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1.
目的评价吉西他滨 (健择) 动脉灌注治疗晚期胰腺癌的疗效和安全性.方法对20例胰腺癌病人采用吉西他滨动脉灌注结合静脉化疗,并与9例采用5-氟尿嘧啶(1000mg)、阿霉素(40~50mg)、卡铂(200mg)经胰十二指肠动脉灌注治疗的胰腺癌病人为对照,对病人的疾病相关症状改善、疗效和毒副反应进行评价.结果吉西他滨组治疗后疼痛改善率为75%,对照组疼痛改善率为44.4%,两者比较无显著性差异.治疗后Karnofsky评分吉西他滨组好转率为60%,对照组为44.4%.吉西他滨组部分缓解率(PR)为30%,半年及1年生存率分别为85%及25%,中位生存时间为9.2个月;对照组PR为22.2%,半年生存率为66.7%,无1年生存者,中位生存时间为7.9个月(P>0.05).两组均有不同程度的胃肠道和骨髓抑制等不良反应(P>0.05),3、4级不良反应较少见.结论吉西他滨动脉灌注治疗晚期胰腺癌能够改善病人的生存质量,延长病人的生存期,无严重毒副反应.  相似文献   

2.
吉西他滨单药治疗老年晚期非小细胞肺癌的疗效分析   总被引:3,自引:1,他引:2  
目的观察吉西他滨单药治疗老年晚期非小细胞肺癌的疗效、临床受益反应(CBR)及毒副反应。方法34例经病理学或细胞学确诊的老年非小细胞肺癌患者(≥60岁),应用吉西他滨1000mg/m^2,静脉滴注,第1,8天给药,每21天为1周期;对照组给予最佳支持治疗(BSC)。结果吉西他滨治疗组有效率(RR)为26.5%,中位缓解时间为6.2个月,中位肿瘤进展时间(TTP)为5.4个月,中位生存期(OS)为11.2个月,1年生存率为38.2%;对照组有效率(RR)为0%,中位TTP为2.4个月,中位OS为4.8个月,1年生存率为9.7%。治疗组临床受益反应较对照组均有明显提高(P〈0.01)。治疗组药物毒副反应较轻,无不良反应需停药者。结论吉西他滨单药治疗老年晚期非小细胞肺癌疗效明确,毒副反应较轻,耐受性较好。  相似文献   

3.
吉西他滨治疗18例胰腺癌疗效和毒副反应分析   总被引:3,自引:2,他引:1  
目的:评价吉西他滨(健择)单药治疗胰腺癌的疗效和毒副反应。方法:胰腺癌患18例,KPS积分≥60,骨髓和肝、肾功能正常。18例患均给予吉西他滨(健择)1000mg/m^2,连续7周,休1周,为1疗程。结果:18例患中PR2例,PD5例。疾病相关症状有较好改善,包括疼痛减轻、KPS积分提高,毒副反应轻,具有良好的耐受性。结论:吉西他滨(健择)能较好改善疾病相关症状,耐受性好。  相似文献   

4.
目的观察吉西他滨联合顺铂的化疗方案对晚期肺鳞癌及肺腺癌的临床疗效及生存差异。方法肺鳞癌组47例及肺腺癌37例患者给予吉西他滨(1000mg/m2)联合顺铂(75mg/m。)化疗,每21天为一周期,共化疗4个周期。结果肺鳞癌组PR为14例(29.8%),SD为21例(44.7%),PD为12例(25.5%),RR为29.8%,中位生存期为13个月,1年生存率为53.2%;肺腺癌组PR为10例(27.0%),SD为18例(48.6%),PD为9例(24.3%),RR为27.0%,中位生存期为9个月,1年生存率为27.0%;结论吉西他滨联合顺铂对晚期肺癌及鳞癌的临床疗效相当,但肺鳞癌较肺腺癌具有较好的1年生存率及生存时间。  相似文献   

