TP化疗方案联合康莱特治疗宫颈癌的效果及对血清CYFRA21-1、CK19水平的影响

Objective: To study the effect of TP chemotherapy regimen combined with Kanglaite in the treatment of cervical carcinoma and its effect on the serum level of CYFRA21-1 and CK19. Methods: 74 patients with cervical carcinoma were admitted in our hospital from October 2015 to May 2017 and were randomly divided into observation group and control group according to random digital table method, 60 cases in each group. The control group was treated with TP chemotherapy and the observation group was treated with TP chemotherapy regimen combined with Kanglaite. The clinical efficacy, the quality of life, serum CYFRA21-1 and CK19 levels and adverse reactions were compared between the two groups before and after treatment. Results: After treatment, the clinical effective rate(83.78%) in the observation group was significantly higher than that of control group (62.16%), u=4.390,P=0.036, with statistical significance(P<0.05). The KPS scores of the two groups were significantly decreased, and the KPS scores in the observation group were significantly higher than those in the control group(u=6.538,P=0.000). After treatment, the serum levels of CYFRA21-1 and CK19 were significantly decreased in both groups, and the levels in the observation group were significantly lower than those in the control group (u = 6.659, 8.647, P=0.000). The adverse reactions were mainly myelosuppression, gastrointestinal reaction and phlebitis. The incidences of myelosuppression and gastrointestinal reaction of grade III-IV in the observation group were significantly lower than that in the control group, while the incidence of phlebitis was significantly higher in the observation group than in the control group ((u = 2.160, 2.000, 4.16, P = 0.030, 0.045, 0.041, respectively). Conclusion: The effect of TP chemotherapy regimen combined with Kanglaite on cervical carcinoma is significantly. It can effectively reduce serum CYFRA21-1 and CK19 levels, improve the quality of life and safety, which is worth popularizing in clinical application.     

鼻咽癌初治放疗临床研究

目的:研究鼻咽癌初治放疗的临床疗效。方法:选取100例鼻咽癌患者,均经CT检查与病理学研究确定符合本研究目的。在原发灶肿瘤的靶区利用中位剂量的67.5Gy进行照射,在上颈部与鼻咽部的淋巴引流区采取IMRT技术进行照射治疗,在锁骨上窝与下颈部的淋巴引流区采取颈前野常规照射治疗。结果:100例患者的病情得到有效缓解,随访发现46例病情完全缓解,7例死亡,15例出现肿瘤远处转移,6例出现局部性复发,3例出现区域性淋巴结肿瘤复发。副反应主要为口干、放射性黏膜炎以及骨髓抑制。结论:加强对鼻咽癌初治放疗的临床研究,利用IMRT技术对患者的鼻咽癌患病部位进行照射治疗,副反应较少,局部治疗的控制率较高,其中远处转移是初治放疗失败的原因之一。     

卡培他滨联合调强放疗治疗乳腺癌肝转移的疗效观察

 目的 探讨卡培他滨联合调强放疗（intensity modulated raduation therapy, IMRT）并序贯卡培他滨治疗乳腺癌肝转移的疗效和不良反应。方法 将52例乳腺癌肝转移患者分为卡培他滨联合放疗组27例和卡培他滨治疗组25例。卡培他滨联合放疗组肝转移灶行IMRT,6 MV-X线照射,以95％剂量曲线包绕99%计划靶区,常规分割,2 Gy/次,1次/d,5次/周,共  4～6周,同时给予卡培他滨1 250 mg/m²,2次/d口服同步化疗,放疗结束后给予卡培他滨2 510 mg/m²,2次/d口服,21 d为1个周期。卡培他滨治疗组仅给予卡培他滨2 510 mg/m²,2次/d口服,21 d为1个周期。比较两组疗效及不良反应。结果 卡培他滨联合放疗组和卡培他滨治疗组有效率（RR）分别为74.1%和44%,肿瘤控制率分别为92.6%和68%,两组比较差异均有统计学意义（P>0.05）;中位缓解时间分别为13.6个月和8.9个月,中位生存时间分别为17.4个月和11.7个月,1年生存率分别为85.2%和56.0% (χ²=5.38,P,2年生存率分别为40.7%和16.0% (χ²=3.84,P＜0.05)。不良反应主要有中性粒细胞减少、胃肠道反应、肝功能损伤等,均以Ｉ级、Ⅱ级为主,卡培他滨联合放疗组Ｉ级、Ⅱ级不良反应发生率高于卡培他滨治疗组（P＜0.05）,但两组Ⅲ级、Ⅳ级不良反应发生率差异无统计学意义（P>0.05）。结论 卡培他滨联合调强放疗并序贯卡培他滨治疗乳腺癌肝转移远期生存率优于单药卡培他滨维持治疗,不良反应可耐受,是一种有效的治疗方案。     

小边界适形调强放疗与指南边界适形调强放疗联合替莫唑胺化疗在脑恶性胶质瘤的应用及其相关因素的回顾性研究

正脑恶性胶质瘤作为难治性的肿瘤之一,在我国的年患病率约为(6~9)/10万,其3年死亡率在全身肿瘤中位于第3位,仅次于胰腺癌与肺癌~[1-2]。在采取最大限度的安全切除术的基础上进行放射治疗与给予替莫唑胺同步化疗是治疗脑恶性胶质瘤的首选手段~[3-4]。目前,有关放疗操作以适形调强放疗为主,且有关脑恶性胶质瘤的放疗剂量及其时间已形成一致看法,而有关放疗靶区的看法仍未统一~[5]。因此,本研