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1.
涎腺恶性淋巴瘤相当少见。我们从1983~1993共收治9例,其中腮腺4例,颌下腺5例,病检前误诊率为100%。按UICC标准分期,ⅠA期5例,ⅠB期1例;ⅡA期3例。全部实行了手术切除,其中单纯手术3例,手术+放疗3例,手术+化疗3例。采用单纯手术治疗者存活2年1例,存活3年2例,采用手术+放疗者存活2年、3年和5年各1例,采用手术+化疗者存活6年,8年和9年各1例。综合治疗的效果明显优于单一手术治疗,而手术+化疗者又优于手术+放疗者。  相似文献   

2.
1970年至1988年期间90例牙龈鳞癌患者,按1987年ULCC标准分期,Ⅰ期9例(10.0%);Ⅱ期25例(27.8%);Ⅲ期42例(46.7%);Ⅳ期14例(15.6%)。采用单纯放疗10例;单纯手术37例;放疗+手术治疗30例;放疗+化疗+手术13例。随访5年,1、3、5年的生存率分别为90.0%,61.1%,47.8%。3、5年生存率随临床期别(Ⅱ期以上)增高而呈明显下降趋势(P<0.01)。笔者认为,对Ⅱ期以上牙龈鳞癌采用综合治疗较单纯放疗或单纯手术治疗有明显的优越性。  相似文献   

3.
本文报告120例原发性结外恶性淋巴瘤,占同期恶性淋巴瘤的22.15%。年龄4~72岁,平均46.8岁。扁桃体恶性淋巴瘤占本组的第一位(23.3%),胃肠道占第二位(19.2%)。临床表现无特异性,极易误诊,多须病理检查才能明确诊断。本病需要综合治疗,其中可手术病例以手术+化疗效果最好,非手术病例以放疗+化疗效果最好。预后与病期、病理类型及治疗方法关系密切,本组1、3、5年生存率分别为69.2%、53.3%及42.5%。  相似文献   

4.
1970年1988年期间90例牙龈鳞癌患,按1987年UICC标准分期,I期9例(10.0%),Ⅱ期25例(27.8%),Ⅲ期42例(46.7%),Ⅳ期14例(15.6%),采用单纯放疗10例,单纯手术37例,放疗+手术治疗30例,放疗+化疗+手术13例,随访5年,1,3,5年的生存率分别为90.0%,61.1%,47.8%,3、5年生存率随临床期别(Ⅱ期以上)增高而呈明显下降趋势(P〈0.01  相似文献   

5.
探讨Ⅰ,Ⅱ期非霍奇金淋巴瘤的综合治疗   总被引:3,自引:2,他引:3  
目的探讨Ⅰ,Ⅱ期非霍奇金淋巴瘤(non-Hodgkin'slymphoma,NHL)综合治疗的有效方法。材料与方法1987年1月~1989年12月收治NHL152例,分别采用单纯放疗、放疗+化疗、化疗+放疗+化疗、化疗+放疗和单纯化疗治疗。结果Ⅰ期NHL分别采用单纯放疗和放、化综合治疗者,其3,5,7年生存率与复发率相近。而Ⅰ期仅有结内受累者,其3,5,7年生存率单纯放疗组分别为100.0%,100.0%,88.9%,放、化综合治疗组分别为88.2%,82.4%,52.9%,单放组生存率较高,而复发率两组相近;Ⅱ期NHL,放、化综合治疗组3,5,7年生存率较单纯放疗组稍高,复发率两组相近,其中高度恶性病例,化疗+放疗+化疗组3,5,7年生存率分别为73.3%,73.3%,60.0%,较放疗+化疗、化疗+放疗组均高,而复发率较低。结论(1)Ⅰ期NHL仅有结内受累者可考虑用单纯放疗。(2)Ⅱ期高度恶性NHL推荐化疗+放疗+化疗方法。  相似文献   

6.
陈杰  王肇炎 《浙江肿瘤》1999,5(3):136-138
目的 研究术前化疗能否提高手术切除率,降低局部复发率。方法 104例头鳞癌病人分成试验组(58例):术前化疗+手术+术后放疗组;对照组(46例):手术+术后放量不用术前化疗。手术方式为原发癌切除+颈淋巴结清扫术,用或不用肌皮瓣修复头颈部组织缺损。术后放疗剂量50Gy~60Gy。术前化疗用PFP方案即DDP+5-Fu+PYM。结果 试验组部分缓解67.2%,微效17.2%。试验组和对照组3中部复发率  相似文献   

