阿苯达唑脂质体治疗包虫病的初期临床观察

目的：评价阿苯达唑脂质体（L－ABZ）口服液的临床疗效及药物副作用，为该药的临床应用提供依据。方法：选择53例包虫病患者，分为3组：A组为单纯服药组（35例），连续口服L－ABZ 3－6个月；B组为包虫囊肿穿刺前后服药组（4例），穿刺前3－7d开始服药，穿刺后连服1个月；C组为手术前后服药组（14例），术前3－7d开始服药，术后可进食水后即开始服药，疗程1个月。3个治疗组服药剂量均为每天10mg/kg，2次／d。同时动态随访病人服药前后的血常规、肝肾功、胸部X线片、B超或CT以及病人对药物的毒副反应。用治愈率、有效率、部分有效率和无效率来衡量A组的疗效。以复发率（观察至少1年）来判断B、C组的疗效。结果：A组治愈16例（45．7％），有效9例（25．7％），部分有效6例（17．1％），无效4例（11．4％），总有效率88．6％；B组、C组随访时间1－3年，尚无复发。临床药物治疗的53例服药病人中，尚未见因药物的副反应而终止治疗的病例。结论：阿苯达唑脂质体（L－ABZ）口服液对包虫病病人疗效较为肯定，毒副反应轻，患者能够长期服用，尤其适用于某些不宜施行手术治疗或复杂的包虫病例。     

5-FU多聚缓释体植入技术治疗脑胶质瘤

目的观察5-氟尿嘧啶(5-FU)多聚缓释体植入胶质瘤内化疗的临床效果,探索化疗药物的新剂型和新途径。方法在60例胶质瘤病人在开颅术中或以立体定向方式植入5-FU多聚缓释体,5-FU含量100～150mg。随访5～24周,通过影像学检查,计算肿瘤平均径。比较手术前及各随访时间段肿瘤平均径的变化,并观察瘤周水肿情况。结果38例病人术后病情稳定。无化疗不良反应。肿瘤平均径在术后5、12和24周以上均有显著缩小。其中第12周随访病例肿瘤平均径缩小最显著。肿瘤周边水肿带在开颅手术的病人比较宽,而在立体定向手术病人无明显加重表现。结论低剂量5-FU瘤内缓释体植入术治疗脑胶质瘤安全有效,无明显不良反应。     

Developments in treatment of primary irresectable rectal cancer

Abstract The treatment options for primary irresectable rectal cancers are discussed. Assessment of tumour stage is the first step for an appropriate choice of treatment. Following a diagnosis of rectal cancer, a vast array of diagnostic procedures is available to determine its stage, and thereby its best treatment options. From the many (new) diagnostic options the merits and drawbacks are discussed. If a diagnosis of irresectability is made, further treatment options should include radiotherapy in most cases, some aspects of timing and application, i.e. intra-operative treatment are discussed. Chemotherapy options are manifold, the results are discussed and some new options are explored.     

Successful treatment for squamous cell carcinoma of the female urethra with combined radio- and chemotherapy

We report on two cases of women with locally advanced squamous cell carcinoma of the urethra. Patient 1 also displayed regional lymph node metastasis. Treatment comprised combined radiotherapy to 60 Gy and chemotherapy with 5-fluorouracil and cisplatin. Complete response was obtained in both patients, including the inguinal lymph nodes of Patient 1. Patient 1 experienced recurrent inguinal lymph node metastasis on the contralateral side at 42 months after initial treatment, and the same treatment was performed followed by surgical excision. Both patients remain alive with no evidence of disease, at 12 months after recurrence in Patient 1, and at 27 months after treatment in Patient 2.     

