％ ); (5) The problems most worried by 15 patients were parents or children would be encumbered (15％ ); (6) The problems most worried by 9 patients were radiological or chemical therapy would not be performed regularly (9％ ); (7) There were 10 patients who had no the special problems most worried (10％ ). By statistical analysis, there was obvious difference in sex between (2) and (3) (P< 0.01). The female worried (2) problems were more than the male, while the male worried (3) problems were more than the female. In addition by statistical disposal, we found the problems most worried were relative with sex,age,educational degree,job of the patients (P >0.05); and obviously relative with the progressive degree of tumor (P< 0.01), because the mental problems of the patients with early stage tumor were less than the patients with late stage tumor obviously. Conclusion: The mental problems of the patients with malignant tumor in the recovery stage should be paid attention to, and it's significant for rehabilitation of the patients to apply effective mental care.     

多西他赛或奥沙利铂联合卡培他滨治疗老年晚期胃癌疗效及并发症比较

Objective To compare the short-term efficacy and adverse effects of docetaxe or oxaliplatin combined with capecitabine in the treatment of late-staged gastric cancer in aged patients. Methods Eighty-two aged patients with late-staged gastric cancer were randomly divided into two groups,of which 38 patients were treated group) ,and 44 patients were treated with oxaliplatin (100 mg/m2 ivgtt on 1st day) and eapecitabine (2000 mg/1 cycle). Results There is no failure of follow-up. In the docetaxe group,the effective rate was 52.63% (20/38) and 54.55 % (24/44) for the docetaxe and oxaliplatin group,respectively (P>0.05). The median progression-free survival(PFS) in the docetaxe group (6.1 months) was similar to that in the oxaliplatin group (6.3 months) (P>0.05). Gastrointestinal response,myelosuppression and neurotoxicity (Ⅰ or Ⅱ level) were the most common ad-verse effects observed in both groups (P>0.05). No chemotherapy-related death was observed. Conclusions The short-term efficacy of decetaxe or oxaliplatin combined with capecitabine in the treatment of late-staged gastric cancer in aged patients is similar,and the adverse effects are all within tolerance limits.     

多西他赛或奥沙利铂联合卡培他滨治疗老年晚期胃癌疗效及并发症比较

Objective To compare the short-term efficacy and adverse effects of docetaxe or oxaliplatin combined with capecitabine in the treatment of late-staged gastric cancer in aged patients. Methods Eighty-two aged patients with late-staged gastric cancer were randomly divided into two groups,of which 38 patients were treated group) ,and 44 patients were treated with oxaliplatin (100 mg/m2 ivgtt on 1st day) and eapecitabine (2000 mg/1 cycle). Results There is no failure of follow-up. In the docetaxe group,the effective rate was 52.63% (20/38) and 54.55 % (24/44) for the docetaxe and oxaliplatin group,respectively (P>0.05). The median progression-free survival(PFS) in the docetaxe group (6.1 months) was similar to that in the oxaliplatin group (6.3 months) (P>0.05). Gastrointestinal response,myelosuppression and neurotoxicity (Ⅰ or Ⅱ level) were the most common ad-verse effects observed in both groups (P>0.05). No chemotherapy-related death was observed. Conclusions The short-term efficacy of decetaxe or oxaliplatin combined with capecitabine in the treatment of late-staged gastric cancer in aged patients is similar,and the adverse effects are all within tolerance limits.     

Effect of low—intensity millimeter wave irradiation on the immune adhesion function of erythrocytes and lymphocytes in tumor patients

Objective To study the effects of low-intensity millimeter wave(MMW)irradiation on the immune adhesion funmction of erythrocytes and lymphocytes in tumor patients.Methodw MMW(36GHz，0.73-1.46mW/cm^2)used to irradiate the vein blood from tumor patients in irradiation group for 30 minutes.Control group received false irradiation using the same method.Then test tumor RBC-C3b receptor rosettes rate(PCR),tumor-RBC rosette rate(TRR)and tumor lmphocyte rosette rate(TLR).Result In irradiation group,the RBC-C3b TRR and TLR were higher than control group‘s (P&;lt;0.01).Conclusion Low-intensity MMW irradiation can improve the immune adhesion function of erythrocytes and lymphocytes in tumor patients.     