5.
吉西他滨联合铂类治疗晚期非小细胞肺癌的临床分析   总被引:5,自引:0,他引:5  
目的评价吉西他滨联合不同铂类化疗药物治疗ⅢB~Ⅳ期非小细胞肺癌(NSCL)的临床疗效和毒副反应。方法45例经细胞学或病理学证实ⅢB~Ⅳ期NSCLC患者(初治35例,复治10例),患者的预计生存时间均超过2个月。按三种方案联合化疗:(1)吉西他滨+顺铂(GEM/DDP),每3周重复1次;(2)吉西他滨+卡铂(GEM/CBP),每3周重复1次;(3)吉西他滨+顺铂(GEM/DDP),每4周重复1次。按美国癌症研究所(NCI)实体瘤疗效评价标准(Recist标准)对目标病灶评价,毒性反应按2007中国肺癌临床指南(NCI—CTCV2.0)标准进行评价。随访患者中位生存时间并计算1年生存率。结果共完成158个周期全身化疗,平均每个病人接受3.5个周期化疗。吉西他滨联合顺铂3周及4周方案、吉西他滨联合卡铂三种方案的有效率分别为45.8%(11/24)、45.5%(5/11)和50%(5/10),总有效率为46.7%(21/45),35例初治患者中有效18例,有效率51.4%,10例复治患者中有效3例,有效率30%。毒副反应主要为白细胞减少、血小板减少、消化道反应、皮疹和搔痒。中位生存时间(MST)为8.9个月,1年生存率为38.7%。结论吉西他滨联合铂类化疗药物治疗晚期NSCL疗效较好,且毒性反应少,耐受性好。  相似文献   

6.
目的观察高强度聚焦超声(high intensity focused ultrasound,HIFU)对老年中晚期胰腺癌患者的治疗作用。方法52例老年中晚期胰腺癌患者,年龄60~83岁,平均年龄(70.8±5.1)岁,按随机表法分为HIFU+化疗组和单纯化疗组。HIFU+化疗组应用HIFU及吉西他滨静脉滴注;对照组单纯化疗组给予吉两他滨静脉滴注。观察治疗后2个月肿瘤体积变化、患者疼痛缓解程度和不良反应发生率,记录治疗后3个月和6个月的生存率。结果HIFU+化疗组根据实体肿瘤疗效的客观评判标准(肿瘤消长),完全缓解率(CR)+部分缓解率(PR)为55.1%,高于单纯化疗组的26.1%(P=0.037);HIFU+化疗组疼痛缓解阳性改善率为69.O%,高于单纯化疗组的21.7%(P=0.001);两组并发症无统计学差异;HIFU+化疗组患者的3个月生存率为100%(29/29),单纯化疗组为91.3%(21/23),两组无统计学差异(P=0.109);HIFU+化疗组6个月生存率为72.4%(21/29),较单纯化疗组的30.4%(7/23)增加(P=0.025)。结论HIFU作为一种绿色的治疗手段,联合吉西他滨化疗可以更有效地控制晚期胰腺癌的肿瘤生长,缓解患者疼痛.延长患者生存期,且无明显不良反应.是一种有效、安全的治疗方法。  相似文献   

7.
目的探讨高强度聚焦超声(HIFU)联合吉西他滨治疗不可切除胰腺癌的疗效和安全性。方法将48例在我院确诊为不可切除胰腺癌患者随机分为HIFU联合吉西他滨组和单纯吉西他滨化疗组。观察治疗后临床受益率、近期有效率、生存率和不良反应。结果联合治疗组和单纯吉西他滨治疗组相比临床受益率(CBR)(83.3%VS30.0%,P〈0.05)、中位生存期(MST)(10.4个月VS6.4个月,P〈0.05)、6和12个月生存率(73.8%,35.2%VS52.3%,17.3%,P〈0.05)差异均具有统计学意义。而疾病控制率(DCR)(82.1%VS60.O%,P〉0.05)和不良反应率两组差异无统计学意义。结论HIFU是一种安全,无创,疗效确切地治疗胰腺癌的方法。HIFU联合吉西他滨化疗治疗不可切除胰腺癌不良反应无明显增加,且能有效地提高CBR和DCR,延长生存期。  相似文献   