ELFP方案治疗晚期鼻咽癌及上消化道癌疗效分析

目的探索ELFP方案治疗转移复发的晚期鼻咽癌、食管癌、胃癌的临床疗效和毒性.方法选择病理证实的64例晚期鼻咽癌、食管癌、胃癌采用Vp-16 0.1 g静滴,d1-3;CF 0.1 g静滴,d1-3 5-FU 0.5 g静滴,d1-3;DDP 50 mg静滴,d1-2;21 d为1周期.治疗2～6个周期.结果鼻咽癌,食管癌、胃癌有效率(CR PR)分别为75%、70%、43.8%,其中胃癌与鼻咽癌及食管癌分别比较有差异;单病灶与多病灶之间疗效无差异.全组病例总生存期为3～41月,中位生存期分别为11.5、10、7.5个月.主要毒性为骨髓抑制,其中Ⅲ、Ⅳ度白细胞下降占21.9%;Ⅲ、Ⅳ度血红蛋白下降占15.6%;Ⅲ、Ⅳ度血小板下降占3.1%.Ⅲ、Ⅳ度恶心、呕吐发生率为7.8%.结论ELFP对晚期鼻咽癌及食管癌有较好的疗效,其毒性可以耐受,是临床治疗鼻咽癌,食管癌切实可行的方案.     

Local blood flow changes in malignant brain tumours under induced hypertension

Summary Changes in tumour blood flow under an induced hypertensive state were examined in malignant brain tumours to know if the precondition for the effectiveness of induced hypertensive chemotherapy — relative increase in tumour blood flow — are fulfilled. Tumour blood flow was measured under both a resting and an induced hypertensive state in 12 patients with various malignant brain tumours (6 gliomas, 6 metastatic brain tumours) using xenon-enhanced computed tomography. The blood pressure was elevated 40% above the systemic blood pressure of the resting state by the infusion of angiotensin II. Tumour blood flow increased 30% on average above the normal brain tissue blood flow after the induction of an induced hypertensive state (p < 0.05). The tumour blood flow increased in 11 cases of malignant tumours, but decreased in one case with massive brain oedema after induced hypertension. The increase in blood flow was higher in hypervascular tumours and less in hypovascular tumours. Therefore, induced hypertensive chemotherapy probably will be more effective in hypervascular malignant brain tumours with small mass effects.     

全植入式药泵行肝血管灌注治疗晚期肝癌

对２４例不能切除的晚期肝癌采用完全植入式药泵行肝动脉和门静脉双灌注化疗。结果：部分缓解（ＰＲ）１５例（６２．５％），稳定（Ｓ）８例（３３．３％），进展（Ｐ）１例。平均生存期为９．１７月，半年生存率为６６．７％，１年为２５％。在ＡＦＰ＞４００μｇ／Ｌ的１０例中，５例下降。     

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目的 探讨临床Ⅰ、Ⅱ期乳腺癌术前短程化疗的意义。方法 122例临床Ⅰ、Ⅱ期乳腺癌术前用CEF方案化疗1疗程，化疗后3-5d手术。结果 部分缓解21例(占17．2％)，轻度缓解76例(占62．3％)，无变化25例(占20．5％)，无临床进展病例。术前可扪及腋窝肿大淋巴结42例，化疗后30例见淋巴结明显缩小或消失。病理组织学观察75例镜下见肿瘤细胞有小点片状坏死。106例按计划手术；16例因白细胞降低等化疗反应推迟手术。全组随访1～6年，无局部复发病例；6例在随访期间1～3年内发现骨转移，经放疗和化疗控制；仅1例同时有骨转移和肺转移者于术后4年死亡；余均健在。结论 可手术乳腺癌的术前短程化疗可观察到肿瘤缩小等治疗效果，为术后化疗提供指导。并可能减少术中血行转移和提高疗效。     

Use of acute peritoneal dialysis catheters for intraperitoneal chemotherapy instead of the semipermanent/permanent Tenkhoff catheters

Intraperitoneal chemotherapy was administered to 13 patients with peritoneal carcinomatosis, using acute peritoneal dialysis catheters immediately before the administration of the chemotherapy. A total of 59 cycles were administered, with insertion of the corresponding catheter. There were no inflow or outflow problems and no insertion-related complications. With the removal of the catheter after its use, there is no risk of abdominal infections.     

小细胞肺癌的二线化疗及研究进展

 小细胞肺癌（SCLC）恶性度较高，早期即可发生血行转移，但对放化疗敏感，故SCLC治疗应以全身化疗为主，联合放疗和手术为主要治疗手段。尽管SCLC化疗的有效率较高，但对于广泛期SCLC患者，从化疗耐药开始至患者死亡的中位时间仍不满意。对于局限期 SCLC患者在诱导放化疗后仍有75 % ~ 80 %出现复发，故二线治疗是治疗SCLC的重点。