7.
放射综合治疗腮腺癌   总被引:4,自引:0,他引:4  
林焕新  李群 《癌症》1997,16(2):129-131
目的:回顾分析影响腮腺癌预后的因素,并从放射治疗的角度提出改善腮腺癌预后的措施。资料和方法;复习1979-1989年收治并经病理证实的腮腺癌182例,Ⅰ期47例,Ⅱ期46例,Ⅲ期45例,Ⅳ期44例,单纯手术64例,手术加放疗114例,单纯放疗和化疗各2例。结果:总的5、10年生存率分别为68.1%(124/182)和53.8%(50/93),肿瘤有疼痛,局部有浸润,Ⅶ颅神经受侵面部有麻木使5、10  相似文献   

8.
原发于头颈部结外Ⅰ,Ⅱ期非何杰金淋巴瘤126例临床分析   总被引:5,自引:0,他引:5  
分析了1987~1990年间原发于头颈部Ⅰ、Ⅱ期非何杰金淋巴瘤(NHL)126例。126例均为初治,均经病理证实。口咽部占64.3%,鼻腔占31%,其他4.7%。126例中男90例,女36例;年龄5~69岁,以30~60岁居多,占62.7%。病理按国际工作分类,则低度恶性1例,中度恶性48例;高度77例。临床分期按AnnArbor分期,Ⅰ期33例,Ⅱ期93例;有B症状20例。治疗方式按病理分类及临床分期,如高度恶性或病变较广泛,多采用化、放疗综合治疗,否则多采用单放疗,5例单化疗均由于各种原因未能放疗。12例中CR101例、PR18例、P3例,近期有效率97.5%,远期生存率为1年83.3%(105/126)、2年70.6%(89/126)、3年68.2%(60/88)、4年62.2%(46/74)、5年58.3%(21/36)。作者进一步探索并分析了放疗前化疗的合理剂量、如何减轻化疗后放疗或放疗后化疗副反应加重的问题。  相似文献   

9.
Ⅲa期非小细胞肺癌术后放疗和化疗的失败原因分析   总被引:1,自引:0,他引:1  
目的 探讨Ⅲa期非小细胞肺癌术后放疗和化疗的增益程度及其失败原因。方法 采用3单因素和多因素Cox回归模型,对107例Ⅲa期非小细胞肺癌根治术后放疗和/或化疗的疗效增益特点及失败原因分析。结果 其单纯手术(S)、手术+化疗(S+C)、手术+放疗(S+R)、手术+放疗+化疗(S+R+C)4年生存率分别为20.8%、24.3%、25.0%、34.6%。但接受放疗者5年无复发生存率为88.5%,明显高于  相似文献   

10.
外科综合化疗治疗小细胞肺癌的初步探讨   总被引:1,自引:0,他引:1  
报告40例小细胞肺癌进行外科综合治疗的初步探讨。其中男性28例,女性12例;年龄27~66岁。咳嗽、血痰、低热、胸痛为主要临床表现。纤维支气管镜检查及病理报告均为小细胞未分化腺癌。单叶切除20例,上(下)叶及中(舌)叶切除9例(含叶支气管袖状切除3例),全肺切除7例,经心包全肺扩大切除术2例,无法切除行肺动脉置入化疗泵管2例。术后病理分期Ⅰ期2例,Ⅱ期18例,Ⅲa期20例。手术+化疗12例,化疗+手术+化疗28例。化疗方案用阿霉素(或顺铂)、环磷酰胺、长春新碱、地塞米松。手术+化疗组及化疗+手术+化疗组1、3、5年生存率分别为70%、45%、30.5%和54%、30%、22%。上述生存率比较显示,小细胞肺癌术后化疗可提高长期生存率。术前化疗对提高手术切除率具有显著作用,本组经术前化疗后的手术切除率为93%。  相似文献   