8.
目的观察参芪扶正注射液配合三维适形放疗(3D-CRT)同步吉西他滨化疗治疗老年胰腺癌的临床疗效。方法将32例老年胰腺癌患者随机分为观察组17例、对照组15例,两组放、化疗方法相同;在此基础上,观察组加用参芪扶正注射液静滴,28 d为一周期,至少用药2个周期。比较两组近期疗效、毒副反应、生活质量改善情况,以及远期疗效和生存率。结果观察组有效率高于对照组,白细胞下降、血小板减少、恶心、呕吐等毒副反应发生率低于对照组,但均无统计学差异(P均〉0.05);临床受益率观察组高于对照组,两组比较有统计学差异(P〈0.05);两组2 a生存率比较无统计学差异(P〉0.05)。结论参芪扶正注射液配合3D-CRT同步吉西他滨化疗治疗老年胰腺癌,可提高患者的临床受益率,减轻放化疗毒副反应,明显改善其生活质量。  相似文献   

9.
贾林  尚鸳鸳 《胰腺病学》2009,(6):380-382
目的探讨抗抑郁药米氮平对吉西他滨治疗的胰腺癌移植瘤裸鼠进食量、体重和肿瘤生长的影响。方法24只胰腺癌裸鼠皮下移植瘤模型随机分为对照组、吉西他滨组(术后第1、4、7、10天腹腔注射吉西他滨100mg/kg体重)和联用组(吉西他滨组+米氮平10mg·kg^-1·d^-1灌胃,持续21d),每组8只。术后21d处死裸鼠,比较3组动物体重、进食量、肿瘤体积的变化。结果吉西他滨组具有显著的抗肿瘤生长作用,但存在显著的胃纳减少和体重降低等不良反应。术后第21天,联用组和吉西他滨组胰腺癌移植瘤体积无明显差异,抑瘤率分别为69.13%和71.60%(P〉0.05);联用组进食量(3.12±0.11)g、体重(14.68±0.42)g,稍高于吉西他滨组的(2.96±0.14)g和(14.38±0.61)g(P值均〉0.05),但显著低于对照组的(4.65±0.13)g和(17.46±0.52)g(P值均〈0.05)。结论吉西他滨化疗具有显著的抗胰腺癌作用,米氮平虽无显著增效作用,但可在一定程度上减轻大剂量吉西他滨化疔的不良反应。  相似文献   

10.
长春瑞滨联合顺铂治疗晚期非小细胞肺癌的疗效观察   总被引:1,自引:0,他引:1  
张英 《临床肺科杂志》2011,16(11):1729-1731
目的观察长春瑞滨联合顺铂治疗晚期非小细胞肺癌的临床疗效,1年生存率和毒副反应。方法 67例晚期非小细胞肺癌患者随机分为对照组(33例)和治疗组(34例)。对照组采用GP方案治疗(吉西他滨+顺铂);治疗组则采用长春瑞滨联合顺铂治疗。治疗结束后观察两组治疗总有效率及毒副反应。结果治疗组总有效率为58.8%,对照组总有效率为45.5%,差异有显著性(P〈0.05);治疗组1年生存率为47.1%,对照组1年生存率为30.3%,差异有显著性(P〈0.05);两组患者毒副反应发生率无明显差异性(P〉0.05)。结论长春瑞滨联合顺铂治疗晚期非小细胞肺癌可提高临床疗效和1年生存率,且毒副反应可耐受,是治疗晚期非小细胞肺癌的首选方案。  相似文献   

