平消胶囊与放疗同步治疗中晚期鼻咽癌增敏研究

目的：评价中成药平消胶囊与放疗同步治疗鼻咽癌疗效，探讨其增敏机制。方法：1999年1月-2004年1月将188例中晚期鼻咽癌患者随机分为两组：治疗组（放疗＋平消胶囊）94例，对照组（单纯放疗）94例。两组采用医用直线加速器产生X线及β线常规外照射，包括鼻咽部原发灶及颅底、颈部转移灶。原发灶DT66—70Gy，颈部转移灶DT60—76Gy（或预防照射DT50Gy）。治疗组放疗前3天开始口服平消胶囊8粒，3次／日，连用至放疗结束。结果：半量疗效及全量（结束时）消失率：治疗组原发灶84．0％及93．6％，颈部转移灶80．9％及93．6％；对照组原发灶54．3％及62．8％，颈部转移灶52．1％及61．7％。半量疗效及全量消失率比原发灶提高29.8％及30．9％，转移灶提高28．7％及31．9％。结论：平消胶囊与放疗同步治疗鼻咽癌与单纯放疗两组间有显著差异（P〈0．01），提示平消胶囊有放疗增敏作用。     

甘氨双唑钠对鼻咽癌放射增敏作用的临床观察

[目的]研究甘氨双唑钠（CMNa）对鼻咽癌放射治疗的增敏作用以及毒副反应。[方法]将46例经病理学确诊的初治鼻咽癌患者分为放射增敏组（A组,放疗加用甘氨双唑钠）和对照组（B组,单纯放疗）。两组放射治疗方法完全相同,整体挡铅法体外常规放射治疗,鼻咽部DT（68～76）Gy/（34～36）次,6～7周,颈转移淋巴结DT（68～72）Gy/（34～36）次,6～7周,颈部预防量DT56Gy/28次,5～6周。A组在放疗前1h静脉滴注CMNa800mg/m2,每周3次,至放疗结束,B组行单纯常规放疗。[结果]放射增敏组和单纯放疗组放疗结束鼻咽癌原发灶CR率分别为87.5%、59.1%（P=0.028）;颈淋巴结转移灶CR率分别为79.1%、45.5%（P=0.018）,放疗后2～3个月,颈淋巴结转移灶CR率分别为87.5%、45.5%（P=0.002）。鼻咽癌原发灶和颈淋巴结转移灶达部分缓解时放射增敏比（SER）分别为1.49和1.40,达完全缓解时SER分别为1.21和1.18。两组患者放疗毒副反应比较差异无统计学意义。[结论]CMNa能提高鼻咽癌放射治疗完全缓解率,降低达缓解时所需剂量,且不增加放疗毒副反应。     

马蔺子素对鼻咽癌后程加速超分割放疗增敏作用的前瞻性临床研究

马蔺子素胶囊是从中药马蔺子种皮中提取制成的一种放射增敏剂，主要成分为马蔺子甲素和乙素，有报道马蔺子素对鼻咽癌、头颈肿瘤原发灶的放疗具有增敏效果，能加速病灶的缩小，增加病灶的全消率。笔者自1999年1月至2000年1月进行了后程加速超分割放疗加马蔺子素增敏治疗鼻咽癌的前瞻性临床研究，观察其局部控制率、远期疗效、副反应，并与常规分割放疗比较，现报道如下。     

马蔺子素放射增敏治疗食管癌的疗效观察

目的:为了观察马蔺子素配合放射治疗食管癌的增敏疗效及其毒副反应.方法:从1996年6月至1997年6月采用马蔺子素配合放疗治疗食管癌患者36例(增敏组)与单纯放疗组36例(对照组),进行临床观察.结果:肿瘤消退率在增敏组为 72.2%(26/36),对照组为 52.8%(19/36),两组间差异显著( P<0.05);肿瘤消失时照射总剂量,在增敏组为 56.2Gy,对照组为64.2 Gy,增敏比为1.13.临床症状改善,进食梗阻改善率,增敏组为75%(27/36),对照组为54%(20/36),胸背疼痛消失两组无明显差异;外周白细胞低于4×10~9/L者,增敏组为22%(8/36),对照组为42%(15/36);患者1年和2年生存率,增敏组为75%(27/36)和58%(21/36),对照组为61%(22/36)和42%(15/36).结论:实验研究表明马蔺子素与放疗合用治疗食管癌可提高肿瘤消退率和近期生存率,有显著的放疗增敏作用,对患者无特殊毒副作用,可能是目前较为理想的放射增敏剂.     