High-dose, short-term, anti-inflammatory treatment with dexamethasone reduces growth and augments the effects of 5-fluorouracil on dimethyl-alpha-benzanthracene-induced mammary tumors in rats

OBJECTIVE: To evaluate the effects of dexamethasone (DXM) alone or in combination with 5-fluorouracil (5-FU) on dimethyl-alpha-benzanthracene (DMBA)-induced mammary tumors in rats. MATERIAL AND METHODS: Female Sprague-Dawley rats were divided into 4 groups receiving: 1) saline (controls), 2) DXM (3 mg/kg), 3) 5-FU (1.5 mg/kg) and 4) DXM and 5-FU combined. The drugs were given i.p. every day for 4 days. Interstitial fluid pressure (Pif) and tumor growth were determined in all tumors on days 1, 5 and 7 using the "wick-in-the needle" technique and by external size measurements, respectively. Vessel density and inflammatory cell infiltration of tumor tissue were analyzed by immunohistochemistry. RESULTS: DXM treatment significantly retarded tumor growth and reduced Pif. Treatment with a combination of DXM and 5-FU reduced tumor size significantly more than any of the agents alone (p<0.01-0.001). Enhanced uptake of 5-FU by DXM treatment was demonstrated by microdialysis. There were no differences in the density of CD31-positive vessels after DXM or 5-FU treatment, but inflammatory cell infiltration of tumor tissue was significantly reduced after DXM treatment. CONCLUSIONS: Our data suggest that DXM may be beneficial as an adjuvant to chemotherapy in the treatment of mammary cancer by increasing the uptake of 5-FU in the tumor.     

内镜下化疗粒子植入对晚期消化道肿瘤患者近期生命质量的影响

目的 观察晚期消化道肿瘤经内镜植入氟尿嘧啶植入剂后近期生命质量的变化.方法 选择2006年1月-2013年5月我院收治的晚期消化道肿瘤59例（食管癌27例,贲门胃底癌20例,胃窦部癌12例）,经内镜植入化疗粒子,观察术前和术后1、2、3个月不同部位的病灶变化,同时采用欧洲癌症研究与治疗组织（EORTC）推荐的“肿瘤生命质量核心量表（QLQ-C30）”对患者生命质量进行评价.结果 本组术后54例病灶缩小,不同部位肿瘤患者总生命质量评分均较术前增高,差异均有统计学意义（P＜0.05）,其中角色功能、情感功能、社会功能评分较术前增高,差异均有统计学意义（P＜0.05）;躯体功能和认知功能评分与术前比较差异无统计学意义（P＞0.05）.恶心呕吐、疼痛、睡眠障碍、食欲缺乏、便秘、腹泻等症状评分均较术前降低,差异有统计学意义（P＜0.05）;各项指标术后1、2、3个月间比较差异均无统计学意义（P＞0.05）.结论 晚期消化道肿瘤内镜植入氟尿嘧啶植入剂疗效显著,近期生命质量明显提高.     

内镜下局部注射HCPT、CF、5-FU和肾上腺素治疗晚期胃癌近期疗效的观察

目的 :在内镜下通过局部注射 10 -羟基喜树碱 (HCPT)、叶酸 (CF)、5 -氟尿嘧啶 (5 -FU)加肾上腺素治疗晚期胃癌与常规 5 -FU HCPT CF全身化疗治疗晚期胃癌作对比 ,观察其疗效。方法 :局部注射治疗组 :用“HCPT 2 0mg CF 30mg 5 -FU 5 0 0mg 0 .1%肾上腺素 0 .1ml”在肿瘤基底布及瘤体内多点注射 ,1次 / 3d ;常规化疗组 :用 5 -FU HCPT CF常规全身化疗。结果 :局部化疗组有效率 5 2 .2 % ,常规组为2 2 .3%。治疗组明显高于常规组 ,且治疗组的毒副反应也小于常规组。结论 :内镜下局部射HCPT ,CF ,5 -FU和肾上腺素治疗晚期胃癌 ,对缓解症状、提高病人的生存质量 ,是一种可行的方法。     