11.
双途径化疗联合伽玛刀治疗局部晚期胰腺癌12例   总被引:2,自引:0,他引:2  
目的:探讨双途径化疗联合三维立体定向伽玛刀治疗局部晚期胰腺癌的临床价值.方法:2005-06/2007-12我科选择性收治局部晚期胰腺癌患者23例, 均经穿刺病理学检查证实或经CT、MRI、肿瘤标志物(CA199、CEA等)临床诊断. 患者随机分为2组:联合治疗组(n = 12)采用双途径化疗(区域动脉灌注和全身静脉化疗)联合三维立体定向伽玛刀治疗;对照组(n = 11)仅采用双途径化疗. 对比2组患者治疗后疗效、疼痛缓解程度、生存期、不良反应.结果:联合治疗组完全缓解和部分缓解率明显高于对照组 (75.0% vs 27.3%, P <0.01); 联合治疗组患者的6、9 mo生存率分别为83.3%和75.0%, 与对照组72.7%和45.5%比较, 无统计学差异; 联合治疗组12 mo生存率50.0%(中位生存期13.1 mo)明显高于对照组9.1%(中位生存期8.7 mo)(P <0.05); 联合治疗组肿瘤标志物CA199的表达明显降低(P <0.05); 联合治疗组比对照组能够较大程度改善患者的疼痛症状(P <0.05); 2组治疗模式的不良反应无统计学差异.结论:双途径化疗联合三维立体定向伽玛刀是治疗局部晚期胰腺癌的较好方法.  相似文献   

12.
目的 比较吉西他滨动脉灌注化疗和外周静脉化疗治疗中晚期胰腺癌的临床疗效,旨在评估吉西他滨动脉灌注化疗的有效性和安全性.方法 按照纳入标准,43例中晚期胰腺癌患者被纳入研究,其中21例采用动脉灌注化疗(灌注组),22例采用外周静脉化疗(静脉组),两组均采用吉西他滨为基础联合5-FU化疗.主要评价指标包括l临床受益反应、肿瘤客观缓解率和不良反应.结果 灌注组的临床受益率为8l%,显著高于静脉组的50%(P=0.033);灌注组的疼痛改善率为76.2%,亦显著高于静脉组的45.5%(P=0.039);灌注组的肿瘤客观有效率为33.3%.略高于静脉组的22.7%,相差不显著(P=0.498);两组不良反应无显著性差异.结论 与外周静脉化疗相比,吉西他滨动脉灌注化疗能显著提高中晚期胰腺癌患者的临床受益率,其不良反应轻微,患者耐受性良好.  相似文献   

13.
目的 探讨经皮胸腔内置管顺铂联合白介素2(interleukin-2,IL-2)治疗恶性胸腔积液的疗效.方法 病理确诊为恶性胸腔积液72例,经皮胸腔内置管引流排尽胸液后,分治疗组37例予IL_2 100万U,加生理盐水50 ml,顺铂按80 mg/m2,加生理盐水40 ml胸腔内注射,对照组35例患者采用顺铂80 mg/m2加生理盐水50ml胸腔内注射,注药后每周B超复查胸水情况,如胸水再积聚,则重复1次上述治疗.观察疗效、生活质量、生存率以及不良反应.结果 治疗组总有效率为83.8%,高于对照组54.3%,病变进展率8.1%,明显低于对照组25.7%,差异有统计学意义(P<0.05).Karnofsky评分大于70分治疗组疗效较对照组显著提高(P<0.05).治疗组6个月、12个月的生存率分别为92.0%、48.6%,分别高于对照组的62.9%、34.3%,其中6个月生存率差异有统计学意义(P<0.05).两组均有发热、恶心呕吐、外周白细胞减少等不良反应,但差异均无统计学意义.结论 胸腔注入IL-2及顺铂治疗恶性胸腔积液是一种疗效肯定、经济安全的方法.  相似文献   