鼻咽癌40例放化疗同步治疗近期疗效观察

目的　探讨中晚期鼻咽癌放疗合并同步化疗的治疗效果。方法　对 40例中晚期鼻咽癌患者于60 Co放疗开始同时行同步化疗 ,三周重复 ,共化疗三个疗程 ,放疗原发灶剂量DT70Gy/ 3 5次 ,颈部淋巴结转移灶总剂量DT60Gy/3 0次。结果　放、化疗全部结束后 ,颈部淋巴结全部消失 16例 ,退缩 >5 0 %者 18例 ,总有效率CR85 % (3 4/ 40 ) ;原发灶退缩CR90 % (3 6/ 40 ) ,PR10 % (4 / 40 )。结论　NPC患者放疗和同步化疗发挥空间协同作用 ,达到同时治疗原发病灶和微转移病灶的目的 ,明显提高治疗效果 ,提高疗效和完全缓解。     

马蔺子素与放疗合用治疗中晚期食管癌的疗效探讨

目的：探讨马蔺子素在食管癌放疗中的增敏作用。材料与方法：从1997年3月～10月，我们将收治的62例中晚期食管癌随机分为治疗组和对照组，其中治疗组30例，对照组32例。对照组采用常规分割放射治疗，5次／周，DT60～70Gy／6～7周。治疗组除常规放射治疗外，加服马蔺子素，60mg／次，每日3次。结果；两组在半量疗效和放疗结束时的全消率方面差异有显著性，治疗组明显优于对照组，治疗组的消化道副反应明显。结论：马蔺子素可作为食管癌病人的放疗增敏剂使用。     

地龙、复方丹参、野木瓜对鼻咽癌放射增敏的前瞻性研究（附557例疗效分析）

本文收集557例鼻咽癌以随机分组联合应用地龙、复方丹参、野木瓜进行放射增敏的前瞻性研究。近期疗效结果显示不管放疗结束时原发灶的全消率还是放疗后3个月鼻咽CT扫描复查原发灶的全消率，中药组均优于对照组P＜0.005。但颈淋巴结转移灶的全消率两组之间没有明显差异P＞0.5。本文还讨论了这3种中药放射增敏的机理问题。     

地龙、复方丹参、野木瓜对鼻咽癌放射增敏的前瞻性研究（附557例近期疗效分析）

收集５５７例鼻咽癌以随机分组联合应用地龙、复方丹参、野木瓜进行放射增敏的前瞻性研究。近期疗效结果显示，不管放疗结束时原发灶的全消中还是放疗后３个月鼻咽ＣＴ扫描复查原发灶的全消率，中药放疗组均优于对照组，Ｐ＜０．００５。但颈淋巴结转移灶的全消率两组之间无明显差异，Ｐ＞０．５。同时还讨论了以上３种中药放射增敏的机理。     

地龙、复方丹参、野木瓜对鼻咽癌放射增敏的前瞻性研究（附557例疗效分析）

本文收集５５７例鼻咽癌以随机分组联合应用地龙、复方丹参、野木瓜进行放射增敏的前瞻性研究。近期疗效结果显示不管放疗结束时原发灶的全消率还是放疗后３个月鼻咽ＣＴ扫描复查原发灶的全消率，中药组均优于对照组Ｐ＜０．００５。但颈淋巴结转移灶的全消率两组之间没有明显差异Ｐ＞０．５。本文还讨论了这３种中药放射增敏的机理问题。     

甘氨双唑钠对ⅣB期鼻咽癌后半程放射治疗增敏的临床研究

目的:探讨甘氨双唑钠(CMNa)在ⅣB期鼻咽癌放射治疗的增敏作用和临床应用价值.方法:选择ⅣB期鼻咽癌,面颈联合野加双下颈前后对穿照射36 Gy后,颈部转移淋巴结残留≥5 cm的患者40例,分为前瞻性分析试验组(CMNa+放疗)和对照组各20例.试验组采用CMNa800 mg/m<'2>,用100 mL生理盐水稀释溶解,于30 min内静脉滴完,在60 min内进行3D-CRT放疗.对照组仅行3D-CRT放疗.结果:放疗70 Gy结束后,评定疗效,颈部转移淋巴结缓解率(CR+PR):试验组90%(18/20),对照组55%(11/20),P=0.01;原发灶(T)缓解率:试验组95%(19/20),对照组65%(13/20),P=0.02.结论:CMNa对鼻咽癌有良好的放疗增敏作用,特别是对于颈部淋巴结转移灶大的患者,近期疗效明显,且药物耐受性好.远期效果有待进一步观察.     

Bacteria and cancer--antagonisms and benefits

There is considerable historical and recent evidence concerning the antagonisms between acute bacterial infections or their toxins and cancer and allied diseases. These data provide renewed incentives to undertake clinical programmes with mixed bacterial vaccines in many countries at the present time.     