Sensitization to Low Dose 5-Fluorouracil: SUBSEQUENT ENHANCEMENT OF ITS SYSTEMIC ANTITUMOR EFFECT IN THE RAT

This report describes a novel method of immunochemotherapy; the active immunization to the drug 5-fluorouracil (5-FU) with enhanced antitumor activity resulting from its subsequent systemic administration. Two metastasizing carcinomas in the Fischer strain (F344) rat have been used: a chemically induced bladder carcinoma (FBCa) and a spontaneous mammary adenocarcinoma (MACa). Both tumors grow rapidly and result in 100% mortality within 10 wk of implantation. Neither tumor is sensitive to systemic 5-FU alone. Intradermal sensitization to 5-FU before FBCa tumor implantation, followed by 5-FU administered systemically, resulted in significant tumor regression and improvement in survival with eradication of all tumor and cure in 20% of animals. A similar antitumor effect was observed with the MACa. A comparable drug effect was observed when methotrexate sensitization was given before FBCa implantation followed by systemic MTX. Specificity to the sensitizing drug was demonstrated by the lack of effect of sensitization with either 5-FU or MTX unless followed by systemic therapy with the requisite sensitizing agent. Sensitization to 5-FU has also been assessed after FBCa implantation followed by resection of the local tumor. Resection was performed after distant tumor metastases had occurred, and was followed by systemic 5-FU therapy. Whereas tumor resection alone failed to cure any animal, sensitization to 5-FU increased cure rate fourfold over animals receiving systemic 5-FU alone. Antibody to 5-FU in the sera of sensitized animals has been suggested by an immunoenzymatic staining technique and its specificity confirmed in a radioimmunoassay. It is postulated that a combination of the systemic agent and the antibody elicited to it by sensitization produces the significant antitumor effect observed. The antitumor effect observed with this new approach to immunochemotherapy warrants further experimental and clinical study.     

Antipyrine Metabolism during Chemotherapy with 5-Fluorouracil Plus Folinic Acid in Patients with Liver Metastases from Primary Colorectal Cancer

Current evidence suggests that the drug-metabolizing capacity of the liver can be altered by neoplastic lesions and by the chemotherapeutic agents used to treat them. Antipyrine metabolism is a widely used dynamic test for assessing mixed hepatic oxidase system activity in humans. This study was conducted to determine the effects of 5-fluorouracil-folinic acid chemotherapy on hepatic drug metabolization in patients with diffuse liver metastases from colorectal tumors using antipyrine metabolism as an index. Twenty-three patients, all with diffuse liver metastases from primary colorectal tumors and normal liver function tests, were treated with 5-day cycles of 5-fluorouracil (5-FU) (370 mg m(minus sign2) day(minus sign1) I.V.) and folinic acid (200 mg m(minus sign2) day(minus sign1) I.V.) administered every 28 days. Antipyrine metabolism was assessed before initiation of therapy and after each 5-day cycle to determine the effects of this chemotherapeutic protocol on the mixed-hepatic oxidase system. Response to treatment was assessed after 4 months. None of the patients displayed any change in antipyrine metabolism following treatment. There was no correlation between the ability to metabolize antipyrine and the response to chemotherapy. 5FU has been found to decrease antipyrine metabolism in rats with no liver disease. The absence of such an effect in our patients is thought to be due to inductive effects exerted by the metastases on the mixed hepatic oxidase system and modification of 5-FU metabolism by folinic acid. The liver appears to have an enormous functional reserve, even when there is massive tumor involvement.     