14.
目的 探讨甲泼尼松龙治疗AECOPD用药时间.方法 选择确诊为AECOPD患者60例,随机分为3组,激素阶梯组、激素短期组、对照组.激素阶梯组予甲基强的松龙40 mg静脉点滴,3~5天后减半,治疗3天后,改强的松10 mg,持续3天.激素短期组予甲基强的松龙40 mg短期静脉点滴3~5天,症状缓解后直接停用.对照组常规治疗.比较三组治疗前、治疗后5天、治疗后10天的动脉血气PaO2及呼吸困难评分、症状体征缓解消失的时间、住院天数.结果 激素阶梯组在治疗10天后PaO2和呼吸困难评分、症状、体征恢复时间、住院时间分别与激素短期组、对照组比较有统计学差异(P<0.05).结论 激素阶梯治疗能较好改善AECOPD患者症状,缩短住院日,临床值得推广.  相似文献   

15.
BACKGROUND: The aim of this study was to compare two surgical procedures in the treatment for chronic pancreatitis (CP): pancreatoduodenectomy resection (classical Whipple - PD procedure, or pylorus-preserving - PPPD) to duodenum-preserving pancreatic head excision with longitudinal pancreatojejunoanastomosis (DPPHE/PJA), to define the advantages of each procedure with regard to postoperative complications, pain relief, and the quality of life. MATERIAL AND METHOD: 104 consecutive patients were included into this study. Duodenopancreatectomy was chosen when the head pancreatic mass was present or pancreatic cancer could not be ruled out (48 patients); otherwise DPPHE/PJA was performed (56 patients). Quality of life was measured prospectively on two occasions, before the procedure and during follow-up (median 39 months after surgery) using the European Organization for Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire (QLQ-C30). The test was re-evaluated for patients suffering from CP. Pain intensity was quantified using a specially designed pain score. Early postoperative morbidity and mortality were assessed and evaluated in both groups of patients. RESULTS: Total pain score decreased significantly after surgery in both groups of patients. During the follow-up period, the global quality of life improved by 30.4% in the DPPHE/PJA group, and by 23.2% in the PD/PPPD group. Postoperative morbidity and mortality were higher in the resection group, but the differences were not significant. CONCLUSIONS: Both surgical procedures led to significant improvement in the quality of life and pain relief after surgery for CP. The EORTC QLQ-C30 was found to be a valid and readily available test for quality-of-life assessment in patients with CP.  相似文献   

16.
Since 1963, 57 consecutive patients with chronic pancreatitis, 44 of them alcoholics who had been operated upon for recurrent severe pain, have been controlled regularly for an average of 6 years. Thirty-two of them had a cyst drainage procedure (group A), and 25 had a ductal drainage procedure and/or distal pancreatectomy (group B). Ten patients died within 2 years (group A, n = 5). Lasting pain relief by surgery occurred in 19 patients only. Of 28 patients with pain relapses after surgery (group A, n = 15), however, 22 (78.6%) obtained late pain relief 1-8 years after surgery in association with marked increase of pancreatic dysfunction (group A, n = 12). Pain relief was associated with pancreatic calcifications in 71-86% of the alcoholics. Cyst drainage procedures were successful in preventing pain relapses mainly in patients with either advanced pancreatic dysfunction or in non-alcoholic pancreatitis. The data suggest that in chronic pancreatitis lasting pain relief is more often due to marked pancreatic dysfunction than to surgery. Alcohol abstinence after surgery was probably an additional factor for lasting pain relief in some patients.  相似文献   

17.
目的探讨肝动脉介入联合全身静脉化疗预防大肠癌术后肝转移的疗效及毒副反应。方法治疗组48例大肠癌术后病人,术后3周行肝动脉介入联合全身静脉化疗6个周期,药物奥沙利铂130 mg/m2,亚叶酸钙300 mg/m2,氟脲苷(FUDR)500/m2,羟基喜树碱15~20 mg/m2,对照组38例病人则仅予以同样药物全身静脉化疗6个疗程。所有病例术前、术后、化疗前后均行影像学检查以评价疗效,随访48个月,评价肝转移及毒副反应。结果肝转移率:治疗组4.17%(2/48)、对照组28.95%(11/38),近期疗效显著,两组均未发生化疗引起的造血系统、肝肾功能的损害,无化疗相关死亡,两组之间呈显著性差异(P<0.01)。结论肝动脉介入联合全身静脉化疗近期可有效预防大肠癌术后肝转移的发生,毒副反应小,安全有效。  相似文献   