11.
From 1955 through 1982, a series of 93 cases of parotid gland carcinoma were treated at the Institut Curie: 55 primarily and 28 for recurrent tumors. Treatment modalities included surgery alone (n : 14), surgery followed by radiotherapy (n : 43), and radiotherapy alone (n : 36). The most advanced cases were mostly in the latter group. With a mean follow-up of 13 years, the actuarial loco-regional control is 67% (62/93) and the median survival 10 years. Ultimate loco-regional control was achieved in 86% of cases managed by surgery alone, 88% of cases managed by surgery and radiotherapy and 33% of cases managed by radiotherapy. In the latter group, control rate was 42% (8/19) in those primarily treated by radiotherapy. Prognosis was related to histology. Twenty patients (22%) presented distant metastasis. The potential advantages of neutron irradiation for parotid neoplasms is discussed.  相似文献   

12.
Primary extranodal lymphoma of the salivary gland is an extremely rare disease. In this report we describe twelve cases of primary lymphoma of the parotid gland seen at a single centre, and review the relevant literature. The 12 cases were treated in different departments and did not receive a uniform therapeutic approach. All three patients with Hodgkin's disease are still alive and two are in complete remission after initial radiotherapy. One of these cases developed stage 4 disease and had to receive combination chemotherapy subsequently. Of the 9 non-Hodgkin's lymphoma (NHL) patients, four had low grade NHL and 5 intermediate or high grade NHL. Of these, 2 died with disseminated disease. However, 6 are still alive and well from 1 to 5 years after therapy. These cases were treated with surgery alone, radiotherapy alone or combination chemotherapy with an anthracycline-bearing regimen. Consequently, we are unable to draw any conclusions relating the success of therapy in these cases, nor can we suggest therapeutic guidelines on the basis of this study alone. The treatment of parotid lymphoma is discussed briefly in the light of the available literature. In most cases, symptoms related to an enlarging mass in the parotid region, were evident. In the light of the above data, we suggest that, despite its rarity, lymphoma of the salivary gland should always be considered in the differential diagnosis of a parotid mass. No correlation between lymphoma and Sjogren's syndrome was noted in the present study.  相似文献   

13.
目的 分析原发腮腺淋巴上皮癌的临床特征、诊断特点及预后。方法 回顾性分析2009-2017年经中国医学科学院肿瘤医院确诊的13例腮腺淋巴上皮癌患者临床资料,中位随访时间38.5个月,所有患者均先行手术+放疗。结果 全组13例患者中男9例,女4例,中位年龄33岁。确诊时局限于腮腺9例、区域淋巴结转移4例,均为Ⅰ b、Ⅱ区。UICC2010分期Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者分别为1、1、6、5例。11例患者手术病理标本EBER检测10例阳性。全组无死亡事件,3年总生存率100%,3年无进展生存率76%,3年局部控制率92%,3年无远处转移率84%。结论 腮腺淋巴上皮癌发病率较低,病变与EBV相关,容易发生颈部淋巴结转移,疗前应除外鼻咽癌转移至腮腺的可能。目前治疗模式是以手术+放疗,总体预后较好,治疗失败主要原因为局部复发和远处转移。  相似文献   

14.
53例肺外小细胞癌的临床分析   总被引:1,自引:0,他引:1  
Yuan ZY  Guan ZZ  Zhou ZM  Xia Y  Huang WZ  Yang XL 《癌症》2006,25(9):1131-1133
背景与目的:小细胞癌主要发生于肺内,肺外小细胞癌(extrapulmonarysmallcellcarcinoma,ESCC)被认为是一类与肺小细胞癌不同的临床病理类型。本研究目的在于探讨ESCC的临床特征、治疗及预后。方法:回顾性分析1985年1月至2005年12月中山大学肿瘤防治中心收治的经病理证实的53例ESCC患者的临床资料,分析本组患者的发病情况,发病部位,病理诊断,肿瘤分期,治疗方法及预后。结果:53例ESCC患者中,男性39例,女性14例。中位年龄53岁(27~76岁)。53例ESCC中食管33例(62.3%),子宫颈5例,喉4例,鼻咽3例,上颌窦2例,直肠2例,舌下腺、甲状腺、胸膜和肝脏各1例。局限期患者40例(75.5%),广泛期患者13例(24.5%)。对于广泛期患者多给予含铂方案化疗,总有效率为69.2%;对于局限期患者采取不同的治疗模式,即手术 化疗 放疗者7例,手术 放疗者3例,手术 化疗者18例,放疗 化疗者6例,单独放疗者4例,单独化疗者2例。全组患者中位生存期(mediansurvivaltime,MST)为20个月,1年和3年生存率(overallsurvival,OS)分别为41.3%和31.4%。局限期患者和广泛期患者的MST分别为26个月和15个月,1年OS分别为51.1%和14.4%,3年OS分别为42.5%和0(P=0.017)。结论:ESCC可发生于人体不同部位,以食管ESCC最多见。局限期ESCC常采用综合治疗模式,化疗仍是广泛期ESCC的主要治疗手段。总体上,局限期ESCC预后明显较广泛期ESCC好。  相似文献   

