强化护理在儿童急性白血病鞘内注射中的应用效果

目的探讨强化护理在儿童急性白血病鞘内注射治疗中的应用效果。方法选取2019年5月至2020年6月于中国科学技术大学附属第一医院西区行鞘内注射治疗的90例急性白血病患儿作为研究对象,按照入院时间将其分为A组(45例)与B组(45例)。A组采用常规护理方法,B组采用强化护理方法。比较两组的不良反应发生情况、家长满意度、护理质量。结果B组不良反应发生率低于A组,差异有统计学意义(P<0.05);B组家长总满意度高于A组,差异有统计学意义(P<0.05);B组护理质量高于A组,差异有统计学意义(P<0.05)。结论采用强化护理模式可缓解患儿鞘内注射治疗不良反应,减轻患儿痛苦,促进治疗顺利完成,提高家长满意度,改善护理质量,应用效果较好。     

Rb蛋白在多发性骨髓瘤细胞中的表达及临床意义

目的：探讨多发性骨髓瘤（MM）细胞Rb蛋白的表达与临床化疗的关系,方法：采用免疫细胞化学S－P法,借助抗Rb蛋白单抗,对47例多发性骨髓瘤患者进行了检测,结果：47例中有11例（11／47）呈阴性表达,阴性表达率30．6％,免疫人型各亚型之间差异显著无显著性（P＞0．05）,所有患者采用常规化疗方案化疗个疗程,Rb蛋白阴性组化疗有效率为36．4％,而Rb蛋白阳性组总有效率为77．9％,两组比较差异显著（P＜0．05）,多变量分析显示,除去血清β2－微球蛋白,乳酸脱氨酶,肌酐三因素对化疗结果的影响,Rb蛋白阴性可作为影响化疗疗效的独立负性因素,结论：Rb蛋白阴性表达在多发性骨髓瘤细胞中较易见,且Rb蛋白不表达者对化疗疗效差。     

瑞血新治疗肿瘤放化疗中白细胞减少临床研究

目的探讨瑞血新(rhG-CSF)治疗因放化疗而引起的白细胞减少的作用。方法应用瑞血新治疗65例恶性肿瘤在放、化疗引起的白细胞减少,并与应用一般升白细胞药物(中成药)治疗58例恶性肿瘤所致白细胞减少进行了对比观察。结果瑞血新和一般升白细胞药物均能使放、化疗白细胞下降的患者恢复至正常范围(4×109/L),但应用瑞血新组白细胞回升到正常的平均时间为3.5d,而一般对照组需要11.2d,瑞血新组最低值为(2.1×109/L),对照组最低值0.8×109/L(两者显著差异P＜0.01)。结果瑞血新与传统中药相比,能明显缩短白细胞回升到正常的时间,减轻白细胞下降的程度,有助于放化疗如期进行。     

白细胞清除术联合化疗治疗高白细胞急性白血病疗效观察

目的：比较白细胞清除术联合化疗治疗高白细胞急性白血病与单纯化疗治疗高白细胞急性白血病的疗效。方法：采用前瞻性同期对照研究方法。结果：11例高白细胞急性白血病经白细胞清除术后化疗,CR率达54．5％,早期死亡率9％。单用化疗例,仅1例完全缓解,早期死亡3例（42．8％）。结论：白细胞清除术联合化疗治疗高白细胞急性白血病是目前较先进的一种方法。     

E（M）COP化疗方案治疗非何杰金淋巴瘤疗效分析

目的：探讨足叶乙甙或米托蒽醌联合化疗方案治疗非何杰金淋巴瘤的治疗效果。方法：应用ECOP方案（足叶乙甙,环磷酰胺,长春新碱,强的松）或MCOP方案（米托蒽醌,环磷酰胺,长春新碱,强的松）治疗23例非何杰金淋巴瘤,其中ⅡA2例,ⅢA3例,ⅢB3例,ⅣA4例,ⅣB11例,18例为初治病人,5例为复发病例。结果：全组完全缓解率（CR）13例占56．5％;部分缓解（PR）4例占17．4％,冲刷 有效率73．9％,其中初治18例,总有效率77．8％,复发5例,总有效率60％,ECOP方案治疗16例,CR率为56．5％（9／16）,PR为18．8％（3／16）,总有效率73．3％,MCOP方案治疗7例,CR率为57．1％（4／7）,部分缓解率14．3％（1／17）,总有效率71．4％,上述方案毒副作用有胃肠道反应,骨髓抑制,所有病例血象经间歇期应用或无G－CSF治疗均能恢复。结论：ECOP或MCOP方案是治疗非何杰金淋巴瘤有效而较安全的方案。     

鼻咽癌多药耐药表型与化疗效果关系的探讨

目的 :观察鼻咽癌患者多药耐药表型与化疗效果的关系。方法 :对 2 4例未经治疗的鼻咽癌患者 ,取鼻咽部活检标本 ,用免疫组化法抗P -糖蛋白 (P -gp)单克隆抗体 (JSB -Ⅰ )检测P -gp。全部患者均接受长春新碱、环磷酰胺和 5 -氟尿嘧啶联合方案的化疗。患者对化疗反应的评分 :有效者包括完全反应或部分反应 ;无效者包括稳定或恶化。结果 :2 4例治疗前鼻咽癌患者中 ,8例 (33 3% )检测出P -gp阳性 ,16例 (6 6 7% )P -gp阴性。 8例P -gp阳性患者对化疗反应有效者 2例(2 5 % ) ,无效者 6例 (75 % )。 16例P -gp阴性患者对化疗有效者 14例 (87 5 % ) ,无效者 2例 (12 5 % ) ,两者差别显著 (P <0 0 1)。结论 :以P -gp介导的多药耐药表型与鼻咽癌对化疗耐药之间存在有统计学意义的关系     