18.
AIM: To assess whether psychological intervention reduces postembolization pain during hepatic arterial chemoembolization therapy. METHODS: Two hundred and sixty-two patients, who required hepatic arterial chemoembolization for hepatic malignancy and postembolization pain, were randomized into control group (n = 46, receiving medication) and intervention group (n = 216, receiving psychological intervention and medication in turn). The symptom checklist-90 (SCL-90) was used to scale the psychological symptoms of the patients before operation. Pain was scored with a 0 to 10 numeric rating scale (NRS-10) before and after analgesia as well as after psychological intervention (only in intervention group). RESULTS: All psychological symptomatic scores measured with SCL-90 in the intervention group were higher than the normal range in Chinese (P 〈 0.05). The somatization, phobia and anxiety symptomatic scores were associated with pain numerical rating score before analgesia (r = 0.141, 0.157 and 0.192, respectively, P 〈 0.05). Patients in both groups experienced pain relief after medication, psychotherapy or psychotherapy combined with medication during the procedure (P 〈 0.01). Only some patients in the intervention group reported partial or entire pain relief (29.17% and 2.31%) after psychological intervention. The pain score after analgesia in the intervention group was significantly lower than that in the control group (P 〈 0.01).CONCLUSION: Severe psychological distress occurs in patients with hepatic malignancy. Psychological intervention reduces pain scores significantly during hepatic arterial chemoembolization therapy and is thus, highly recommended as a complementary approach to drug analgesia.  相似文献   

19.
AIM: To study the safety of epidural anesthesia(EA),its effect on pancreatic perfusion and the outcome of patients with acute pancreatitis(AP).METHODS: From 2005 to August 2010,patients with predicted severe AP [Ranson score ≥ 2,C-reactive protein 100 or necrosis on computed tomography(CT)] were prospectively randomized to either a group receiving EA or a control group treated by patientcontrolled intravenous analgesia. Pain management was evaluated in the two groups every eight hours using the visual analog pain scale(VAS). Parameters for clinical severity such as length of hospital stay,use of antibiotics,admission to the intensive care unit,radiological/clinical complications and the need for surgical necrosectomy including biochemical data were recorded. A CT scan using a perfusion protocol was performed on admission and at 72 h to evaluate pancreatic blood flow. A significant variation in blood flow was defined as a 20% difference in pancreatic perfusion between admission and 72 h and was measured in the head,body and tail of the pancreas.RESULTS: We enrolled 35 patients. Thirteen were randomized to the EA group and 22 to the control group. There were no differences in demographic characteristics between the two groups. The Balthazar radiological severity score on admission was higher in the EA group than in the control group(mean score 4.15 ± 2.54 vs 3.38 ± 1.75,respectively,P = 0.347) and the median Ranson scores were 3.4 and 2.7 respectively(P = NS). The median duration of EA was 5.7 d,and no complications of the epidural procedure were reported. An improvement in perfusion of the pancreas was observed in 13/30(43%) of measurements in the EA group vs 2/27(7%) in the control group(P = 0.0025). Necrosectomy was performed in 1/13 patients in the EA group vs 4/22 patients in the control group(P = 0.63). The VAS improved during the first ten days in the EA group compared to the control group(0.2 vs 2.33,P = 0.034 at 10 d). Length of stay and mortality were not statistically different between the 2 groups(26 d vs 30 d,P = 0.65,and 0% for both respectively).CONCLUSION: Our study demonstrates that EA increases arterial perfusion of the pancreas and improves the clinical outcome of patients with AP.  相似文献   

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