15.
To observe the efficacy of intra-arterial chemotherapy with subcutaneously implanted pump for soft tissue sarcoma in extremities and cancerous ulcer. 31 patients with ulcerative skin squamous cell carcinoma or sarcoma in extremities who received treatment during the period from July 2003 to November 2011 at our hospital were recruited, including 15 male and 16 female patients, aging between 14 and 83 with average age of 49 years old. 10 patients had tumor in upper extremities and 21 patients in lower extremities. The pathological types of studied cases include 9 cases with skin squamous cell carcinoma, 6 cases with synovial sarcoma, 5 cases with malignant fibrous histiocytoma, 3 cases with liposarcoma, 3 cases with osteosarcoma, 2 cases with malignant melanoma, 2 cases with epidermoid sarcoma, and 1 case with protuberans. The main symptoms of cancerous ulcer were pain, infection and hemorrhage; All the studied patients were administrated with cisplatin and doxorubicin by intra-arterial chemotherapy pump, and the patients with squamous cell carcinoma were additionally applied with bleomycin and patients with malignant melanoma were additionally applied with dacarbazine. The chemotherapy efficiency was observed after at 3 cycles of intra-arterial chemotherapy. The total remission rate of pain (RR) was 87 %, and total remission rate of ulcer cicatrization (RR) was 71 %, with ulcer cicatrizing spontaneously in 9 cases and obvious homeostasis in 5 cases with bleeding ulcers. 19 patients underwent surgery after chemotherapy, in which 16 cases had limb-salvage surgery and 3 cases underwent lower leg amputation after chemotherapy, and 3 patients out of 16 cases had local recurrence (19 %). The subcutaneous intra-arterial targeting chemotherapy could be applied to treat refractory sarcoma and cancerous ulcer in extremities to significantly increase the chemotherapeutic concentration at tumor area so as to effectively constrain the tumor rupture induced main symptoms including pain, infection and bleeding, which would help to make a decreased blood supplied and well defined tumor boundary to finally decrease the recurrence rate.  相似文献   

16.
局部晚期宫颈癌综合治疗方法探讨   总被引:3,自引:1,他引:3  
目的比较三种不同方法综合手术治疗局部晚期宫颈癌的优越性。方法86例经病理证实的局部晚期宫颈癌,宫颈局部肿瘤直径〉4cm,Ⅰb2期5例,Ⅱa期39例,Ⅱb期39例,Ⅲa期3例。组织学分型:鳞状细胞癌72例,病理分级:高分化5例,中分化49例,低分化18例;腺癌14例。入院病人随机分为动脉化疗组(A)32例,根治性放疗组(B)27例,同步放化疗组(C)27例。结果三种不同治疗方法术后淋巴结转移率分别是:A组:19.35%(6/31);B组:45%(9/20);C组:18.5%(5/27),经统计学处理,A组及C组相比无显著差异,C组与A组及B组相比,χ^2值分别是3.86、4.61,P〈0.05,差异有显著意义,手术切除率分别是96.9%、74%、100%,3年及5年生存率A组和C组相近,统计学上无显著差异,B组明显低于A组和C组,差异有显著意义。结论动脉灌注化疗栓塞能明显提高局部晚期宫颈癌切除率,并不增加远期并发症,同步放化疗能明显提高近期疗效及5年生存率,年轻患者可优先选择动脉灌注化疗栓塞综合手术的治疗方案。  相似文献   