胃癌术中动脉区域灌注化疗与全身静脉化疗的临床疗效比较

目的　评价胃癌术中动脉区域灌注化疗药物的临床疗效。方法　对 40例经病理确诊的胃癌患者 (治疗组 )于术中经供应肿瘤的区域动脉行插管化疗 ,同时进行手术治疗 ,并与同期术中行全身静脉化疗的 2 4例胃癌患者 (对照组 )进行临床疗效比较。结果　术后病理检查显示 ,治疗组原发灶中的癌细胞均有不同程度地变性坏死 ,其近期有效率为 95 % ,对照组有效率为 41.6 7% ,两组比较差异显著 (P<0 .0 5 )。结论　胃癌患者术中经动脉灌注化疗 ,其近期抗癌效果好 ,毒副反应轻 ,对减少或防止术中癌细胞的医源性扩散与种植以及术后复发 ,均有重要的临床意义     

Unique challenges and outcomes of young women with breast cancers from a tertiary care cancer centre in India

BackgroundYoung (≤40 years) breast cancers (YBC) are uncommon, inadequately represented in trials and have unique concerns and merit studying.MethodsThe YBC treated with a curative intent between 2015 and 2016 at our institute were analysed.ResultsThere were 1228 patients with a median age of 36 (12–40) years; 38 (3.1%) had Stage I, 455 (37.1%) - II, 692 (56.3%) –III, and remaining 43 (3.5%) Stage IV (oligo-metastatic) disease; 927 (75.5%) were node positive; 422 (34.4%) were Triple negatives (TNBC), 331 (27%) were HER-2 positive. There were 549 (48.2%) breast conservations and 591 (51.8%) mastectomies of which 62 (10.4%) underwent breast reconstruction. 1143 women received chemotherapy, 617 (53.9%) received as neoadjuvant and 142 (23.1%) had pathological complete response; 934 (81.9%) received adjuvant radiotherapy. At the median follow-up of 48 (0–131) months, 5-year overall and disease-free survival was 79.6% (76.8–82.5) and 59.1% (55.8–62.6). For stage I, II, III and IV, the 5-year overall-survival was 100%, 86.7% (82.8–90.6), 77.3% (73.4–81.2), 69.7% (52.5–86.9) and disease-free survival was 94% (85.9–100), 65.9% (60.3–71.5), 55% (50.5–59.5), and 29.6% (14–45.2) respectively. On multivariate analysis, TNBC and HER-2+ subgroups had poorer survival (p = 0.0035). 25 patients had BRCA mutations with a 5-year DFS of 65.1% (95% CI:43.6–86.6). Fertility preservation was administered in 104 (8.5%) patients; seven women conceived and 5 had live births. Significant postmenopausal symptoms were present in 153 (13%) patients.ConclusionMore than half of the YBC in India were diagnosed at an advanced stage with aggressive features leading to suboptimal outcomes. Awareness via national registry and early diagnosis is highly warranted. Menopausal symptoms and fertility issues are prevalent and demand special focus.     

Effect of Jianpi Bushen formula for colon cancer patients who underwent adjuvant chemotherapy: Statistical analysis plan for a multicenter trial

BackgroundPatients with colon cancer who receive chemotherapy usually experience various gastrointestinal adverse reactions, including nausea, vomiting, and diarrhea, which make it challenging for them to adhere to treatment. As an effective traditional Chinese medicine, the Jianpi Bushen formula has been widely used to alleviate the side effects of chemotherapy.ObjectiveTo evaluate the efficacy and safety of Jianpi Bushen formulae for patients who undergo chemotherapy. This statistical analysis plan (SAP) is intended to enhance the transparency and research quality of our randomized controlled trial.MethodsOur study is a multicenter, double-blind, randomized controlled clinical trial. This trial aimed to compare the completion rate of chemotherapy in colon cancer patients who are using and not using Jianpi Bushen formula. To attenuate possible selection bias in the final report, we declared the overall trial design, outcome measures, subgroup analyses, and safety measures. Also, we described the data management and statistical analysis methods in detail.ConclusionThe SAP provides more detailed information than the trial protocol for data management and statistical analysis methods. Further post-hoc analyses can be performed by referring to the SAP, and possible selection bias can be attenuated.     

Protroca: A Noninterventional Study on Prophylactic Lipegfilgrastim against Chemotherapy-Induced Neutropenia in Nonselected Breast Cancer Patients

BackgroundProtroca evaluated the efficacy and safety of primary and secondary prophylaxis of neutropenia with lipegfilgrastim (Lonquex®) in breast cancer patients receiving neoadjuvant or adjuvant chemotherapy (CT).Patients and MethodsOf the 255 patients enrolled, 248 patients were evaluable for the intent-to-treat (ITT) and 194 patients for the per-protocol set. Primary and secondary end points after lipegfilgrastim treatment were assessed.ResultsNine patients of the ITT set receiving lipegfilgrastim as primary prophylaxis (n = 222) had febrile neutropenia of grade 3–4 (5 patients) or infection of grade 3–4 (4 patients); 1/26 of those receiving secondary prophylaxis had an event. Dose reductions were performed in 9.5% of the patients. Postponement of cancer CT cycles for >3 days occurred in <15% of patients; 10.8% (92/851 AEs) and 8% (2/25 SAEs) of documented adverse events and serious adverse events, respectively, were related to lipegfilgrastim.ConclusionsApplication of lipegfilgrastim was effective as primary and secondary prophylaxis in the prevention of CT-induced neutropenia in breast cancer.