VEGF及KDR在大肠腺瘤和腺癌中的表达及意义

目的：探讨VEGF和KDR在大肠腺瘤和大肠腺癌中的表达及临床病理特征的关系。方法：大肠腺瘤和大肠腺癌组织标本各100例,采用免疫组织化学染色法检测VEGF和KDR在标本中的表达情况。结果：VEGF和KDR在大肠腺癌组中的阳性表达明显高于大肠腺瘤组（P〈0.05）;在正常大肠黏膜均未见VEGF和KDR表达的阳性染色;VEGF阳性表达组中KDR的阳性表达率为70%,显著高于VEGF阴性表达组中KDR的阳性表达率16%,两组比较有统计学意义（P〈0.01）。结论：大肠腺癌组织中KDR的表达与肿瘤大小、转移情况、浸润深度密切相关;VEGF和KDR在大肠腺瘤中的表达与患者的年龄、性别及分型均无相关性,而与增生程度相关（P〈0.05）。在大肠腺癌患者中VEGF及KDR表达更高,二者具有协同效应。     

Religiosity and physical and emotional functioning among African American and White colorectal and lung cancer patients

The literature suggests that religiosity helps cope with illness. The present study examined the role of religiosity in functioning among African Americans and Whites with a cancer diagnosis. Patients were recruited from an existing study and mailed a religiosity survey. Participants (N = 269; 36% African American, 56% women) completed the mail survey, and interview data from the larger cohort was utilized in the analysis. Multivariate analyses indicated that in the overall sample religious behaviors were marginally and positively associated with mental health and negatively with depressive symptoms. Among women, religious behaviors were positively associated with mental health and negatively with depressive symptoms. Religiosity was not a predictor of study outcomes for men. Among African Americans, religious behaviors were positively associated with mental health and vitality. Among Whites, religious behaviors were negatively associated with depressive symptoms. These findings suggest a mixed role of religious involvement in cancer outcomes. The current findings may have applied potential in the areas of emotional functioning and depression.     

Genetic polymorphisms of alcohol and aldehyde dehydrogenases and risk for esophageal and head and neck cancers

Alcoholic beverages are causally related to cancer of the oral cavity, pharynx, larynx and esophagus. Ethanol is oxidized to acetaldehyde and then to acetate by alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH), both of which have genetic polymorphisms. A review of case-control studies of the effects of ALDH2, ADH2 and ADH3 genotypes shows consistently positive associations between inactive heterozygous ALDH2 and the less-active ADH2 genotypes and the risk for esophageal cancer in East Asian heavy drinkers and this enzyme-related vulnerability may extend to light-to-moderate drinkers. Some studies suggest similar associations with the risk for head and neck cancer in moderate-to-heavy-drinking Japanese. An established carcinogen in experimental animals, acetaldehyde can interact with human DNA. ALDH2-associated cancer susceptibility fits into a scenario in which acetaldehyde plays a critical role in the development of human cancer. Alcohol flushing and drinking behavior may partly explain this carcinogenic effect in carriers of less-active ADH2 genotypes. Whether the ADH3 genotype influences head and neck cancer risk in Western nations is controversial. Professional and public education about risky conditions connected to the ALDH2 and ADH2 genotypes and environmental factors is important in a new strategic approach to the prevention of alcohol-related cancers in East Asians. The use of simple tests to identify inactive ALDH2 on the basis of alcohol flushing responses could benefit many people, by helping them to identify their own cancer risks. Such testing could also help clinicians diagnose esophageal cancer earlier, through the use of endoscopic screening in the high-risk population.     

Religiosity and Physical and Emotional Functioning Among African American and White Colorectal and Lung Cancer Patients

The literature suggests that religiosity helps cope with illness. The present study examined the role of religiosity in functioning among African Americans and Whites with a cancer diagnosis. Patients were recruited from an existing study and mailed a religiosity survey. Participants (N = 269; 36% African American, 56% women) completed the mail survey, and interview data from the larger cohort was utilized in the analysis. Multivariate analyses indicated that in the overall sample religious behaviors were marginally and positively associated with mental health and negatively with depressive symptoms. Among women, religious behaviors were positively associated with mental health and negatively with depressive symptoms. Religiosity was not a predictor of study outcomes for men. Among African Americans, religious behaviors were positively associated with mental health and vitality. Among Whites, religious behaviors were negatively associated with depressive symptoms. These findings suggest a mixed role of religious involvement in cancer outcomes. The current findings may have applied potential in the areas of emotional functioning and depression.     

New and emerging radiosensitizers and radioprotectors

The combination of chemotherapy and radiation has led to clinical breakthroughs in several disease sites, and current work continues to define optimum combinations of proven chemotherapy as well as more recently available, noncytotoxic agents. Administration of systemic therapies allows modulation of radiation response to improve tumor control (radiosensitization) or to prevent normal tissue toxicity (radioprotection). Substantial progress has been made in identifying the targets of standard chemotherapeutic radiation sensitizers and protectors as well as in the introduction of a new generation of molecularly targeted therapies in combination with radiation. We have reviewed the most recent, predominantly early phase clinical trials combining systemic agents with radiation. Although the proof of an improved schedule ultimately needs to come from well-run Phase III trials, the search among schedules could be shortened by the use of surrogate endpoints such as presence of active drug metabolites in the tumor. This has been accomplished only in a few cases and needs to become a more standard part of radiation sensitizer and protector trials.