E1B-55分子缺失的腺病毒与化疗药物联合应用在食管癌细胞中产生抗肿瘤协同效应

目的 观察E1B-55分子缺失的腺病毒(E1B-55 molecule deleted adenovirus,Ad-delE1B55)在联合各种化疗药物后针对9种人食管癌细胞系所产生的协同作用.方法 采用细胞的增殖检测法(MTT)法检测Ad-delE1B55和(或)4种化疗药物在9种食管癌细胞中的细胞毒性,并根据所得数据计算50%抑制浓度(IC50);使用流式细胞学方法检测表达绿色荧光蛋白基因的腺病毒(Ad-GFP)对各种细胞的感染率;细胞经过处理后,通过流式细胞学方法检测细胞的凋亡和细胞周期;用蛋白印迹western blot法检测腺病毒在细胞内产生的蛋白,以检验病毒复制与细胞毒性的关系;通过使用裸鼠的动物实验,验证体外实验的联合效应.结果 聚合酶链反应(PCR)结果显示,Ad-delE1B55在所感染的细胞中能够复制,针对E1B55的PCR结果证明了其缺失.MTT结果说明Ad-delE1B55在9种食管癌细胞中均产生细胞毒性,但敏感性并不相同;通过细胞毒性结果计算了Ad-delE1B55对9种食管癌细胞株的IC50.通过Ad-GFP感染细胞,计算出病毒感染率,将其与Ad-delE1B55对细胞的IC50作对比,发现两者之间无明显相关性;将9种食管癌细胞株的p53基因型与Ad-delE1B55对细胞的IC50作对比,发现两者之间也无明显相关性.Western blot结果显示Ad-delE1B55感染细胞后48小时,其复制水平达到峰值.在讨论化疗药物与Ad-delE1B55联合给药时的顺序时,不论是western blot结果还是细胞周期结果均显示同时给药效果最好.所以,Ad-delE1B55分别与5-氟尿嘧啶(5-FU),丝裂霉素(MMC),足叶乙甙(VP-16)或顺铂(CDDP)4种化疗药物以同时给药形式联合应用于食管癌细胞株,MTT结果显示腺病毒与5-FU、MMC、VP-16联合能够产生抗肿瘤的协同作用,但与CDDP联合应用不能产生协同作用;动物实验中联合应用Ad-delE1B55与5-FU产生的抗肿瘤作用均好于单独应用任意一种,与体外实验一致,证明了抗肿瘤的协同作用.结论 在食管癌细胞中腺病毒的感染率和内源性p53基因型与Ad-delE1B55的IC50没有相关性,不能预测其细胞毒性.联合应用Ad-delE1B55与5-FU、MMC、VP-16能够产生抗肿瘤的协同作用,但与CDDP联合应用不能产生协同作用.Ad-delE1B55与化疗药物的联合应用为临床失去手术机会的食管癌患者提供了一个新的治疗方案.两种药物的协同作用能够提高疗效,并降低不良反应.     

植入5-氟脲嘧啶缓释剂在直肠癌根治术中的应用研究

目的评价5-氟脲嘧啶（5-Fu）缓释剂在直肠癌术中植入的临床疗效。方法对161例直肠癌拟手术者采用配对设计分为两组，缓释剂组85例，患者于直肠癌根治术中采用5-Fu缓释剂局部植入化疗；普通化疗组76例，于直肠癌根治术后行常规化疗。两组患者均随访2年，观察其不良反应、肿瘤复发率及患者死亡率。结果与普通化疗组患者相比，缓释剂组患者无明显不良反应，肿瘤复发少，患者死亡率低。结论术中植入5-Fu缓释剂效果明显，能减少复发和转移，患者耐受性良好，可望提高直肠癌根治术后的疗效。     