17.
PurposeTo describe the clinical, therapeutic and prognostic features of ductal carcinomas of the parotid gland.Material and methodsFive patients with ductal carcinoma of the parotid gland (primary and secondary carcinoma) treated, between 2007 and 2019, in our ENT department, were reviewed.ResultsFour men and one woman were included. The mean age was 61,4 years. One patient had a history of an invasive ductal carcinoma of the breast. Four patients consulted for swelling in the parotid region. One patient referred to our department for dysfunction of facial nerve. Skin invasion was found in one case. Four patients underwent total parotidectomy with sacrifice of the facial nerve (three cases). One patient underwent extended parotidectomy involving the skin. An ipsilateral selective neck dissection was performed in four cases. One patient had a parotid gland biopsy. Ductal carcinoma was primary in four cases and metastatic from breast origin in one case. Four patients were treated with postoperative radiotherapy. Remission was obtained in three cases. One patient had a local and meningeal recurrence. The patient with metastatic carcinoma had pulmonary, bone, hepatic and brain progression.ConclusionDuctal carcinoma is a rare and aggressive tumor of the parotid gland. It can be primary or secondary. The treatment is based on surgery and radiotherapy. The prognosis is poor.  相似文献   

18.
目的 :观察手术不能切除的晚期胰腺癌动脉灌注化疗结合三维适形放疗的疗效。方法 :对 4 7例晚期胰腺癌患者先给予动脉灌注健择 180 0mg、5 FU 10 0 0mg ,1周后给予三维适形放疗DT30~ 5 0Gy 10~ 2 5F。结果 :全组患者有效率 (CR +PR)为 4 8% ,临床症状缓解率为 82 % ,中位生存期 10 2个月。结论 :动脉灌注化疗结合三维适形放疗是治疗晚期胰腺癌的一个安全有效的方法  相似文献   

19.
目的 腺样囊性癌(ACC)是头颈部少见的恶性肿瘤,本研究分析大涎腺ACC的治疗疗效和预后因素.方法 回顾分析54例大涎腺ACC患者,其中腮腺24例,颌下腺或舌下腺30例.单纯手术治疗26例,术后放疗28例.放疗中位剂量为58 Gy(50~65 Gy).结果 随访率为94%,其中随访时间满5年者35例,术后放疗组和单纯手术组分别为15例和20例.全组5年总生存率为97%,5年局部区域控制率为71%,5年远处转移率为13%(7例均为肺转移),5年无瘤生存率为69%.局部区域失败15例,其中单纯手术组13例,术后放疗组2例.术后放疗组和单纯手术组5年局部区域控制率分别为90%和54%,无瘤生存率分别为85%和55%.单因素和多因素分析均显示术后放疗是影响局部区域控制和无瘤生存率的一个重要预后因素.结论 大涎腺ACC术后放疗与单纯手术相比明显提高了疗效,但远处转移较常见.  相似文献   

20.
Radiotherapy for pleomorphic adenoma of the parotid gland.   总被引:6,自引:0,他引:6  
A study was made of 187 patients with parotid pleomorphic adenoma treated by radiotherapy. This followed surgery but with incomplete removal or tumor spillage. In the early years of the study radiotherapy was given by radium needle implant done usually at the time of surgery, but from the late 1960s beam-directed external radiotherapy with a head shell was used most commonly. A 3-field technique or wedge pair was the standard technique. The median age was 46 with nearly half the patients (87/187) aged between 40 and 60, and the ratio of women to men was 1.4:1 (110:77). Median follow-up for all patients was 14 years. One hundred fifteen patients had radiotherapy immediately after their first operation with a recurrence rate of 0.9% (1/115). Of the 115 there were 2 cases of radionecrosis (1 major, 1 minor), 1 case of permanent facial nerve palsy, 1 Frey Syndrome (post-gustatory sweating), and 1 salivary fistula. Seventy-two patients had radiotherapy delayed until one or more recurrences had been surgically treated. Nine (12.5%) of these developed yet further recurrence after radiotherapy. There were 2 cases of radionecrosis (1 major), 4 cases of facial nerve palsy (3 of which were complete), 16 cases (22.2%) of Frey Syndrome, and 1 case of malignant change in a parotid tumor. In addition one squamous cell carcinoma developed at the site of a needle implant 25 years later. Recurrences after radiotherapy continued beyond 20 years of follow-up. Patients having unsatisfactory surgery due to spill at operation or residual tumor left behind should have radiotherapy immediately and not delayed until local recurrence occurs because of the increased morbidity and the higher incidence of yet further recurrence.  相似文献   

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