扩散加权MRI活体评价外源野生型P53逆转SW480/5-FU人类结肠癌效果

目的探索扩散加权MRI(DWI)活体评价rAd/p53逆转耐5-FU结肠癌SW480/5-FU对5-FU耐药性效果的可能性。材料与方法 100只结肠癌SW480/5-FU荷瘤裸鼠随机分成4组,对照组、5-FU组、rAd/p53组、rAd/p53+5-FU组。各组在治疗后24 h、48 h、72 h、120 h、168 h分别随机取5只荷瘤鼠行DWI检查,随后处死荷瘤鼠,切下肿瘤检测肿瘤细胞凋亡(TUNNEL法)。结果 rAd/p53组与rAd/p53+5-FU组在观察时间点肿瘤ADC值均较对照组增加,与对照组比较差别有统计学意义(P0.05);rAd/p53组与rAd/p53+5-FU组在观察时间点肿瘤凋亡较对照组增加;rAd/p53+5-FU组在观察时间点肿瘤肿瘤凋亡和ADC值较rAd/p53组高。ADC值与肿瘤凋亡呈正相关。结论 ADC值能活体评价外源野生型p53逆转SW480/5-FU耐药性早期疗效。     

国产多西紫杉醇加奥沙利铂加LV5FU3方案治疗晚期胃癌临床研究

目的评价国产多西紫杉醇(艾素) 奥沙利铂(艾恒) LV5FU3方案(艾素 FOLFOX方案)治疗晚期胃癌的疗效及毒性。方法35例进入该临床研究,并按下列方法治疗:艾素85 mg/m2分2次,d1、d8;艾恒130 mg/m2分2次、d1、d8;甲酰四氢叶酸钙(CF)200 mg/m2静滴2 h d1;氟尿嘧啶(5-FU)300 mg/m2静推(CF后进行)d1;5-FU500mg/m2持续输注24 h(5-FU静推后进行)1次/d(3 d1-3;以上化疗每3周重复。所有病人接受2周期及以上化疗,平均3.2周期。结果客观有效率为82.2%(29/35)。肿瘤进度时间(TTP)为4.5月。主要毒副作用为骨髓抑制、恶心/呕吐和口腔炎。没有严重化疗并发症发生。化疗后7例做了手术治疗。结论艾素 艾恒 LV5FU3方案(艾素 FOLFOX方案)治疗晚期胃癌是可行的和有效的方案。该方案价值有待进一步研究,临床上可有选择地应用。     

A pilot trial of combination cisplatin, 5-fluorouracil and interferon-alpha in the treatment of advanced esophageal carcinoma

BACKGROUND/OBJECTIVES: Based on the synergistic effect between cisplatin and 5-fluorouracil (5-FU), and between 5-FU and interferon-alpha, we conducted a trial to assess the response rate and toxicity of the combination of cisplatin, 5-FU and interferon-alpha in patients with advanced esophageal cancer. METHODS: Patients with locally advanced or metastatic squamous cell or adenocarcinoma of the esophagus were eligible. No prior chemotherapy or interferon were allowed. Patients received cisplatin 80 mg/m(2) on day 1, 5-FU 750 mg/m(2)/day by continuous intravenous infusion for 5 days, and interferon-alpha 5 x 10(6) units/m(2)/day by subcutaneous injection on days 1-5 of each cycle. Cycles were repeated every 21 days for a total of 6 cycles. RESULTS: Forty patients were enrolled. Median age was 57.5 years (range 30-70). 33 had squamous carcinoma and 7 adenocarcinoma; 15 were male; the locoregional metastatic ratio was 1:39; median ECOG performance status was 2 (range 1-3). Grade 3-4 toxicities were: leukopenia (9 cases), thrombocytopenia (4), electrolyte imbalance (11), febrile neutropenia (11), vomiting (5), diarrhea (4), and mucositis (11). There were 3 early deaths, most probably related to therapy. Five patients (13%) achieved a complete response and 17 (42%) achieved a partial response, yielding an overall response rate of 55%. Response rates for squamous and adeno histology were 61% and 29%, respectively. Median survival was 6.4 months. CONCLUSION: The combination of cisplatin, 5-FU and interferon-alpha produces a high response rate in advanced squamous cell esophageal carcinoma, but with considerable toxicity. A modified combination of the above agents is presently being evaluated at our institution.